The quality system of any modern pharmaceutical company is the pharmaceutical quality system(PQS),which extends the GMP standards to all stages of the medicinal productslife cycle,from pharmaceutical development to it...The quality system of any modern pharmaceutical company is the pharmaceutical quality system(PQS),which extends the GMP standards to all stages of the medicinal productslife cycle,from pharmaceutical development to its withdrawal from production.The principal difference between PQS and GxP rules from other quality systems is that the medicinal product,its safety and efficacy is put at the forefront.At the same time,PQS implies a process approach to all components that should be aimed at achieving the main goal—ensuring and guaranteeing the quality of the medicinal product for the end user(patient)—and should be based on the quality risk management system.An integral part of PQS,as well as the GxP rules adopted in the European Union and PIC/S,is a process for self-inspections and/or quality audits,which regularly appraises the effectiveness and applicability of the PQS.This publication is dedicated to the definition of self-inspections(internal audits)as one of the PQS’s processes.The article defines the main standard stages and develops a model of a risk-based approach to the self-inspections’planning in relation to processes of the pharmaceutical quality system.展开更多
In 1999, the first International Maritime Confere- nce on Design for Safety was successfully held in Glasgow, UK as a WEGEMT Euro Conference with the sponsorship of the European Commission. Respo- nding to the expecta...In 1999, the first International Maritime Confere- nce on Design for Safety was successfully held in Glasgow, UK as a WEGEMT Euro Conference with the sponsorship of the European Commission. Respo- nding to the expectation from the world maritime safety community, the second was held in 2004 in Japan. The third and fourth were held in USA, 2007 and Italy, 2010, respectively. This year the Design for Safety conference including a single event of the 4th Workshop on Risk-Based Approaches in the Marine Industries will be held in Shanghai on November 25- 27, 2013. The conference is organized by Shanghai Jiao Tong University and is co-organized/sponsored by Marine Design and Research Institute of China （MARIC） and China Classification Society （CCS~.展开更多
BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality rates.Approaches to this surgery are still debated,with ...BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality rates.Approaches to this surgery are still debated,with no consensus regarding the superiority of any single approach.AIM To compare early postoperative complications after implementing the direct anterior and posterior approaches(PL)for hip hemiarthroplasty after femoral neck fractures.METHODS This is a comparative,retrospective,single-center cohort study conducted at a university hospital.Between March 2008 and December 2018,273 patients(a total of 280 hips)underwent bipolar hemiarthroplasties(n=280)for displaced femoral neck fractures using either the PL(n=171)or the minimally invasive direct anterior approach(DAA)(n=109).The choice of approach was related to the surgeons’practices;the implant types were similar and unrelated to the approach.Dislocation rates and other complications were reviewed after a minimum followup of 6 mo.RESULTS Both treatment groups had similarly aged patients(mean age:82 years),sex ratios,patient body mass indexes,and patient comorbidities.Surgical data(surgery delay time,operative time,and blood loss volume)did not differ significantly between the groups.The 30 d mortality rate was higher in the PL group(9.9%)than in the DAA group(3.7%),but the difference was not statistically significant(P=0.052).Among the one-month survivors,a significantly higher rate of dislocation was observed in the PL group(14/154;9.1%)than in the DAA group(0/105;0%)(P=0.002).Of the 14 patients with dislocation,8 underwent revision surgery for recurrent instability(posterior group),and one of them had 2 additional procedures due to a deep infection.The rate of other complications(e.g.,perioperative and early postoperative periprosthetic fractures and infection-related complications)did not differ significantly between the groups.CONCLUSION These findings suggest that the DAA to bipolar hemiarthroplasty for patients with femoral neck fractures is associated with a lower dislocation rate(<1%)than the PL.展开更多
Soil tensile strength is a critical parameter governing the initiation and propagation of tensile cracking.This study proposes an eco-friendly approach to improve the tensile behavior and crack resistance of clayey so...Soil tensile strength is a critical parameter governing the initiation and propagation of tensile cracking.This study proposes an eco-friendly approach to improve the tensile behavior and crack resistance of clayey soils.To validate the feasibility and efficacy of the proposed approach,direct tensile tests were employed to determine the tensile strength of the compacted soil with different W-OH treatment concentrations and water contents.Desiccation tests were also performed to evaluate the effectiveness of W-OH treatment in enhancing soil tensile cracking resistance.During this period,the effects of W-OH treatment concentration and water content on tensile properties,soil suction and microstructure were investigated.The tensile tests reveal that W-OH treatment has a significant impact on the tensile strength and failure mode of the soil,which not only effectively enhances the tensile strength and failure displacement,but also changes the brittle failure behavior into a more ductile quasi-brittle failure behavior.The suction measurements and mercury intrusion porosimetry(MIP)tests show that W-OH treatment can slightly reduce soil suction by affecting skeleton structure and increasing macropores.Combined with the microstructural analysis,it becomes evident that the significant improvement in soil tensile behavior through W-OH treatment is mainly attributed to the W-OH gel's ability to provide additional binding force for bridging and encapsulating the soil particles.Moreover,desiccation tests demonstrate that W-OH treatment can significantly reduce or even inhibit the formation of soil tensile cracking.With the increase of W-OH treatment concentration,the surface crack ratio and total crack length are significantly reduced.This study enhances a fundamental understanding of eco-polymer impacts on soil mechanical properties and provides valuable insight into their potential application for improving soil crack resistance.展开更多
