Purpose: To compare the complication rates arising from surgical removal of lower third molars (L3M) under general anaesthesia (GA) versus local anaesthesia (LA) in the Oral and Maxillofacial Surgery (OMFS) Department...Purpose: To compare the complication rates arising from surgical removal of lower third molars (L3M) under general anaesthesia (GA) versus local anaesthesia (LA) in the Oral and Maxillofacial Surgery (OMFS) Department, Hospital Sultanah Nora Ismail (HSNI), Batu Pahat, Johor, Malaysia. Materials and methods: This is a retrospective clinical audit of patients who underwent L3M removal under LA or GA from 1/1/2013 to 31/3/2018, with recorded complications such as surgical site infection (SSI), wound breakdown, severe pain, trismus, retained tooth structure, nerve injury and dry socket evaluated at different time intervals. Results: A total of 313 patients with 375 L3M were included in this study (male: 160, 51.1%;female: 153, 48.9%) with an age range of 18 to 40 years (mean = 27.43 years). 79 L3M were removed under GA (34.2% were classified as mild;65.8% were moderate), whereas 296 L3M were removed under LA, (31.4% were mild impaction, 63.9% moderate and 4.7% severe. Preoperative antibiotics were given before all L3M removal under GA, while only 23 out of 296 L3M removal under LA had antibiotics. 15.2% of L3M removal under GA and 16.6% of those done under LA were associated with complications. Generally, patient with GA had lesser complications;however only SSI outcome was significant (p = 0.034). Conclusion: L3M removal under LA may have a higher risk of SSI when compared to GA. This raises the possibility that a single prophylactic antibiotic dose may prevent SSI in LA procedures.展开更多
<strong>Background:</strong> In most centers worldwide, thyroidectomy is performed under general anaesthesia as a result of advances in anaesthetic technique, consideration for patients’ safety and surge...<strong>Background:</strong> In most centers worldwide, thyroidectomy is performed under general anaesthesia as a result of advances in anaesthetic technique, consideration for patients’ safety and surgeons’ convenience. However, in some developing countries such as Nigeria, facilities and expertise for general anaesthesia are not equitably distributed. As such, they are not available in some health centers especially in the rural communities. Hence, the need to explore other suitable alternatives such as operating under local anaesthesia. <strong>Aim:</strong> This study aims to highlight the feasibility and safety of thyroidectomy under local anaesthesia at a surgical outreach in a rural community in Nigeria. <strong>Patients and Methods:</strong> The study site was conducted at Bethany Medical Centre, Gboko, Benue State, Nigeria. It was a one-week surgical outreach. Neck infiltration with local anaesthesia was carried out using 2% xylocaine with adrenaline 1:200,000 and a standard open technique was used to carry out all thyroidectomies. <strong>Results:</strong> Out of seventy (70) patients that presented during the study period, 31 (44.3%) met the inclusion criteria and were operated within the seven (7) days period. There were 3 (10.7%) males and 28 (89.3%) females. There ages ranged between 22 to 65 years, average was 43 years. The average duration of surgery was 90 minutes, and 3 days’ hospital stay. Those followed up two weeks post-operation recuperated well with no notable complications. <strong>Conclusion:</strong> Thyroidectomy under local anaesthesia is safe and feasible in our rural communities and in selected cases can be a suitable alternative to general anaesthesia.展开更多
Background: Unlike developed countries where adult primary cleft lip and palate cases are barely nonexistent, developing countries still have a backlog of adults with unrepaired cleft lip and palate. Method: A retrosp...Background: Unlike developed countries where adult primary cleft lip and palate cases are barely nonexistent, developing countries still have a backlog of adults with unrepaired cleft lip and palate. Method: A retrospective review of adult/adolescent cleft lip repair under local anesthesia was performed between 2012 and 2015. Results: Fifty six (56) adolescent and adults were seen comprising 35 females and 21 males. Forty two patients presented with unrepaired unilateral cleft lip of which only 6 were complete;4 were unrepaired bilateral cleft lip and 10 were revisions. The lowest age was 13 years (two patients) and the highest age was 66 years (one patient). The mean weight was 54 kg. The mean anaesthetic time including waiting time was 12.94 minutes and mean operation time was 56.52 minutes. Majority of the patients were discharged same day except for five who needed to stay overnight because of distance from their home. There were no reported early postoperative complications and wound healing was uneventful for all the patients. Conclusion: Cleft lip repair in adults under local anesthesia is safe, effective and less expensive. A modification in technique with minimal dissection and efficiency is essential in such cases.展开更多
Auricular acupuncture combined with local anaesthesia in cervical larninoplasty was studied. The aim of the study was to observe the analgesic action of this anaesthesia and the effects on respiratory and circulatory ...Auricular acupuncture combined with local anaesthesia in cervical larninoplasty was studied. The aim of the study was to observe the analgesic action of this anaesthesia and the effects on respiratory and circulatory function. 70 patients were included in the study. There were 55 male and 15 female patients, aged between 39 and 67 years old. The unilateral otopoints including Shenmen, cervical vertebrae, sympathetic, subcortex, external lung and kidney points were used. The sterilized filiform needle of 1 - 1. 5 cm were inserted into each otopoint and connected to 57 - 6 electrcrpulse stimulator being stimulated with continuous wave. Local infiltration anaesthesia was also used with 1 - 2 g/L Lignocaine. The results showed that all the patients were conscious, quiet and co-operative with doctors.The respiration, blood pressure and heart rate were all stable. Analgesie action was rather definite. All the patients recovered quickly after operation. We consider that this anaesthesia is a very simple and effective method for cervical laminoplasty.展开更多
