Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal d...Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal discharges.Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice.An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tra ctography,diffusion kurtosis imaging-based fiber tractography,fiber ball imagingbased tra ctography,electroencephalography,functional magnetic resonance imaging,magnetoencephalography,positron emission tomography,molecular imaging,and functional ultrasound imaging have been extensively used to delineate epileptic networks.In this review,we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy,and extensively analyze the imaging mechanisms,advantages,limitations,and clinical application ranges of each technique.A greater focus on emerging advanced technologies,new data analysis software,a combination of multiple techniques,and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.展开更多
Reliable long-term settlement prediction of a high embankment relates to mountain infrastructure safety.This study developed a novel hybrid model(NHM)that combines a joint denoising technique with an enhanced gray wol...Reliable long-term settlement prediction of a high embankment relates to mountain infrastructure safety.This study developed a novel hybrid model(NHM)that combines a joint denoising technique with an enhanced gray wolf optimizer(EGWO)-n-support vector regression(n-SVR)method.High-embankment field measurements were preprocessed using the joint denoising technique,which in-cludes complete ensemble empirical mode decomposition,singular value decomposition,and wavelet packet transform.Furthermore,high-embankment settlements were predicted using the EGWO-n-SVR method.In this method,the standard gray wolf optimizer(GWO)was improved to obtain the EGWO to better tune the n-SVR model hyperparameters.The proposed NHM was then tested in two case studies.Finally,the influences of the data division ratio and kernel function on the EGWO-n-SVR forecasting performance and prediction efficiency were investigated.The results indicate that the NHM suppresses noise and restores details in high-embankment field measurements.Simultaneously,the NHM out-performs other alternative prediction methods in prediction accuracy and robustness.This demonstrates that the proposed NHM is effective in predicting high-embankment settlements with noisy field mea-surements.Moreover,the appropriate data division ratio and kernel function for EGWO-n-SVR are 7:3 and radial basis function,respectively.展开更多
This study develops an Enhanced Threshold Based Energy Detection approach(ETBED)for spectrum sensing in a cognitive radio network.The threshold identification method is implemented in the received signal at the second...This study develops an Enhanced Threshold Based Energy Detection approach(ETBED)for spectrum sensing in a cognitive radio network.The threshold identification method is implemented in the received signal at the secondary user based on the square law.The proposed method is implemented with the signal transmission of multiple outputs-orthogonal frequency division multiplexing.Additionally,the proposed method is considered the dynamic detection threshold adjustments and energy identification spectrum sensing technique in cognitive radio systems.In the dynamic threshold,the signal ratio-based threshold is fixed.The threshold is computed by considering the Modified Black Widow Optimization Algorithm(MBWO).So,the proposed methodology is a combination of dynamic threshold detection and MBWO.The general threshold-based detection technique has different limitations such as the inability optimal signal threshold for determining the presence of the primary user signal.These limitations undermine the sensing accuracy of the energy identification technique.Hence,the ETBED technique is developed to enhance the energy efficiency of cognitive radio networks.The projected approach is executed and analyzed with performance and comparison analysis.The proposed method is contrasted with the conventional techniques of theWhale Optimization Algorithm(WOA)and GreyWolf Optimization(GWO).It indicated superior results,achieving a high average throughput of 2.2 Mbps and an energy efficiency of 3.8,outperforming conventional techniques.展开更多
BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling techn...BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling technique(SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer patients.METHODS In this retrospective cohort study,we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October 2022.The incidence of postoperative delirium was recorded for 7 d post-surgery.Patients were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not.A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative delirium.The SMOTE technique was applied to enhance the model by oversampling the delirium cases.The model’s predictive accuracy was then validated.RESULTS In our study involving 611 elderly patients with abdominal malignant tumors,multivariate logistic regression analysis identified significant risk factors for postoperative delirium.These included the Charlson comorbidity index,American Society of Anesthesiologists classification,history of cerebrovascular disease,surgical duration,perioperative blood transfusion,and postoperative pain score.The incidence rate of postoperative delirium in our study was 22.91%.The original predictive model(P1)exhibited an area under the receiver operating characteristic curve of 0.862.In comparison,the SMOTE-based logistic early warning model(P2),which utilized the SMOTE oversampling algorithm,showed a slightly lower but comparable area under the curve of 0.856,suggesting no significant difference in performance between the two predictive approaches.CONCLUSION This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of traditional methods,effectively addressing data imbalance.展开更多
The widespread adoption of the Internet of Things (IoT) has transformed various sectors globally, making themmore intelligent and connected. However, this advancement comes with challenges related to the effectiveness...The widespread adoption of the Internet of Things (IoT) has transformed various sectors globally, making themmore intelligent and connected. However, this advancement comes with challenges related to the effectiveness ofIoT devices. These devices, present in offices, homes, industries, and more, need constant monitoring to ensuretheir proper functionality. The success of smart systems relies on their seamless operation and ability to handlefaults. Sensors, crucial components of these systems, gather data and contribute to their functionality. Therefore,sensor faults can compromise the system’s reliability and undermine the trustworthiness of smart environments.To address these concerns, various techniques and algorithms can be employed to enhance the performance ofIoT devices through effective fault detection. This paper conducted a thorough review of the existing literature andconducted a detailed analysis.This analysis effectively links sensor errors with a prominent fault detection techniquecapable of addressing them. This study is innovative because it paves theway for future researchers to explore errorsthat have not yet been tackled by existing fault detection methods. Significant, the paper, also highlights essentialfactors for selecting and adopting fault detection techniques, as well as the characteristics of datasets and theircorresponding recommended techniques. Additionally, the paper presents amethodical overview of fault detectiontechniques employed in smart devices, including themetrics used for evaluation. Furthermore, the paper examinesthe body of academic work related to sensor faults and fault detection techniques within the domain. This reflectsthe growing inclination and scholarly attention of researchers and academicians toward strategies for fault detectionwithin the realm of the Internet of Things.展开更多