BACKGROUND Advancements in laparoscopic technology and a deeper understanding of intra-hepatic anatomy have led to the establishment of more precise laparoscopic hepatectomy(LH)techniques.The indocyanine green(ICG)flu...BACKGROUND Advancements in laparoscopic technology and a deeper understanding of intra-hepatic anatomy have led to the establishment of more precise laparoscopic hepatectomy(LH)techniques.The indocyanine green(ICG)fluorescence navi-gation technique has emerged as the most effective method for identifying hepatic regions,potentially overcoming the limitations of LH.While laparoscopic left hemihepatectomy(LLH)is a standardized procedure,there is a need for innova-tive strategies to enhance its outcomes.important anatomical markers,surgical skills,and ICG staining methods.METHODS Thirty-seven patients who underwent ICG fluorescence-guided LLH at Qujing Second People's Hospital between January 2019 and February 2022 were retrospectively analyzed.The cranial-dorsal approach was performed which involves dissecting the left hepatic vein cephalad,isolating the Arantius ligament,exposing the middle hepatic vein,and dissecting the parenchyma from the dorsal to the foot in order to complete the anatomical LLH.The surgical methods,as well as intra-and post-surgical data,were recorded and analyzed.Our hospital’s Medical Ethics Committee approved this study(Ethical review:2022-019-01).RESULTS Intraoperative blood loss during LLH was 335.68±99.869 mL and the rates of transfusion and conversion to laparotomy were 13.5%and 0%,respectively.The overall incidence of complications throughout the follow-up(median of 18 months;range 1-36 months)was 21.6%.No mortality or severe complications(level IV)were reported.CONCLUSION LLH has the potential to become a novel,standardized approach that can effectively,safely,and simply expose the middle hepatic vein and meet the requirements of precision surgery.展开更多
BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications o...BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications of hip approaches remains inconclusive.This study conducted an umbrella review to systematically appraise previous meta-analysis(MAs)including conventional posterior approach(PA),and minimally invasive surgeries as the lateral approach(LA),direct anterior approach(DAA),2-incisions method,mini-lateral approach and the newest technique direct superior approach(DSA)or supercapsular percutaneouslyassisted total hip(SuperPath).AIM To compare the efficacy and complications of hip approaches that have been published in all MAs and randomized controlled trials(RCTs).METHODS MAs were identified from MEDLINE and Scopus from inception until 2023.RCTs were then updated from the latest MA to September 2023.This study included studies which compared hip approaches and reported at least one outcome such as Harris Hip Score(HHS),dislocation,intra-operative fracture,wound compliData were independently selected,extracted and assessed by two reviewers.Network MA and cluster rank and surface under the cumulative ranking curve(SUCRA)were estimated for treatment efficacy and safety.RESULTS Finally,twenty-eight MAs(40 RCTs),and 13 RCTs were retrieved.In total 47 RCTs were included for reanalysis.The results of corrected covered area showed high degree(13.80%).Among 47 RCTs,most of the studies were low risk of bias in part of random process and outcome reporting,while other domains were medium to high risk of bias.DAA significantly provided higher HHS at three months than PA[pooled unstandardized mean difference(USMD):3.49,95%confidence interval(CI):0.98,6.00 with SUCRA:85.9],followed by DSA/SuperPath(USMD:1.57,95%CI:-1.55,4.69 with SUCRA:57.6).All approaches had indifferent dislocation and intraoperative fracture rates.SUCRA comparing early functional outcome and composite complications(dislocation,intra-operative fracture,wound complication,and nerve injury)found DAA was the best approach followed by DSA/SuperPath.CONCLUSION DSA/SuperPath had better earlier functional outcome than PA,but still could not overcome the result of DAA.This technique might be the other preferred option with acceptable complications.展开更多
OBJECTIVE To assess the feasibility and safety of the minimalistic approach to left atrial appendage occlusion(LAAO) guided by cardiac computed tomography angiography(CCTA).METHODS Ninety consecutive patients who unde...OBJECTIVE To assess the feasibility and safety of the minimalistic approach to left atrial appendage occlusion(LAAO) guided by cardiac computed tomography angiography(CCTA).METHODS Ninety consecutive patients who underwent LAAO, with or without CCTA-guided, were matched(1:2). Each step of the LAAO procedure in the computed tomography(CT) guidance group(CT group) was directed by preprocedural CT planning. In the control group, LAAO was performed using the standard method. All patients were followed up for 12 months, and device surveillance was conducted using CCTA.RESULTS A total of 90 patients were included in the analysis, with 30 patients in the CT group and 60 matched patients in the control group. All patients were successfully implanted with Watchman devices. The mean ages for the CT group and the control group were 70.0 ± 9.4 years and 68.4 ± 11.9 years(P = 0.52), respectively. The procedure duration(45.6 ± 10.7 min vs. 58.8 ± 13.0 min,P < 0.001) and hospital stay(7.5 ± 2.4 day vs. 9.6 ± 2.8 day, P = 0.001) in the CT group was significantly shorter compared to the control group. However, the total radiation dose was higher in the CT group compared to the control group(904.9 ± 348.0 m Gy vs.711.9 ± 211.2 m Gy, P = 0.002). There were no significant differences in periprocedural pericardial effusion(3.3% vs. 6.3%, P = 0.8) between the two groups. The rate of postprocedural adverse events(13.3% vs. 18.3%, P = 0.55) were comparable between both groups at 12 months follow-up.CONCLUSIONS CCTA is capable of detailed LAAO procedure planning. Minimalistic LAAO with preprocedural CCTA planning was feasible and safe, with shortened procedure time and acceptable increased radiation and contras consumption. For patients with contraindications to general anesthesia and/or transesophageal echocardiography, this promising method may be an alternative to conventional LAAO.展开更多
