Optimization Control of Multi-Mode Coupling All-Wheel Drive System for Hybrid Vehicle

The all-wheel drive(AWD)hybrid system is a research focus on high-performance new energy vehicles that can meet the demands of dynamic performance and passing ability.Simultaneous optimization of the power and economy of hybrid vehicles becomes an issue.A unique multi-mode coupling(MMC)AWD hybrid system is presented to realize the distributed and centralized driving of the front and rear axles to achieve vectored distribution and full utilization of the system power between the axles of vehicles.Based on the parameters of the benchmarking model of a hybrid vehicle,the best model-predictive control-based energy management strategy is proposed.First,the drive system model was built after the analysis of the MMC-AWD’s drive modes.Next,three fundamental strategies were established to address power distribution adjustment and battery SOC maintenance when the SOC changed,which was followed by the design of a road driving force observer.Then,the energy consumption rate in the average time domain was processed before designing the minimum fuel consumption controller based on the equivalent fuel consumption coefficient.Finally,the advantage of the MMC-AWD was confirmed by comparison with the dynamic performance and economy of the BYD Song PLUS DMI-AWD.The findings indicate that,in comparison to the comparative hybrid system at road adhesion coefficients of 0.8 and 0.6,the MMC-AWD’s capacity to accelerate increases by 5.26%and 7.92%,respectively.When the road adhesion coefficient is 0.8,0.6,and 0.4,the maximum climbing ability increases by 14.22%,12.88%,and 4.55%,respectively.As a result,the dynamic performance is greatly enhanced,and the fuel savings rate per 100 km of mileage reaches 12.06%,which is also very economical.The proposed control strategies for the new hybrid AWD vehicle can optimize the power and economy simultaneously.

Fake News Detection Based on Text-Modal Dominance and Fusing Multiple Multi-Model Clues

In recent years,how to efficiently and accurately identify multi-model fake news has become more challenging.First,multi-model data provides more evidence but not all are equally important.Secondly,social structure information has proven to be effective in fake news detection and how to combine it while reducing the noise information is critical.Unfortunately,existing approaches fail to handle these problems.This paper proposes a multi-model fake news detection framework based on Tex-modal Dominance and fusing Multiple Multi-model Cues(TD-MMC),which utilizes three valuable multi-model clues:text-model importance,text-image complementary,and text-image inconsistency.TD-MMC is dominated by textural content and assisted by image information while using social network information to enhance text representation.To reduce the irrelevant social structure’s information interference,we use a unidirectional cross-modal attention mechanism to selectively learn the social structure’s features.A cross-modal attention mechanism is adopted to obtain text-image cross-modal features while retaining textual features to reduce the loss of important information.In addition,TD-MMC employs a new multi-model loss to improve the model’s generalization ability.Extensive experiments have been conducted on two public real-world English and Chinese datasets,and the results show that our proposed model outperforms the state-of-the-art methods on classification evaluation metrics.

Seeing beneath the surface:Harnessing point-of-care ultrasound for internal jugular vein evaluation

Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery.While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein,this method lacks sensitivity.The utilization of POCUS significantly enhances the visualization of the vein,leading to a more accurate identification.It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation.This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein,drawing upon existing data.

Diagnostic and therapeutic role of endoscopic ultrasound in liver diseases:A systematic review and meta-analysis

BACKGROUND In hepatology,the clinical use of endoscopic ultrasound(EUS)has experienced a notable increase in recent times.These applications range from the diagnosis to the treatment of various liver diseases.Therefore,this systematic review summarizes the evidence for the diagnostic and therapeutic roles of EUS in liver diseases.AIM To examine and summarize the current available evidence of the possible roles of the EUS in making a suitable diagnosis in liver diseases as well as the therapeutic accuracy and efficacy.METHODS PubMed,Medline,Cochrane Library,Web of Science,and Google Scholar databases were extensively searched until October 2023.The methodological quality of the eligible articles was assessed using the Newcastle-Ottawa scale or Cochrane Risk of Bias tool.In addition,statistical analyses were performed using the Comprehensive Meta-Analysis software.RESULTS Overall,45 articles on EUS were included(28 on diagnostic role and 17 on therapeutic role).Pooled analysis demonstrated that EUS diagnostic tests had an accuracy of 92.4%for focal liver lesions(FLL)and 96.6%for parenchymal liver diseases.EUS-guided liver biopsies with either fine needle aspiration or fine needle biopsy had low complication rates when sampling FLL and parenchymal liver diseases(3.1%and 8.7%,respectively).Analysis of data from four studies showed that EUS-guided liver abscess had high clinical(90.7%)and technical success(90.7%)without significant complications.Similarly,EUS-guided interventions for the treatment of gastric varices(GV)have high technical success(98%)and GV obliteration rate(84%)with few complications(15%)and rebleeding events(17%).CONCLUSION EUS in liver diseases is a promising technique with the potential to be considered a first-line therapeutic and diagnostic option in selected cases.