BACKGROUND Radical surgery combined with systemic chemotherapy offers the possibility of long-term survival or even cure for patients with pancreatic ductal adenocar-cinoma(PDAC),although tumor recurrence,especially l...BACKGROUND Radical surgery combined with systemic chemotherapy offers the possibility of long-term survival or even cure for patients with pancreatic ductal adenocar-cinoma(PDAC),although tumor recurrence,especially locally,still inhibits the treatment efficacy.The TRIANGLE technique was introduced as an extended dissection procedure to improve the R0 resection rate of borderline resectable or locally advanced PDAC.However,there was a lack of studies concerning postoperative complications and long-term outcomes of this procedure on patients with resectable PDAC.PDAC.METHODS Patients with resectable PDAC eligible for PD from our hospital between June 2018 and December 2021 were enrolled in this retrospective cohort study.All the patients were divided into PDstandard and PDTRIANGLE groups according to the surgical procedure.Baseline characteristics,surgical data,and postoperative morbidities were recorded.All of the patients were followed up,and the date and location of tumor recurrence,and death were recorded.The Kaplan-Meier method and log-rank test were used for the survival analysis.RESULTS There were 93 patients included in the study and 37 underwent the TRIANGLE technique.Duration of operation was longer in the PDTRIANGLE group compared with the PDstandard group[440(410-480)min vs 320(265-427)min](P=0.001).Intraoperative blood loss[700(500-1200)mL vs 500(300-800)mL](P=0.009)and blood transfusion[975(0-1250)mL vs 400(0-800)mL](P=0.009)were higher in the PDTRIANGLE group.There was a higher incidence of surgical site infection(43.2%vs 12.5%)(P=0.001)and postoperative diarrhea(54.1%vs 12.5%)(P=0.001)in the PDTRIANGLE group.The rates of R0 resection and local recurrence,overall survival,and disease-free survival did not differ significantly between the two groups.CONCLUSION The TRIANGLE technique is safe,with acceptable postoperative morbidities compared with standardized PD,but it does not improve prognosis for patients with resectable PDAC.展开更多
BACKGROUND Developmental dysplasia of the hip(DDH)is a common osteoarticular deformity in pediatric orthopedics.A patient with bilateral DDH was diagnosed and treated using our improved technique"(powerful overtu...BACKGROUND Developmental dysplasia of the hip(DDH)is a common osteoarticular deformity in pediatric orthopedics.A patient with bilateral DDH was diagnosed and treated using our improved technique"(powerful overturning acetabuloplasty)"combined with femoral rotational shortening osteotomy.CASE SUMMARY A 4-year-old girl who was diagnosed with bilateral DDH could not stand normally,and sought surgical treatment to solve the problem of double hip extension and standing.As this child had high dislocation of the hip joint and the acetabular index was high,we changed the traditional acetabuloplasty to"powerful turnover acetabuloplasty"combined with femoral rotation shortening osteotomy.During the short-term postoperative follow-up(1,3,6,9,12,and 15 months),the child had no discomfort in her lower limbs.After the braces and internal fixation plates were removed,formal rehabilitation training was actively carried out.CONCLUSION Our"powerful overturning acetabuloplasty"combined with femoral rotational shortening osteotomy is feasible in the treatment of DDH in children.This technology may be widely used in the clinic.展开更多
BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complic...BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.展开更多
Chinese chive is a kind of medicinal and edible plant,with many diseases,and chemical fungicides are usually used for control.In order to find out the risk of pesticide residues in Chinese chives,this paper summarized...Chinese chive is a kind of medicinal and edible plant,with many diseases,and chemical fungicides are usually used for control.In order to find out the risk of pesticide residues in Chinese chives,this paper summarized relevant literatures published in recent years,and sorted out and analyzed the types of pesticides used and detection techniques of common diseases in Chinese chives.展开更多
In the increasingly decentralized energy environment,economical power dispatching from distributed generations(DGs)is crucial to minimizing operating costs,optimizing resource utilization,and guaranteeing a consistent...In the increasingly decentralized energy environment,economical power dispatching from distributed generations(DGs)is crucial to minimizing operating costs,optimizing resource utilization,and guaranteeing a consistent and sustainable supply of electricity.A comprehensive review of optimization techniques for economic power dispatching from distributed generations is imperative to identify the most effective strategies for minimizing operational costs while maintaining grid stability and sustainability.The choice of optimization technique for economic power dispatching from DGs depends on a number of factors,such as the size and complexity of the power system,the availability of computational resources,and the specific requirements of the application.Optimization techniques for economic power dispatching from distributed generations(DGs)can be classified into two main categories:(i)Classical optimization techniques,(ii)Heuristic optimization techniques.In classical optimization techniques,the linear programming(LP)model is one of the most popular optimization methods.Utilizing the LP model,power demand and network constraints are met while minimizing the overall cost of generating electricity from DGs.This approach is efficient in determining the best DGs dispatch and is capable of handling challenging optimization issues in the large-scale system including renewables.The quadratic programming(QP)model,a classical optimization technique,is a further popular optimization method,to consider non-linearity.The QP model can take into account the quadratic cost of energy production,with consideration constraints like network capacity,voltage,and frequency.The metaheuristic optimization techniques are also used for economic power dispatching from DGs,which include genetic algorithms(GA),particle swarm optimization(PSO),and ant colony optimization(ACO).Also,Some researchers are developing hybrid optimization techniques that combine elements of classical and heuristic optimization techniques with the incorporation of droop control,predictive control,and fuzzy-based methods.These methods can deal with large-scale systems with many objectives and non-linear,non-convex optimization issues.The most popular approaches are the LP and QP models,while more difficult problems are handled using metaheuristic optimization techniques.In summary,in order to increase efficiency,reduce costs,and ensure a consistent supply of electricity,optimization techniques are essential tools used in economic power dispatching from DGs.展开更多
Amplitudes have been found to be a function of incident angle and offset. Hence data required to test for amplitude variation with angle or offset needs to have its amplitudes for all offsets preserved and not stacked...Amplitudes have been found to be a function of incident angle and offset. Hence data required to test for amplitude variation with angle or offset needs to have its amplitudes for all offsets preserved and not stacked. Amplitude Variation with Offset (AVO)/Amplitude Variation with Angle (AVA) is necessary to account for information in the offset/angle parameter (mode converted S-wave and P-wave velocities). Since amplitudes are a function of the converted S- and P-waves, it is important to investigate the dependence of amplitudes on the elastic (P- and S-waves) parameters from the seismic data. By modelling these effects for different reservoir fluids via fluid substitution, various AVO geobody classes present along the well and in the entire seismic cube can be observed. AVO analysis was performed on one test well (Well_1) and 3D pre-stack angle gathers from the Tano Basin. The analysis involves creating a synthetic model to infer the effect of offset scaling techniques on amplitude responses in the Tano basin as compared to the effect of unscaled seismic data. The spectral balance process was performed to match the amplitude spectra of all angle stacks to that of the mid (26°) stack on the test lines. The process had an effect primarily on the far (34° - 40°) stacks. The frequency content of these stacks slightly increased to match that of the near and mid stacks. In offset scaling process, the root mean square (RMS) amplitude comparison between the synthetic and seismic suggests that the amplitude of the far traces should be reduced relative to the nears by up to 16%. However, the exact scaler values depend on the time window considered. This suggests that the amplitude scaling with offset delivered from seismic processing is only approximately correct and needs to be checked with well synthetics and adjusted accordingly prior to use for AVO studies. The AVO attribute volumes generated were better at resolving anomalies on spectrally balanced and offset scaled data than data delivered from conventional processing. A typical class II AVO anomaly is seen along the test well from the cross-plot analysis and AVO attribute cube which indicates an oil filled reservoir.展开更多
