Objective Previous studies on adakitic rocks with high Sr/Y and La/Yb ratios have established that such rocks may form in a variety of tectonic settings through different petrogenetic processes including:(1)partial me...Objective Previous studies on adakitic rocks with high Sr/Y and La/Yb ratios have established that such rocks may form in a variety of tectonic settings through different petrogenetic processes including:(1)partial melting of subducted young(<25 Ma),hot and hydrated oceanic slab;(2)partial melting of thickened lower crust;(3)assimilation and fractional crystallization processes involving basaltic magma;(4)partial melting of delaminated lower crust;and(5)partial melting of hydrous garnet peridotite.The various origins for展开更多
PEG (Polyethylene glycol average molecular weight 300) is used as absorbent of NO2. The absorption efficiency is found to reach up to 97%. The absorbing product, PEG NO2, can be used to cleave benzyl ethers mildly and...PEG (Polyethylene glycol average molecular weight 300) is used as absorbent of NO2. The absorption efficiency is found to reach up to 97%. The absorbing product, PEG NO2, can be used to cleave benzyl ethers mildly and selectively to benzaldehyde and corresponding fatty alcohols, showing that PEG is a valuable oxidizing agent of benzyl ethers. As a carrier of NO2.PEG can be recovered and utilized repeatedly after the oxidation.展开更多
Objective To explore the relevant risk factors of tramatic arthritis resulting from the surgery of acetabular fractures. Methods From January 2000 to January 2009,88 patients aged from 20 to 60 years old with acetabul...Objective To explore the relevant risk factors of tramatic arthritis resulting from the surgery of acetabular fractures. Methods From January 2000 to January 2009,88 patients aged from 20 to 60 years old with acetabular fractures展开更多
In this editorial I comment on the article by Ahmed et al published in a recent issue of the World J Orthop 2023;14:784-790.It is well known that patients who have undergone a liver transplant(LT)may need to have a to...In this editorial I comment on the article by Ahmed et al published in a recent issue of the World J Orthop 2023;14:784-790.It is well known that patients who have undergone a liver transplant(LT)may need to have a total hip arthroplasty(THA)or total knee arthroplasty(TKA)implanted.Ahmed et al stated that the mortality rate in these patients was similar to the one of the general population.However,there are three articles previously published that found higher mortality in LT patients who experienced THA/TKA than in the general population(individuals without LT).Therefore,in this Editorial I would like to point out that there is controversy in the literature regarding whether LT patients undergoing THA/TKA have higher mortality than the general population.Therefore,future research should attempt to resolve this controversy.展开更多
BACKGROUND Gastric cancer(GC)is prevalent and aggressive,especially when patients have distant lung metastases,which often places patients into advanced stages.By identifying prognostic variables for lung metastasis i...BACKGROUND Gastric cancer(GC)is prevalent and aggressive,especially when patients have distant lung metastases,which often places patients into advanced stages.By identifying prognostic variables for lung metastasis in GC patients,it may be po-ssible to construct a good prediction model for both overall survival(OS)and the cumulative incidence prediction(CIP)plot of the tumour.AIM To investigate the predictors of GC with lung metastasis(GCLM)to produce nomograms for OS and generate CIP by using cancer-specific survival(CSS)data.METHODS Data from January 2000 to December 2020 involving 1652 patients with GCLM were obtained from the Surveillance,epidemiology,and end results program database.The major observational endpoint was OS;hence,patients were se-parated into training and validation groups.Correlation analysis determined va-rious connections.Univariate and multivariate Cox analyses validated the independent predictive factors.Nomogram distinction and calibration were performed with the time-dependent area under the curve(AUC)and calibration curves.To evaluate the accuracy and clinical usefulness of the nomograms,decision curve analysis(DCA)was performed.The clinical utility of the novel prognostic model was compared to that of the 7th edition of the American Joint Committee on Cancer(AJCC)staging system by utilizing Net Reclassification Improvement(NRI)and Integrated Discrimination Improvement(IDI).Finally,the OS prognostic model and Cox-AJCC risk stratification model modified for the AJCC system were compared.RESULTS For the purpose of creating the OS nomogram,a CIP plot based on CSS was generated.Cox multivariate regression analysis identified eleven significant prognostic factors(P<0.05)related to liver metastasis,bone metastasis,primary site,surgery,regional surgery,treatment sequence,chemotherapy,radiotherapy,positive lymph node count,N staging,and time from diagnosis to treatment.It was clear from the DCA(net benefit>0),time-de-pendent ROC curve(training/validation set AUC>0.7),and calibration curve(reliability slope closer to 45 degrees)results that the OS nomogram demonstrated a high level of predictive efficiency.The OS prediction model(New Model AUC=0.83)also performed much better than the old Cox-AJCC model(AUC difference between the new model and the old model greater than 0)in terms of risk stratification(P<0.0001)and verification using the IDI and NRI.CONCLUSION The OS nomogram for GCLM successfully predicts 1-and 3-year OS.Moreover,this approach can help to ap-propriately classify patients into high-risk and low-risk groups,thereby guiding treatment.展开更多
In view of the problems of inconsistent data semantics,inconsistent data formats,and difficult data quality assurance between the railway engineering design phase and the construction and operation phase,as well as th...In view of the problems of inconsistent data semantics,inconsistent data formats,and difficult data quality assurance between the railway engineering design phase and the construction and operation phase,as well as the difficulty in fully realizing the value of design results,this paper proposes a design and implementation scheme for a railway engineering collaborative design platform.The railway engineering collaborative design platform mainly includes functional modules such as metadata management,design collaboration,design delivery management,model component library,model rendering services,and Building Information Modeling(BIM)application services.Based on this,research is conducted on multi-disciplinary parameterized collaborative design technology for railway engineering,infrastructure data management and delivery technology,and design multi-source data fusion and application technology.The railway engineering collaborative design platform is compared with other railway design software to further validate its advantages and advanced features.The platform has been widely applied in multiple railway construction projects,greatly improving the design and project management efficiency.展开更多
