BACKGROUND Schizophrenia is commonly associated with comorbid depression,which exacerbates cognitive impairments and negatively impacts quality of life.Despite the high prevalence and burden of these comorbidities,eff...BACKGROUND Schizophrenia is commonly associated with comorbid depression,which exacerbates cognitive impairments and negatively impacts quality of life.Despite the high prevalence and burden of these comorbidities,effective treatment options,particularly for cognitive dysfunction,remain limited.AIM To evaluate the efficacy of computerized cognitive behavioral therapy(CCBT)with sertraline vs sertraline monotherapy in improving depressive symptoms,cognitive function,and quality of life in schizophrenia and depressive episodes.METHODS In this single-center,randomized controlled trial,68 adults[mean age(SD)=36.5(10.0),57.4%male]with schizophrenia and depressive symptoms were randomly assigned to receive either CCBT with sertraline or sertraline monotherapy during a 4-week hospitalization.The CCBT intervention involved 45-60-minute sessions twice weekly for four weeks.Outcomes included comparisons of depressive symptoms(Calgary depression scale for schizophrenia),cognitive function[MATRICS consensus cognitive battery(MCCB)],and quality of life(36-item short form survey)between the groups.RESULTS The experimental group showed greater improvements in depressive symptoms at 4,8,and 12 weeks compared to the controls,with the most notable difference at 12 weeks[mean difference(MD)=-1.7;P<0.001;Cohen’s d=0.9].Cognitive function improved across all MCCB domains in the experimental group,with higher processing speed scores(MD=4.1;P=0.043;Cohen’s d=0.5)and social cognition scores(MD=4.9;P=0.006;Cohen’s d=0.7)than in the control group.Quality of life,particularly in mental health,was significantly better in the experimental group.CONCLUSION CCBT with sertraline was more effective than sertraline monotherapy for patients with schizophrenia and depressive episodes,supporting its use as an adjunctive therapy.展开更多
BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to impr...BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.展开更多
BACKGROUND Patients with schizophrenia may have various disease manifestations,most of which gradually tend toward incurable chronic decline,leading to mental disability.The basic symptoms of the disease can impair so...BACKGROUND Patients with schizophrenia may have various disease manifestations,most of which gradually tend toward incurable chronic decline,leading to mental disability.The basic symptoms of the disease can impair social function,whereas long-term hospitalization produces hospitalization syndrome,causing serious damage to social function.AIM To investigate the effects of Computerized Cognitive Remediation Therapy(CCRT)on cognitive and social functioning in patients with chronic schizophrenia.METHODS A retrospective analysis of 120 patients with chronic schizophrenia in Shanghai Pudong New Area Mental Health Center was performed.They were divided into an intervention group(60 cases treated with CCRT combined with conventional medication)and a control group(60 cases treated with conventional medication).After treatment,effects on cognitive function and social roles were observed in both groups.The Positive and Negative Syndrome Scale(PANSS)was used to assess the patients'psychiatric symptoms.The Wisconsin Card Sorting Test(WCST)was used to assess the patients'cognitive functioning,and the Social Functioning Scale for Psychiatric Inpatients(SSPI)was used to assess the social functioning of the inpatient psychiatric patients.RESULTS No significant differences were observed in the PANSS,WCST,and SSPI intergroup scores before treatment(P>0.05).After 2,4,and 6 wk of therapy,general psychopathological factors,positive symptoms,negative symptoms,and total PANSS scores of PANSS in the intervention group were lower than in the control group(P<0.05).After 2,4,and 6 wk of treatment,the number of false responses,number of persistent bugs,and total responses in the WCST were significantly lower in the intervention group than in the control group(P<0.05),and the amount of completed classification was significantly higher than in the control group(P<0.05).After 2,4,and 6 wk of therapy,the SSPI scores were significantly greater than those of the controls(P<0.05).After 6 wk of treatment,the efficacy rates of the control and intervention groups were 81.67%and 91.67%,respectively.The curative effect in the intervention group was significantly higher than that in the control group(P<0.05).CONCLUSION CCRT can significantly improve cognitive function and social abilities in patients with chronic schizophrenia.展开更多