Introduction: Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they mig...Introduction: Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye Teaching Hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy postoperatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bulbar urethral strictures. The repair methods employed were anastomotic urethroplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethroplasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Complications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the procedure should not be denied solely based on age.展开更多
In light of the rapid growth and development of social media, it has become the focus of interest in many different scientific fields. They seek to extract useful information from it, and this is called (knowledge), s...In light of the rapid growth and development of social media, it has become the focus of interest in many different scientific fields. They seek to extract useful information from it, and this is called (knowledge), such as extracting information related to people’s behaviors and interactions to analyze feelings or understand the behavior of users or groups, and many others. This extracted knowledge has a very important role in decision-making, creating and improving marketing objectives and competitive advantage, monitoring events, whether political or economic, and development in all fields. Therefore, to extract this knowledge, we need to analyze the vast amount of data found within social media using the most popular data mining techniques and applications related to social media sites.展开更多
This thorough review explores the complexities of geotechnical engineering, emphasizing soil-structure interaction (SSI). The investigation centers on sheet pile design, examining two primary methodologies: Limit Equi...This thorough review explores the complexities of geotechnical engineering, emphasizing soil-structure interaction (SSI). The investigation centers on sheet pile design, examining two primary methodologies: Limit Equilibrium Methods (LEM) and Soil-Structure Interaction Methods (SSIM). While LEM methods, grounded in classical principles, provide valuable insights for preliminary design considerations, they may encounter limitations in addressing real-world complexities. In contrast, SSIM methods, including the SSI-SR approach, introduce precision and depth to the field. By employing numerical techniques such as Finite Element (FE) and Finite Difference (FD) analyses, these methods enable engineers to navigate the dynamics of soil-structure interaction. The exploration extends to SSI-FE, highlighting its essential role in civil engineering. By integrating Finite Element analysis with considerations for soil-structure interaction, the SSI-FE method offers a holistic understanding of how structures dynamically interact with their geotechnical environment. Throughout this exploration, the study dissects critical components governing SSIM methods, providing engineers with tools to navigate the intricate landscape of geotechnical design. The study acknowledges the significance of the Mohr-Coulomb constitutive model while recognizing its limitations, and guiding practitioners toward informed decision-making in geotechnical analyses. As the article concludes, it underscores the importance of continuous learning and innovation for the future of geotechnical engineering. With advancing technology and an evolving understanding of soil-structure interaction, the study remains committed to ensuring the safety, stability, and efficiency of geotechnical structures through cutting-edge design and analysis techniques.展开更多
Objective:Although endoscopic treatment has been used by many pediatric urologists for the treatment of vesicoureteral reflux(VUR),it has no considerable success in high-grade VUR.We aimed to describe the primary outc...Objective:Although endoscopic treatment has been used by many pediatric urologists for the treatment of vesicoureteral reflux(VUR),it has no considerable success in high-grade VUR.We aimed to describe the primary outcomes of unilateral periureteral injection technique(PIT),as well as bilateral PIT in high-grade VUR.Methods:In this prospective study,we examined 92 ureters in 45 boys and 40 girls from February 2010 to May 2018.Bilateral PIT and unilateral PIT were applied in 67 and 25 refluxing units,respectively.In the unilateral PIT,the subureteral injection site was only at the 5-or 7-o’clock position.However,in the bilateral PIT,the subureteral injection sites were at 5-and 7-o’clock position.Pre-and post-operative reflux grades were evaluated by voiding cystourethrography 6 months after surgery.Results:Seven patients had bilateral reflux.Overall,75(81.5%)ureters showed Grade IV VUR,while 17(18.5%)had primary Grade V VUR.The mean age of the subjects was 39.2 months.In unilateral PIT ureters,VUR was resolved in 23(92.0%)refluxing units.It was downgraded to Grade III in one ureter(4.0%)and to Grade II in another ureter(4.0%).In addition,in bilateral PIT cases,VUR was resolved in 60(89.6%)ureters;it downgraded to Grades II and III in 3(4.5%)and 4(6.0%)refluxing units,respectively.Conclusion:Unilateral PIT can be highly effective in the treatment of selected ureters of high-grade VUR.However,further studies are needed to confirm our results.展开更多
Objective:To review the current literature on the practice of intramuscular injections(IMIs),focusing on immunizations.Methods:The present study comprises 2 reviews,characterized by high-quality evidence,per taining t...Objective:To review the current literature on the practice of intramuscular injections(IMIs),focusing on immunizations.Methods:The present study comprises 2 reviews,characterized by high-quality evidence,per taining to the deployment of the slow injection technique without aspiration(referred to in this paper as the without-aspiration slow injection technique[WASi T])and combined with the Zeta-track technique(ZTT).The literature review is oriented toward the analysis of 2 features associated with IMIs techniques:safety and pain,integrating new evidence on vaccinee positioning for each muscle site and general relaxation techniques in the multi-parametric analysis.Results:The rigorous and in-depth reviews in the current study reveal the usefulness of including,among the international guidelines for via intramuscular immunizations,the adoption of WASi T only for compliant vaccinees,and in combination with all validated techniques for IMIs,and the use of ZTT limitedly if specific well-developed muscles are indicated.All the technique's limitations are exposed.Conclusions:Future research directions are presented by including the author's study designs to provide indirect evidence for the validity of the rationale of the slow injection technique using scientific methods,and for the conduction of future randomized controlled trials(RCTs)focused on revisiting the adoption of ZTT in a dynamic and integrated immunizations protocol in anterolateral thigh(ALT),ventrogluteal(VG),and also in the deltoid muscle,in the specific cases analyzed.展开更多