High-energy gamma-ray radiography has exceptional penetration ability and has become an indispensable nondestructive testing(NDT)tool in various fields.For high-energy photons,point projection radiography is almost th...High-energy gamma-ray radiography has exceptional penetration ability and has become an indispensable nondestructive testing(NDT)tool in various fields.For high-energy photons,point projection radiography is almost the only feasible imaging method,and its spatial resolution is primarily constrained by the size of the gamma-ray source.In conventional industrial applications,gamma-ray sources are commonly based on electron beams driven by accelerators,utilizing the process of bremsstrahlung radiation.The size of the gamma-ray source is dependent on the dimensional characteristics of the electron beam.Extensive research has been conducted on various advanced accelerator technologies that have the potential to greatly improve spatial resolution in NDT.In our investigation of laser-driven gamma-ray sources,a spatial resolution of about 90μm is achieved when the areal density of the penetrated object is 120 g/cm^(2).A virtual source approach is proposed to optimize the size of the gamma-ray source used for imaging,with the aim of maximizing spatial resolution.In this virtual source approach,the gamma ray can be considered as being emitted from a virtual source within the convertor,where the equivalent gamma-ray source size in imaging is much smaller than the actual emission area.On the basis of Monte Carlo simulations,we derive a set of evaluation formulas for virtual source scale and gamma-ray emission angle.Under optimal conditions,the virtual source size can be as small as 15μm,which can significantly improve the spatial resolution of high-penetration imaging to less than 50μm.展开更多
We read and discussed the study entitled“Complication rates after direct anterior vs posterior approach for Hip Hemiarthroplasty in elderly individuals with femoral neck fractures”with great interest.The authors hav...We read and discussed the study entitled“Complication rates after direct anterior vs posterior approach for Hip Hemiarthroplasty in elderly individuals with femoral neck fractures”with great interest.The authors have done justice to the topic of comparison of anterior and posterior surgical approaches for bipolar hemiarthroplasty which has been an everlasting debate in the existing literature.However,there are certain aspects of this study that need clarification from the authors.展开更多
The differences in complication rates between the direct anterior and posterior approaches for hemiarthroplasty in elderly patients with femoral neck fractures are not yet fully understood.Dislocation,a severe complic...The differences in complication rates between the direct anterior and posterior approaches for hemiarthroplasty in elderly patients with femoral neck fractures are not yet fully understood.Dislocation,a severe complication associated with increased mortality and often requiring additional surgery,may occur less frequently with the direct anterior approach compared to the posterior approach.Careful consideration of patient demographics is essential when planning the surgical approach.Future research in this area should focus on robust randomized controlled trials involving elderly patients recovering from femoral neck fractures.展开更多
In this article, a novel scalarization technique, called the improved objective-constraint approach, is introduced to find efficient solutions of a given multiobjective programming problem. The presented scalarized pr...In this article, a novel scalarization technique, called the improved objective-constraint approach, is introduced to find efficient solutions of a given multiobjective programming problem. The presented scalarized problem extends the objective-constraint problem. It is demonstrated that how adding variables to the scalarized problem, can lead to find conditions for (weakly, properly) Pareto optimal solutions. Applying the obtained necessary and sufficient conditions, two algorithms for generating the Pareto front approximation of bi-objective and three-objective programming problems are designed. These algorithms are easy to implement and can achieve an even approximation of (weakly, properly) Pareto optimal solutions. These algorithms can be generalized for optimization problems with more than three criterion functions, too. The effectiveness and capability of the algorithms are demonstrated in test problems.展开更多
We consider an image semantic communication system in a time-varying fading Gaussian MIMO channel,with a finite number of channel states.A deep learning-aided broadcast approach scheme is proposed to benefit the adapt...We consider an image semantic communication system in a time-varying fading Gaussian MIMO channel,with a finite number of channel states.A deep learning-aided broadcast approach scheme is proposed to benefit the adaptive semantic transmission in terms of different channel states.We combine the classic broadcast approach with the image transformer to implement this adaptive joint source and channel coding(JSCC)scheme.Specifically,we utilize the neural network(NN)to jointly optimize the hierarchical image compression and superposition code mapping within this scheme.The learned transformers and codebooks allow recovering of the image with an adaptive quality and low error rate at the receiver side,in each channel state.The simulation results exhibit our proposed scheme can dynamically adapt the coding to the current channel state and outperform some existing intelligent schemes with the fixed coding block.展开更多
For decades, Lychrel numbers have been studied on many bases. Their existence has been proven in base 2, 11 or 17. This paper presents a probabilistic proof of the existence of Lychrel number in base 10 and provides s...For decades, Lychrel numbers have been studied on many bases. Their existence has been proven in base 2, 11 or 17. This paper presents a probabilistic proof of the existence of Lychrel number in base 10 and provides some properties which enable a mathematical extraction of new Lychrel numbers from existing ones. This probabilistic approach has the advantage of being extendable to other bases. The results show that palindromes can also be Lychrel numbers.展开更多
The stability study of the ongoing and recurring Amalpata landslide in Baglung in Nepal’s Gandaki Province is presented in this research. The impacted slope is around 200 meters high, with two terraces that have diff...The stability study of the ongoing and recurring Amalpata landslide in Baglung in Nepal’s Gandaki Province is presented in this research. The impacted slope is around 200 meters high, with two terraces that have different slope inclinations. The lower bench, located above the basement, consistently fails and sets others up for failure. The fluctuating water level of the slope, which travels down the slope masses, exacerbates the slide problem. The majority of these rocks are Amalpata landslide area experiences several structural disruptions. The area’s stability must be evaluated in order to prevent and control more harm from occurring to the nearby agricultural land and people living along the slope. The slopes’ failures increase the damages of house existing in nearby area and the erosion of the slope. Two modeling techniques the finite element approach and the limit equilibrium method were used to simulate the slope. The findings show that, in every case, the terrace above the basement is where the majority of the stress is concentrated, with a safety factor of near unity. Using probabilistic slope stability analysis, the failure probability was predicted to be between 98.90% and 100%.展开更多
