Objective:To investigate the clinical efficacy and safety of percutaneous kyphoplasty at different surgical timings in the treatment of osteoporotic vertebral compression fracture(OVCF)based on the theory of“dynamic-...Objective:To investigate the clinical efficacy and safety of percutaneous kyphoplasty at different surgical timings in the treatment of osteoporotic vertebral compression fracture(OVCF)based on the theory of“dynamic-static integration”.Methods:Patients with OVCF who underwent percutaneous kyphoplasty in our hospital were selected and divided into Groups A,B,and C for those undergoing surgery within 7,7—21,and>21 days of fracture occurrence.The variations in the amount of bone cement injected,pre-and post-operative pain levels,functional activity,deformity correction of the injured vertebrae,bone cement leakage,and vertebral body height loss were compared among the three groups.Results:Regarding pain relief and functional activity,the postoperative Visual Analog Scale and Oswestry Disability Index scores of the three groups significantly improved.Furthermore,the deformities of the injured vertebrae in the three groups were significantly corrected,with Groups A and B exhibiting superior correction compared to Group C.Moreover,the bone cement leakage rates in groups A and C were higher than that in Group B.At the 3-month follow-up,the loss of vertebral height in Group C was significantly higher than those in groups A and B.Conclusion:Kyphoplasty is effective for OVCF treatment.Early surgery can effectively restore the vertebral height of the injured vertebra,reduce kyphosis,and reduce height loss of the injured vertebra after surgery;nevertheless,treatment within 1—3 weeks of the fracture can reduce the occurrence of bone cement leakage,making the surgery safer.Therefore,surgical treatment within 1—3 weeks of fracture is safer and can achieve satisfactory therapeutic effects.From the perspective of traditional Chinese medicine,PKP surgery can transform the fracture end from a micromotion state to a fixed state,which fully embodies the theory of“dynamic-static integration”.展开更多
BACKGROUND Intra-abdominal infections(IAIs)is the most common type of surgical infection,with high associated morbidity and mortality rates.In recent years,due to the use of antibiotics,various drug-resistant bacteria...BACKGROUND Intra-abdominal infections(IAIs)is the most common type of surgical infection,with high associated morbidity and mortality rates.In recent years,due to the use of antibiotics,various drug-resistant bacteria have emerged,making the treatment of abdominal infections more challenging.Early surgical exploration can reduce the mortality of patients with abdominal infection and the occurrence of complications.However,available evidence regarding the optimal timing of IAI surgery is still weak.In study,we compared the effects of operation time on patients with abdominal cavity infection and tried to confirm the best timing of surgery.AIM To assess the efficacy of early vs delayed surgical exploration in the treatment of IAI,in terms of overall mortality.METHODS A systematic literature search was performed using PubMed,EMBASE,Cochrane Central Register of Controlled Trials,Ovid,and ScienceDirect.The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method.Based on the timing of the surgical operation,we divided the literature into two groups:Early surgery and delayed surgery.For the early and delayed surgery groups,the intervention was performed with and after 12 h of the initial surgical intervention,respectively.The main outcome measure was the mortality rate.The literature search was performed from May 5 to 20,2021.We also searched the World Health Organization International Clinical Trials Registry Platform search portal and ClinicalTrials.gov on May 20,2021,for ongoing trials.This study was registered with the International Prospective Register of Systematic Reviews.RESULTS We identified nine eligible trial comparisons.Early surgical exploration of patients with IAIs(performed within 12 h)has significantly reduced the mortality and complications of patients,improved the survival rate,and shortened the hospital stay.CONCLUSION Early surgical exploration within 12 h may be more effective for the treatment of IAIs relative to a delayed operation.展开更多
Due to the impact of source-load prediction power errors and uncertainties,the actual operation of the park will have a wide range of fluctuations compared with the expected state,resulting in its inability to achieve...Due to the impact of source-load prediction power errors and uncertainties,the actual operation of the park will have a wide range of fluctuations compared with the expected state,resulting in its inability to achieve the expected economy.This paper constructs an operating simulation model of the park power grid operation considering demand response and proposes a multi-time scale operating simulation method that combines day-ahead optimization and model predictive control(MPC).In the day-ahead stage,an operating simulation plan that comprehensively considers the user’s side comfort and operating costs is proposed with a long-term time scale of 15 min.In order to cope with power fluctuations of photovoltaic,wind turbine and conventional load,MPC is used to track and roll correct the day-ahead operating simulation plan in the intra-day stage to meet the actual operating operation status of the park.Finally,the validity and economy of the operating simulation strategy are verified through the analysis of arithmetic examples.展开更多
In recent decades, tokamak discharges with zero total toroidal current have been reported in tokamak experiments, and this is one of the key problems in alternating current(AC) operations.An efficient free-boundary eq...In recent decades, tokamak discharges with zero total toroidal current have been reported in tokamak experiments, and this is one of the key problems in alternating current(AC) operations.An efficient free-boundary equilibrium code is developed to investigate such advanced tokamak discharges with current reversal equilibrium configuration. The calculation results show that the reversal current equilibrium can maintain finite pressure and also has considerable effects on the position of the X-point and the magnetic separatrix shape, and hence also on the position of the strike point on the divertor plates, which is extremely useful for magnetic design, MHD stability analysis, and experimental data analysis etc. for the AC plasma current operation on tokamaks.展开更多