Background: Excisional haemorrhoidectomy engenders considerable pain and has popularly been managed as an in-patient procedure. There has been anxiety over a major complication occurring in the community instead of in...Background: Excisional haemorrhoidectomy engenders considerable pain and has popularly been managed as an in-patient procedure. There has been anxiety over a major complication occurring in the community instead of in the hospital which is still pervasive in the developing world despite evidence to the contrary. Aim: It compared the post operative complications, time to bowel action, and post-operative pain scores in patients who had open haemorrhoidectomy either under spinal anaesthesia as in-patient or under local anaesthesia as day case procedure. Materials and Methods: The study involved two populations of patients who underwent open haemorrhoidectomy either under spinal anesthesia or under local anaesthesia with conscious sedation at the Korle Bu Teaching Hospital between 2008 and 2013. Results: It involved 275 patients made up of 145 and 130 in the spinal and local aneasthesia groups respectively. Their mean age was 43.1, SD ± 13.2 and median 41 years. Complications occurred in 44 patients (16%), 24 and 20 in the spinal and local aneasthesia groups respectively, with bleeding being the most frequent [11/44, (25%)] and significant. More wound bleeding occurred in the spinal than the local anaesthesia group, 7 vs. 2 patients. Except one day only (p = 0.0001) the mean pain scores on days 2, 3, 5 and 7 were statistically significantly lower in the spinal group than in the local group. The median time to bowel motion was 4 days in both groups. Conclusion: The post operative outcomes in the two populations were similar except the more frequent bleeding noted in the spinal anaesthesia group. Day case haemorrhoidectomy is safe in centres where day case surgery is routinely performed.展开更多
Patients who suffer a Fractured Neck of Femur (NOF) have a high mortality and morbidity rate with up to 20% needing long term care post fracture and a further 30% not returning to their pre fracture functioning. Hip f...Patients who suffer a Fractured Neck of Femur (NOF) have a high mortality and morbidity rate with up to 20% needing long term care post fracture and a further 30% not returning to their pre fracture functioning. Hip fracture accounts for 87% of total fragility fractures. We describe an anaesthetic technique of fixation of fracture of the femoral neck under direct infiltration local anaesthesia;that can be performed on the sick elderly patient. Twenty-eight NOF fractures were included in this series (24 DHS, 4 Hemiarthroplasty);twenty-three procedures were completed (82.14%);no patient required conversion to another form of anaesthesia either general or spinal;five patients required some degree of light sedation due to agitation (17.8%). This method presents itself as an option in managing patient with high comorbidities which can also be implemented in impoverished areas with limited access to operating surgical facilities.展开更多
Nonlocal set of orthogonal product states(OPSs)can improve the confidentiality of information when it is used to design quantum cryptographic protocols.It is a difficult question how to construct a nonlocal set of OPS...Nonlocal set of orthogonal product states(OPSs)can improve the confidentiality of information when it is used to design quantum cryptographic protocols.It is a difficult question how to construct a nonlocal set of OPSs on general multipartite and high dimensional quantum systems.Different from the previous works,we first present a novel method for constructing a nonlocal product set with 3d-2 members on C^(d)■C^(d)■C^(d)quantum system for d≥3.Then,we extend this construction method to C^(d_(1))■C^(d_(2))■C^(d_(3))quantum system and■_(i=1)^(n)C^(di)quantum system respectively,where 3≤d_(1)≤d_(2)≤d_(3)≤…≤dC_(d_(i))and n≥3.The nonlocal set of OPSs constructed by our method contains fewer elements than those constructed by the existing methods,except for one special case.More importantly,the set of states constructed by our method has a completely different structure from those constructed by the existing methods since our nonlocal set does not contain a“stopper”state.Our result is helpful to further understand the different structures of nonlocal sets on multipartite systems.展开更多
Existing Transformer-based image captioning models typically rely on the self-attention mechanism to capture long-range dependencies,which effectively extracts and leverages the global correlation of image features.Ho...Existing Transformer-based image captioning models typically rely on the self-attention mechanism to capture long-range dependencies,which effectively extracts and leverages the global correlation of image features.However,these models still face challenges in effectively capturing local associations.Moreover,since the encoder extracts global and local association features that focus on different semantic information,semantic noise may occur during the decoding stage.To address these issues,we propose the Local Relationship Enhanced Gated Transformer(LREGT).In the encoder part,we introduce the Local Relationship Enhanced Encoder(LREE),whose core component is the Local Relationship Enhanced Module(LREM).LREM consists of two novel designs:the Local Correlation Perception Module(LCPM)and the Local-Global Fusion Module(LGFM),which are beneficial for generating a comprehensive feature representation that integrates both global and local information.In the decoder part,we propose the Dual-level Multi-branch Gated Decoder(DMGD).It first creates multiple decoding branches to generate multi-perspective contextual feature representations.Subsequently,it employs the Dual-Level Gating Mechanism(DLGM)to model the multi-level relationships of these multi-perspective contextual features,enhancing their fine-grained semantics and intrinsic relationship representations.This ultimately leads to the generation of high-quality and semantically rich image captions.Experiments on the standard MSCOCO dataset demonstrate that LREGT achieves state-of-the-art performance,with a CIDEr score of 140.8 and BLEU-4 score of 41.3,significantly outperforming existing mainstream methods.These results highlight LREGT’s superiority in capturing complex visual relationships and resolving semantic noise during decoding.展开更多