Proactive Semantic Interference (PSI) and failure to recover from PSI (frPSI), are novel constructs assessed by the LASSI-L. These measures are sensitive to cognitive changes in early Mild Cognitive Impairment (MCI) a...Proactive Semantic Interference (PSI) and failure to recover from PSI (frPSI), are novel constructs assessed by the LASSI-L. These measures are sensitive to cognitive changes in early Mild Cognitive Impairment (MCI) and preclinical AD determined by Aβ load using PET. The goal of this study was to compare a new computerized version of the LASSI-L (LASSI-Brief Computerized) to the standard paper-and-pencil version of the test. In this study, we examined 110 cognitively unimpaired (CU) older adults and 79 with amnestic MCI (aMCI) who were administered the paper-and-pencil form of the LASSI-L. Their performance was compared with 62 CU older adults and 52 aMCI participants examined using the LASSI-BC. After adjustment for covariates (degree of initial learning, sex, education, and language of evaluation) both the standard and computerized versions distinguished between aMCI and CU participants. The performance of CU and aMCI groups using either form was relatively commensurate. Importantly, an optimal combination of Cued B2 recall and Cued B1 intrusions on the LASSI-BC yielded an area under the ROC curve of .927, a sensitivity of 92.3% and specificity of 88.1%, relative to an area under the ROC curve of .815, a sensitivity of 72.5%, and a specificity of 79.1% obtained for the paper-and-pencil LASSI-L. Overall, the LASSI-BC was comparable, and in some ways, superior to the paper-and-pencil LASSI-L. Advantages of the LASSI-BC include a more standardized administration, suitability for remote assessment, and an automated scoring mechanism that can be verified by a built-in audio recording of responses.展开更多
AIM:To evaluate the reliability of Photo-Hirschberg screening for global strabismus performed by non-specialized personnel.METHODS:Participants at three sites were enrolled.One person at each site was trained in visua...AIM:To evaluate the reliability of Photo-Hirschberg screening for global strabismus performed by non-specialized personnel.METHODS:Participants at three sites were enrolled.One person at each site was trained in visual acuity measurement and use of the computerized system.Visual acuity was measured,and strabismus testing was performed using two flash photographs.All data from the three primary observers were sent to an experienced assistant researcher,who was blinded to the primary results,for re-evaluation.The primary and re-evaluation results of the Photo-Hirschberg screenings using weighted kappa for agreement were compared.RESULTS:The study included 181 participants(88 males and 93 females)and the results for primary and re-evaluation screenings were corresponded.Ten participants with contrasting results presented with unclear corneal light reflex.Sensitivity and specificity were 100%[95%confidence interval(CI):29.0%-100%]and 99.4%(95%CI:96.6%-100%),respectively,based on the Agresti test of the primary evaluation,considering the re-evaluated classification as true.CONCLUSION:The computerized system can be used for primary strabismus screening by non-specialized personnel,with 98.8%agreement with specialists.However,it cannot be used as a substitute for professional examination.展开更多
BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors.However,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampe...BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors.However,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampers the establishment of consistent conclusions.AIM To comprehensively assess 16 pelvic and 7 soft tissue parameters through computerized tomography(CT)-based three-dimensional(3D)reconstruction,providing a strong theoretical basis to address challenges in laparoscopic rectal cancer radical surgery.METHODS We analyzed data from 218 patients who underwent radical laparoscopic surgery for rectal cancer,and utilized CT data for 3D pelvic reconstruction.Specific anatomical points were carefully marked and measured using advanced 3D modeling software.To analyze the pelvic and soft tissue parameters,we emp-loyed statistical methods including paired sample t-tests,Wilcoxon rank-sum tests,and correlation analysis.RESULTS The investigation highlighted significant sex disparities in 14 pelvic bone parameters and 3 soft tissue parameters.Males demonstrated larger measurements in pelvic depth and overall curvature,smaller measurements in pelvic width,a larger mesorectal fat area,and a larger anterior-posterior abdominal diameter.By contrast,females exhibited wider pelvises,shallower depth,smaller overall curvature,and an increased amount of subcutaneous fat tissue.However,there were no significant sex differences observed in certain parameters such as sacral curvature height,superior pubococcygeal diameter,rectal area,visceral fat area,waist circumference,and transverse abdominal diameter.CONCLUSION The reconstruction of 3D CT data enabled accurate pelvic measurements,revealing significant sex differences in both pelvic and soft tissue parameters.This study design offer potential in predicting surgical difficulties and creating personalized surgical plans for male rectal cancer patients with a potentially“difficult pelvis”,ultimately improving surgical outcomes.Further research and utilization of these parameters could lead to enhanced surgical methods and patient care in laparoscopic rectal cancer radical surgery.展开更多