Based on the elastic theory of porous media,embedded discrete fracture model and finite volume method,and considering the micro-seepage mechanism of shale gas,a fully coupled seepage-geomechanical model suitable for f...Based on the elastic theory of porous media,embedded discrete fracture model and finite volume method,and considering the micro-seepage mechanism of shale gas,a fully coupled seepage-geomechanical model suitable for fractured shale gas reservoirs is established,the optimization method of refracturing timing is proposed,and the influencing factors of refracturing timing are analyzed based on the data from shale gas well in Fuling of Sichuan Basin.The results show that due to the depletion of formation pressure,the percentage of the maximum horizontal principal stress reversal area in the total area increases and then decreases with time.The closer the area is to the hydraulic fracture,the shorter the time for the peak of the stress reversal area percentage curve to appear,and the shorter the time for the final zero return(to the initial state).The optimum time of refracturing is affected by matrix permeability,initial stress difference and natural fracture approach angle.The larger the matrix permeability and initial stress difference is,the shorter the time for stress reversal area percentage curve to reach peak and return to the initial state,and the earlier the time to take refracturing measures.The larger the natural fracture approach angle is,the more difficult it is for stress reversal to occur near the fracture,and the earlier the optimum refracturing time is.The more likely the stress reversal occurs at the far end of the artificial fracture,the later the optimal time of refracturing is.Reservoirs with low matrix permeability have a rapid decrease in single well productivity.To ensure economic efficiency,measures such as shut-in or gas injection can be taken to restore the stress,and refracturing can be implemented in advance.展开更多
BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to e...BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to enhance the psychological well-being and overall quality of life for primipara,while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum.AIM To explore the effect of timing theory combined with behavior change on selfefficacy,negative emotions and quality of life in patients with primipara.METHODS A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022.These cases were divided into two groups,namely the observation group and the control group,with 40 cases in each group.The nursing interventions differed between the two groups,with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change.The study aimed to compare the pre-and post-nursing scores of Chinese Perceived Stress Scale(CPSS),Edinburgh Postpartum Depression Scale(EPDS),Self-rating Anxiety Scale(SAS),breast milk knowledge,self-efficacy,and SF-36 quality of life in both groups.RESULTS After nursing,the CPSS,EPDS,and SAS scores of the two groups was significantly lower than that before nursing,and the CPSS,EPDS,and SAS scores of the observation group was significantly lower than that of the control group(P=0.002,P=0.011,and P=0.001 respectively).After nursing,the breastfeeding knowledge mastery,selfefficacy,and SF-36 quality of life scores was significantly higher than that before nursing,and the breastfeeding knowledge mastery(P=0.013),self-efficacy(P=0.008),and SF-36 quality of life(P=0.011)scores of the observation group was significantly higher than that of the control group.CONCLUSION The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals,while also enhancing their selfefficacy and overall quality of life.This study focuses on the key concepts of timing theory,behavior change,primipara individuals,negative mood,and quality of life.展开更多
Concentrate copper grade(CCG)is one of the important production indicators of copper flotation processes,and keeping the CCG at the set value is of great significance to the economic benefit of copper flotation indust...Concentrate copper grade(CCG)is one of the important production indicators of copper flotation processes,and keeping the CCG at the set value is of great significance to the economic benefit of copper flotation industrial processes.This paper addresses the fluctuation problem of CCG through an operational optimization method.Firstly,a density-based affinity propagationalgorithm is proposed so that more ideal working condition categories can be obtained for the complex raw ore properties.Next,a Bayesian network(BN)is applied to explore the relationship between the operational variables and the CCG.Based on the analysis results of BN,a weighted Gaussian process regression model is constructed to predict the CCG that a higher prediction accuracy can be obtained.To ensure the predicted CCG is close to the set value with a smaller magnitude of the operation adjustments and a smaller uncertainty of the prediction results,an index-oriented adaptive differential evolution(IOADE)algorithm is proposed,and the convergence performance of IOADE is superior to the traditional differential evolution and adaptive differential evolution methods.Finally,the effectiveness and feasibility of the proposed methods are verified by the experiments on a copper flotation industrial process.展开更多
We describe a 63-year-old male who appears to have undergone an early form of the arterial switch operation for D-transposition of the great arteries performed in the mid-1960s.We review the clinical and imaging data ...We describe a 63-year-old male who appears to have undergone an early form of the arterial switch operation for D-transposition of the great arteries performed in the mid-1960s.We review the clinical and imaging data that support our conclusion.He had a diagnostic cardiac catheterization which demonstrated severe pulmonary hypertension responsive to epoprostenol and oxygen.Our case may represent one example of the experimental surgical work done prior to Dr.Adibe Jatene’s description of thefirst successful arterial switch performed in 1975.展开更多
The weapon and equipment operational requirement analysis(WEORA) is a necessary condition to win a future war,among which the acquisition of knowledge about weapons and equipment is a great challenge. The main challen...The weapon and equipment operational requirement analysis(WEORA) is a necessary condition to win a future war,among which the acquisition of knowledge about weapons and equipment is a great challenge. The main challenge is that the existing weapons and equipment data fails to carry out structured knowledge representation, and knowledge navigation based on natural language cannot efficiently support the WEORA. To solve above problem, this research proposes a method based on question answering(QA) of weapons and equipment knowledge graph(WEKG) to construct and navigate the knowledge related to weapons and equipment in the WEORA. This method firstly constructs the WEKG, and builds a neutral network-based QA system over the WEKG by means of semantic parsing for knowledge navigation. Finally, the method is evaluated and a chatbot on the QA system is developed for the WEORA. Our proposed method has good performance in the accuracy and efficiency of searching target knowledge, and can well assist the WEORA.展开更多
BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abd...BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P<0.05).Further,the proportion of patients with at least one organ dysfunction in group A was significantly lower than those in groups B and groups C(41.57%vs 70.91%and 75.00%,P<0.05).The mortality rates in group A,group B,and group C were similar(P>0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than those in groups B and group C(24.50±4.16 d vs 35.54±6.62 d and 38.89±7.10 d,P<0.05).The hospitalization expenses in group A were also significantly lower than those in groups B and groups C[2.70(1.20,3.55)ten-thousand-yuan vs 5.50(2.98,7.12)ten-thousand-yuan and 6.00(3.10,8.05)ten-thousand-yuan,P<0.05).The incidence of complications in group A was markedly lower than that in group C(5.62%vs 25.00%,P<0.05),and similar to group B(P>0.05).CONCLUSION Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is most effective when performed within 2 d of onset.展开更多
Background: The optimal time to closure of a newborn with a myelomeningocele has been the focus of a number of evaluations. The Timing of primary surgery has received significant attention due to its relationship to r...Background: The optimal time to closure of a newborn with a myelomeningocele has been the focus of a number of evaluations. The Timing of primary surgery has received significant attention due to its relationship to repair-site infection that can lead to increased morbidity and prolonged hospital stays. It is on this basis that recommendations have utilized 48 - 72 hours post birth as ideal time of closure. This is not only prevent infection at the site but also prevent ventriculitis and neural structure damage. We therefore, hypothesized an increase in wound infection rates in those patients with delays in myelomeningocele repair. Methods: We retrospectively reviewed the records of 103 children with myelomeningocele treated between 2016 and 2023. At discharge the patients were followed up at the post-operative clinic visit 2 weeks later. Children were assigned to 1 of 2 groups, those who underwent primary neurosurgical repair within 72 hours of delivery (Group 1) and those undergoing repair after 72 hours (Group 2). We compared the infection rates. Results: 103 children who underwent myelomeningocele repair were identified, with a median time from birth to treatment of 1 day. Eight (7.8 %) patients were noted to have post-repair surgical site complications. There was no significant difference in rates of infection between Group 1 and Group 2 repair times. The presence of infection was associated increased length of stay when compared to neonates without infection. Conclusion: In children with myelomeningocele, the timing of primary neurosurgical repair appears not to have a significant impact on surgical site infection. Closure of the spinal lesion within the first 72 hours of life may be more favorable for neural damage prevention. These results suggest that early myelomeningocele repair may not impart significantly on the rate of wound-site infection.展开更多
With the advent of Industry 4.0, smart construction sites have seen significant development in China. However, accidents involving digitized tower cranes continue to be a persistent issue. Among the contributing facto...With the advent of Industry 4.0, smart construction sites have seen significant development in China. However, accidents involving digitized tower cranes continue to be a persistent issue. Among the contributing factors, human unsafe behavior stands out as a primary cause for these incidents. This study aims to assess the human reliability of tower crane operations on smart construction sites. To proactively enhance safety measures, the research employs text mining techniques (TF-IDF-Truncated SVD-Complement NB) to identify patterns of human errors among tower crane operators. Building upon the SHEL model, the study categorizes behavioral factors affecting human reliability in the man-machine interface, leading to the establishment of the Performance Shaping Factors (PSFs) system. Furthermore, the research constructs an error impact indicator system for the intelligent construction site tower crane operator interface. Using the DEMATEL method, it analyzes the significance of various factors influencing human errors in tower crane operations. Additionally, the ISM-MICMAC method is applied to unveil the hierarchical relationships and driving-dependent connections among these influencing factors. The findings indicate that personal state, operating procedures, and physical environment directly impact human errors, while personal capability, technological environment, and one fundamental organizational management factor contribute indirectly. .展开更多
This article proposes a comprehensive monitoring system for tunnel operation to address the risks associated with tunnel operations.These risks include safety control risks,increased traffic flow,extreme weather event...This article proposes a comprehensive monitoring system for tunnel operation to address the risks associated with tunnel operations.These risks include safety control risks,increased traffic flow,extreme weather events,and movement of tectonic plates.The proposed system is based on the Internet of Things and artificial intelligence identification technology.The monitoring system will cover various aspects of tunnel operations,such as the slope of the entrance,the structural safety of the cave body,toxic and harmful gases that may appear during operation,excessively high and low-temperature humidity,poor illumination,water leakage or road water accumulation caused by extreme weather,combustion and smoke caused by fires,and more.The system will enable comprehensive monitoring and early warning of fire protection systems,accident vehicles,and overheating vehicles.This will effectively improve safety during tunnel operation.展开更多
Objective:To explore the clinical benefits achieved by implementing the operating room nursing cooperation path for patients undergoing laparoscopic hysterectomy.Methods:64 laparoscopic hysterectomy cases were divided...Objective:To explore the clinical benefits achieved by implementing the operating room nursing cooperation path for patients undergoing laparoscopic hysterectomy.Methods:64 laparoscopic hysterectomy cases were divided into groups according to the order of admission.The control group received routine perioperative care.The observation group implemented the nursing cooperation path in the operating room on the same basis as the control group.The two groups’physiological responses,stimulus indicators,anxiety,and complication rates were compared.Results:The heart rate,blood pressure 0.5 hours after surgery,anxiety scores 1 day before and 3 days after surgery,and the total number of complications in the observation group were all lower than those in the control group(P<0.05).Conclusion:The development of a nursing cooperation path in the operating room can help patients undergoing laparoscopic hysterectomy reduce heart rate,blood pressure,stress responses,and the risk of complications,and is worthy of promotion.展开更多