Objective:To analyze the efficacy of whole-course local simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT)on patients with locally advanced esophageal squamous cell carcinoma(ESCC).Methods:88 pat...Objective:To analyze the efficacy of whole-course local simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT)on patients with locally advanced esophageal squamous cell carcinoma(ESCC).Methods:88 patients with ESCC admitted to the hospital between October 2022 and October 2024 were selected and randomly divided into two groups using a random number table.The experimental group received SIB-IMRT treatment,while the control group received conventional intensity-modulated radiotherapy(C-IMRT).The objective remission rate,immune function,tumor markers,and adverse reaction rate were compared between the two groups.Results:The objective remission rate in the experimental group was higher than that in the control group(P<0.05).Before treatment,there was no difference in immune function levels and tumor marker levels between the two groups(P>0.05).After treatment,the immune function levels in the experimental group were better than those in the control group,and the tumor marker levels were lower than those in the control group(P<0.05).The adverse reaction rate in the experimental group was lower than that in the control group(P<0.05).Conclusion:SIB-IMRT can improve the objective remission rate of patients with ESCC,protect their immune function,down-regulate tumor marker levels,and prevent side effects after treatment.展开更多
To improve the accuracy of indoor localization methods with channel state information(CSI)images,a localization method that used CSI images from selected multiple access points(APs)was proposed.The method had an off-l...To improve the accuracy of indoor localization methods with channel state information(CSI)images,a localization method that used CSI images from selected multiple access points(APs)was proposed.The method had an off-line phase and an on-line phase.In the off-line phase,three APs were selected from the four APs in the localization area based on the received signal strength indication(RSSI).Next,CSI data was collected from the three selected APs using a commercial Intel 5300 network interface card.A single-channel subimage was constructed for each selected AP by combining the amplitude information from different antennas and the phase difference information between neighboring antennas.These sub-images were then merged to form a three-channel RGB image,which was subsequently fed into the convolutional neural network(CNN)for training.The CNN model was saved upon completion of training.In the on-line phase,the CSI data from the target device was collected,converted into images using the same process as in the off-line phase,and fed into the well-trained CNN model.Finally,the real position of the target device was estimated using a weighted centroid algorithm based on the model’s output probabilities.The proposed method was validated in indoor environments using two datasets,achieving good localization accuracy.展开更多
In recent years,local government debt reduction and risk prevention have been the subjects of common concern to all parties.China's local government debt has different reasons in different historical periods,and t...In recent years,local government debt reduction and risk prevention have been the subjects of common concern to all parties.China's local government debt has different reasons in different historical periods,and the main line running through this is the development orientation of local governments.It is undeniable that local government debt has played an indelible role in China's rapid economic growth.However,due to historical restrictions,flood irrigation inevitably brought sediment all over the ground.Therefore,this paper intends to rethink the causes of local government debt from the perspective of the dual role of regional government and the main body of meso economics.展开更多
Polytrauma with significant bone and volumetric muscle loss presents substantial clinical challenges.Although immune responses significantly influence fracture healing post-polytrauma,the cellular and molecular underp...Polytrauma with significant bone and volumetric muscle loss presents substantial clinical challenges.Although immune responses significantly influence fracture healing post-polytrauma,the cellular and molecular underpinnings of polytrauma-induced immune dysregulation require further investigation.While previous studies examined either injury site tissue or systemic tissue(peripheral blood),our study uniquely investigated both systemic and local immune cells at the same time to better understand polytrauma-induced immune dysregulation and associated impaired bone healing.Using single-cell RNA sequencing(scRNA-seq)in a rat polytrauma model,we analyzed blood,bone marrow,and the local defect soft tissue to identify potential cellular and molecular targets involved in immune dysregulation.We identified a trauma-associated immunosuppressive myeloid(TIM)cell population that drives systemic immune dysregulation,immunosuppression,and potentially impaired bone healing.We found CD1d as a global marker for TIM cells in polytrauma.展开更多