A Multi-mode Electronic Load Sensing Control Scheme with Power Limitation and Pressure Cut-off for Mobile Machinery

In mobile machinery,hydro-mechanical pumps are increasingly replaced by electronically controlled pumps to improve the automation level,but diversified control functions(e.g.,power limitation and pressure cut-off)are integrated into the electronic controller only from the pump level,leading to the potential instability of the overall system.To solve this problem,a multi-mode electrohydraulic load sensing(MELS)control scheme is proposed especially considering the switching stability from the system level,which includes four working modes of flow control,load sensing,power limitation,and pressure control.Depending on the actual working requirements,the switching rules for the different modes and the switching direction(i.e.,the modes can be switched bilaterally or unilaterally)are defined.The priority of different modes is also defined,from high to low:pressure control,power limitation,load sensing,and flow control.When multiple switching rules are satisfied at the same time,the system switches to the control mode with the highest priority.In addition,the switching stability between flow control and pressure control modes is analyzed,and the controller parameters that guarantee the switching stability are obtained.A comparative study is carried out based on a test rig with a 2-ton hydraulic excavator.The results show that the MELS controller can achieve the control functions of proper flow supplement,power limitation,and pressure cut-off,which has good stability performance when switching between different control modes.This research proposes the MELS control method that realizes the stability of multi-mode switching of the hydraulic system of mobile machinery under different working conditions.

Endoscopic-ultrasound-guided biliary drainage with placement of electrocautery-enhanced lumen-apposing metal stent for palliation of malignant biliary obstruction:Updated meta-analysis

BACKGROUND Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced(ECE)delivery of lumen-apposing metal stent(LAMS)is gradually being re-cognized as a viable palliative technique for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography(ERCP)failure.However,most of the studies that have assessed its efficacy and safety were small and hetero-geneous.Prior meta-analyses of six or fewer studies that were published 2 years ago were therefore underpowered to yield convincing evidence.AIM To update the efficacy and safety of ECE-LAMS for treatment of biliary ob-struction after ERCP failure.METHODS We searched PubMed,EMBASE,and Scopus databases from the inception of the ECE technique to May 13,2022.Primary outcome measure was pooled technical success rate,and secondary outcomes were pooled rates of clinical success,re-intervention,and adverse events.Meta-analysis was performed using a random-effects model following Freeman-Tukey double-arcsine transformation in R soft-ware(version 4.1.3).RESULTS Fourteen eligible studies involving 620 participants were ultimately included.The pooled rate of technical success was 96.7%,and clinical success was 91.0%.Adverse events were reported in 17.5%of patients.Overall reinter-vention rate was 7.3%.Subgroup analyses showed results were generally consistent.CONCLUSION ECE-LAMS has favorable success with acceptable adverse events in relieving biliary obstruction when ERCP is impossible.The consistency of results across most subgroups suggested that this is a generalizable approach.

Prognostic value of ultrasound in early arterial complications post liver transplant