BACKGROUND Endoscopic submucosal dissection(ESD)is a treatment for early gastric cancer with the advantages of small invasion,fewer complications,and a low local recurrence rate.However,there is a high risk of complic...BACKGROUND Endoscopic submucosal dissection(ESD)is a treatment for early gastric cancer with the advantages of small invasion,fewer complications,and a low local recurrence rate.However,there is a high risk of complications such as bleeding and perforation,and the operation time is also longer.ESD operation time is closely related to bleeding and perforation.AIM To investigate the influencing factors associated with ESD operation time and postoperative delayed hemorrhage to provide a reference for early planning,early identification,and prevention of complications.METHODS We conducted a retrospective study based on the clinical data of 520 patients with early gastric cancer in the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2021.The baseline data,clinical features,and endoscopic and pathological characteristics of patients were collected.The multivariate linear regression model was used to investigate the influencing factors of ESD operation time.Logistic regression analysis was carried out to evaluate the influencing factors of postoperative delayed hemorrhage.RESULTS The multivariate analysis of ESD operation time showed that the maximum lesion diameter could affect 8.815%of ESD operation time when other influencing factors remained unchanged.The operation time increased by 3.766%or 10.247%if the lesion was mixed or concave.The operation time increased by 4.417%if combined with an ulcer or scar.The operation time increased by 3.692%if combined with perforation.If infiltrated into the submucosa,it increased by 2.536%.Multivariate analysis of delayed hemorrhage after ESD showed that the maximum diameter of the lesion,lesion morphology,and ESD operation time were independent influencing factors for delayed hemorrhage after ESD.Patients with lesion≥3.0 cm(OR=3.785,95%CI:1.165-4.277),lesion morphology-concave(OR=10.985,95%CI:2.133-35.381),and ESD operation time≥60 min(OR=2.958,95%CI:1.117-3.526)were prone to delayed hemorrhage after ESD.CONCLUSION If the maximum diameter of the lesion in patients with early gastric cancer is≥3.0 cm,and the shape of the lesion is concave,or accompanied by an ulcer or scar,combined with perforation,and infiltrates into the submucosa,the ESD operation will take a longer time.When the maximum diameter of the lesion is≥3.0 cm,the shape of the lesion is concave in patients and the operation time of ESD takes longer time,the risk of delayed hemorrhage after ESD is higher.展开更多
This article reports on a retrospective analysis on 121 patients and a prospectivestudy on 21 patients with acute cholangitis of severe type(ACST)for a study on the timing se-lection of emergency operation for ACST.Tw...This article reports on a retrospective analysis on 121 patients and a prospectivestudy on 21 patients with acute cholangitis of severe type(ACST)for a study on the timing se-lection of emergency operation for ACST.Twenty two clinical,biological,etiologic,pathologicand operative variables were analyzed.Simple regression revealed 11 factors with prognosticsignificance,but multivariate analysis detected only 6 factors with independent significance inpredicting mortality(age,mean blood pressure,generalized peritonitis,serum albumin-globin ra-tio,blood culture,and the number of failed organs and systems).The results indicate that theclinical principles of treatment for ACST should be the combination of medical and surgicaltreatment.Active conservative treatment is practically applicable to the majority of ACST,espe-cially,those with short history and few complication.Prognostic mathematical model of ACSTdoes good for its timing selection of emergency operation.A critical level of 0.40 is determinedto be the discriminant score for emergency bile duct drainage.The model seems to have advan-tages over the traditional method.展开更多
Radical operation for hilar cholangiocarcinoma(HCCA)is the most effective treatment,but high rates of severe postoperative complication and death remain concerns due to the complexity of biliary and vascular anatomy o...Radical operation for hilar cholangiocarcinoma(HCCA)is the most effective treatment,but high rates of severe postoperative complication and death remain concerns due to the complexity of biliary and vascular anatomy of the hepatobiliary region.De-layed arterial hemorrhage(DAH)occurring>24 h postoperatively usually causes life-threatening bleeding,and relaparotomy for DAH would be difficult and hazardous because of postoperative adhe-sions and critical general condition.As endovascular technique is less invasive and has improved over the recent decades,clini-cians have begun to prefer endovascular treatment(EVT)to surgi-cal treatment of DAH after hepatobiliary pancreatic surgery.How-ever,to our knowledge,a relatively large series of patients dealing with the outcomes of EVT of DAH after surgery for HCCA has not been reported.Herein,we analyzed the technical and clinical out-comes of EVT in 17 patients to evaluate the efficacy and safety of EVT.展开更多
Patent foramen ovale(PFO)is a remnant of normal fetal anatomy,which occurs in about 20%–25%of cases.Patients with PFO are at increased risk for migraine,acute limb ischemia secondary to emboli and cryptogenic(no othe...Patent foramen ovale(PFO)is a remnant of normal fetal anatomy,which occurs in about 20%–25%of cases.Patients with PFO are at increased risk for migraine,acute limb ischemia secondary to emboli and cryptogenic(no other identifiable cause)stroke.The traditional approach has been to use a fluoroscopically guided blocking device,but this is contraindicated in patients with severe allergies to contrast media or inability to undergo angiography.With the advancements in technology,ultrasonic robotic systems have become available for medical procedures.In the current study,we reported a case of using the ultrasonic robotic teleoperation system to achieve closure of PFO at the Chinese PLA General Hospital,Beijing,China.展开更多
This study proposes a combined hybrid energy storage system(HESS) and transmission grid(TG) model, and a corresponding time series operation simulation(TSOS) model is established to relieve the peak-shaving pressure o...This study proposes a combined hybrid energy storage system(HESS) and transmission grid(TG) model, and a corresponding time series operation simulation(TSOS) model is established to relieve the peak-shaving pressure of power systems under the integration of renewable energy. First, a linear model for the optimal operation of the HESS is established, which considers the different power-efficiency characteristics of the pumped storage system, electrochemical storage system, and a new type of liquid compressed air energy storage. Second, a TSOS simulation model for peak shaving is built to maximize the power entering the grid from the wind farms and HESS. Based on the proposed model, this study considers the transmission capacity of a TG. By adding the power-flow constraints of the TG, a TSOS-based HESS and TG combination model for peak shaving is established. Finally, the improved IEEE-39 and IEEE-118 bus systems were considered as examples to verify the effectiveness and feasibility of the proposed model.展开更多
基金supported by the National Natural Science Foundation of China(82374493).