Electron-electron interactions(EEIs),quantum interference,and the effects of disorder on transport properties are essential topics in condensed matter physics.A series of our characterization work demonstrates that th...Electron-electron interactions(EEIs),quantum interference,and the effects of disorder on transport properties are essential topics in condensed matter physics.A series of our characterization work demonstrates that the morphology of Bi_(2)Te_(3)/MnTe bilayer film mainly depends on the magnetic substrate's growth mode and thickness.We propose that the temperature-dependent quantum interference of the electron wave function caused by disorder drives the transition from weak antilocalization(WAL) to weak localization(WL).Due to spin regulation,WL under low fields originates from the ferromagnetism in MnTe.The quantum interference effect(QIE) model analysis gives the degree of impurity scattering of the electron wave function.The electron wave is scattered by impurities,which causes the Berry phase to change from π to 0,producing a complete WL behavior.The stacked structure provides tunable degrees of freedom,allowing for independent optimization of topological properties and magnetic order through preferential growth orientation of topological insulator(TI) and magnetic layers,respectively.展开更多
Urban investment bonds are another financing method designed by local governments in China to avoid the legal restrictions of urban economic construction, especially urban infrastructure construction under specific ec...Urban investment bonds are another financing method designed by local governments in China to avoid the legal restrictions of urban economic construction, especially urban infrastructure construction under specific economic environment. Although the issuance of urban investment bonds has eased the financing difficulties of local governments to a certain extent, the credit risk of urban investment bonds has gradually emerged due to the rapid increase in the number of urban investment companies and the expansion of the debt scale. In the borrowing process, not only the local government has expanded the land finance, but also the financial transparency has decreased, which will affect the regional economic development level, the urbanization process and the financial and credit status of the city investment companies themselves. Therefore, first of all, the local government should promote the improvement of the tax system, reduce the government's reliance on land finance, actively enhance the government's financial transparency, reduce the information asymmetry between bond issuers and market investors, and reduce the debt risk. Secondly, for the sake of stable growth of local economy, over-investment and development of cities should be avoided. Finally, standardize enterprises to increase credit guarantee, avoid false credit guarantee, and improve the system of public disclosure of corporate financial risk information and the role of third-party market capital in strictly guarding the market, providing a more reliable capital guarantee for the issuance and operation of China's bond market.展开更多
In this paper,we present local functional law of the iterated logarithm for Cs?rg?-Révész type increments of fractional Brownian motion.The results obtained extend works of Gantert[Ann.Probab.,1993,21(2):104...In this paper,we present local functional law of the iterated logarithm for Cs?rg?-Révész type increments of fractional Brownian motion.The results obtained extend works of Gantert[Ann.Probab.,1993,21(2):1045-1049]and Monrad and Rootzén[Probab.Theory Related Fields,1995,101(2):173-192].展开更多
Laser-welded Ti-6Al-4 V is prone to severe residual stresses,microstructural variation,and structural de-fects which are known detrimental to the mechanical properties of weld joints.Residual stress removal is typical...Laser-welded Ti-6Al-4 V is prone to severe residual stresses,microstructural variation,and structural de-fects which are known detrimental to the mechanical properties of weld joints.Residual stress removal is typically applied to weld joints for engineering purposes via heat treatment,in order to avoid prema-ture failure and performance degradation.In the present work,we found that proper welding residual stresses in laser-welded Ti-6Al-4 V sheets can maintain better ductility during uniaxial tension,as op-posed to the stress-relieved counterparts.A detailed experimental investigation has been performed on the deformation behaviours of Ti-6Al-4 V butt welds,including residual stress distribution characteriza-tions by focused ion beam ring-coring coupled with digital image correlation(FIB-DIC),X-ray comput-erized tomography(CT)for internal voids,and in-situ DIC analysis of the subregional strain evolutions.It was found that the pores preferentially distributed near the fusion zone(FZ)boundary,where the compressive residual stress was up to-330 MPa.The removal of residual stress resulted in a changed failure initiation site from the base material to the FZ boundary,the former with ductile and the latter with brittle fracture characteristics under tensile deformation.The combined effects of residual stresses,microstructures,and internal pores on the mechanical responses are discussed in detail.This work high-lights the importance of inevitable residual stress and pores in laser weld pieces,leading to key insights for post-welding treatment and service performance evaluations.展开更多
Neurons are highly polarized cells with axons reaching over a meter long in adult humans.To survive and maintain their proper function,neurons depend on specific mechanisms that regulate spatiotemporal signaling and m...Neurons are highly polarized cells with axons reaching over a meter long in adult humans.To survive and maintain their proper function,neurons depend on specific mechanisms that regulate spatiotemporal signaling and metabolic events,which need to be carried out at the right place,time,and intensity.Such mechanisms include axonal transport,local synthesis,and liquid-liquid phase separations.Alterations and malfunctions in these processes are correlated to neurodegenerative diseases such as amyotrophic lateral sclerosis(ALS).展开更多