Liver transplantation is the primary therapeutic intervention for end-stage liver disease.However,vascular complications,particularly those involving the hepatic artery,pose significant risks to patients.The clinical manifestations associated with early arterial complications following liver transplantation are often non-specific.Without timely intervention,these complications can result in graft fai-lure or patient mortality.Therefore,early diagnosis and the formulation of an op-timal treatment plan are imperative.Ultrasound examination remains the pre-dominant imaging modality for detecting complications post liver transplan-tation.This article comprehensively reviews common causes and clinical present-ations of early hepatic artery complications in the post-transplantation period and delineates abnormal sonographic findings for accurate diagnosis of these con-ditions.Overall,ultrasound offers the advantages of convenience,safety,effect-iveness,and non-invasiveness.It enables real-time,dynamic,and precise evalua-tion,making it the preferred diagnostic method for post-liver transplantation assessments.INTRODUCTION Liver transplantation stands as the primary therapeutic approach for end-stage liver disease.Continuous advancements in surgical techniques and the application of novel immunosuppressive agents contribute to ongoing improvements in the success rate and overall survival in patients undergoing liver transplantation procedures.Despite these advan-cements,vascular complications,particularly those involving the hepatic artery,pose significant risks to patients.During the early stages following liver transplantation(within the first 30 d),proper hepatic artery function is crucial for hepatic arterial blood flow.During later stages,collateral circulation,including arteries such as the phrenic artery,right gastric artery,and gastroduodenal artery,becomes important for maintaining hepatic blood supply.It is now understood that the establishment of effective collateral circulation is pivotal for determining the prognosis of hepatic artery complic-ations.The clinical manifestations of these complications are closely linked to factors such as timing,severity,and the specific type of onset.Insufficient hepatic arterial blood flow can lead to abnormal liver function,hepatic infarction,and the formation of hepatic abscesses.Additionally,since the hepatic artery is the sole blood supply to the biliary tract,hepatic artery-related ischemia may result in biliary stricture,obstruction,and the formation of bile ducts.Ultrasound examination remains the primary imaging modality for diagnosing complications post liver transplantation.This article comprehensively reviews common causes and clinical presentations of early hepatic artery complications in the post-transplantation period and outlines abnormal sonographic findings for accurately diagnosing these conditions.NORMAL HEPATIC ARTERY During the intraoperative phase,an ultrasound examination is typically conducted to evaluate the hepatic artery anas-tomosis.The normal internal diameter of the hepatic artery typically ranges from 2 to 5 mm.Two strong echo points are typically identified near the anastomosis.To assess blood flow dynamics,peak systolic velocity,end-diastolic velocity,and resistance index are measured at the donor and recipient sides of the anastomosis following angle correction.Anastomotic stenosis presence and severity can be evaluated by comparing the velocity at the anastomotic site with that at the recipient side.Postoperatively,direct visualization of the anastomosis site through gray ultrasound scans is often challenging.The surgical approach has a significant impact on the proper hepatic artery’s position,resulting in a lower overall success rate of continuous visualization.Color Doppler ultrasound is primarily employed to trace the artery’s path,and spectral measurements are taken at the brightest position of the Color Doppler blood flow signal,primarily used to identify the presence of high-speed turbulence.Hepatic artery spectrum examination plays a crucial role,as a favorable arterial spectral waveform and appropriate hepatic artery flow velocity typically indicate a successful anastomosis,even in cases where the hepatic artery anastomosis cannot be directly visualized by ultrasound.The hepatic artery runs alongside the portal vein,often selected as a reference due to its larger inner diameter.A normal hepatic artery spectrum displays a regular pulsation pattern with a rapid rise in systole and a slow decline in diastole.Parameters for assessing hepatic artery resistance include a resistance index between 0.5 to 0.8 and an artery systolic acceleration of less than 80 ms.Instantaneous increases in the resistance index(RI>0.8)often occur within 2 d after surgery,followed by a subsequent return to normal hepatic arterial parameters.It has been established that the maximum blood flow velocity during systole in the hepatic artery should not exceed 200 cm/s[1].

Multi-mode Multi-frequency GNSS-IR Combination System for Sea Level Retrieval

With the development of Global Navigation Satellite Systems(GNSS),geodetic GNSS receivers have been utilized to monitor sea levels using GNSS-Interferometry Reflectometry(GNSS-IR)technology.The multi-mode,multi-frequency signals of GPS,GLONASS,Galileo,and Beidou can be used for GNSS-IR sea level retrieval,but combining these retrievals remains problematic.To address this issue,a GNSS-IR sea level retrieval combination system has been developed,which begins by analyzing error sources in GNSS-IR sea level retrieval and establishing and solving the GNSS-IR retrieval equation.This paper focuses on two key points:time window selection and equation stability.The stability of the retrieval combination equations is determined by the condition number of the coefficient matrix within the time window.The impact of ill-conditioned coefficient matrices on the retrieval results is demonstrated using an extreme case of SNR data with only ascending or descending trajectories.After determining the time window and removing ill-conditioned equations,the multi-mode,multi-frequency GNSS-IR retrieval is performed.Results from three International GNSS Service(IGS)stations show that the combination method produces high-precision,high-resolution,and high-reliability sea level retrieval combination sequences.