文摘Objective:To investigate the clinical efficacy and safety of percutaneous kyphoplasty at different surgical timings in the treatment of osteoporotic vertebral compression fracture(OVCF)based on the theory of“dynamic-static integration”.Methods:Patients with OVCF who underwent percutaneous kyphoplasty in our hospital were selected and divided into Groups A,B,and C for those undergoing surgery within 7,7—21,and>21 days of fracture occurrence.The variations in the amount of bone cement injected,pre-and post-operative pain levels,functional activity,deformity correction of the injured vertebrae,bone cement leakage,and vertebral body height loss were compared among the three groups.Results:Regarding pain relief and functional activity,the postoperative Visual Analog Scale and Oswestry Disability Index scores of the three groups significantly improved.Furthermore,the deformities of the injured vertebrae in the three groups were significantly corrected,with Groups A and B exhibiting superior correction compared to Group C.Moreover,the bone cement leakage rates in groups A and C were higher than that in Group B.At the 3-month follow-up,the loss of vertebral height in Group C was significantly higher than those in groups A and B.Conclusion:Kyphoplasty is effective for OVCF treatment.Early surgery can effectively restore the vertebral height of the injured vertebra,reduce kyphosis,and reduce height loss of the injured vertebra after surgery;nevertheless,treatment within 1—3 weeks of the fracture can reduce the occurrence of bone cement leakage,making the surgery safer.Therefore,surgical treatment within 1—3 weeks of fracture is safer and can achieve satisfactory therapeutic effects.From the perspective of traditional Chinese medicine,PKP surgery can transform the fracture end from a micromotion state to a fixed state,which fully embodies the theory of“dynamic-static integration”.
基金Taishan Scholar Foundation of Shandong Province,No.2018092901.
文摘BACKGROUND Intra-abdominal infections(IAIs)is the most common type of surgical infection,with high associated morbidity and mortality rates.In recent years,due to the use of antibiotics,various drug-resistant bacteria have emerged,making the treatment of abdominal infections more challenging.Early surgical exploration can reduce the mortality of patients with abdominal infection and the occurrence of complications.However,available evidence regarding the optimal timing of IAI surgery is still weak.In study,we compared the effects of operation time on patients with abdominal cavity infection and tried to confirm the best timing of surgery.AIM To assess the efficacy of early vs delayed surgical exploration in the treatment of IAI,in terms of overall mortality.METHODS A systematic literature search was performed using PubMed,EMBASE,Cochrane Central Register of Controlled Trials,Ovid,and ScienceDirect.The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method.Based on the timing of the surgical operation,we divided the literature into two groups:Early surgery and delayed surgery.For the early and delayed surgery groups,the intervention was performed with and after 12 h of the initial surgical intervention,respectively.The main outcome measure was the mortality rate.The literature search was performed from May 5 to 20,2021.We also searched the World Health Organization International Clinical Trials Registry Platform search portal and ClinicalTrials.gov on May 20,2021,for ongoing trials.This study was registered with the International Prospective Register of Systematic Reviews.RESULTS We identified nine eligible trial comparisons.Early surgical exploration of patients with IAIs(performed within 12 h)has significantly reduced the mortality and complications of patients,improved the survival rate,and shortened the hospital stay.CONCLUSION Early surgical exploration within 12 h may be more effective for the treatment of IAIs relative to a delayed operation.
基金supported by the Science and Technology Project of State Grid Shanxi Electric Power Research Institute:Research on Data-Driven New Power System Operation Simulation and Multi Agent Control Strategy(52053022000F).
文摘Due to the impact of source-load prediction power errors and uncertainties,the actual operation of the park will have a wide range of fluctuations compared with the expected state,resulting in its inability to achieve the expected economy.This paper constructs an operating simulation model of the park power grid operation considering demand response and proposes a multi-time scale operating simulation method that combines day-ahead optimization and model predictive control(MPC).In the day-ahead stage,an operating simulation plan that comprehensively considers the user’s side comfort and operating costs is proposed with a long-term time scale of 15 min.In order to cope with power fluctuations of photovoltaic,wind turbine and conventional load,MPC is used to track and roll correct the day-ahead operating simulation plan in the intra-day stage to meet the actual operating operation status of the park.Finally,the validity and economy of the operating simulation strategy are verified through the analysis of arithmetic examples.