Finger Knuckle Print biometric plays a vital role in establishing security for real-time environments. The success of human authentication depends on high speed and accuracy. This paper proposed an integrated approach...Finger Knuckle Print biometric plays a vital role in establishing security for real-time environments. The success of human authentication depends on high speed and accuracy. This paper proposed an integrated approach of personal authentication using texture based Finger Knuckle Print (FKP) recognition in multiresolution domain. FKP images are rich in texture patterns. Recently, many texture patterns are proposed for biometric feature extraction. Hence, it is essential to review whether Local Binary Patterns or its variants perform well for FKP recognition. In this paper, Local Directional Pattern (LDP), Local Derivative Ternary Pattern (LDTP) and Local Texture Description Framework based Modified Local Directional Pattern (LTDF_MLDN) based feature extraction in multiresolution domain are experimented with Nearest Neighbor and Extreme Learning Machine (ELM) Classifier for FKP recognition. Experiments were conducted on PolYU database. The result shows that LDTP in Contourlet domain achieves a promising performance. It also proves that Soft classifier performs better than the hard classifier.展开更多
文摘Purpose: To compare the complication rates arising from surgical removal of lower third molars (L3M) under general anaesthesia (GA) versus local anaesthesia (LA) in the Oral and Maxillofacial Surgery (OMFS) Department, Hospital Sultanah Nora Ismail (HSNI), Batu Pahat, Johor, Malaysia. Materials and methods: This is a retrospective clinical audit of patients who underwent L3M removal under LA or GA from 1/1/2013 to 31/3/2018, with recorded complications such as surgical site infection (SSI), wound breakdown, severe pain, trismus, retained tooth structure, nerve injury and dry socket evaluated at different time intervals. Results: A total of 313 patients with 375 L3M were included in this study (male: 160, 51.1%;female: 153, 48.9%) with an age range of 18 to 40 years (mean = 27.43 years). 79 L3M were removed under GA (34.2% were classified as mild;65.8% were moderate), whereas 296 L3M were removed under LA, (31.4% were mild impaction, 63.9% moderate and 4.7% severe. Preoperative antibiotics were given before all L3M removal under GA, while only 23 out of 296 L3M removal under LA had antibiotics. 15.2% of L3M removal under GA and 16.6% of those done under LA were associated with complications. Generally, patient with GA had lesser complications;however only SSI outcome was significant (p = 0.034). Conclusion: L3M removal under LA may have a higher risk of SSI when compared to GA. This raises the possibility that a single prophylactic antibiotic dose may prevent SSI in LA procedures.
文摘<strong>Background:</strong> In most centers worldwide, thyroidectomy is performed under general anaesthesia as a result of advances in anaesthetic technique, consideration for patients’ safety and surgeons’ convenience. However, in some developing countries such as Nigeria, facilities and expertise for general anaesthesia are not equitably distributed. As such, they are not available in some health centers especially in the rural communities. Hence, the need to explore other suitable alternatives such as operating under local anaesthesia. <strong>Aim:</strong> This study aims to highlight the feasibility and safety of thyroidectomy under local anaesthesia at a surgical outreach in a rural community in Nigeria. <strong>Patients and Methods:</strong> The study site was conducted at Bethany Medical Centre, Gboko, Benue State, Nigeria. It was a one-week surgical outreach. Neck infiltration with local anaesthesia was carried out using 2% xylocaine with adrenaline 1:200,000 and a standard open technique was used to carry out all thyroidectomies. <strong>Results:</strong> Out of seventy (70) patients that presented during the study period, 31 (44.3%) met the inclusion criteria and were operated within the seven (7) days period. There were 3 (10.7%) males and 28 (89.3%) females. There ages ranged between 22 to 65 years, average was 43 years. The average duration of surgery was 90 minutes, and 3 days’ hospital stay. Those followed up two weeks post-operation recuperated well with no notable complications. <strong>Conclusion:</strong> Thyroidectomy under local anaesthesia is safe and feasible in our rural communities and in selected cases can be a suitable alternative to general anaesthesia.
文摘Background: Unlike developed countries where adult primary cleft lip and palate cases are barely nonexistent, developing countries still have a backlog of adults with unrepaired cleft lip and palate. Method: A retrospective review of adult/adolescent cleft lip repair under local anesthesia was performed between 2012 and 2015. Results: Fifty six (56) adolescent and adults were seen comprising 35 females and 21 males. Forty two patients presented with unrepaired unilateral cleft lip of which only 6 were complete;4 were unrepaired bilateral cleft lip and 10 were revisions. The lowest age was 13 years (two patients) and the highest age was 66 years (one patient). The mean weight was 54 kg. The mean anaesthetic time including waiting time was 12.94 minutes and mean operation time was 56.52 minutes. Majority of the patients were discharged same day except for five who needed to stay overnight because of distance from their home. There were no reported early postoperative complications and wound healing was uneventful for all the patients. Conclusion: Cleft lip repair in adults under local anesthesia is safe, effective and less expensive. A modification in technique with minimal dissection and efficiency is essential in such cases.