Because of its simplicity,reliability,and replicability,the Masquelet induced membrane technique(IMT)has become one of the preferred methods for critical bone defect reconstruction in extremities.Although it is now us...Because of its simplicity,reliability,and replicability,the Masquelet induced membrane technique(IMT)has become one of the preferred methods for critical bone defect reconstruction in extremities.Although it is now used worldwide,few studies have been published about IMT in military practice.Bone reconstruction is particularly challenging in this context of care due to extensive soft-tissue injury,early wound infection,and even delayed management in austere conditions.Based on our clinical expertise,recent research,and a literature analysis,this narrative review provides an overview of the IMT application to combat-related bone defects.It presents technical specificities and future developments aiming to optimize IMT outcomes,including for the management of massive multi-tissue defects or bone reconstruction performed in the field with limited resources.展开更多
BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the ...BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative complications.To address these issues,scholars have proposed the use of a“gunsight suture”technique.This technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection.Building on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative complications.AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas.METHODS In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021.The patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture method.We collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization costs.Non-parametric tests and chi-square tests were utilized for data analysis.RESULTS There were no statistically significant differences in general patient information between the two groups,including the interval between the first surgery and the stoma closure[132(105,184)d vs 134(109,181)d,P=0.63],gender ratio(0.64 vs 0.69,P=0.44),age[62(52,68)years vs 60(52,68)years,P=0.33],preoperative body mass index(BMI)[23.83(21.60,25.95)kg/m²vs 23.12(20.94,25.06)kg/m²,P=0.17].The incidence of incision infection in the improved gunsight suture group tended to be lower than that in the traditional interrupted suture group[(n=2/135,1.4%)vs(n=10/135,7.4%),P<0.05],and the postoperative hospital stay in the improved gunsight suture group was significantly shorter than that in the traditional interrupted suture group[5(4,7)d vs 7(6,8)d,P<0.05].Additionally,the surgical cost in the modified gunsight suture group was slightly lower than that in the traditional suture group[4840(4330,5138)yuan vs 4980(4726,5221)yuan,P>0.05],but there was no significant difference in the total hospitalization cost between the two groups.CONCLUSION In stoma closure surgery,the improved gunsight technique can reduce the incision infection rate,shorten the postoperative hospital stay,reduce wound tension,and provide better wound cosmetic effects compared to traditional interrupted suture.展开更多
Electrocatalytic oxygen reduction reaction(ORR)is one of the most important reactions in electrochemical energy technologies such as fuel cells and metal–O2/air batteries,etc.However,the essential catalysts to overco...Electrocatalytic oxygen reduction reaction(ORR)is one of the most important reactions in electrochemical energy technologies such as fuel cells and metal–O2/air batteries,etc.However,the essential catalysts to overcome its slow reaction kinetic always undergo a complex dynamic evolution in the actual catalytic process,and the concomitant intermediates and catalytic products also occur continuous conversion and reconstruction.This makes them difficult to be accurately captured,making the identification of ORR active sites and the elucidation of ORR mechanisms difficult.Thus,it is necessary to use extensive in-situ characterization techniques to proceed the real-time monitoring of the catalyst structure and the evolution state of intermediates and products during ORR.This work reviews the major advances in the use of various in-situ techniques to characterize the catalytic processes of various catalysts.Specifically,the catalyst structure evolutions revealed directly by in-situ techniques are systematically summarized,such as phase,valence,electronic transfer,coordination,and spin states varies.In-situ revelation of intermediate adsorption/desorption behavior,and the real-time monitoring of the product nucleation,growth,and reconstruction evolution are equally emphasized in the discussion.Other interference factors,as well as in-situ signal assignment with the aid of theoretical calculations,are also covered.Finally,some major challenges and prospects of in-situ techniques for future catalysts research in the ORR process are proposed.展开更多
In the world,nonalcoholic fatty liver disease(NAFLD)accounts for majority of diffuse hepatic diseases.Notably,substantial liver fat accumulation can trigger and accelerate hepatic fibrosis,thus contributing to disease...In the world,nonalcoholic fatty liver disease(NAFLD)accounts for majority of diffuse hepatic diseases.Notably,substantial liver fat accumulation can trigger and accelerate hepatic fibrosis,thus contributing to disease progression.Moreover,the presence of NAFLD not only puts adverse influences for liver but is also associated with an increased risk of type 2 diabetes and cardiovascular diseases.Therefore,early detection and quantified measurement of hepatic fat content are of great importance.Liver biopsy is currently the most accurate method for the evaluation of hepatic steatosis.However,liver biopsy has several limitations,namely,its invasiveness,sampling error,high cost and moderate intraobserver and interobserver reproducibility.Recently,various quantitative imaging techniques have been developed for the diagnosis and quantified measurement of hepatic fat content,including ultrasound-or magnetic resonancebased methods.These quantitative imaging techniques can provide objective continuous metrics associated with liver fat content and be recorded for comparison when patients receive check-ups to evaluate changes in liver fat content,which is useful for longitudinal follow-up.In this review,we introduce several imaging techniques and describe their diagnostic performance for the diagnosis and quantified measurement of hepatic fat content.展开更多
基金supported by the Natural Science Foundation of Sichuan Province of China,Nos.2022NSFSC1545 (to YG),2022NSFSC1387 (to ZF)the Natural Science Foundation of Chongqing of China,Nos.CSTB2022NSCQ-LZX0038,cstc2021ycjh-bgzxm0035 (both to XT)+3 种基金the National Natural Science Foundation of China,No.82001378 (to XT)the Joint Project of Chongqing Health Commission and Science and Technology Bureau,No.2023QNXM009 (to XT)the Science and Technology Research Program of Chongqing Education Commission of China,No.KJQN202200435 (to XT)the Chongqing Talents:Exceptional Young Talents Project,No.CQYC202005014 (to XT)。
文摘Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal discharges.Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice.An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tra ctography,diffusion kurtosis imaging-based fiber tractography,fiber ball imagingbased tra ctography,electroencephalography,functional magnetic resonance imaging,magnetoencephalography,positron emission tomography,molecular imaging,and functional ultrasound imaging have been extensively used to delineate epileptic networks.In this review,we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy,and extensively analyze the imaging mechanisms,advantages,limitations,and clinical application ranges of each technique.A greater focus on emerging advanced technologies,new data analysis software,a combination of multiple techniques,and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.