基金supported by National Natural Science Foundation of China (No. 12075276)partly by the Comprehensive Research Facility for Fusion Technology Program of China (No. 2018000052-73-01-001228)。
文摘In recent decades, tokamak discharges with zero total toroidal current have been reported in tokamak experiments, and this is one of the key problems in alternating current(AC) operations.An efficient free-boundary equilibrium code is developed to investigate such advanced tokamak discharges with current reversal equilibrium configuration. The calculation results show that the reversal current equilibrium can maintain finite pressure and also has considerable effects on the position of the X-point and the magnetic separatrix shape, and hence also on the position of the strike point on the divertor plates, which is extremely useful for magnetic design, MHD stability analysis, and experimental data analysis etc. for the AC plasma current operation on tokamaks.
基金Supported by National Natural Science Foundation Joint Fund Project(U21B2071)National Natural Science Foundation of China(52174033)National Natural Science Youth Foundation of China(52304041).
文摘Based on the elastic theory of porous media,embedded discrete fracture model and finite volume method,and considering the micro-seepage mechanism of shale gas,a fully coupled seepage-geomechanical model suitable for fractured shale gas reservoirs is established,the optimization method of refracturing timing is proposed,and the influencing factors of refracturing timing are analyzed based on the data from shale gas well in Fuling of Sichuan Basin.The results show that due to the depletion of formation pressure,the percentage of the maximum horizontal principal stress reversal area in the total area increases and then decreases with time.The closer the area is to the hydraulic fracture,the shorter the time for the peak of the stress reversal area percentage curve to appear,and the shorter the time for the final zero return(to the initial state).The optimum time of refracturing is affected by matrix permeability,initial stress difference and natural fracture approach angle.The larger the matrix permeability and initial stress difference is,the shorter the time for stress reversal area percentage curve to reach peak and return to the initial state,and the earlier the time to take refracturing measures.The larger the natural fracture approach angle is,the more difficult it is for stress reversal to occur near the fracture,and the earlier the optimum refracturing time is.The more likely the stress reversal occurs at the far end of the artificial fracture,the later the optimal time of refracturing is.Reservoirs with low matrix permeability have a rapid decrease in single well productivity.To ensure economic efficiency,measures such as shut-in or gas injection can be taken to restore the stress,and refracturing can be implemented in advance.
文摘BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to enhance the psychological well-being and overall quality of life for primipara,while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum.AIM To explore the effect of timing theory combined with behavior change on selfefficacy,negative emotions and quality of life in patients with primipara.METHODS A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022.These cases were divided into two groups,namely the observation group and the control group,with 40 cases in each group.The nursing interventions differed between the two groups,with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change.The study aimed to compare the pre-and post-nursing scores of Chinese Perceived Stress Scale(CPSS),Edinburgh Postpartum Depression Scale(EPDS),Self-rating Anxiety Scale(SAS),breast milk knowledge,self-efficacy,and SF-36 quality of life in both groups.RESULTS After nursing,the CPSS,EPDS,and SAS scores of the two groups was significantly lower than that before nursing,and the CPSS,EPDS,and SAS scores of the observation group was significantly lower than that of the control group(P=0.002,P=0.011,and P=0.001 respectively).After nursing,the breastfeeding knowledge mastery,selfefficacy,and SF-36 quality of life scores was significantly higher than that before nursing,and the breastfeeding knowledge mastery(P=0.013),self-efficacy(P=0.008),and SF-36 quality of life(P=0.011)scores of the observation group was significantly higher than that of the control group.CONCLUSION The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals,while also enhancing their selfefficacy and overall quality of life.This study focuses on the key concepts of timing theory,behavior change,primipara individuals,negative mood,and quality of life.
基金supported in part by the National Key Research and Development Program of China(2021YFC2902703)the National Natural Science Foundation of China(62173078,61773105,61533007,61873049,61873053,61703085,61374147)。
文摘Concentrate copper grade(CCG)is one of the important production indicators of copper flotation processes,and keeping the CCG at the set value is of great significance to the economic benefit of copper flotation industrial processes.This paper addresses the fluctuation problem of CCG through an operational optimization method.Firstly,a density-based affinity propagationalgorithm is proposed so that more ideal working condition categories can be obtained for the complex raw ore properties.Next,a Bayesian network(BN)is applied to explore the relationship between the operational variables and the CCG.Based on the analysis results of BN,a weighted Gaussian process regression model is constructed to predict the CCG that a higher prediction accuracy can be obtained.To ensure the predicted CCG is close to the set value with a smaller magnitude of the operation adjustments and a smaller uncertainty of the prediction results,an index-oriented adaptive differential evolution(IOADE)algorithm is proposed,and the convergence performance of IOADE is superior to the traditional differential evolution and adaptive differential evolution methods.Finally,the effectiveness and feasibility of the proposed methods are verified by the experiments on a copper flotation industrial process.
文摘We describe a 63-year-old male who appears to have undergone an early form of the arterial switch operation for D-transposition of the great arteries performed in the mid-1960s.We review the clinical and imaging data that support our conclusion.He had a diagnostic cardiac catheterization which demonstrated severe pulmonary hypertension responsive to epoprostenol and oxygen.Our case may represent one example of the experimental surgical work done prior to Dr.Adibe Jatene’s description of thefirst successful arterial switch performed in 1975.
文摘The weapon and equipment operational requirement analysis(WEORA) is a necessary condition to win a future war,among which the acquisition of knowledge about weapons and equipment is a great challenge. The main challenge is that the existing weapons and equipment data fails to carry out structured knowledge representation, and knowledge navigation based on natural language cannot efficiently support the WEORA. To solve above problem, this research proposes a method based on question answering(QA) of weapons and equipment knowledge graph(WEKG) to construct and navigate the knowledge related to weapons and equipment in the WEORA. This method firstly constructs the WEKG, and builds a neutral network-based QA system over the WEKG by means of semantic parsing for knowledge navigation. Finally, the method is evaluated and a chatbot on the QA system is developed for the WEORA. Our proposed method has good performance in the accuracy and efficiency of searching target knowledge, and can well assist the WEORA.