Purpose: Surgical treatment of chronic anterior shoulder instability is a difficult therapeutic challenge for contact athletes. The aim of our study is to evaluate the clinical and radiological results of 40 cases of ...Purpose: Surgical treatment of chronic anterior shoulder instability is a difficult therapeutic challenge for contact athletes. The aim of our study is to evaluate the clinical and radiological results of 40 cases of chronic anterior shoulder instability treated in our institution by Latarjet technique. Methods: We report our experience with the intervention of Latarjet modified by the analysis of a retrospective study of 40 cases. They were all young athletic men, with an average age of 29 years with a predominance of the dominant shoulder. Results: Eighty percent had bone lesions, the first dislocation being traumatic (plating). One patient had a recurrence of his instability due to a new trauma and 67% resumed sport within an average period of eight months, some of whom still had functional discomfort in sports practice (9 patients). After an average follow-up of 75 months, 93% of patients were satisfied with their intervention. Only two mechanical complications were observed. Conclusion: Chronic anterior shoulder instability is pathology of young and active subjects. The preregulenoid coracoid block according to Latarjet represents the therapeutic method of choice in the treatment of chronic anterior instabilities of the shoulder, especially in young and athletic subjects. The result of this intervention remains good despite the complications that can occur such as pseudarthrosis, osteoarthritis, lysis or mobility of the screw.展开更多
Introduction: The aim of this study was to report the indications and evaluate the results of vulvectomy in the general surgery department of Ignace Deen Hospital, CHU Conakry. Materials and Methods: This was a retros...Introduction: The aim of this study was to report the indications and evaluate the results of vulvectomy in the general surgery department of Ignace Deen Hospital, CHU Conakry. Materials and Methods: This was a retrospective descriptive study, conducted over a period of five (05) years from January 1, 2018 to December 31, 2022, in the general surgery department of Ignace Deen Hospital, CHU Conakry. We included in our study all patient records in whom vulvectomy was performed. Results: We recorded 15 cases of vulvectomy out of 453 perineal surgeries, i.e. 3.31%, with a mean age of 43.56 years and extremes of 35 and 69 years. Vulvar cancer was the most common diagnosis (46.67%), followed by Buschke-Lowenstein (33.33%) and anal canal cancer extending to the vulva (20%). Six patients had undergone biopsy (40%). Vulvectomy with lymph node dissection was performed in only 9 patients (60%), and all surgical specimens were sent to anatomical pathology (100%). Conclusion: Vulvectomy is a surgical technique most often indicated for the treatment of vulvar cancer.展开更多
Research on the use of EHR is contradictory since it presents contradicting results regarding the time spent documenting. There is research that supports the use of electronic records as a tool to speed documentation;...Research on the use of EHR is contradictory since it presents contradicting results regarding the time spent documenting. There is research that supports the use of electronic records as a tool to speed documentation;and research that found that it is time consuming. The purpose of this quantitative retrospective before-after project was to measure the impact of using the laboratory value flowsheet within the EHR on documentation time. The research question was: “Does the use of a laboratory value flowsheet in the EHR impact documentation time by primary care providers (PCPs)?” The theoretical framework utilized in this project was the Donabedian Model. The population in this research was the two PCPs in a small primary care clinic in the northwest of Puerto Rico. The sample was composed of all the encounters during the months of October 2019 and December 2019. The data was obtained through data mining and analyzed using SPSS 27. The evaluative outcome of this project is that there is a decrease in documentation time after implementation of the use of the laboratory value flowsheet in the EHR. However, patients per day increase therefore having an impact on the number of patients seen per day/week/month. The implications for clinical practice include the use of templates to improve workflow and documentation as well as decreasing documentation time while also increasing the number of patients seen per day. .展开更多
The Atlantic Meridional Overturning Circulation(AMOC)is a crucial component of the Earth’s climate system due to its fundamental role in heat distribution,carbon and oxygen transport,and the weather.Other climate com...The Atlantic Meridional Overturning Circulation(AMOC)is a crucial component of the Earth’s climate system due to its fundamental role in heat distribution,carbon and oxygen transport,and the weather.Other climate components,such as the atmosphere and sea ice,influence the AMOC.Evaluating the physical mechanisms of those interactions is paramount to increasing knowledge about AMOC’s functioning.In this study,the authors used outputs from the Community Earth System Model version 2 and observational data to investigate changes in theAMOC and the associated physical processes.Two DECK experiments were evaluated:piControl and 1pctCO_(2),with an annual increase of 1%of atmospheric CO_(2).The analysis revealed a significant decrease in the AMOC,associated with changes in mixed layer depth and buoyancy in high latitudes of the North Atlantic,resulting in the shutdown of deep convection and potentially affecting the formation of North Atlantic Deep Water and Antarctic Bottom Water.A vital aspect observed in this study is the association between increased runoff and reduced water evaporation,giving rise to a positive feedback process.Consequently,the rates of freshwater spreading have intensified during this period,which could lead to an accelerated disruption of the AMOC beyond the projections of existing models.展开更多
Objective:The purpose of this study was to evaluate the functional and patient-reported outcomes,and their correlation,after percutaneous bone-anchored hearing aid(BAHA)implantation.Methods:A prospective study was con...Objective:The purpose of this study was to evaluate the functional and patient-reported outcomes,and their correlation,after percutaneous bone-anchored hearing aid(BAHA)implantation.Methods:A prospective study was conducted between January 2018 and December 2020 in a tertiary care center.All adult patients who were implanted with a percutaneous BAHA device during this evaluation period were included in the study.Complete auditory function and patients reported outcome measures(PROMs)were assessed in the preoperative period and 6 months after the implant activation.The PROMs included a generic form(Medical Outcome Study 36 Short Form Healthy Survey(MOS SF-36)),and three disease-specific forms(Hearing Handicap Inventory(HHI),Satisfaction with Amplification in Daily Life Scale(SADLS),and Tinnitus Handicap Inventory(THI)).Results:Twenty-two patients with an average age of 53 years were included in the study.The overall functional gain with the BAHA in sound-field pure tone average(PTA)was 29 dB,with no statistically significant differences according to surgical indication(F(3,18)=2.319,p=0.110).The greater the preoperative air-bone gap,the greater the functional gain obtained(r=0.505,p<0.05).In the PROMs,we found a significant improvement in HHI scores(p<0.005)and a significant increase in overall SADLS scores(p<0.05)with the use of percutaneous BAHA devices.We did not verify any statistically significant correlation between functional and PROMs results.Conclusions:The BAHA is a safe and effective alternative hearing rehabilitation option in selected patients.The PROMs results prove patient's overall satisfaction.展开更多