基金We acknowledge the funding support from the National Natural Science Foundation of China(Grant No.51808462)the Natural Science Foundation Project of Sichuan Province,China(Grant No.2023NSFSC0346)the Science and Technology Project of Inner Mongolia Transportation Department,China(Grant No.NJ-2022-14).
文摘Reliable long-term settlement prediction of a high embankment relates to mountain infrastructure safety.This study developed a novel hybrid model(NHM)that combines a joint denoising technique with an enhanced gray wolf optimizer(EGWO)-n-support vector regression(n-SVR)method.High-embankment field measurements were preprocessed using the joint denoising technique,which in-cludes complete ensemble empirical mode decomposition,singular value decomposition,and wavelet packet transform.Furthermore,high-embankment settlements were predicted using the EGWO-n-SVR method.In this method,the standard gray wolf optimizer(GWO)was improved to obtain the EGWO to better tune the n-SVR model hyperparameters.The proposed NHM was then tested in two case studies.Finally,the influences of the data division ratio and kernel function on the EGWO-n-SVR forecasting performance and prediction efficiency were investigated.The results indicate that the NHM suppresses noise and restores details in high-embankment field measurements.Simultaneously,the NHM out-performs other alternative prediction methods in prediction accuracy and robustness.This demonstrates that the proposed NHM is effective in predicting high-embankment settlements with noisy field mea-surements.Moreover,the appropriate data division ratio and kernel function for EGWO-n-SVR are 7:3 and radial basis function,respectively.
文摘This study develops an Enhanced Threshold Based Energy Detection approach(ETBED)for spectrum sensing in a cognitive radio network.The threshold identification method is implemented in the received signal at the secondary user based on the square law.The proposed method is implemented with the signal transmission of multiple outputs-orthogonal frequency division multiplexing.Additionally,the proposed method is considered the dynamic detection threshold adjustments and energy identification spectrum sensing technique in cognitive radio systems.In the dynamic threshold,the signal ratio-based threshold is fixed.The threshold is computed by considering the Modified Black Widow Optimization Algorithm(MBWO).So,the proposed methodology is a combination of dynamic threshold detection and MBWO.The general threshold-based detection technique has different limitations such as the inability optimal signal threshold for determining the presence of the primary user signal.These limitations undermine the sensing accuracy of the energy identification technique.Hence,the ETBED technique is developed to enhance the energy efficiency of cognitive radio networks.The projected approach is executed and analyzed with performance and comparison analysis.The proposed method is contrasted with the conventional techniques of theWhale Optimization Algorithm(WOA)and GreyWolf Optimization(GWO).It indicated superior results,achieving a high average throughput of 2.2 Mbps and an energy efficiency of 3.8,outperforming conventional techniques.
基金Supported by Discipline Advancement Program of Shanghai Fourth People’s Hospital,No.SY-XKZT-2020-2013.
文摘BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling technique(SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer patients.METHODS In this retrospective cohort study,we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October 2022.The incidence of postoperative delirium was recorded for 7 d post-surgery.Patients were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not.A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative delirium.The SMOTE technique was applied to enhance the model by oversampling the delirium cases.The model’s predictive accuracy was then validated.RESULTS In our study involving 611 elderly patients with abdominal malignant tumors,multivariate logistic regression analysis identified significant risk factors for postoperative delirium.These included the Charlson comorbidity index,American Society of Anesthesiologists classification,history of cerebrovascular disease,surgical duration,perioperative blood transfusion,and postoperative pain score.The incidence rate of postoperative delirium in our study was 22.91%.The original predictive model(P1)exhibited an area under the receiver operating characteristic curve of 0.862.In comparison,the SMOTE-based logistic early warning model(P2),which utilized the SMOTE oversampling algorithm,showed a slightly lower but comparable area under the curve of 0.856,suggesting no significant difference in performance between the two predictive approaches.CONCLUSION This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of traditional methods,effectively addressing data imbalance.