文摘BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P<0.05).Further,the proportion of patients with at least one organ dysfunction in group A was significantly lower than those in groups B and groups C(41.57%vs 70.91%and 75.00%,P<0.05).The mortality rates in group A,group B,and group C were similar(P>0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than those in groups B and group C(24.50±4.16 d vs 35.54±6.62 d and 38.89±7.10 d,P<0.05).The hospitalization expenses in group A were also significantly lower than those in groups B and groups C[2.70(1.20,3.55)ten-thousand-yuan vs 5.50(2.98,7.12)ten-thousand-yuan and 6.00(3.10,8.05)ten-thousand-yuan,P<0.05).The incidence of complications in group A was markedly lower than that in group C(5.62%vs 25.00%,P<0.05),and similar to group B(P>0.05).CONCLUSION Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is most effective when performed within 2 d of onset.
文摘Background: The optimal time to closure of a newborn with a myelomeningocele has been the focus of a number of evaluations. The Timing of primary surgery has received significant attention due to its relationship to repair-site infection that can lead to increased morbidity and prolonged hospital stays. It is on this basis that recommendations have utilized 48 - 72 hours post birth as ideal time of closure. This is not only prevent infection at the site but also prevent ventriculitis and neural structure damage. We therefore, hypothesized an increase in wound infection rates in those patients with delays in myelomeningocele repair. Methods: We retrospectively reviewed the records of 103 children with myelomeningocele treated between 2016 and 2023. At discharge the patients were followed up at the post-operative clinic visit 2 weeks later. Children were assigned to 1 of 2 groups, those who underwent primary neurosurgical repair within 72 hours of delivery (Group 1) and those undergoing repair after 72 hours (Group 2). We compared the infection rates. Results: 103 children who underwent myelomeningocele repair were identified, with a median time from birth to treatment of 1 day. Eight (7.8 %) patients were noted to have post-repair surgical site complications. There was no significant difference in rates of infection between Group 1 and Group 2 repair times. The presence of infection was associated increased length of stay when compared to neonates without infection. Conclusion: In children with myelomeningocele, the timing of primary neurosurgical repair appears not to have a significant impact on surgical site infection. Closure of the spinal lesion within the first 72 hours of life may be more favorable for neural damage prevention. These results suggest that early myelomeningocele repair may not impart significantly on the rate of wound-site infection.
文摘With the advent of Industry 4.0, smart construction sites have seen significant development in China. However, accidents involving digitized tower cranes continue to be a persistent issue. Among the contributing factors, human unsafe behavior stands out as a primary cause for these incidents. This study aims to assess the human reliability of tower crane operations on smart construction sites. To proactively enhance safety measures, the research employs text mining techniques (TF-IDF-Truncated SVD-Complement NB) to identify patterns of human errors among tower crane operators. Building upon the SHEL model, the study categorizes behavioral factors affecting human reliability in the man-machine interface, leading to the establishment of the Performance Shaping Factors (PSFs) system. Furthermore, the research constructs an error impact indicator system for the intelligent construction site tower crane operator interface. Using the DEMATEL method, it analyzes the significance of various factors influencing human errors in tower crane operations. Additionally, the ISM-MICMAC method is applied to unveil the hierarchical relationships and driving-dependent connections among these influencing factors. The findings indicate that personal state, operating procedures, and physical environment directly impact human errors, while personal capability, technological environment, and one fundamental organizational management factor contribute indirectly. .
文摘This article proposes a comprehensive monitoring system for tunnel operation to address the risks associated with tunnel operations.These risks include safety control risks,increased traffic flow,extreme weather events,and movement of tectonic plates.The proposed system is based on the Internet of Things and artificial intelligence identification technology.The monitoring system will cover various aspects of tunnel operations,such as the slope of the entrance,the structural safety of the cave body,toxic and harmful gases that may appear during operation,excessively high and low-temperature humidity,poor illumination,water leakage or road water accumulation caused by extreme weather,combustion and smoke caused by fires,and more.The system will enable comprehensive monitoring and early warning of fire protection systems,accident vehicles,and overheating vehicles.This will effectively improve safety during tunnel operation.
文摘Objective:To explore the clinical benefits achieved by implementing the operating room nursing cooperation path for patients undergoing laparoscopic hysterectomy.Methods:64 laparoscopic hysterectomy cases were divided into groups according to the order of admission.The control group received routine perioperative care.The observation group implemented the nursing cooperation path in the operating room on the same basis as the control group.The two groups’physiological responses,stimulus indicators,anxiety,and complication rates were compared.Results:The heart rate,blood pressure 0.5 hours after surgery,anxiety scores 1 day before and 3 days after surgery,and the total number of complications in the observation group were all lower than those in the control group(P<0.05).Conclusion:The development of a nursing cooperation path in the operating room can help patients undergoing laparoscopic hysterectomy reduce heart rate,blood pressure,stress responses,and the risk of complications,and is worthy of promotion.