The algebraic reconstruction technique(ART),multiplicative algebraic reconstruction technique(MART),and simultaneous iterative reconstruction technique(SIRT)are computational methodologies extensively utilized within ...The algebraic reconstruction technique(ART),multiplicative algebraic reconstruction technique(MART),and simultaneous iterative reconstruction technique(SIRT)are computational methodologies extensively utilized within the field of computerized ionospheric tomography(CIT)to facilitate three-dimensional reconstruction of the ionospheric morphology.However,reconstruction accuracy elicits recurrent disputes over its practical application,and people usually attribute this issue to incomplete and uneven coverage of the measurements.The Thermosphere Ionosphere Electrodynamics General Circulation Model(TIEGCM)offers a reasonable physics-based ionospheric background and is widely utilized in ionospheric research.We use the TIEGCM simulations as the targeted ionosphere because the current measurements are far from able to realistically reproduce the ionosphere in detail.Optimized designations of satellite measurements are conducted to investigate the limiting performance of CIT methods in ionospheric reconstruction.Similar to common practice,electron density distributions from outputs of the International Reference Ionosphere(IRI)model are used as the iterative initial value in CIT applications.The outcomes suggest that despite data coverage,iterative initial conditions also play an essential role in ionospheric reconstruction.In particular,in the longitudinal sectors where the iterative initial height of the F2-layer peak electron density(hmF2)differs substantially from the background densities,none of the three CIT methods can reproduce the exact background profile.When hmF2 is close but the ionospheric F2-layer peak density(NmF2)is different between the targeted background and initial conditions,the MART performs better than the ART and SIRT,as evidenced by the correlation coefficients of MART being above 0.97 and those of ART and SIRT being below 0.85.In summary,this investigation reveals the potential uncertainties in traditional CIT reconstruction,particularly when realistic hmF2 or NmF2 values differ substantially from the initial CIT conditions.展开更多
Continuous carbon fiber reinforced silicon carbide(C/SiC)composites are often subjected to low-velocity impacts when utilized as structural materials for thermal protection.However,research on in-plane impact damage a...Continuous carbon fiber reinforced silicon carbide(C/SiC)composites are often subjected to low-velocity impacts when utilized as structural materials for thermal protection.However,research on in-plane impact damage and multiple impact damage of C/SiC composites is limited.To investigate the in-plane impact damage behavior of C/SiC composites,a drop-weight impact test method was developed for strip samples,and these results were subsequently compared with those of C/SiC composite plates.Results show that the in-plane impact behavior of C/SiC strip samples is similar to that of C/SiC composite plates.Variation of the impact load with displacement is characterized by three stages:a nearly linear stage,a severe load drop stage,and a rebound stage where displacement occurs after the impact energy exceeds its peak value.Impact damage behavior under single and multiple impacts on 2D plain and 3D needled C/SiC composites was investigated at different impact energies and durations.Crack propagation in C/SiC composites was studied by computerized tomography(CT)technique.In the 2D plain C/SiC composite,load propagation between layers is hindered during impact,leading to delamination and 90°fiber brittle fracture.The crack length perpendicular to the impact direction increases with impact energy increases,resulting in more serious 0°fiber fracture and a larger area of fiber loss.In the 3D needled C/SiC composite,load propagates between the layers during impact through the connection of needled fibers.The fibers continue to provide substantial structural support,with notable instances of fiber pull-off and debonding.Consequently,the impact resistance is superior to that of 2D plain C/SiC composite.When the 3D needled C/SiC composite undergoes two successive impacts of 1.5 J,the energy absorption efficiency of the second impact is significantly lower,accompanied by a smaller impact displacement.Moreover,the total energy absorption efficiency of these two impacts of 1.5 J is lower than that of a single 3.0 J impact.展开更多
基金Supported by Fuzhou Science and Technology Plan Project,No.2023-S-028.