文摘Auricular acupuncture combined with local anaesthesia in cervical larninoplasty was studied. The aim of the study was to observe the analgesic action of this anaesthesia and the effects on respiratory and circulatory function. 70 patients were included in the study. There were 55 male and 15 female patients, aged between 39 and 67 years old. The unilateral otopoints including Shenmen, cervical vertebrae, sympathetic, subcortex, external lung and kidney points were used. The sterilized filiform needle of 1 - 1. 5 cm were inserted into each otopoint and connected to 57 - 6 electrcrpulse stimulator being stimulated with continuous wave. Local infiltration anaesthesia was also used with 1 - 2 g/L Lignocaine. The results showed that all the patients were conscious, quiet and co-operative with doctors.The respiration, blood pressure and heart rate were all stable. Analgesie action was rather definite. All the patients recovered quickly after operation. We consider that this anaesthesia is a very simple and effective method for cervical laminoplasty.
文摘Background: Excisional haemorrhoidectomy engenders considerable pain and has popularly been managed as an in-patient procedure. There has been anxiety over a major complication occurring in the community instead of in the hospital which is still pervasive in the developing world despite evidence to the contrary. Aim: It compared the post operative complications, time to bowel action, and post-operative pain scores in patients who had open haemorrhoidectomy either under spinal anaesthesia as in-patient or under local anaesthesia as day case procedure. Materials and Methods: The study involved two populations of patients who underwent open haemorrhoidectomy either under spinal anesthesia or under local anaesthesia with conscious sedation at the Korle Bu Teaching Hospital between 2008 and 2013. Results: It involved 275 patients made up of 145 and 130 in the spinal and local aneasthesia groups respectively. Their mean age was 43.1, SD ± 13.2 and median 41 years. Complications occurred in 44 patients (16%), 24 and 20 in the spinal and local aneasthesia groups respectively, with bleeding being the most frequent [11/44, (25%)] and significant. More wound bleeding occurred in the spinal than the local anaesthesia group, 7 vs. 2 patients. Except one day only (p = 0.0001) the mean pain scores on days 2, 3, 5 and 7 were statistically significantly lower in the spinal group than in the local group. The median time to bowel motion was 4 days in both groups. Conclusion: The post operative outcomes in the two populations were similar except the more frequent bleeding noted in the spinal anaesthesia group. Day case haemorrhoidectomy is safe in centres where day case surgery is routinely performed.
文摘Patients who suffer a Fractured Neck of Femur (NOF) have a high mortality and morbidity rate with up to 20% needing long term care post fracture and a further 30% not returning to their pre fracture functioning. Hip fracture accounts for 87% of total fragility fractures. We describe an anaesthetic technique of fixation of fracture of the femoral neck under direct infiltration local anaesthesia;that can be performed on the sick elderly patient. Twenty-eight NOF fractures were included in this series (24 DHS, 4 Hemiarthroplasty);twenty-three procedures were completed (82.14%);no patient required conversion to another form of anaesthesia either general or spinal;five patients required some degree of light sedation due to agitation (17.8%). This method presents itself as an option in managing patient with high comorbidities which can also be implemented in impoverished areas with limited access to operating surgical facilities.
基金supported by the National Natural Science Foundation of China(Grant No.62171264)the Natural Science Foundation of Shandong Province of China(Grant No.ZR2023MF080)the Natural Science Foundation of Beijing(Grant No.4252014).
文摘Nonlocal set of orthogonal product states(OPSs)can improve the confidentiality of information when it is used to design quantum cryptographic protocols.It is a difficult question how to construct a nonlocal set of OPSs on general multipartite and high dimensional quantum systems.Different from the previous works,we first present a novel method for constructing a nonlocal product set with 3d-2 members on C^(d)■C^(d)■C^(d)quantum system for d≥3.Then,we extend this construction method to C^(d_(1))■C^(d_(2))■C^(d_(3))quantum system and■_(i=1)^(n)C^(di)quantum system respectively,where 3≤d_(1)≤d_(2)≤d_(3)≤…≤dC_(d_(i))and n≥3.The nonlocal set of OPSs constructed by our method contains fewer elements than those constructed by the existing methods,except for one special case.More importantly,the set of states constructed by our method has a completely different structure from those constructed by the existing methods since our nonlocal set does not contain a“stopper”state.Our result is helpful to further understand the different structures of nonlocal sets on multipartite systems.
基金supported by the Natural Science Foundation of China(62473105,62172118)Nature Science Key Foundation of Guangxi(2021GXNSFDA196002)+1 种基金in part by the Guangxi Key Laboratory of Image and Graphic Intelligent Processing under Grants(GIIP2302,GIIP2303,GIIP2304)Innovation Project of Guang Xi Graduate Education(2024YCXB09,2024YCXS039).