Being different from testing for popular GUI software, the “instruction-category” approach is proposed for testing embedded system. This approach is constructed by three steps including refining items, drawing instr...Being different from testing for popular GUI software, the “instruction-category” approach is proposed for testing embedded system. This approach is constructed by three steps including refining items, drawing instruction-brief and instruction-category, and constructing test suite. Consequently, this approach is adopted to test oven embedded system, and detail process is deeply discussed. As a result, the factual result indicates that the “instruction-category” approach can be effectively applied in embedded system testing as a black-box method for conformity testing.展开更多
BACKGROUND Spinal meningiomas(SMs)are common benign tumors that are typically treated with surgical resection.The choice of surgical approach may vary depending on the location of dural attachment of the SM,with a pos...BACKGROUND Spinal meningiomas(SMs)are common benign tumors that are typically treated with surgical resection.The choice of surgical approach may vary depending on the location of dural attachment of the SM,with a posterior approach being the traditional preference.However,there is limited research available on the impact of dural attachment location on outcomes following posterior approach for SM resection.The average age of the included 34 patients’(10 males and 24 females)age was 62.09 years.Mean follow-up duration was 22.65 months.The location of SM was the thoracic spine in 32 cases,with only 2 in the cervical spine.On average,intraoperative blood loss was 520.59 mL,and operating time was 176.76 minutes.Thirty three cases had successful outcomes while only 1 experienced an unexpe-cted outcome.The tumor recurrence rate was 2.9%.After surgery,there were 3 cases of cerebral spinal fluid leakage,1 case of pneumonia,and 1 case of urinary tract infection.Dural attachments were predominantly found dorsal or dorso-lateral(13 cases),followed by ventral or ventrolateral(14 cases),and lateral(7 cases).The outcomes among these subgroups were similar.CONCLUSION The posterior approach for SM resection is safe and effective,yielding comparable surgical and neurological outcomes regardless of the dural attachment location.展开更多
For the first time, the isogeometric analysis(IGA) approach is used to model and analyze free and forced vibrations of doubly-curved magneto-electro-elastic(MEE) composite shallow shell resting on the visco-Pasternak ...For the first time, the isogeometric analysis(IGA) approach is used to model and analyze free and forced vibrations of doubly-curved magneto-electro-elastic(MEE) composite shallow shell resting on the visco-Pasternak foundation in a hygro-temperature environment. The doubly-curved MEE shallow shell types include spherical shallow shell, cylindrical shallow shell, saddle shallow shell, and elliptical shallow shell subjected to blast load are investigated. The Maxwell equation and electromagnetic boundary conditions are used to determine the vary of the electric and magnetic potentials. The MEE shallow shell's equations of motion are derived from Hamilton's principle and refined higher-order shear theory. Then, the IGA method is used to derive the laws of natural frequencies and dynamic responses of the shell under various boundary conditions. The accuracy of the model and method is verified through reliable numerical comparisons. Aside from this, the impact of the input parameters on the free and forced vibration of the doubly-curved MEE shallow shell is examined in detail. These results may be useful in the design and manufacture of military structures such as warships, fighter aircraft, drones and missiles.展开更多
Introduction: Standard procedures for surgical fixation of proximal femoral fractures (PFF) require an image intensifier which in developing countries remains a luxury. We hypothesized that, with a well-codified techn...Introduction: Standard procedures for surgical fixation of proximal femoral fractures (PFF) require an image intensifier which in developing countries remains a luxury. We hypothesized that, with a well-codified technique, the Watson Jones approach (WJA) without image intensifier nor traction table, can allow open reduction and internal fixation (ORIF) of PFF using Dynamic hip screw (DHS), with satisfactory outcome. Patients and methods: Forty one consecutive patients (mean age 59.5 ± 21.6 years, 61% males) who were followed in a Teaching Hospital for PFF treated by ORIF using the WJA and DHS from January 2016 to December 2020 were reassessed. The outcome measures were the quality of the reduction, the positioning of the implants, the tip-apex distance (TAD), the rate and delay of consolidation, the functional results using Postel Merle d’Aubigné (PMA) score, the rate of surgical site infection (SSI) and the overall mortality. Logistic regression was used to determine factors associated with mechanical failure. Results: The mean follow-up period was 33.8 ± 15.0 months. Fracture reduction was good in 31 (75.6%) cases and acceptable in 8(19.5%) cases. Implant position was fair to good in 37 (90.2%) patients. The mean TAD was 26.1 ± 3.9 mm. Three patients developed SSI. Consolidation was achieved in 38 (92.6%) patients. The functional results were good to excellent in 80.5% of patients. The overall mortality rate was 7.3%. There were an association between mechanical failure and osteoporosis (p = 0.04), fracture reduction (p = 0.003), and TAD (p = 0.025). In multivariate logistic regression, no independent factors were predictive of mechanical failure. Conclusion: This study shows that ORIF using DHS for PFF via the Watson-Jones approach without an image intensifier can give satisfactory anatomical and functional outcomes in low-resource settings. It provides and validates a reliable and reproducible technique that deserves to be diffused to surgeons in austere areas over the world.展开更多
A case report entitled“Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction”recently published in the World Journal of Clinical Cases presented a rare cause of gastric outlet obstruction and ...A case report entitled“Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction”recently published in the World Journal of Clinical Cases presented a rare cause of gastric outlet obstruction and highlighted the atypical manner in which gastrointestinal tuberculosis(TB)can present.The literature with regards to this rare pathology is limited to case reports and case series with the largest being published using data from between 2003 and 2013.However,since then the diagnostic tools available have significantly changed with more modern and increasingly accurate tests now available.This editorial reviews the current state of the art with regards to diagnosis in gastrointestinal TB.展开更多
Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium...Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium channel Nav1.7 as a pivotal target in OA treatment.Preclinical studies demonstrate carbamazepine's efficacy in Nav1.7 blockade,offering significant joint protection in animal models.However,human trials are needed to validate these findings.Carbamazepine's repurposing holds promise for OA management,potentially revolutionizing treatment paradigms.Further research is essential to bridge the gap between preclinical evidence and clinical application,offering hope for improved OA management and enhanced patient quality of life.展开更多
文摘The quality system of any modern pharmaceutical company is the pharmaceutical quality system(PQS),which extends the GMP standards to all stages of the medicinal productslife cycle,from pharmaceutical development to its withdrawal from production.The principal difference between PQS and GxP rules from other quality systems is that the medicinal product,its safety and efficacy is put at the forefront.At the same time,PQS implies a process approach to all components that should be aimed at achieving the main goal—ensuring and guaranteeing the quality of the medicinal product for the end user(patient)—and should be based on the quality risk management system.An integral part of PQS,as well as the GxP rules adopted in the European Union and PIC/S,is a process for self-inspections and/or quality audits,which regularly appraises the effectiveness and applicability of the PQS.This publication is dedicated to the definition of self-inspections(internal audits)as one of the PQS’s processes.The article defines the main standard stages and develops a model of a risk-based approach to the self-inspections’planning in relation to processes of the pharmaceutical quality system.
文摘In 1999, the first International Maritime Confere- nce on Design for Safety was successfully held in Glasgow, UK as a WEGEMT Euro Conference with the sponsorship of the European Commission. Respo- nding to the expectation from the world maritime safety community, the second was held in 2004 in Japan. The third and fourth were held in USA, 2007 and Italy, 2010, respectively. This year the Design for Safety conference including a single event of the 4th Workshop on Risk-Based Approaches in the Marine Industries will be held in Shanghai on November 25- 27, 2013. The conference is organized by Shanghai Jiao Tong University and is co-organized/sponsored by Marine Design and Research Institute of China （MARIC） and China Classification Society （CCS~.
基金This study was reviewed and approved by the Ethics Committee of the HUB-Hospital Erasme.
文摘BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality rates.Approaches to this surgery are still debated,with no consensus regarding the superiority of any single approach.AIM To compare early postoperative complications after implementing the direct anterior and posterior approaches(PL)for hip hemiarthroplasty after femoral neck fractures.METHODS This is a comparative,retrospective,single-center cohort study conducted at a university hospital.Between March 2008 and December 2018,273 patients(a total of 280 hips)underwent bipolar hemiarthroplasties(n=280)for displaced femoral neck fractures using either the PL(n=171)or the minimally invasive direct anterior approach(DAA)(n=109).The choice of approach was related to the surgeons’practices;the implant types were similar and unrelated to the approach.Dislocation rates and other complications were reviewed after a minimum followup of 6 mo.RESULTS Both treatment groups had similarly aged patients(mean age:82 years),sex ratios,patient body mass indexes,and patient comorbidities.Surgical data(surgery delay time,operative time,and blood loss volume)did not differ significantly between the groups.The 30 d mortality rate was higher in the PL group(9.9%)than in the DAA group(3.7%),but the difference was not statistically significant(P=0.052).Among the one-month survivors,a significantly higher rate of dislocation was observed in the PL group(14/154;9.1%)than in the DAA group(0/105;0%)(P=0.002).Of the 14 patients with dislocation,8 underwent revision surgery for recurrent instability(posterior group),and one of them had 2 additional procedures due to a deep infection.The rate of other complications(e.g.,perioperative and early postoperative periprosthetic fractures and infection-related complications)did not differ significantly between the groups.CONCLUSION These findings suggest that the DAA to bipolar hemiarthroplasty for patients with femoral neck fractures is associated with a lower dislocation rate(<1%)than the PL.
基金supported by the National Natural Science Foundation of China(Grant Nos.41925012,42230710)Key Laboratory Cooperation Special Project of Western Cross Team of Western Light,Chinese Academy of Sciences(Grant No.xbzg-zdsys-202107).
文摘Soil tensile strength is a critical parameter governing the initiation and propagation of tensile cracking.This study proposes an eco-friendly approach to improve the tensile behavior and crack resistance of clayey soils.To validate the feasibility and efficacy of the proposed approach,direct tensile tests were employed to determine the tensile strength of the compacted soil with different W-OH treatment concentrations and water contents.Desiccation tests were also performed to evaluate the effectiveness of W-OH treatment in enhancing soil tensile cracking resistance.During this period,the effects of W-OH treatment concentration and water content on tensile properties,soil suction and microstructure were investigated.The tensile tests reveal that W-OH treatment has a significant impact on the tensile strength and failure mode of the soil,which not only effectively enhances the tensile strength and failure displacement,but also changes the brittle failure behavior into a more ductile quasi-brittle failure behavior.The suction measurements and mercury intrusion porosimetry(MIP)tests show that W-OH treatment can slightly reduce soil suction by affecting skeleton structure and increasing macropores.Combined with the microstructural analysis,it becomes evident that the significant improvement in soil tensile behavior through W-OH treatment is mainly attributed to the W-OH gel's ability to provide additional binding force for bridging and encapsulating the soil particles.Moreover,desiccation tests demonstrate that W-OH treatment can significantly reduce or even inhibit the formation of soil tensile cracking.With the increase of W-OH treatment concentration,the surface crack ratio and total crack length are significantly reduced.This study enhances a fundamental understanding of eco-polymer impacts on soil mechanical properties and provides valuable insight into their potential application for improving soil crack resistance.