文摘The widespread adoption of the Internet of Things (IoT) has transformed various sectors globally, making themmore intelligent and connected. However, this advancement comes with challenges related to the effectiveness ofIoT devices. These devices, present in offices, homes, industries, and more, need constant monitoring to ensuretheir proper functionality. The success of smart systems relies on their seamless operation and ability to handlefaults. Sensors, crucial components of these systems, gather data and contribute to their functionality. Therefore,sensor faults can compromise the system’s reliability and undermine the trustworthiness of smart environments.To address these concerns, various techniques and algorithms can be employed to enhance the performance ofIoT devices through effective fault detection. This paper conducted a thorough review of the existing literature andconducted a detailed analysis.This analysis effectively links sensor errors with a prominent fault detection techniquecapable of addressing them. This study is innovative because it paves theway for future researchers to explore errorsthat have not yet been tackled by existing fault detection methods. Significant, the paper, also highlights essentialfactors for selecting and adopting fault detection techniques, as well as the characteristics of datasets and theircorresponding recommended techniques. Additionally, the paper presents amethodical overview of fault detectiontechniques employed in smart devices, including themetrics used for evaluation. Furthermore, the paper examinesthe body of academic work related to sensor faults and fault detection techniques within the domain. This reflectsthe growing inclination and scholarly attention of researchers and academicians toward strategies for fault detectionwithin the realm of the Internet of Things.
基金Supported by the National Natural Science Foundation of China,No.31971518.
文摘BACKGROUND Radical surgery combined with systemic chemotherapy offers the possibility of long-term survival or even cure for patients with pancreatic ductal adenocar-cinoma(PDAC),although tumor recurrence,especially locally,still inhibits the treatment efficacy.The TRIANGLE technique was introduced as an extended dissection procedure to improve the R0 resection rate of borderline resectable or locally advanced PDAC.However,there was a lack of studies concerning postoperative complications and long-term outcomes of this procedure on patients with resectable PDAC.PDAC.METHODS Patients with resectable PDAC eligible for PD from our hospital between June 2018 and December 2021 were enrolled in this retrospective cohort study.All the patients were divided into PDstandard and PDTRIANGLE groups according to the surgical procedure.Baseline characteristics,surgical data,and postoperative morbidities were recorded.All of the patients were followed up,and the date and location of tumor recurrence,and death were recorded.The Kaplan-Meier method and log-rank test were used for the survival analysis.RESULTS There were 93 patients included in the study and 37 underwent the TRIANGLE technique.Duration of operation was longer in the PDTRIANGLE group compared with the PDstandard group[440(410-480)min vs 320(265-427)min](P=0.001).Intraoperative blood loss[700(500-1200)mL vs 500(300-800)mL](P=0.009)and blood transfusion[975(0-1250)mL vs 400(0-800)mL](P=0.009)were higher in the PDTRIANGLE group.There was a higher incidence of surgical site infection(43.2%vs 12.5%)(P=0.001)and postoperative diarrhea(54.1%vs 12.5%)(P=0.001)in the PDTRIANGLE group.The rates of R0 resection and local recurrence,overall survival,and disease-free survival did not differ significantly between the two groups.CONCLUSION The TRIANGLE technique is safe,with acceptable postoperative morbidities compared with standardized PD,but it does not improve prognosis for patients with resectable PDAC.
文摘BACKGROUND Developmental dysplasia of the hip(DDH)is a common osteoarticular deformity in pediatric orthopedics.A patient with bilateral DDH was diagnosed and treated using our improved technique"(powerful overturning acetabuloplasty)"combined with femoral rotational shortening osteotomy.CASE SUMMARY A 4-year-old girl who was diagnosed with bilateral DDH could not stand normally,and sought surgical treatment to solve the problem of double hip extension and standing.As this child had high dislocation of the hip joint and the acetabular index was high,we changed the traditional acetabuloplasty to"powerful turnover acetabuloplasty"combined with femoral rotation shortening osteotomy.During the short-term postoperative follow-up(1,3,6,9,12,and 15 months),the child had no discomfort in her lower limbs.After the braces and internal fixation plates were removed,formal rehabilitation training was actively carried out.CONCLUSION Our"powerful overturning acetabuloplasty"combined with femoral rotational shortening osteotomy is feasible in the treatment of DDH in children.This technology may be widely used in the clinic.
基金Supported by the Zhejiang Provincial Natural Science Foundation of China,No.LQ20H260002.
文摘BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.
基金Supported by Special Project of the Central Government in Guidance of Local Science and Technology Development (Scientific and Technological Innovation Base Project) (226Z5504G)The Fourth Batch of High-end Talent Project in Hebei Province.
文摘Chinese chive is a kind of medicinal and edible plant,with many diseases,and chemical fungicides are usually used for control.In order to find out the risk of pesticide residues in Chinese chives,this paper summarized relevant literatures published in recent years,and sorted out and analyzed the types of pesticides used and detection techniques of common diseases in Chinese chives.
文摘In the increasingly decentralized energy environment,economical power dispatching from distributed generations(DGs)is crucial to minimizing operating costs,optimizing resource utilization,and guaranteeing a consistent and sustainable supply of electricity.A comprehensive review of optimization techniques for economic power dispatching from distributed generations is imperative to identify the most effective strategies for minimizing operational costs while maintaining grid stability and sustainability.The choice of optimization technique for economic power dispatching from DGs depends on a number of factors,such as the size and complexity of the power system,the availability of computational resources,and the specific requirements of the application.Optimization techniques for economic power dispatching from distributed generations(DGs)can be classified into two main categories:(i)Classical optimization techniques,(ii)Heuristic optimization techniques.In classical optimization techniques,the linear programming(LP)model is one of the most popular optimization methods.Utilizing the LP model,power demand and network constraints are met while minimizing the overall cost of generating electricity from DGs.This approach is efficient in determining the best DGs dispatch and is capable of handling challenging optimization issues in the large-scale system including renewables.The quadratic programming(QP)model,a classical optimization technique,is a further popular optimization method,to consider non-linearity.The QP model can take into account the quadratic cost of energy production,with consideration constraints like network capacity,voltage,and frequency.The metaheuristic optimization techniques are also used for economic power dispatching from DGs,which include genetic algorithms(GA),particle swarm optimization(PSO),and ant colony optimization(ACO).Also,Some researchers are developing hybrid optimization techniques that combine elements of classical and heuristic optimization techniques with the incorporation of droop control,predictive control,and fuzzy-based methods.These methods can deal with large-scale systems with many objectives and non-linear,non-convex optimization issues.The most popular approaches are the LP and QP models,while more difficult problems are handled using metaheuristic optimization techniques.In summary,in order to increase efficiency,reduce costs,and ensure a consistent supply of electricity,optimization techniques are essential tools used in economic power dispatching from DGs.