文摘Existing Transformer-based image captioning models typically rely on the self-attention mechanism to capture long-range dependencies,which effectively extracts and leverages the global correlation of image features.However,these models still face challenges in effectively capturing local associations.Moreover,since the encoder extracts global and local association features that focus on different semantic information,semantic noise may occur during the decoding stage.To address these issues,we propose the Local Relationship Enhanced Gated Transformer(LREGT).In the encoder part,we introduce the Local Relationship Enhanced Encoder(LREE),whose core component is the Local Relationship Enhanced Module(LREM).LREM consists of two novel designs:the Local Correlation Perception Module(LCPM)and the Local-Global Fusion Module(LGFM),which are beneficial for generating a comprehensive feature representation that integrates both global and local information.In the decoder part,we propose the Dual-level Multi-branch Gated Decoder(DMGD).It first creates multiple decoding branches to generate multi-perspective contextual feature representations.Subsequently,it employs the Dual-Level Gating Mechanism(DLGM)to model the multi-level relationships of these multi-perspective contextual features,enhancing their fine-grained semantics and intrinsic relationship representations.This ultimately leads to the generation of high-quality and semantically rich image captions.Experiments on the standard MSCOCO dataset demonstrate that LREGT achieves state-of-the-art performance,with a CIDEr score of 140.8 and BLEU-4 score of 41.3,significantly outperforming existing mainstream methods.These results highlight LREGT’s superiority in capturing complex visual relationships and resolving semantic noise during decoding.
文摘Objective:To analyze the efficacy of whole-course local simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT)on patients with locally advanced esophageal squamous cell carcinoma(ESCC).Methods:88 patients with ESCC admitted to the hospital between October 2022 and October 2024 were selected and randomly divided into two groups using a random number table.The experimental group received SIB-IMRT treatment,while the control group received conventional intensity-modulated radiotherapy(C-IMRT).The objective remission rate,immune function,tumor markers,and adverse reaction rate were compared between the two groups.Results:The objective remission rate in the experimental group was higher than that in the control group(P<0.05).Before treatment,there was no difference in immune function levels and tumor marker levels between the two groups(P>0.05).After treatment,the immune function levels in the experimental group were better than those in the control group,and the tumor marker levels were lower than those in the control group(P<0.05).The adverse reaction rate in the experimental group was lower than that in the control group(P<0.05).Conclusion:SIB-IMRT can improve the objective remission rate of patients with ESCC,protect their immune function,down-regulate tumor marker levels,and prevent side effects after treatment.
基金supported by Lanzhou Science and Technology Plan Project(No.2023-3-104)Gansu Province Higher Education Industry Support Plan Project(No.2023CYZC-40)Gansu Province Excellent Graduate“Innovation Star”Program(No.2023CXZX-546)。
文摘To improve the accuracy of indoor localization methods with channel state information(CSI)images,a localization method that used CSI images from selected multiple access points(APs)was proposed.The method had an off-line phase and an on-line phase.In the off-line phase,three APs were selected from the four APs in the localization area based on the received signal strength indication(RSSI).Next,CSI data was collected from the three selected APs using a commercial Intel 5300 network interface card.A single-channel subimage was constructed for each selected AP by combining the amplitude information from different antennas and the phase difference information between neighboring antennas.These sub-images were then merged to form a three-channel RGB image,which was subsequently fed into the convolutional neural network(CNN)for training.The CNN model was saved upon completion of training.In the on-line phase,the CSI data from the target device was collected,converted into images using the same process as in the off-line phase,and fed into the well-trained CNN model.Finally,the real position of the target device was estimated using a weighted centroid algorithm based on the model’s output probabilities.The proposed method was validated in indoor environments using two datasets,achieving good localization accuracy.
文摘In recent years,local government debt reduction and risk prevention have been the subjects of common concern to all parties.China's local government debt has different reasons in different historical periods,and the main line running through this is the development orientation of local governments.It is undeniable that local government debt has played an indelible role in China's rapid economic growth.However,due to historical restrictions,flood irrigation inevitably brought sediment all over the ground.Therefore,this paper intends to rethink the causes of local government debt from the perspective of the dual role of regional government and the main body of meso economics.
文摘Polytrauma with significant bone and volumetric muscle loss presents substantial clinical challenges.Although immune responses significantly influence fracture healing post-polytrauma,the cellular and molecular underpinnings of polytrauma-induced immune dysregulation require further investigation.While previous studies examined either injury site tissue or systemic tissue(peripheral blood),our study uniquely investigated both systemic and local immune cells at the same time to better understand polytrauma-induced immune dysregulation and associated impaired bone healing.Using single-cell RNA sequencing(scRNA-seq)in a rat polytrauma model,we analyzed blood,bone marrow,and the local defect soft tissue to identify potential cellular and molecular targets involved in immune dysregulation.We identified a trauma-associated immunosuppressive myeloid(TIM)cell population that drives systemic immune dysregulation,immunosuppression,and potentially impaired bone healing.We found CD1d as a global marker for TIM cells in polytrauma.