This research aims to understand the fractional order dynamics of the deadly Nipah virus(NiV)disease.We focus on using piecewise derivatives in the context of classical and singular kernels of power operators in the C...This research aims to understand the fractional order dynamics of the deadly Nipah virus(NiV)disease.We focus on using piecewise derivatives in the context of classical and singular kernels of power operators in the Caputo sense to investigate the crossover behavior of the considered dynamical system.We establish some qualitative results about the existence and uniqueness of the solution to the proposed problem.By utilizing the Newtonian polynomials interpolation technique,we recall a powerful algorithm to interpret the numerical findings for the aforesaid model.Here,we remark that the said viral infection is caused by an RNA type virus which can transmit from animals and also from an infected person to person.Fruits bats which are also known as flying foxes are one of the sources of transmission of NiV disease.Here in this work,we investigate its transmission mechanism through some new concepts of fractional calculus for further analysis and prediction.We present the approximate results for different compartments using different fractional orders.By using the piecewise derivative concept,we detect the crossover ormulti-steps behavior in the transmission dynamics of the mentioned disease.Therefore,the considered form of the derivative is used to deal with problems exhibiting crossover behaviors.展开更多
This article studies a nonlinear fractional order Lotka-Volterra prey-predator type dynamical system.For the proposed study,we consider the model under the conformable fractional order derivative(CFOD).We investigate ...This article studies a nonlinear fractional order Lotka-Volterra prey-predator type dynamical system.For the proposed study,we consider the model under the conformable fractional order derivative(CFOD).We investigate the mentioned dynamical system for the existence and uniqueness of at least one solution.Indeed,Schauder and Banach fixed point theorems are utilized to prove our claim.Further,an algorithm for the approximate analytical solution to the proposed problem has been established.In this regard,the conformable fractional differential transform(CFDT)technique is used to compute the required results in the form of a series.Using Matlab-16,we simulate the series solution to illustrate our results graphically.Finally,a comparison of our solution to that obtained for the Caputo fractional order derivative via the perturbation method is given.展开更多
BACKGROUND Gallbladder mucinous adenocarcinoma(GBMAC)is a rare subtype of gallbladder adenocarcinoma(GBAC),with limited knowledge of its survival outcomes from small case series and single-center retrospective analysi...BACKGROUND Gallbladder mucinous adenocarcinoma(GBMAC)is a rare subtype of gallbladder adenocarcinoma(GBAC),with limited knowledge of its survival outcomes from small case series and single-center retrospective analysis.AIM To compare the clinicopathological characteristics of GBMAC with typical GBAC and its prognostic factors to gain insights into this field.METHODS This study was conducted using data from the Surveillance,Epidemiology,and End Results database,including cases of GBMAC and typical GBAC diagnosed from 2010 to 2017.The Pearson chi-square test or Fisher exact test was used to examine the differences in clinicopathological features between these two cohorts.In addition,propensity score matching(PSM)analysis was performed to balance the selection biases.Univariate and multivariate Cox hazards regression analyses were performed to determine independent prognostic factors for cancer-specic survival(CSS)and overall survival(OS).The Kaplan–Meier curves and log-rank tests were used to assess the OS and CSS of GBMAC and typical GBAC patients.RESULTS The clinicopathological and demographic characteristics of GBMAC were different from typical GBAC.They included a larger proportion of patients with unmarried status,advanced American Joint Committee on Cancer(AJCC)stage,higher T stage,higher N1 stage rate and lower N0 and N2 stage rates(P<0.05).Multivariate analyses demonstrated that surgery[OS:Hazard ratio(HR)=2.27,P=0.0037;CSS:HR=2.05,P=0.0151],chemotherapy(OS:HR=6.41,P<0.001;CSS:HR=5.24,P<0.001)and advanced AJCC stage(OS:Stage IV:HR=28.99,P=0.0046;CSS:Stage III:HR=12.31,P=0.015;stage IV:HR=32.69,P=0.0015)were independent prognostic indicators for OS and CSS of GBMAC patients.Furthermore,after PSM analysis,there was no significant difference between GBMAC and matched typical GBAC patients regarding OS(P=0.82)and CSS(P=0.69).CONCLUSION The biological behaviors of GBMAC are aggressive and significantly different from that of typical GBAC.However,they show similar survival prognoses.Surgery,chemotherapy,and lower AJCC stage were associated with better survival outcomes.Further research is needed in the future to verify these results.展开更多
BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)is a rare distinct subtype of precursor lesions of biliary carcinoma.IPNB is considered to originate from luminal biliary epithelial cells,typically disp...BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)is a rare distinct subtype of precursor lesions of biliary carcinoma.IPNB is considered to originate from luminal biliary epithelial cells,typically displays mucin-hypersecretion or a papillary growth pattern,and results in cystic dilatation[1].IPNB develops anywhere in the intrahepatic and extrahepatic biliary tracts,and can occur in various pathological stages from low-grade dysplasia to invasive carcinoma.IPNBs have similar phenotypic changes in the occurrence and development of all subtypes,and the prognosis is significantly better than that of traditional(nonpapillary)cholangiocarcinoma.AIM To evaluate the clinicopathological features of IPNB to provide evidence-based guidance for treatment.METHODS Invasive IPNB,invasive intraductal papillary mucinous neoplasm of the pancreas(IPMN),and traditional cholangiocarcinoma data for affected individuals from 1975 to 2016 were obtained from the Surveillance,Epidemiology,and End Results(SEER)database.Annual percentage changes(APCs)in the incidence and incidence-based(IB)mortality were calculated.We identified the independent predictors of overall survival(OS)and cancer-specific survival(CSS)in indivi duals with invasive IPNB.RESULTS The incidence and IB mortality of invasive IPNB showed sustained decreases,with an APC of-4.5%(95%CI:-5.1%to-3.8%)and-3.3%(95%CI:-4.1%to-2.6%)(P<0.001),respectively.Similar decreases in incidence and IB mortality were seen for invasive IPMN but not for traditional cholangiocarcinoma.Both OS and CSS for invasive IPNB were better than for invasive IPMN and traditional cholangiocarcinoma.A total of 1635 individuals with invasive IPNB were included in our prognosis analysis.The most common tumor sites were the pancreaticobiliary ampulla(47.9%)and perihilar tract(36.7%),but the mucin-related subtype of invasive IPNB was the main type,intrahepatically(approximately 90%).In the univariate and multivariate Cox regression analysis,age,tumor site,grade and stage,subtype,surgery,and chemotherapy were associated with OS and CSS(P<0.05).CONCLUSION Incidence and IB mortality of invasive IPNB trended steadily downward.The heterogeneity of IPNB comprises site and the tumor’s mucin-producing status.展开更多