文摘BACKGROUND Endoscopic submucosal dissection(ESD)is a treatment for early gastric cancer with the advantages of small invasion,fewer complications,and a low local recurrence rate.However,there is a high risk of complications such as bleeding and perforation,and the operation time is also longer.ESD operation time is closely related to bleeding and perforation.AIM To investigate the influencing factors associated with ESD operation time and postoperative delayed hemorrhage to provide a reference for early planning,early identification,and prevention of complications.METHODS We conducted a retrospective study based on the clinical data of 520 patients with early gastric cancer in the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2021.The baseline data,clinical features,and endoscopic and pathological characteristics of patients were collected.The multivariate linear regression model was used to investigate the influencing factors of ESD operation time.Logistic regression analysis was carried out to evaluate the influencing factors of postoperative delayed hemorrhage.RESULTS The multivariate analysis of ESD operation time showed that the maximum lesion diameter could affect 8.815%of ESD operation time when other influencing factors remained unchanged.The operation time increased by 3.766%or 10.247%if the lesion was mixed or concave.The operation time increased by 4.417%if combined with an ulcer or scar.The operation time increased by 3.692%if combined with perforation.If infiltrated into the submucosa,it increased by 2.536%.Multivariate analysis of delayed hemorrhage after ESD showed that the maximum diameter of the lesion,lesion morphology,and ESD operation time were independent influencing factors for delayed hemorrhage after ESD.Patients with lesion≥3.0 cm(OR=3.785,95%CI:1.165-4.277),lesion morphology-concave(OR=10.985,95%CI:2.133-35.381),and ESD operation time≥60 min(OR=2.958,95%CI:1.117-3.526)were prone to delayed hemorrhage after ESD.CONCLUSION If the maximum diameter of the lesion in patients with early gastric cancer is≥3.0 cm,and the shape of the lesion is concave,or accompanied by an ulcer or scar,combined with perforation,and infiltrates into the submucosa,the ESD operation will take a longer time.When the maximum diameter of the lesion is≥3.0 cm,the shape of the lesion is concave in patients and the operation time of ESD takes longer time,the risk of delayed hemorrhage after ESD is higher.
基金Supported by the National Natural Science Foundation of China
文摘This article reports on a retrospective analysis on 121 patients and a prospectivestudy on 21 patients with acute cholangitis of severe type(ACST)for a study on the timing se-lection of emergency operation for ACST.Twenty two clinical,biological,etiologic,pathologicand operative variables were analyzed.Simple regression revealed 11 factors with prognosticsignificance,but multivariate analysis detected only 6 factors with independent significance inpredicting mortality(age,mean blood pressure,generalized peritonitis,serum albumin-globin ra-tio,blood culture,and the number of failed organs and systems).The results indicate that theclinical principles of treatment for ACST should be the combination of medical and surgicaltreatment.Active conservative treatment is practically applicable to the majority of ACST,espe-cially,those with short history and few complication.Prognostic mathematical model of ACSTdoes good for its timing selection of emergency operation.A critical level of 0.40 is determinedto be the discriminant score for emergency bile duct drainage.The model seems to have advan-tages over the traditional method.
基金supported by a grant from the National Natural Science Foundation of China(31971249).
文摘Radical operation for hilar cholangiocarcinoma(HCCA)is the most effective treatment,but high rates of severe postoperative complication and death remain concerns due to the complexity of biliary and vascular anatomy of the hepatobiliary region.De-layed arterial hemorrhage(DAH)occurring>24 h postoperatively usually causes life-threatening bleeding,and relaparotomy for DAH would be difficult and hazardous because of postoperative adhe-sions and critical general condition.As endovascular technique is less invasive and has improved over the recent decades,clini-cians have begun to prefer endovascular treatment(EVT)to surgi-cal treatment of DAH after hepatobiliary pancreatic surgery.How-ever,to our knowledge,a relatively large series of patients dealing with the outcomes of EVT of DAH after surgery for HCCA has not been reported.Herein,we analyzed the technical and clinical out-comes of EVT in 17 patients to evaluate the efficacy and safety of EVT.
基金the National Key Research and Development Program(2021YFC2501106)the Key Discipline Construction Project of Chinese PLA Medical College during the 13^(th) Five-Year Plan Period(A350109).
文摘Patent foramen ovale(PFO)is a remnant of normal fetal anatomy,which occurs in about 20%–25%of cases.Patients with PFO are at increased risk for migraine,acute limb ischemia secondary to emboli and cryptogenic(no other identifiable cause)stroke.The traditional approach has been to use a fluoroscopically guided blocking device,but this is contraindicated in patients with severe allergies to contrast media or inability to undergo angiography.With the advancements in technology,ultrasonic robotic systems have become available for medical procedures.In the current study,we reported a case of using the ultrasonic robotic teleoperation system to achieve closure of PFO at the Chinese PLA General Hospital,Beijing,China.
基金supported by the State Grid Science and Technology Project (No.52999821N004)。
文摘This study proposes a combined hybrid energy storage system(HESS) and transmission grid(TG) model, and a corresponding time series operation simulation(TSOS) model is established to relieve the peak-shaving pressure of power systems under the integration of renewable energy. First, a linear model for the optimal operation of the HESS is established, which considers the different power-efficiency characteristics of the pumped storage system, electrochemical storage system, and a new type of liquid compressed air energy storage. Second, a TSOS simulation model for peak shaving is built to maximize the power entering the grid from the wind farms and HESS. Based on the proposed model, this study considers the transmission capacity of a TG. By adding the power-flow constraints of the TG, a TSOS-based HESS and TG combination model for peak shaving is established. Finally, the improved IEEE-39 and IEEE-118 bus systems were considered as examples to verify the effectiveness and feasibility of the proposed model.