Novel approach of ultrasound-guided lateral recess block for a patient with lateral recess stenosis: A case report

BACKGROUND Ultrasound guide technology,which can provide real-time visualization of the needle tip and tissues and avoid many adverse events,is widely used in mini-mally invasive therapy.However,the studies on ultrasound-guided Lateral recess block(LRB)are limited,this is probably because there is no recognized standard method for ultrasound scanning.This study aimed to evaluate the effect of ultrasound-guided LRB in patients with lateral recess stenosis(LRS).CASE SUMMARY A 65-year-old patient complained of low back pain accompanied occasionally by pain and numbness in the left lower limb.Physical examination showed ten-derness on the spinous process and paraspinal muscles from L1 to S1,extensor hallucis longus and tibialis anterior weakness(muscle strength:4-),and a positive straight leg raising test in the left lower limb(60°).Magnetic resonance imaging showed L4–L5 disc degeneration with left LRS and nerve root entrapment.Subsequently,the patient was diagnosed with LRS.This patient was treated with a novel ultrasound-guided LRB approach.The patient’s symptoms significantly improved without any complications at 1 wk postoperatively and at the 3-month follow-up.CONCLUSION This is the first report on the LRS treatment with ultrasound-guided LRB from the contralateral spinous process along the inner side of the articular process by out-plane technique.Further studies are expected to investigate the efficacy and safety of ultrasound-guided LRB for patients with LRS.

Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage

This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage(EUS-GBD)as a salvage approach in cases of unsuccessful conventional management.EUS-GBD is a minimally invasive and effective technique for drainage in patients with acute cholecystitis with high risk of surgery.The procedure has demonstrated impressive technical and clinical success rates with low rates of adverse events,making it a safe and effective option for appropriate candidates.Furthermore,EUS-GBD can also serve as a rescue option for patients who have failed endoscopic retrograde cholangiopancreatography or EUS biliary drainage for relief of jaundice in malignant biliary stricture.However,patient selection is critical for the success of EUS-GBD,and proper patient selection and risk assessment are important to ensure the safety and efficacy of the procedure.As the field continues to evolve and mature,ongoing research will further refine our understanding of the benefits and limitations of EUS-GBD,ultimately leading to improved outcomes for patients.

Method of Multi-Mode Sensor Data Fusion with an Adaptive Deep Coupling Convolutional Auto-Encoder

To address the difficulties in fusing multi-mode sensor data for complex industrial machinery, an adaptive deep coupling convolutional auto-encoder (ADCCAE) fusion method was proposed. First, the multi-mode features extracted synchronously by the CCAE were stacked and fed to the multi-channel convolution layers for fusion. Then, the fused data was passed to all connection layers for compression and fed to the Softmax module for classification. Finally, the coupling loss function coefficients and the network parameters were optimized through an adaptive approach using the gray wolf optimization (GWO) algorithm. Experimental comparisons showed that the proposed ADCCAE fusion model was superior to existing models for multi-mode data fusion.

Evaluation of hand infections in the emergency department using point-of-care ultrasound

BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient management.METHODS:We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December 2021.Two trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the hand.We then reviewed patients’electronic health records(EHR)for demographic characteristics,history,physical examination findings,ED course,additional imaging studies,consultations,impact of POCUS on patient care and final disposition.RESULTS:We included a total of 50 cases(28 male,22 female)in the final analysis.The most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 times.CONCLUSION:POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.

A Hand Features Based Fusion Recognition Network with Enhancing Multi-Modal Correlation