Parameter calculation and result storage, as two necessary steps in phase-field simulation play an important role in ensuring the accuracy of simulation results. A strategy of parameter calculation and result storage ...Parameter calculation and result storage, as two necessary steps in phase-field simulation play an important role in ensuring the accuracy of simulation results. A strategy of parameter calculation and result storage is presented for phase-field simulation in α-Mg dendrite growth of Mg-5-wt% Zn alloy under isothermal solidification. Based on the phase diagram and empirical formulas, key parameters of the phase-field model, such as equilibrium partition coefficient k, liquidus slope m, solutal diffusion coefficient in liquid Dl, and solutal diffusion coefficient in solid Ds, can be obtained.Both structured grid method and structured point method can be used to store simulation results, but using the latter method will reduce about 60% storage space and 37.5% storage time compared with the former. Finally, convergent simulation results of α-Mg dendrite growth are obtained and they are in good agreement with the experimental results about optical micrograph, which verify the accuracy of parameters and stability of storage method.展开更多
Estimation of in situ stresses based on back-analysis of measured stress changes and displacements has become an alternative to the direct stress measurement methods.In order to help users conduct own measurement and ...Estimation of in situ stresses based on back-analysis of measured stress changes and displacements has become an alternative to the direct stress measurement methods.In order to help users conduct own measurement and analysis,this paper presents in detail a field stress back-analysis approach directly from borehole strain changes measured during nearby underground excavation.Essential formulations in major steps and the procedure for the entire analysis process are provided to allow users to follow.The instrument for borehole strain change measurement can be the CSIR or CSIRO stress cells and other borehole strain cells that can measure strains on borehole walls.Strain changes corresponding to the stress changes at a borehole location are calculated in borehole environment.The stress changes due to nearby excavation can be calculated by an analytical model for a single circular opening and simulated by a numerical model for non-circular and multiple openings.These models are based on isotropic,homogeneous and linear elastic assumptions.The analysis of borehole strain changes is accomplished by multiple linear regression based on error minimization and an integrated process provides the best-fit solution directly to the in situ stresses.A statistical technique is adopted for screening outliers in the measurement data,checking measurement compatibility and evaluating the reliability of analysis results.An application example is included to demonstrate the practical application and the analysis procedure.展开更多
This works intends to provide numerical solutions based on the nonlinear fractional order derivatives of the classical White and Comiskey model(NFD-WCM).The fractional order derivatives have provided authentic and acc...This works intends to provide numerical solutions based on the nonlinear fractional order derivatives of the classical White and Comiskey model(NFD-WCM).The fractional order derivatives have provided authentic and accurate solutions for the NDF-WCM.The solutions of the fractional NFD-WCM are provided using the stochastic computing supervised algorithm named Levenberg-Marquard Backpropagation(LMB)based on neural networks(NNs).This regression approach combines gradient descent and Gauss-Newton iterative methods,which means finding a solution through the sequences of different calculations.WCM is used to demonstrate the heroin epidemics.Heroin has been on-growth world wide,mainly in Asia,Europe,and the USA.It is the fourth foremost cause of death due to taking an overdose in the USA.The nonlinear mathematical system NFD-WCM discusses the overall circumstance of different drug users,such as suspected groups,drug users without treatment,and drug users with treatment.The numerical results of NFD-WCM via LMB-NNs have been substantiated through training,testing,and validation measures.The stability and accuracy are then checked through the statistical tool,such asmean square error(MSE),error histogram,and fitness curves.The suggested methodology’s strength is demonstrated by the high convergence between the reference solutions and the solutions generated by adding the efficacy of a constructed solver LMB-NNs,with accuracy levels ranging from 10?9 to 10?10.展开更多
In order to analyze the response of a hydraulic turbine to a variation in the operating conditions,different laws of variation in time of the massflow rate have been considered.After validating the overall numerical fr...In order to analyze the response of a hydraulic turbine to a variation in the operating conditions,different laws of variation in time of the massflow rate have been considered.After validating the overall numerical framework through comparison with relevant experiments,the performances of the considered turbine have been analyzed from afluid-dynamic point of view.The results show that different time profiles of the massflow rate(in this work,for simplicity,referred to as“transition functions”)have a varying influence on the transient behavior of the turbine.When a quadratic function is considered for the case of largeflow,the transient head and torque increase gradually with time,thefluctuation amplitude of the transient hydraulic efficiency at the main frequency is the largest,and thefluctuation amplitude of the radial force is the smallest.For the smallflow case,the time profile with exponential nature leads to the best results.The transient head and torque decrease gradually with time,the pulsation amplitude of the transient hydraulic efficiency is the largest at the main frequency,and the pulsation amplitude of the radial force is the smallest.展开更多
基金financially supported by the National Nature Science Foundation of China(grant No. 41202037)
文摘Objective Previous studies on adakitic rocks with high Sr/Y and La/Yb ratios have established that such rocks may form in a variety of tectonic settings through different petrogenetic processes including:(1)partial melting of subducted young(<25 Ma),hot and hydrated oceanic slab;(2)partial melting of thickened lower crust;(3)assimilation and fractional crystallization processes involving basaltic magma;(4)partial melting of delaminated lower crust;and(5)partial melting of hydrous garnet peridotite.The various origins for
文摘PEG (Polyethylene glycol average molecular weight 300) is used as absorbent of NO2. The absorption efficiency is found to reach up to 97%. The absorbing product, PEG NO2, can be used to cleave benzyl ethers mildly and selectively to benzaldehyde and corresponding fatty alcohols, showing that PEG is a valuable oxidizing agent of benzyl ethers. As a carrier of NO2.PEG can be recovered and utilized repeatedly after the oxidation.