文摘BACKGROUND Schizophrenia is commonly associated with comorbid depression,which exacerbates cognitive impairments and negatively impacts quality of life.Despite the high prevalence and burden of these comorbidities,effective treatment options,particularly for cognitive dysfunction,remain limited.AIM To evaluate the efficacy of computerized cognitive behavioral therapy(CCBT)with sertraline vs sertraline monotherapy in improving depressive symptoms,cognitive function,and quality of life in schizophrenia and depressive episodes.METHODS In this single-center,randomized controlled trial,68 adults[mean age(SD)=36.5(10.0),57.4%male]with schizophrenia and depressive symptoms were randomly assigned to receive either CCBT with sertraline or sertraline monotherapy during a 4-week hospitalization.The CCBT intervention involved 45-60-minute sessions twice weekly for four weeks.Outcomes included comparisons of depressive symptoms(Calgary depression scale for schizophrenia),cognitive function[MATRICS consensus cognitive battery(MCCB)],and quality of life(36-item short form survey)between the groups.RESULTS The experimental group showed greater improvements in depressive symptoms at 4,8,and 12 weeks compared to the controls,with the most notable difference at 12 weeks[mean difference(MD)=-1.7;P<0.001;Cohen’s d=0.9].Cognitive function improved across all MCCB domains in the experimental group,with higher processing speed scores(MD=4.1;P=0.043;Cohen’s d=0.5)and social cognition scores(MD=4.9;P=0.006;Cohen’s d=0.7)than in the control group.Quality of life,particularly in mental health,was significantly better in the experimental group.CONCLUSION CCBT with sertraline was more effective than sertraline monotherapy for patients with schizophrenia and depressive episodes,supporting its use as an adjunctive therapy.
基金Supported by 2022 Fujian Medical University Qihang Fund General Project Plan,No.2022QH1120。
文摘BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.
基金Supported by Shanghai Pudong New Area Science and Technology Development and Livelihood Research Special Fund Support Project,No.PKJ2023-Y80Integrated Traditional Chinese and Western Medicine Specialized Disease Diagnosis and Treatment Center Project,No.PDZY-2022-05-01.
文摘BACKGROUND Patients with schizophrenia may have various disease manifestations,most of which gradually tend toward incurable chronic decline,leading to mental disability.The basic symptoms of the disease can impair social function,whereas long-term hospitalization produces hospitalization syndrome,causing serious damage to social function.AIM To investigate the effects of Computerized Cognitive Remediation Therapy(CCRT)on cognitive and social functioning in patients with chronic schizophrenia.METHODS A retrospective analysis of 120 patients with chronic schizophrenia in Shanghai Pudong New Area Mental Health Center was performed.They were divided into an intervention group(60 cases treated with CCRT combined with conventional medication)and a control group(60 cases treated with conventional medication).After treatment,effects on cognitive function and social roles were observed in both groups.The Positive and Negative Syndrome Scale(PANSS)was used to assess the patients'psychiatric symptoms.The Wisconsin Card Sorting Test(WCST)was used to assess the patients'cognitive functioning,and the Social Functioning Scale for Psychiatric Inpatients(SSPI)was used to assess the social functioning of the inpatient psychiatric patients.RESULTS No significant differences were observed in the PANSS,WCST,and SSPI intergroup scores before treatment(P>0.05).After 2,4,and 6 wk of therapy,general psychopathological factors,positive symptoms,negative symptoms,and total PANSS scores of PANSS in the intervention group were lower than in the control group(P<0.05).After 2,4,and 6 wk of treatment,the number of false responses,number of persistent bugs,and total responses in the WCST were significantly lower in the intervention group than in the control group(P<0.05),and the amount of completed classification was significantly higher than in the control group(P<0.05).After 2,4,and 6 wk of therapy,the SSPI scores were significantly greater than those of the controls(P<0.05).After 6 wk of treatment,the efficacy rates of the control and intervention groups were 81.67%and 91.67%,respectively.The curative effect in the intervention group was significantly higher than that in the control group(P<0.05).CONCLUSION CCRT can significantly improve cognitive function and social abilities in patients with chronic schizophrenia.