基金Supported by The High-level Talent Training Support Project of Yunnan Province,No.YNWR-MY-2020-053and the Key Project of the Second People's Hospital of Qujing in 2022,No.2022ynkt04。
文摘BACKGROUND Advancements in laparoscopic technology and a deeper understanding of intra-hepatic anatomy have led to the establishment of more precise laparoscopic hepatectomy(LH)techniques.The indocyanine green(ICG)fluorescence navi-gation technique has emerged as the most effective method for identifying hepatic regions,potentially overcoming the limitations of LH.While laparoscopic left hemihepatectomy(LLH)is a standardized procedure,there is a need for innova-tive strategies to enhance its outcomes.important anatomical markers,surgical skills,and ICG staining methods.METHODS Thirty-seven patients who underwent ICG fluorescence-guided LLH at Qujing Second People's Hospital between January 2019 and February 2022 were retrospectively analyzed.The cranial-dorsal approach was performed which involves dissecting the left hepatic vein cephalad,isolating the Arantius ligament,exposing the middle hepatic vein,and dissecting the parenchyma from the dorsal to the foot in order to complete the anatomical LLH.The surgical methods,as well as intra-and post-surgical data,were recorded and analyzed.Our hospital’s Medical Ethics Committee approved this study(Ethical review:2022-019-01).RESULTS Intraoperative blood loss during LLH was 335.68±99.869 mL and the rates of transfusion and conversion to laparotomy were 13.5%and 0%,respectively.The overall incidence of complications throughout the follow-up(median of 18 months;range 1-36 months)was 21.6%.No mortality or severe complications(level IV)were reported.CONCLUSION LLH has the potential to become a novel,standardized approach that can effectively,safely,and simply expose the middle hepatic vein and meet the requirements of precision surgery.
文摘BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications of hip approaches remains inconclusive.This study conducted an umbrella review to systematically appraise previous meta-analysis(MAs)including conventional posterior approach(PA),and minimally invasive surgeries as the lateral approach(LA),direct anterior approach(DAA),2-incisions method,mini-lateral approach and the newest technique direct superior approach(DSA)or supercapsular percutaneouslyassisted total hip(SuperPath).AIM To compare the efficacy and complications of hip approaches that have been published in all MAs and randomized controlled trials(RCTs).METHODS MAs were identified from MEDLINE and Scopus from inception until 2023.RCTs were then updated from the latest MA to September 2023.This study included studies which compared hip approaches and reported at least one outcome such as Harris Hip Score(HHS),dislocation,intra-operative fracture,wound compliData were independently selected,extracted and assessed by two reviewers.Network MA and cluster rank and surface under the cumulative ranking curve(SUCRA)were estimated for treatment efficacy and safety.RESULTS Finally,twenty-eight MAs(40 RCTs),and 13 RCTs were retrieved.In total 47 RCTs were included for reanalysis.The results of corrected covered area showed high degree(13.80%).Among 47 RCTs,most of the studies were low risk of bias in part of random process and outcome reporting,while other domains were medium to high risk of bias.DAA significantly provided higher HHS at three months than PA[pooled unstandardized mean difference(USMD):3.49,95%confidence interval(CI):0.98,6.00 with SUCRA:85.9],followed by DSA/SuperPath(USMD:1.57,95%CI:-1.55,4.69 with SUCRA:57.6).All approaches had indifferent dislocation and intraoperative fracture rates.SUCRA comparing early functional outcome and composite complications(dislocation,intra-operative fracture,wound complication,and nerve injury)found DAA was the best approach followed by DSA/SuperPath.CONCLUSION DSA/SuperPath had better earlier functional outcome than PA,but still could not overcome the result of DAA.This technique might be the other preferred option with acceptable complications.
基金supported by the Logistics Support Ministry of China (No.22BJZ41)the Capital's Funds for Health Improvement and Research (No.CFH2024-2-5071)。
文摘OBJECTIVE To assess the feasibility and safety of the minimalistic approach to left atrial appendage occlusion(LAAO) guided by cardiac computed tomography angiography(CCTA).METHODS Ninety consecutive patients who underwent LAAO, with or without CCTA-guided, were matched(1:2). Each step of the LAAO procedure in the computed tomography(CT) guidance group(CT group) was directed by preprocedural CT planning. In the control group, LAAO was performed using the standard method. All patients were followed up for 12 months, and device surveillance was conducted using CCTA.RESULTS A total of 90 patients were included in the analysis, with 30 patients in the CT group and 60 matched patients in the control group. All patients were successfully implanted with Watchman devices. The mean ages for the CT group and the control group were 70.0 ± 9.4 years and 68.4 ± 11.9 years(P = 0.52), respectively. The procedure duration(45.6 ± 10.7 min vs. 58.8 ± 13.0 min,P < 0.001) and hospital stay(7.5 ± 2.4 day vs. 9.6 ± 2.8 day, P = 0.001) in the CT group was significantly shorter compared to the control group. However, the total radiation dose was higher in the CT group compared to the control group(904.9 ± 348.0 m Gy vs.711.9 ± 211.2 m Gy, P = 0.002). There were no significant differences in periprocedural pericardial effusion(3.3% vs. 6.3%, P = 0.8) between the two groups. The rate of postprocedural adverse events(13.3% vs. 18.3%, P = 0.55) were comparable between both groups at 12 months follow-up.CONCLUSIONS CCTA is capable of detailed LAAO procedure planning. Minimalistic LAAO with preprocedural CCTA planning was feasible and safe, with shortened procedure time and acceptable increased radiation and contras consumption. For patients with contraindications to general anesthesia and/or transesophageal echocardiography, this promising method may be an alternative to conventional LAAO.