Fusing hand-based features in multi-modal biometric recognition enhances anti-spoofing capabilities.Additionally,it leverages inter-modal correlation to enhance recognition performance.Concurrently,the robustness and recognition performance of the system can be enhanced through judiciously leveraging the correlation among multimodal features.Nevertheless,two issues persist in multi-modal feature fusion recognition:Firstly,the enhancement of recognition performance in fusion recognition has not comprehensively considered the inter-modality correlations among distinct modalities.Secondly,during modal fusion,improper weight selection diminishes the salience of crucial modal features,thereby diminishing the overall recognition performance.To address these two issues,we introduce an enhanced DenseNet multimodal recognition network founded on feature-level fusion.The information from the three modalities is fused akin to RGB,and the input network augments the correlation between modes through channel correlation.Within the enhanced DenseNet network,the Efficient Channel Attention Network(ECA-Net)dynamically adjusts the weight of each channel to amplify the salience of crucial information in each modal feature.Depthwise separable convolution markedly reduces the training parameters and further enhances the feature correlation.Experimental evaluations were conducted on four multimodal databases,comprising six unimodal databases,including multispectral palmprint and palm vein databases from the Chinese Academy of Sciences.The Equal Error Rates(EER)values were 0.0149%,0.0150%,0.0099%,and 0.0050%,correspondingly.In comparison to other network methods for palmprint,palm vein,and finger vein fusion recognition,this approach substantially enhances recognition performance,rendering it suitable for high-security environments with practical applicability.The experiments in this article utilized amodest sample database comprising 200 individuals.The subsequent phase involves preparing for the extension of the method to larger databases.

A Comprehensive Survey on Deep Learning Multi-Modal Fusion:Methods,Technologies and Applications

Multi-modal fusion technology gradually become a fundamental task in many fields,such as autonomous driving,smart healthcare,sentiment analysis,and human-computer interaction.It is rapidly becoming the dominant research due to its powerful perception and judgment capabilities.Under complex scenes,multi-modal fusion technology utilizes the complementary characteristics of multiple data streams to fuse different data types and achieve more accurate predictions.However,achieving outstanding performance is challenging because of equipment performance limitations,missing information,and data noise.This paper comprehensively reviews existing methods based onmulti-modal fusion techniques and completes a detailed and in-depth analysis.According to the data fusion stage,multi-modal fusion has four primary methods:early fusion,deep fusion,late fusion,and hybrid fusion.The paper surveys the three majormulti-modal fusion technologies that can significantly enhance the effect of data fusion and further explore the applications of multi-modal fusion technology in various fields.Finally,it discusses the challenges and explores potential research opportunities.Multi-modal tasks still need intensive study because of data heterogeneity and quality.Preserving complementary information and eliminating redundant information between modalities is critical in multi-modal technology.Invalid data fusion methods may introduce extra noise and lead to worse results.This paper provides a comprehensive and detailed summary in response to these challenges.

Towards trustworthy multi-modal motion prediction:Holistic evaluation and interpretability of outputs

Predicting the motion of other road agents enables autonomous vehicles to perform safe and efficient path planning.This task is very complex,as the behaviour of road agents depends on many factors and the number of possible future trajectories can be consid-erable(multi-modal).Most prior approaches proposed to address multi-modal motion prediction are based on complex machine learning systems that have limited interpret-ability.Moreover,the metrics used in current benchmarks do not evaluate all aspects of the problem,such as the diversity and admissibility of the output.The authors aim to advance towards the design of trustworthy motion prediction systems,based on some of the re-quirements for the design of Trustworthy Artificial Intelligence.The focus is on evaluation criteria,robustness,and interpretability of outputs.First,the evaluation metrics are comprehensively analysed,the main gaps of current benchmarks are identified,and a new holistic evaluation framework is proposed.Then,a method for the assessment of spatial and temporal robustness is introduced by simulating noise in the perception system.To enhance the interpretability of the outputs and generate more balanced results in the proposed evaluation framework,an intent prediction layer that can be attached to multi-modal motion prediction models is proposed.The effectiveness of this approach is assessed through a survey that explores different elements in the visualisation of the multi-modal trajectories and intentions.The proposed approach and findings make a significant contribution to the development of trustworthy motion prediction systems for autono-mous vehicles,advancing the field towards greater safety and reliability.

Is endoscopic ultrasound a promising technique in the diagnosis and treatment of liver diseases?

Percutaneous ultrasound has been a longstanding method in the diagnostics and interventional procedures of liver diseases.In some countries,its use is restricted to radiologists,limiting access for other clinicians,such as gastroenterologists.Endoscopic ultrasound,as a novel technique,plays a crucial role in diagnosis and treatment of digestive diseases.However,its use is sometimes recommended for conditions where no clear advantage over percutaneous ultrasound exists,leaving the impression that clinicians sometimes resort to an endoscopic approach due to the unavailability of percutaneous options.