文摘Proactive Semantic Interference (PSI) and failure to recover from PSI (frPSI), are novel constructs assessed by the LASSI-L. These measures are sensitive to cognitive changes in early Mild Cognitive Impairment (MCI) and preclinical AD determined by Aβ load using PET. The goal of this study was to compare a new computerized version of the LASSI-L (LASSI-Brief Computerized) to the standard paper-and-pencil version of the test. In this study, we examined 110 cognitively unimpaired (CU) older adults and 79 with amnestic MCI (aMCI) who were administered the paper-and-pencil form of the LASSI-L. Their performance was compared with 62 CU older adults and 52 aMCI participants examined using the LASSI-BC. After adjustment for covariates (degree of initial learning, sex, education, and language of evaluation) both the standard and computerized versions distinguished between aMCI and CU participants. The performance of CU and aMCI groups using either form was relatively commensurate. Importantly, an optimal combination of Cued B2 recall and Cued B1 intrusions on the LASSI-BC yielded an area under the ROC curve of .927, a sensitivity of 92.3% and specificity of 88.1%, relative to an area under the ROC curve of .815, a sensitivity of 72.5%, and a specificity of 79.1% obtained for the paper-and-pencil LASSI-L. Overall, the LASSI-BC was comparable, and in some ways, superior to the paper-and-pencil LASSI-L. Advantages of the LASSI-BC include a more standardized administration, suitability for remote assessment, and an automated scoring mechanism that can be verified by a built-in audio recording of responses.
文摘AIM:To evaluate the reliability of Photo-Hirschberg screening for global strabismus performed by non-specialized personnel.METHODS:Participants at three sites were enrolled.One person at each site was trained in visual acuity measurement and use of the computerized system.Visual acuity was measured,and strabismus testing was performed using two flash photographs.All data from the three primary observers were sent to an experienced assistant researcher,who was blinded to the primary results,for re-evaluation.The primary and re-evaluation results of the Photo-Hirschberg screenings using weighted kappa for agreement were compared.RESULTS:The study included 181 participants(88 males and 93 females)and the results for primary and re-evaluation screenings were corresponded.Ten participants with contrasting results presented with unclear corneal light reflex.Sensitivity and specificity were 100%[95%confidence interval(CI):29.0%-100%]and 99.4%(95%CI:96.6%-100%),respectively,based on the Agresti test of the primary evaluation,considering the re-evaluated classification as true.CONCLUSION:The computerized system can be used for primary strabismus screening by non-specialized personnel,with 98.8%agreement with specialists.However,it cannot be used as a substitute for professional examination.
基金2021 Zhejiang Province Public Welfare Technology Application Research Funding Project,No.LGC21H160002Basic Scientific Research Projects in Wenzhou City in 2022,No.Y20220885Wenzhou Medical University 2021 Higher Education Teaching Reform Project,No.JG2021167.
文摘BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors.However,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampers the establishment of consistent conclusions.AIM To comprehensively assess 16 pelvic and 7 soft tissue parameters through computerized tomography(CT)-based three-dimensional(3D)reconstruction,providing a strong theoretical basis to address challenges in laparoscopic rectal cancer radical surgery.METHODS We analyzed data from 218 patients who underwent radical laparoscopic surgery for rectal cancer,and utilized CT data for 3D pelvic reconstruction.Specific anatomical points were carefully marked and measured using advanced 3D modeling software.To analyze the pelvic and soft tissue parameters,we emp-loyed statistical methods including paired sample t-tests,Wilcoxon rank-sum tests,and correlation analysis.RESULTS The investigation highlighted significant sex disparities in 14 pelvic bone parameters and 3 soft tissue parameters.Males demonstrated larger measurements in pelvic depth and overall curvature,smaller measurements in pelvic width,a larger mesorectal fat area,and a larger anterior-posterior abdominal diameter.By contrast,females exhibited wider pelvises,shallower depth,smaller overall curvature,and an increased amount of subcutaneous fat tissue.However,there were no significant sex differences observed in certain parameters such as sacral curvature height,superior pubococcygeal diameter,rectal area,visceral fat area,waist circumference,and transverse abdominal diameter.CONCLUSION The reconstruction of 3D CT data enabled accurate pelvic measurements,revealing significant sex differences in both pelvic and soft tissue parameters.This study design offer potential in predicting surgical difficulties and creating personalized surgical plans for male rectal cancer patients with a potentially“difficult pelvis”,ultimately improving surgical outcomes.Further research and utilization of these parameters could lead to enhanced surgical methods and patient care in laparoscopic rectal cancer radical surgery.