文摘Amplitudes have been found to be a function of incident angle and offset. Hence data required to test for amplitude variation with angle or offset needs to have its amplitudes for all offsets preserved and not stacked. Amplitude Variation with Offset (AVO)/Amplitude Variation with Angle (AVA) is necessary to account for information in the offset/angle parameter (mode converted S-wave and P-wave velocities). Since amplitudes are a function of the converted S- and P-waves, it is important to investigate the dependence of amplitudes on the elastic (P- and S-waves) parameters from the seismic data. By modelling these effects for different reservoir fluids via fluid substitution, various AVO geobody classes present along the well and in the entire seismic cube can be observed. AVO analysis was performed on one test well (Well_1) and 3D pre-stack angle gathers from the Tano Basin. The analysis involves creating a synthetic model to infer the effect of offset scaling techniques on amplitude responses in the Tano basin as compared to the effect of unscaled seismic data. The spectral balance process was performed to match the amplitude spectra of all angle stacks to that of the mid (26°) stack on the test lines. The process had an effect primarily on the far (34° - 40°) stacks. The frequency content of these stacks slightly increased to match that of the near and mid stacks. In offset scaling process, the root mean square (RMS) amplitude comparison between the synthetic and seismic suggests that the amplitude of the far traces should be reduced relative to the nears by up to 16%. However, the exact scaler values depend on the time window considered. This suggests that the amplitude scaling with offset delivered from seismic processing is only approximately correct and needs to be checked with well synthetics and adjusted accordingly prior to use for AVO studies. The AVO attribute volumes generated were better at resolving anomalies on spectrally balanced and offset scaled data than data delivered from conventional processing. A typical class II AVO anomaly is seen along the test well from the cross-plot analysis and AVO attribute cube which indicates an oil filled reservoir.
文摘Introduction: Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye Teaching Hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy postoperatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bulbar urethral strictures. The repair methods employed were anastomotic urethroplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethroplasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Complications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the procedure should not be denied solely based on age.
文摘In light of the rapid growth and development of social media, it has become the focus of interest in many different scientific fields. They seek to extract useful information from it, and this is called (knowledge), such as extracting information related to people’s behaviors and interactions to analyze feelings or understand the behavior of users or groups, and many others. This extracted knowledge has a very important role in decision-making, creating and improving marketing objectives and competitive advantage, monitoring events, whether political or economic, and development in all fields. Therefore, to extract this knowledge, we need to analyze the vast amount of data found within social media using the most popular data mining techniques and applications related to social media sites.
文摘This thorough review explores the complexities of geotechnical engineering, emphasizing soil-structure interaction (SSI). The investigation centers on sheet pile design, examining two primary methodologies: Limit Equilibrium Methods (LEM) and Soil-Structure Interaction Methods (SSIM). While LEM methods, grounded in classical principles, provide valuable insights for preliminary design considerations, they may encounter limitations in addressing real-world complexities. In contrast, SSIM methods, including the SSI-SR approach, introduce precision and depth to the field. By employing numerical techniques such as Finite Element (FE) and Finite Difference (FD) analyses, these methods enable engineers to navigate the dynamics of soil-structure interaction. The exploration extends to SSI-FE, highlighting its essential role in civil engineering. By integrating Finite Element analysis with considerations for soil-structure interaction, the SSI-FE method offers a holistic understanding of how structures dynamically interact with their geotechnical environment. Throughout this exploration, the study dissects critical components governing SSIM methods, providing engineers with tools to navigate the intricate landscape of geotechnical design. The study acknowledges the significance of the Mohr-Coulomb constitutive model while recognizing its limitations, and guiding practitioners toward informed decision-making in geotechnical analyses. As the article concludes, it underscores the importance of continuous learning and innovation for the future of geotechnical engineering. With advancing technology and an evolving understanding of soil-structure interaction, the study remains committed to ensuring the safety, stability, and efficiency of geotechnical structures through cutting-edge design and analysis techniques.
文摘Objective:Although endoscopic treatment has been used by many pediatric urologists for the treatment of vesicoureteral reflux(VUR),it has no considerable success in high-grade VUR.We aimed to describe the primary outcomes of unilateral periureteral injection technique(PIT),as well as bilateral PIT in high-grade VUR.Methods:In this prospective study,we examined 92 ureters in 45 boys and 40 girls from February 2010 to May 2018.Bilateral PIT and unilateral PIT were applied in 67 and 25 refluxing units,respectively.In the unilateral PIT,the subureteral injection site was only at the 5-or 7-o’clock position.However,in the bilateral PIT,the subureteral injection sites were at 5-and 7-o’clock position.Pre-and post-operative reflux grades were evaluated by voiding cystourethrography 6 months after surgery.Results:Seven patients had bilateral reflux.Overall,75(81.5%)ureters showed Grade IV VUR,while 17(18.5%)had primary Grade V VUR.The mean age of the subjects was 39.2 months.In unilateral PIT ureters,VUR was resolved in 23(92.0%)refluxing units.It was downgraded to Grade III in one ureter(4.0%)and to Grade II in another ureter(4.0%).In addition,in bilateral PIT cases,VUR was resolved in 60(89.6%)ureters;it downgraded to Grades II and III in 3(4.5%)and 4(6.0%)refluxing units,respectively.Conclusion:Unilateral PIT can be highly effective in the treatment of selected ureters of high-grade VUR.However,further studies are needed to confirm our results.