文摘Objective To explore the relevant risk factors of tramatic arthritis resulting from the surgery of acetabular fractures. Methods From January 2000 to January 2009,88 patients aged from 20 to 60 years old with acetabular fractures
文摘In this editorial I comment on the article by Ahmed et al published in a recent issue of the World J Orthop 2023;14:784-790.It is well known that patients who have undergone a liver transplant(LT)may need to have a total hip arthroplasty(THA)or total knee arthroplasty(TKA)implanted.Ahmed et al stated that the mortality rate in these patients was similar to the one of the general population.However,there are three articles previously published that found higher mortality in LT patients who experienced THA/TKA than in the general population(individuals without LT).Therefore,in this Editorial I would like to point out that there is controversy in the literature regarding whether LT patients undergoing THA/TKA have higher mortality than the general population.Therefore,future research should attempt to resolve this controversy.
基金Supported by Peng-Cheng Talent-Medical Young Reserve Talent Training Program,No.XWRCHT20220002Xuzhou City Health and Health Commission Technology Project Contract,No.XWKYHT20230081and Key Research and Development Plan Project of Xuzhou City,No.KC22179.
文摘BACKGROUND Gastric cancer(GC)is prevalent and aggressive,especially when patients have distant lung metastases,which often places patients into advanced stages.By identifying prognostic variables for lung metastasis in GC patients,it may be po-ssible to construct a good prediction model for both overall survival(OS)and the cumulative incidence prediction(CIP)plot of the tumour.AIM To investigate the predictors of GC with lung metastasis(GCLM)to produce nomograms for OS and generate CIP by using cancer-specific survival(CSS)data.METHODS Data from January 2000 to December 2020 involving 1652 patients with GCLM were obtained from the Surveillance,epidemiology,and end results program database.The major observational endpoint was OS;hence,patients were se-parated into training and validation groups.Correlation analysis determined va-rious connections.Univariate and multivariate Cox analyses validated the independent predictive factors.Nomogram distinction and calibration were performed with the time-dependent area under the curve(AUC)and calibration curves.To evaluate the accuracy and clinical usefulness of the nomograms,decision curve analysis(DCA)was performed.The clinical utility of the novel prognostic model was compared to that of the 7th edition of the American Joint Committee on Cancer(AJCC)staging system by utilizing Net Reclassification Improvement(NRI)and Integrated Discrimination Improvement(IDI).Finally,the OS prognostic model and Cox-AJCC risk stratification model modified for the AJCC system were compared.RESULTS For the purpose of creating the OS nomogram,a CIP plot based on CSS was generated.Cox multivariate regression analysis identified eleven significant prognostic factors(P<0.05)related to liver metastasis,bone metastasis,primary site,surgery,regional surgery,treatment sequence,chemotherapy,radiotherapy,positive lymph node count,N staging,and time from diagnosis to treatment.It was clear from the DCA(net benefit>0),time-de-pendent ROC curve(training/validation set AUC>0.7),and calibration curve(reliability slope closer to 45 degrees)results that the OS nomogram demonstrated a high level of predictive efficiency.The OS prediction model(New Model AUC=0.83)also performed much better than the old Cox-AJCC model(AUC difference between the new model and the old model greater than 0)in terms of risk stratification(P<0.0001)and verification using the IDI and NRI.CONCLUSION The OS nomogram for GCLM successfully predicts 1-and 3-year OS.Moreover,this approach can help to ap-propriately classify patients into high-risk and low-risk groups,thereby guiding treatment.
基金supported by the National Key Research and Development Program of China(2021YFB2600405).
文摘In view of the problems of inconsistent data semantics,inconsistent data formats,and difficult data quality assurance between the railway engineering design phase and the construction and operation phase,as well as the difficulty in fully realizing the value of design results,this paper proposes a design and implementation scheme for a railway engineering collaborative design platform.The railway engineering collaborative design platform mainly includes functional modules such as metadata management,design collaboration,design delivery management,model component library,model rendering services,and Building Information Modeling(BIM)application services.Based on this,research is conducted on multi-disciplinary parameterized collaborative design technology for railway engineering,infrastructure data management and delivery technology,and design multi-source data fusion and application technology.The railway engineering collaborative design platform is compared with other railway design software to further validate its advantages and advanced features.The platform has been widely applied in multiple railway construction projects,greatly improving the design and project management efficiency.