基金supported by the National Key R&D Program of China (Grant No. 2022YFF0503702)the National Natural Science Foundation of China (Grant No. 42074186)
文摘The algebraic reconstruction technique(ART),multiplicative algebraic reconstruction technique(MART),and simultaneous iterative reconstruction technique(SIRT)are computational methodologies extensively utilized within the field of computerized ionospheric tomography(CIT)to facilitate three-dimensional reconstruction of the ionospheric morphology.However,reconstruction accuracy elicits recurrent disputes over its practical application,and people usually attribute this issue to incomplete and uneven coverage of the measurements.The Thermosphere Ionosphere Electrodynamics General Circulation Model(TIEGCM)offers a reasonable physics-based ionospheric background and is widely utilized in ionospheric research.We use the TIEGCM simulations as the targeted ionosphere because the current measurements are far from able to realistically reproduce the ionosphere in detail.Optimized designations of satellite measurements are conducted to investigate the limiting performance of CIT methods in ionospheric reconstruction.Similar to common practice,electron density distributions from outputs of the International Reference Ionosphere(IRI)model are used as the iterative initial value in CIT applications.The outcomes suggest that despite data coverage,iterative initial conditions also play an essential role in ionospheric reconstruction.In particular,in the longitudinal sectors where the iterative initial height of the F2-layer peak electron density(hmF2)differs substantially from the background densities,none of the three CIT methods can reproduce the exact background profile.When hmF2 is close but the ionospheric F2-layer peak density(NmF2)is different between the targeted background and initial conditions,the MART performs better than the ART and SIRT,as evidenced by the correlation coefficients of MART being above 0.97 and those of ART and SIRT being below 0.85.In summary,this investigation reveals the potential uncertainties in traditional CIT reconstruction,particularly when realistic hmF2 or NmF2 values differ substantially from the initial CIT conditions.
基金Aeronautical Science Foundation of China(2021Z057053001)。
文摘Continuous carbon fiber reinforced silicon carbide(C/SiC)composites are often subjected to low-velocity impacts when utilized as structural materials for thermal protection.However,research on in-plane impact damage and multiple impact damage of C/SiC composites is limited.To investigate the in-plane impact damage behavior of C/SiC composites,a drop-weight impact test method was developed for strip samples,and these results were subsequently compared with those of C/SiC composite plates.Results show that the in-plane impact behavior of C/SiC strip samples is similar to that of C/SiC composite plates.Variation of the impact load with displacement is characterized by three stages:a nearly linear stage,a severe load drop stage,and a rebound stage where displacement occurs after the impact energy exceeds its peak value.Impact damage behavior under single and multiple impacts on 2D plain and 3D needled C/SiC composites was investigated at different impact energies and durations.Crack propagation in C/SiC composites was studied by computerized tomography(CT)technique.In the 2D plain C/SiC composite,load propagation between layers is hindered during impact,leading to delamination and 90°fiber brittle fracture.The crack length perpendicular to the impact direction increases with impact energy increases,resulting in more serious 0°fiber fracture and a larger area of fiber loss.In the 3D needled C/SiC composite,load propagates between the layers during impact through the connection of needled fibers.The fibers continue to provide substantial structural support,with notable instances of fiber pull-off and debonding.Consequently,the impact resistance is superior to that of 2D plain C/SiC composite.When the 3D needled C/SiC composite undergoes two successive impacts of 1.5 J,the energy absorption efficiency of the second impact is significantly lower,accompanied by a smaller impact displacement.Moreover,the total energy absorption efficiency of these two impacts of 1.5 J is lower than that of a single 3.0 J impact.