基金This work was supported by the National Natural Science Foundation of China(Grant Nos.12175212,11991071,12004353,11975214,and 11905202)the National Key R&D Program of China(Grant No.2022YFA1603300)+1 种基金the Science Challenge Project(Project No.TZ2018005)the Sciences and Technology on Plasma Physics Laboratory at CAEP(Grant No.6142A04200103).
文摘High-energy gamma-ray radiography has exceptional penetration ability and has become an indispensable nondestructive testing(NDT)tool in various fields.For high-energy photons,point projection radiography is almost the only feasible imaging method,and its spatial resolution is primarily constrained by the size of the gamma-ray source.In conventional industrial applications,gamma-ray sources are commonly based on electron beams driven by accelerators,utilizing the process of bremsstrahlung radiation.The size of the gamma-ray source is dependent on the dimensional characteristics of the electron beam.Extensive research has been conducted on various advanced accelerator technologies that have the potential to greatly improve spatial resolution in NDT.In our investigation of laser-driven gamma-ray sources,a spatial resolution of about 90μm is achieved when the areal density of the penetrated object is 120 g/cm^(2).A virtual source approach is proposed to optimize the size of the gamma-ray source used for imaging,with the aim of maximizing spatial resolution.In this virtual source approach,the gamma ray can be considered as being emitted from a virtual source within the convertor,where the equivalent gamma-ray source size in imaging is much smaller than the actual emission area.On the basis of Monte Carlo simulations,we derive a set of evaluation formulas for virtual source scale and gamma-ray emission angle.Under optimal conditions,the virtual source size can be as small as 15μm,which can significantly improve the spatial resolution of high-penetration imaging to less than 50μm.
文摘We read and discussed the study entitled“Complication rates after direct anterior vs posterior approach for Hip Hemiarthroplasty in elderly individuals with femoral neck fractures”with great interest.The authors have done justice to the topic of comparison of anterior and posterior surgical approaches for bipolar hemiarthroplasty which has been an everlasting debate in the existing literature.However,there are certain aspects of this study that need clarification from the authors.
文摘The differences in complication rates between the direct anterior and posterior approaches for hemiarthroplasty in elderly patients with femoral neck fractures are not yet fully understood.Dislocation,a severe complication associated with increased mortality and often requiring additional surgery,may occur less frequently with the direct anterior approach compared to the posterior approach.Careful consideration of patient demographics is essential when planning the surgical approach.Future research in this area should focus on robust randomized controlled trials involving elderly patients recovering from femoral neck fractures.
文摘In this article, a novel scalarization technique, called the improved objective-constraint approach, is introduced to find efficient solutions of a given multiobjective programming problem. The presented scalarized problem extends the objective-constraint problem. It is demonstrated that how adding variables to the scalarized problem, can lead to find conditions for (weakly, properly) Pareto optimal solutions. Applying the obtained necessary and sufficient conditions, two algorithms for generating the Pareto front approximation of bi-objective and three-objective programming problems are designed. These algorithms are easy to implement and can achieve an even approximation of (weakly, properly) Pareto optimal solutions. These algorithms can be generalized for optimization problems with more than three criterion functions, too. The effectiveness and capability of the algorithms are demonstrated in test problems.
基金supported in part by the National Key R&D Project of China under Grant 2020YFA0712300National Natural Science Foundation of China under Grant NSFC-62231022,12031011supported in part by the NSF of China under Grant 62125108。
文摘We consider an image semantic communication system in a time-varying fading Gaussian MIMO channel,with a finite number of channel states.A deep learning-aided broadcast approach scheme is proposed to benefit the adaptive semantic transmission in terms of different channel states.We combine the classic broadcast approach with the image transformer to implement this adaptive joint source and channel coding(JSCC)scheme.Specifically,we utilize the neural network(NN)to jointly optimize the hierarchical image compression and superposition code mapping within this scheme.The learned transformers and codebooks allow recovering of the image with an adaptive quality and low error rate at the receiver side,in each channel state.The simulation results exhibit our proposed scheme can dynamically adapt the coding to the current channel state and outperform some existing intelligent schemes with the fixed coding block.
文摘For decades, Lychrel numbers have been studied on many bases. Their existence has been proven in base 2, 11 or 17. This paper presents a probabilistic proof of the existence of Lychrel number in base 10 and provides some properties which enable a mathematical extraction of new Lychrel numbers from existing ones. This probabilistic approach has the advantage of being extendable to other bases. The results show that palindromes can also be Lychrel numbers.
文摘The stability study of the ongoing and recurring Amalpata landslide in Baglung in Nepal’s Gandaki Province is presented in this research. The impacted slope is around 200 meters high, with two terraces that have different slope inclinations. The lower bench, located above the basement, consistently fails and sets others up for failure. The fluctuating water level of the slope, which travels down the slope masses, exacerbates the slide problem. The majority of these rocks are Amalpata landslide area experiences several structural disruptions. The area’s stability must be evaluated in order to prevent and control more harm from occurring to the nearby agricultural land and people living along the slope. The slopes’ failures increase the damages of house existing in nearby area and the erosion of the slope. Two modeling techniques the finite element approach and the limit equilibrium method were used to simulate the slope. The findings show that, in every case, the terrace above the basement is where the majority of the stress is concentrated, with a safety factor of near unity. Using probabilistic slope stability analysis, the failure probability was predicted to be between 98.90% and 100%.