文摘Purpose: Surgical treatment of chronic anterior shoulder instability is a difficult therapeutic challenge for contact athletes. The aim of our study is to evaluate the clinical and radiological results of 40 cases of chronic anterior shoulder instability treated in our institution by Latarjet technique. Methods: We report our experience with the intervention of Latarjet modified by the analysis of a retrospective study of 40 cases. They were all young athletic men, with an average age of 29 years with a predominance of the dominant shoulder. Results: Eighty percent had bone lesions, the first dislocation being traumatic (plating). One patient had a recurrence of his instability due to a new trauma and 67% resumed sport within an average period of eight months, some of whom still had functional discomfort in sports practice (9 patients). After an average follow-up of 75 months, 93% of patients were satisfied with their intervention. Only two mechanical complications were observed. Conclusion: Chronic anterior shoulder instability is pathology of young and active subjects. The preregulenoid coracoid block according to Latarjet represents the therapeutic method of choice in the treatment of chronic anterior instabilities of the shoulder, especially in young and athletic subjects. The result of this intervention remains good despite the complications that can occur such as pseudarthrosis, osteoarthritis, lysis or mobility of the screw.
文摘Introduction: The aim of this study was to report the indications and evaluate the results of vulvectomy in the general surgery department of Ignace Deen Hospital, CHU Conakry. Materials and Methods: This was a retrospective descriptive study, conducted over a period of five (05) years from January 1, 2018 to December 31, 2022, in the general surgery department of Ignace Deen Hospital, CHU Conakry. We included in our study all patient records in whom vulvectomy was performed. Results: We recorded 15 cases of vulvectomy out of 453 perineal surgeries, i.e. 3.31%, with a mean age of 43.56 years and extremes of 35 and 69 years. Vulvar cancer was the most common diagnosis (46.67%), followed by Buschke-Lowenstein (33.33%) and anal canal cancer extending to the vulva (20%). Six patients had undergone biopsy (40%). Vulvectomy with lymph node dissection was performed in only 9 patients (60%), and all surgical specimens were sent to anatomical pathology (100%). Conclusion: Vulvectomy is a surgical technique most often indicated for the treatment of vulvar cancer.
文摘Research on the use of EHR is contradictory since it presents contradicting results regarding the time spent documenting. There is research that supports the use of electronic records as a tool to speed documentation;and research that found that it is time consuming. The purpose of this quantitative retrospective before-after project was to measure the impact of using the laboratory value flowsheet within the EHR on documentation time. The research question was: “Does the use of a laboratory value flowsheet in the EHR impact documentation time by primary care providers (PCPs)?” The theoretical framework utilized in this project was the Donabedian Model. The population in this research was the two PCPs in a small primary care clinic in the northwest of Puerto Rico. The sample was composed of all the encounters during the months of October 2019 and December 2019. The data was obtained through data mining and analyzed using SPSS 27. The evaluative outcome of this project is that there is a decrease in documentation time after implementation of the use of the laboratory value flowsheet in the EHR. However, patients per day increase therefore having an impact on the number of patients seen per day/week/month. The implications for clinical practice include the use of templates to improve workflow and documentation as well as decreasing documentation time while also increasing the number of patients seen per day. .
基金This work was possible through the financing of PEC-20480 Project between Royal Dutch Shell(Shell)and the Laboratório de Métodos Computacionais em Engenharia(LAMCE)and through the doctoral fellowship funding by CNPq for Elisa Passos Case number 141819/2016-2the postdoctoral fellowship funding by FAPERJ E 10/2020-Edital Inteligência Artificial Case Number E-26/203.327/2022-Enrollment No.Scholarship 2015.08297.7 for Lívia Sancho.
文摘The Atlantic Meridional Overturning Circulation(AMOC)is a crucial component of the Earth’s climate system due to its fundamental role in heat distribution,carbon and oxygen transport,and the weather.Other climate components,such as the atmosphere and sea ice,influence the AMOC.Evaluating the physical mechanisms of those interactions is paramount to increasing knowledge about AMOC’s functioning.In this study,the authors used outputs from the Community Earth System Model version 2 and observational data to investigate changes in theAMOC and the associated physical processes.Two DECK experiments were evaluated:piControl and 1pctCO_(2),with an annual increase of 1%of atmospheric CO_(2).The analysis revealed a significant decrease in the AMOC,associated with changes in mixed layer depth and buoyancy in high latitudes of the North Atlantic,resulting in the shutdown of deep convection and potentially affecting the formation of North Atlantic Deep Water and Antarctic Bottom Water.A vital aspect observed in this study is the association between increased runoff and reduced water evaporation,giving rise to a positive feedback process.Consequently,the rates of freshwater spreading have intensified during this period,which could lead to an accelerated disruption of the AMOC beyond the projections of existing models.
文摘Objective:The purpose of this study was to evaluate the functional and patient-reported outcomes,and their correlation,after percutaneous bone-anchored hearing aid(BAHA)implantation.Methods:A prospective study was conducted between January 2018 and December 2020 in a tertiary care center.All adult patients who were implanted with a percutaneous BAHA device during this evaluation period were included in the study.Complete auditory function and patients reported outcome measures(PROMs)were assessed in the preoperative period and 6 months after the implant activation.The PROMs included a generic form(Medical Outcome Study 36 Short Form Healthy Survey(MOS SF-36)),and three disease-specific forms(Hearing Handicap Inventory(HHI),Satisfaction with Amplification in Daily Life Scale(SADLS),and Tinnitus Handicap Inventory(THI)).Results:Twenty-two patients with an average age of 53 years were included in the study.The overall functional gain with the BAHA in sound-field pure tone average(PTA)was 29 dB,with no statistically significant differences according to surgical indication(F(3,18)=2.319,p=0.110).The greater the preoperative air-bone gap,the greater the functional gain obtained(r=0.505,p<0.05).In the PROMs,we found a significant improvement in HHI scores(p<0.005)and a significant increase in overall SADLS scores(p<0.05)with the use of percutaneous BAHA devices.We did not verify any statistically significant correlation between functional and PROMs results.Conclusions:The BAHA is a safe and effective alternative hearing rehabilitation option in selected patients.The PROMs results prove patient's overall satisfaction.