Ultrasound Scanning Competencies in Midwifery Education in Zambia: Findings from a Desk Review and Needs Assessment

Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. Methods: A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. Results: The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. Conclusion: Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.

Dynamic contrast enhanced ultrasound in differential diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis

BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(i.e.cholangiocarcinoma or metastasis)is highly challenging and definitive diagnosis still relies on histological exam.The patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical features.Dynamic contrast-enhanced ultrasound(DCEUS)with standardized software could help to overcome these obstacles,providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor perfusion.AIM To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver nodules.METHODS A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological diagnosis.In accordance with the study protocol,a qualitative and quantitative analysis of the evidence was planned.RESULTS Rise time was significantly higher in HCC patients with a standardized mean difference(SMD)of 0.83(95%CI:0.48-1.18).Similarly,other statistically significant parameters were mean transit time local with a SMD of 0.73(95%CI:0.20-1.27),peak enhancement with a SMD of 0.37(95%CI:0.03-0.70),area wash-in area under the curve with a SMD of 0.47(95%CI:0.13-0.81),wash-out area under the curve with a SMD of 0.55(95%CI:0.21-0.89)and wash-in and wash-out area under the curve with SMD of 0.51(95%CI:0.17-0.85).SMD resulted not significant in fall time and wash-in rate,but the latter presented a trend towards greater values in HCC compared to intrahepatic cholangiocarcinoma.CONCLUSION DCEUS could improve non-invasive diagnosis of HCC,leading to less liver biopsy and early treatment.This quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.

Evaluating the efficacy of percutaneous puncture biopsy guided by contrast-enhanced ultrasound for peripheral pulmonary lesions

BACKGROUND The incidence and mortality of lung cancer have increased annually.Accurate diagnosis can help improve therapeutic efficacy of interventions and prognosis.Percutaneous lung biopsy is a reliable method for the clinical diagnosis of lung cancer.Ultrasound-guided percutaneous lung biopsy technology has been widely promoted and applied in recent years.AIM To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)-guided percutaneous biopsy in peripheral pulmonary lesions.METHODS We retrospectively collected data on 237 patients with peripheral thoracic focal lesions who underwent puncture biopsy at Wuxi People’s Hospital.The patients were randomly divided into two groups:The CEUS-guided before lesion puncture group(contrast group)and conventional ultrasound-guided group(control group).Analyze the diagnostic efficacy of the puncture biopsy,impact of tumor size,and number of puncture needles and complications were analyzed and compared between the two groups.RESULTS Accurate pathological results were obtained for 92.83%(220/237)of peripheral lung lesions during the first biopsy,with an accuracy rate of 95.8%(113/118)in the contrast group and 89.9%(107/119)in the control group.The difference in the area under the curve(AUC)between the contrast and the control groups was not statistically significant(0.952 vs 0.902,respectively;P>0.05).However,when the lesion diameter≥5 cm,the diagnostic AUC of the contrast group was higher than that of the control group(0.952 vs 0.902,respectively;P<0.05).In addition,the average number of puncture needles in the contrast group was lower than that in the control group(2.58±0.53 vs 2.90±0.56,respectively;P<0.05).CONCLUSION CEUS guidance can enhance the efficiency of puncture biopsy of peripheral pulmonary lesions,especially for lesions with a diameter≥5 cm.Therefore,CEUS guidance has high clinical diagnostic value in puncture biopsy of peripheral focal lung lesions.

Multi-modal knowledge graph inference via media convergence and logic rule

Media convergence works by processing information from different modalities and applying them to different domains.It is difficult for the conventional knowledge graph to utilise multi-media features because the introduction of a large amount of information from other modalities reduces the effectiveness of representation learning and makes knowledge graph inference less effective.To address the issue,an inference method based on Media Convergence and Rule-guided Joint Inference model(MCRJI)has been pro-posed.The authors not only converge multi-media features of entities but also introduce logic rules to improve the accuracy and interpretability of link prediction.First,a multi-headed self-attention approach is used to obtain the attention of different media features of entities during semantic synthesis.Second,logic rules of different lengths are mined from knowledge graph to learn new entity representations.Finally,knowledge graph inference is performed based on representing entities that converge multi-media features.Numerous experimental results show that MCRJI outperforms other advanced baselines in using multi-media features and knowledge graph inference,demonstrating that MCRJI provides an excellent approach for knowledge graph inference with converged multi-media features.