文摘Objective:To review the current literature on the practice of intramuscular injections(IMIs),focusing on immunizations.Methods:The present study comprises 2 reviews,characterized by high-quality evidence,per taining to the deployment of the slow injection technique without aspiration(referred to in this paper as the without-aspiration slow injection technique[WASi T])and combined with the Zeta-track technique(ZTT).The literature review is oriented toward the analysis of 2 features associated with IMIs techniques:safety and pain,integrating new evidence on vaccinee positioning for each muscle site and general relaxation techniques in the multi-parametric analysis.Results:The rigorous and in-depth reviews in the current study reveal the usefulness of including,among the international guidelines for via intramuscular immunizations,the adoption of WASi T only for compliant vaccinees,and in combination with all validated techniques for IMIs,and the use of ZTT limitedly if specific well-developed muscles are indicated.All the technique's limitations are exposed.Conclusions:Future research directions are presented by including the author's study designs to provide indirect evidence for the validity of the rationale of the slow injection technique using scientific methods,and for the conduction of future randomized controlled trials(RCTs)focused on revisiting the adoption of ZTT in a dynamic and integrated immunizations protocol in anterolateral thigh(ALT),ventrogluteal(VG),and also in the deltoid muscle,in the specific cases analyzed.
文摘Because of its simplicity,reliability,and replicability,the Masquelet induced membrane technique(IMT)has become one of the preferred methods for critical bone defect reconstruction in extremities.Although it is now used worldwide,few studies have been published about IMT in military practice.Bone reconstruction is particularly challenging in this context of care due to extensive soft-tissue injury,early wound infection,and even delayed management in austere conditions.Based on our clinical expertise,recent research,and a literature analysis,this narrative review provides an overview of the IMT application to combat-related bone defects.It presents technical specificities and future developments aiming to optimize IMT outcomes,including for the management of massive multi-tissue defects or bone reconstruction performed in the field with limited resources.
基金the Natural Science Foundation of Shandong Province,No.ZR2020MH257。
文摘BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative complications.To address these issues,scholars have proposed the use of a“gunsight suture”technique.This technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection.Building on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative complications.AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas.METHODS In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021.The patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture method.We collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization costs.Non-parametric tests and chi-square tests were utilized for data analysis.RESULTS There were no statistically significant differences in general patient information between the two groups,including the interval between the first surgery and the stoma closure[132(105,184)d vs 134(109,181)d,P=0.63],gender ratio(0.64 vs 0.69,P=0.44),age[62(52,68)years vs 60(52,68)years,P=0.33],preoperative body mass index(BMI)[23.83(21.60,25.95)kg/m²vs 23.12(20.94,25.06)kg/m²,P=0.17].The incidence of incision infection in the improved gunsight suture group tended to be lower than that in the traditional interrupted suture group[(n=2/135,1.4%)vs(n=10/135,7.4%),P<0.05],and the postoperative hospital stay in the improved gunsight suture group was significantly shorter than that in the traditional interrupted suture group[5(4,7)d vs 7(6,8)d,P<0.05].Additionally,the surgical cost in the modified gunsight suture group was slightly lower than that in the traditional suture group[4840(4330,5138)yuan vs 4980(4726,5221)yuan,P>0.05],but there was no significant difference in the total hospitalization cost between the two groups.CONCLUSION In stoma closure surgery,the improved gunsight technique can reduce the incision infection rate,shorten the postoperative hospital stay,reduce wound tension,and provide better wound cosmetic effects compared to traditional interrupted suture.
基金the National Natural Science Foundation of China(No.52072256)Shanxi Science and Technology Major Project(No.20201101016)+1 种基金Key R&D program of Shanxi Province(No.202102030201006)Research Project Supported by Shanxi Scholarship Council of China(HGKY2019031).
文摘Electrocatalytic oxygen reduction reaction(ORR)is one of the most important reactions in electrochemical energy technologies such as fuel cells and metal–O2/air batteries,etc.However,the essential catalysts to overcome its slow reaction kinetic always undergo a complex dynamic evolution in the actual catalytic process,and the concomitant intermediates and catalytic products also occur continuous conversion and reconstruction.This makes them difficult to be accurately captured,making the identification of ORR active sites and the elucidation of ORR mechanisms difficult.Thus,it is necessary to use extensive in-situ characterization techniques to proceed the real-time monitoring of the catalyst structure and the evolution state of intermediates and products during ORR.This work reviews the major advances in the use of various in-situ techniques to characterize the catalytic processes of various catalysts.Specifically,the catalyst structure evolutions revealed directly by in-situ techniques are systematically summarized,such as phase,valence,electronic transfer,coordination,and spin states varies.In-situ revelation of intermediate adsorption/desorption behavior,and the real-time monitoring of the product nucleation,growth,and reconstruction evolution are equally emphasized in the discussion.Other interference factors,as well as in-situ signal assignment with the aid of theoretical calculations,are also covered.Finally,some major challenges and prospects of in-situ techniques for future catalysts research in the ORR process are proposed.
文摘In the world,nonalcoholic fatty liver disease(NAFLD)accounts for majority of diffuse hepatic diseases.Notably,substantial liver fat accumulation can trigger and accelerate hepatic fibrosis,thus contributing to disease progression.Moreover,the presence of NAFLD not only puts adverse influences for liver but is also associated with an increased risk of type 2 diabetes and cardiovascular diseases.Therefore,early detection and quantified measurement of hepatic fat content are of great importance.Liver biopsy is currently the most accurate method for the evaluation of hepatic steatosis.However,liver biopsy has several limitations,namely,its invasiveness,sampling error,high cost and moderate intraobserver and interobserver reproducibility.Recently,various quantitative imaging techniques have been developed for the diagnosis and quantified measurement of hepatic fat content,including ultrasound-or magnetic resonancebased methods.These quantitative imaging techniques can provide objective continuous metrics associated with liver fat content and be recorded for comparison when patients receive check-ups to evaluate changes in liver fat content,which is useful for longitudinal follow-up.In this review,we introduce several imaging techniques and describe their diagnostic performance for the diagnosis and quantified measurement of hepatic fat content.