文摘This research aims to understand the fractional order dynamics of the deadly Nipah virus(NiV)disease.We focus on using piecewise derivatives in the context of classical and singular kernels of power operators in the Caputo sense to investigate the crossover behavior of the considered dynamical system.We establish some qualitative results about the existence and uniqueness of the solution to the proposed problem.By utilizing the Newtonian polynomials interpolation technique,we recall a powerful algorithm to interpret the numerical findings for the aforesaid model.Here,we remark that the said viral infection is caused by an RNA type virus which can transmit from animals and also from an infected person to person.Fruits bats which are also known as flying foxes are one of the sources of transmission of NiV disease.Here in this work,we investigate its transmission mechanism through some new concepts of fractional calculus for further analysis and prediction.We present the approximate results for different compartments using different fractional orders.By using the piecewise derivative concept,we detect the crossover ormulti-steps behavior in the transmission dynamics of the mentioned disease.Therefore,the considered form of the derivative is used to deal with problems exhibiting crossover behaviors.
文摘This article studies a nonlinear fractional order Lotka-Volterra prey-predator type dynamical system.For the proposed study,we consider the model under the conformable fractional order derivative(CFOD).We investigate the mentioned dynamical system for the existence and uniqueness of at least one solution.Indeed,Schauder and Banach fixed point theorems are utilized to prove our claim.Further,an algorithm for the approximate analytical solution to the proposed problem has been established.In this regard,the conformable fractional differential transform(CFDT)technique is used to compute the required results in the form of a series.Using Matlab-16,we simulate the series solution to illustrate our results graphically.Finally,a comparison of our solution to that obtained for the Caputo fractional order derivative via the perturbation method is given.
基金Supported by The National Key Research and Development Program of China,No.2021YFF1201300.
文摘BACKGROUND Gallbladder mucinous adenocarcinoma(GBMAC)is a rare subtype of gallbladder adenocarcinoma(GBAC),with limited knowledge of its survival outcomes from small case series and single-center retrospective analysis.AIM To compare the clinicopathological characteristics of GBMAC with typical GBAC and its prognostic factors to gain insights into this field.METHODS This study was conducted using data from the Surveillance,Epidemiology,and End Results database,including cases of GBMAC and typical GBAC diagnosed from 2010 to 2017.The Pearson chi-square test or Fisher exact test was used to examine the differences in clinicopathological features between these two cohorts.In addition,propensity score matching(PSM)analysis was performed to balance the selection biases.Univariate and multivariate Cox hazards regression analyses were performed to determine independent prognostic factors for cancer-specic survival(CSS)and overall survival(OS).The Kaplan–Meier curves and log-rank tests were used to assess the OS and CSS of GBMAC and typical GBAC patients.RESULTS The clinicopathological and demographic characteristics of GBMAC were different from typical GBAC.They included a larger proportion of patients with unmarried status,advanced American Joint Committee on Cancer(AJCC)stage,higher T stage,higher N1 stage rate and lower N0 and N2 stage rates(P<0.05).Multivariate analyses demonstrated that surgery[OS:Hazard ratio(HR)=2.27,P=0.0037;CSS:HR=2.05,P=0.0151],chemotherapy(OS:HR=6.41,P<0.001;CSS:HR=5.24,P<0.001)and advanced AJCC stage(OS:Stage IV:HR=28.99,P=0.0046;CSS:Stage III:HR=12.31,P=0.015;stage IV:HR=32.69,P=0.0015)were independent prognostic indicators for OS and CSS of GBMAC patients.Furthermore,after PSM analysis,there was no significant difference between GBMAC and matched typical GBAC patients regarding OS(P=0.82)and CSS(P=0.69).CONCLUSION The biological behaviors of GBMAC are aggressive and significantly different from that of typical GBAC.However,they show similar survival prognoses.Surgery,chemotherapy,and lower AJCC stage were associated with better survival outcomes.Further research is needed in the future to verify these results.