文摘Being different from testing for popular GUI software, the “instruction-category” approach is proposed for testing embedded system. This approach is constructed by three steps including refining items, drawing instruction-brief and instruction-category, and constructing test suite. Consequently, this approach is adopted to test oven embedded system, and detail process is deeply discussed. As a result, the factual result indicates that the “instruction-category” approach can be effectively applied in embedded system testing as a black-box method for conformity testing.
文摘BACKGROUND Spinal meningiomas(SMs)are common benign tumors that are typically treated with surgical resection.The choice of surgical approach may vary depending on the location of dural attachment of the SM,with a posterior approach being the traditional preference.However,there is limited research available on the impact of dural attachment location on outcomes following posterior approach for SM resection.The average age of the included 34 patients’(10 males and 24 females)age was 62.09 years.Mean follow-up duration was 22.65 months.The location of SM was the thoracic spine in 32 cases,with only 2 in the cervical spine.On average,intraoperative blood loss was 520.59 mL,and operating time was 176.76 minutes.Thirty three cases had successful outcomes while only 1 experienced an unexpe-cted outcome.The tumor recurrence rate was 2.9%.After surgery,there were 3 cases of cerebral spinal fluid leakage,1 case of pneumonia,and 1 case of urinary tract infection.Dural attachments were predominantly found dorsal or dorso-lateral(13 cases),followed by ventral or ventrolateral(14 cases),and lateral(7 cases).The outcomes among these subgroups were similar.CONCLUSION The posterior approach for SM resection is safe and effective,yielding comparable surgical and neurological outcomes regardless of the dural attachment location.
文摘For the first time, the isogeometric analysis(IGA) approach is used to model and analyze free and forced vibrations of doubly-curved magneto-electro-elastic(MEE) composite shallow shell resting on the visco-Pasternak foundation in a hygro-temperature environment. The doubly-curved MEE shallow shell types include spherical shallow shell, cylindrical shallow shell, saddle shallow shell, and elliptical shallow shell subjected to blast load are investigated. The Maxwell equation and electromagnetic boundary conditions are used to determine the vary of the electric and magnetic potentials. The MEE shallow shell's equations of motion are derived from Hamilton's principle and refined higher-order shear theory. Then, the IGA method is used to derive the laws of natural frequencies and dynamic responses of the shell under various boundary conditions. The accuracy of the model and method is verified through reliable numerical comparisons. Aside from this, the impact of the input parameters on the free and forced vibration of the doubly-curved MEE shallow shell is examined in detail. These results may be useful in the design and manufacture of military structures such as warships, fighter aircraft, drones and missiles.
文摘Introduction: Standard procedures for surgical fixation of proximal femoral fractures (PFF) require an image intensifier which in developing countries remains a luxury. We hypothesized that, with a well-codified technique, the Watson Jones approach (WJA) without image intensifier nor traction table, can allow open reduction and internal fixation (ORIF) of PFF using Dynamic hip screw (DHS), with satisfactory outcome. Patients and methods: Forty one consecutive patients (mean age 59.5 ± 21.6 years, 61% males) who were followed in a Teaching Hospital for PFF treated by ORIF using the WJA and DHS from January 2016 to December 2020 were reassessed. The outcome measures were the quality of the reduction, the positioning of the implants, the tip-apex distance (TAD), the rate and delay of consolidation, the functional results using Postel Merle d’Aubigné (PMA) score, the rate of surgical site infection (SSI) and the overall mortality. Logistic regression was used to determine factors associated with mechanical failure. Results: The mean follow-up period was 33.8 ± 15.0 months. Fracture reduction was good in 31 (75.6%) cases and acceptable in 8(19.5%) cases. Implant position was fair to good in 37 (90.2%) patients. The mean TAD was 26.1 ± 3.9 mm. Three patients developed SSI. Consolidation was achieved in 38 (92.6%) patients. The functional results were good to excellent in 80.5% of patients. The overall mortality rate was 7.3%. There were an association between mechanical failure and osteoporosis (p = 0.04), fracture reduction (p = 0.003), and TAD (p = 0.025). In multivariate logistic regression, no independent factors were predictive of mechanical failure. Conclusion: This study shows that ORIF using DHS for PFF via the Watson-Jones approach without an image intensifier can give satisfactory anatomical and functional outcomes in low-resource settings. It provides and validates a reliable and reproducible technique that deserves to be diffused to surgeons in austere areas over the world.
文摘A case report entitled“Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction”recently published in the World Journal of Clinical Cases presented a rare cause of gastric outlet obstruction and highlighted the atypical manner in which gastrointestinal tuberculosis(TB)can present.The literature with regards to this rare pathology is limited to case reports and case series with the largest being published using data from between 2003 and 2013.However,since then the diagnostic tools available have significantly changed with more modern and increasingly accurate tests now available.This editorial reviews the current state of the art with regards to diagnosis in gastrointestinal TB.
文摘Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium channel Nav1.7 as a pivotal target in OA treatment.Preclinical studies demonstrate carbamazepine's efficacy in Nav1.7 blockade,offering significant joint protection in animal models.However,human trials are needed to validate these findings.Carbamazepine's repurposing holds promise for OA management,potentially revolutionizing treatment paradigms.Further research is essential to bridge the gap between preclinical evidence and clinical application,offering hope for improved OA management and enhanced patient quality of life.