基金Supported by the National Natural Science Foundation of China,No. 81860431 and 82060447the Jiangxi Natural Science Foundation,No. 20181BBG70025
文摘BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)is a rare distinct subtype of precursor lesions of biliary carcinoma.IPNB is considered to originate from luminal biliary epithelial cells,typically displays mucin-hypersecretion or a papillary growth pattern,and results in cystic dilatation[1].IPNB develops anywhere in the intrahepatic and extrahepatic biliary tracts,and can occur in various pathological stages from low-grade dysplasia to invasive carcinoma.IPNBs have similar phenotypic changes in the occurrence and development of all subtypes,and the prognosis is significantly better than that of traditional(nonpapillary)cholangiocarcinoma.AIM To evaluate the clinicopathological features of IPNB to provide evidence-based guidance for treatment.METHODS Invasive IPNB,invasive intraductal papillary mucinous neoplasm of the pancreas(IPMN),and traditional cholangiocarcinoma data for affected individuals from 1975 to 2016 were obtained from the Surveillance,Epidemiology,and End Results(SEER)database.Annual percentage changes(APCs)in the incidence and incidence-based(IB)mortality were calculated.We identified the independent predictors of overall survival(OS)and cancer-specific survival(CSS)in indivi duals with invasive IPNB.RESULTS The incidence and IB mortality of invasive IPNB showed sustained decreases,with an APC of-4.5%(95%CI:-5.1%to-3.8%)and-3.3%(95%CI:-4.1%to-2.6%)(P<0.001),respectively.Similar decreases in incidence and IB mortality were seen for invasive IPMN but not for traditional cholangiocarcinoma.Both OS and CSS for invasive IPNB were better than for invasive IPMN and traditional cholangiocarcinoma.A total of 1635 individuals with invasive IPNB were included in our prognosis analysis.The most common tumor sites were the pancreaticobiliary ampulla(47.9%)and perihilar tract(36.7%),but the mucin-related subtype of invasive IPNB was the main type,intrahepatically(approximately 90%).In the univariate and multivariate Cox regression analysis,age,tumor site,grade and stage,subtype,surgery,and chemotherapy were associated with OS and CSS(P<0.05).CONCLUSION Incidence and IB mortality of invasive IPNB trended steadily downward.The heterogeneity of IPNB comprises site and the tumor’s mucin-producing status.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 52074246, 52275390, 52205429, and 52201146)the National Defense Basic Scientific Research Program of China (Grant Nos. JCKY2020408B002 and WDZC2022-12)+1 种基金the Science and Technology Major Project of Shanxi Province, China (Grant Nos. 20191102008 and 20191102007)the Guiding Local Science and Technology Development Projects by the Central Government, China (Grant Nos. YDZJSX2022A025 and YDZJSX2021A027)。
文摘Parameter calculation and result storage, as two necessary steps in phase-field simulation play an important role in ensuring the accuracy of simulation results. A strategy of parameter calculation and result storage is presented for phase-field simulation in α-Mg dendrite growth of Mg-5-wt% Zn alloy under isothermal solidification. Based on the phase diagram and empirical formulas, key parameters of the phase-field model, such as equilibrium partition coefficient k, liquidus slope m, solutal diffusion coefficient in liquid Dl, and solutal diffusion coefficient in solid Ds, can be obtained.Both structured grid method and structured point method can be used to store simulation results, but using the latter method will reduce about 60% storage space and 37.5% storage time compared with the former. Finally, convergent simulation results of α-Mg dendrite growth are obtained and they are in good agreement with the experimental results about optical micrograph, which verify the accuracy of parameters and stability of storage method.
文摘Estimation of in situ stresses based on back-analysis of measured stress changes and displacements has become an alternative to the direct stress measurement methods.In order to help users conduct own measurement and analysis,this paper presents in detail a field stress back-analysis approach directly from borehole strain changes measured during nearby underground excavation.Essential formulations in major steps and the procedure for the entire analysis process are provided to allow users to follow.The instrument for borehole strain change measurement can be the CSIR or CSIRO stress cells and other borehole strain cells that can measure strains on borehole walls.Strain changes corresponding to the stress changes at a borehole location are calculated in borehole environment.The stress changes due to nearby excavation can be calculated by an analytical model for a single circular opening and simulated by a numerical model for non-circular and multiple openings.These models are based on isotropic,homogeneous and linear elastic assumptions.The analysis of borehole strain changes is accomplished by multiple linear regression based on error minimization and an integrated process provides the best-fit solution directly to the in situ stresses.A statistical technique is adopted for screening outliers in the measurement data,checking measurement compatibility and evaluating the reliability of analysis results.An application example is included to demonstrate the practical application and the analysis procedure.
基金National Research Council of Thailand(NRCT)and Khon Kaen University:N42A650291.
文摘This works intends to provide numerical solutions based on the nonlinear fractional order derivatives of the classical White and Comiskey model(NFD-WCM).The fractional order derivatives have provided authentic and accurate solutions for the NDF-WCM.The solutions of the fractional NFD-WCM are provided using the stochastic computing supervised algorithm named Levenberg-Marquard Backpropagation(LMB)based on neural networks(NNs).This regression approach combines gradient descent and Gauss-Newton iterative methods,which means finding a solution through the sequences of different calculations.WCM is used to demonstrate the heroin epidemics.Heroin has been on-growth world wide,mainly in Asia,Europe,and the USA.It is the fourth foremost cause of death due to taking an overdose in the USA.The nonlinear mathematical system NFD-WCM discusses the overall circumstance of different drug users,such as suspected groups,drug users without treatment,and drug users with treatment.The numerical results of NFD-WCM via LMB-NNs have been substantiated through training,testing,and validation measures.The stability and accuracy are then checked through the statistical tool,such asmean square error(MSE),error histogram,and fitness curves.The suggested methodology’s strength is demonstrated by the high convergence between the reference solutions and the solutions generated by adding the efficacy of a constructed solver LMB-NNs,with accuracy levels ranging from 10?9 to 10?10.
基金This work is financially supported by Gansu Province Key Research and Development Plan Projects(20YF3GA019)Gansu Province Science and Technology Project(20JR5RA447,20JR10RA174,20JR10RA203)+1 种基金Gansu Province Colleges and Universities Industrial Support Program Projects(2020C-20)Key Laboratory of Fluid and Power Machinery,Ministry of Education,Xihua University(szjj2019-016,LTDL2020-007).
文摘In order to analyze the response of a hydraulic turbine to a variation in the operating conditions,different laws of variation in time of the massflow rate have been considered.After validating the overall numerical framework through comparison with relevant experiments,the performances of the considered turbine have been analyzed from afluid-dynamic point of view.The results show that different time profiles of the massflow rate(in this work,for simplicity,referred to as“transition functions”)have a varying influence on the transient behavior of the turbine.When a quadratic function is considered for the case of largeflow,the transient head and torque increase gradually with time,thefluctuation amplitude of the transient hydraulic efficiency at the main frequency is the largest,and thefluctuation amplitude of the radial force is the smallest.For the smallflow case,the time profile with exponential nature leads to the best results.The transient head and torque decrease gradually with time,the pulsation amplitude of the transient hydraulic efficiency is the largest at the main frequency,and the pulsation amplitude of the radial force is the smallest.