基金financially supported by the National Natural Science Foundation of China (Nos.52371204, 52201233,and 52031014)
文摘Electron-electron interactions(EEIs),quantum interference,and the effects of disorder on transport properties are essential topics in condensed matter physics.A series of our characterization work demonstrates that the morphology of Bi_(2)Te_(3)/MnTe bilayer film mainly depends on the magnetic substrate's growth mode and thickness.We propose that the temperature-dependent quantum interference of the electron wave function caused by disorder drives the transition from weak antilocalization(WAL) to weak localization(WL).Due to spin regulation,WL under low fields originates from the ferromagnetism in MnTe.The quantum interference effect(QIE) model analysis gives the degree of impurity scattering of the electron wave function.The electron wave is scattered by impurities,which causes the Berry phase to change from π to 0,producing a complete WL behavior.The stacked structure provides tunable degrees of freedom,allowing for independent optimization of topological properties and magnetic order through preferential growth orientation of topological insulator(TI) and magnetic layers,respectively.
文摘Urban investment bonds are another financing method designed by local governments in China to avoid the legal restrictions of urban economic construction, especially urban infrastructure construction under specific economic environment. Although the issuance of urban investment bonds has eased the financing difficulties of local governments to a certain extent, the credit risk of urban investment bonds has gradually emerged due to the rapid increase in the number of urban investment companies and the expansion of the debt scale. In the borrowing process, not only the local government has expanded the land finance, but also the financial transparency has decreased, which will affect the regional economic development level, the urbanization process and the financial and credit status of the city investment companies themselves. Therefore, first of all, the local government should promote the improvement of the tax system, reduce the government's reliance on land finance, actively enhance the government's financial transparency, reduce the information asymmetry between bond issuers and market investors, and reduce the debt risk. Secondly, for the sake of stable growth of local economy, over-investment and development of cities should be avoided. Finally, standardize enterprises to increase credit guarantee, avoid false credit guarantee, and improve the system of public disclosure of corporate financial risk information and the role of third-party market capital in strictly guarding the market, providing a more reliable capital guarantee for the issuance and operation of China's bond market.
基金Supported by NSFC(Nos.11661025,12161024)Natural Science Foundation of Guangxi(Nos.2020GXNSFAA159118,2021GXNSFAA196045)+2 种基金Guangxi Science and Technology Project(No.Guike AD20297006)Training Program for 1000 Young and Middle-aged Cadre Teachers in Universities of GuangxiNational College Student's Innovation and Entrepreneurship Training Program(No.202110595049)。
文摘In this paper,we present local functional law of the iterated logarithm for Cs?rg?-Révész type increments of fractional Brownian motion.The results obtained extend works of Gantert[Ann.Probab.,1993,21(2):1045-1049]and Monrad and Rootzén[Probab.Theory Related Fields,1995,101(2):173-192].
基金supported by the National Key Re-search&Development Plan of China(No.2020YFA0405900)the Major Research Plan of the National Natural Science Foundation of China(No.92263201)Y.P.Xia would like to thank the support by the Jiangsu Funding Program for Excellent Postdoctoral Talent.All authors thank the Advanced Material Research Institute of Jiangsu Industrial Technology Research Institute(JITRI,Suzhou,China)for the experimental support.
文摘Laser-welded Ti-6Al-4 V is prone to severe residual stresses,microstructural variation,and structural de-fects which are known detrimental to the mechanical properties of weld joints.Residual stress removal is typically applied to weld joints for engineering purposes via heat treatment,in order to avoid prema-ture failure and performance degradation.In the present work,we found that proper welding residual stresses in laser-welded Ti-6Al-4 V sheets can maintain better ductility during uniaxial tension,as op-posed to the stress-relieved counterparts.A detailed experimental investigation has been performed on the deformation behaviours of Ti-6Al-4 V butt welds,including residual stress distribution characteriza-tions by focused ion beam ring-coring coupled with digital image correlation(FIB-DIC),X-ray comput-erized tomography(CT)for internal voids,and in-situ DIC analysis of the subregional strain evolutions.It was found that the pores preferentially distributed near the fusion zone(FZ)boundary,where the compressive residual stress was up to-330 MPa.The removal of residual stress resulted in a changed failure initiation site from the base material to the FZ boundary,the former with ductile and the latter with brittle fracture characteristics under tensile deformation.The combined effects of residual stresses,microstructures,and internal pores on the mechanical responses are discussed in detail.This work high-lights the importance of inevitable residual stress and pores in laser weld pieces,leading to key insights for post-welding treatment and service performance evaluations.
文摘Neurons are highly polarized cells with axons reaching over a meter long in adult humans.To survive and maintain their proper function,neurons depend on specific mechanisms that regulate spatiotemporal signaling and metabolic events,which need to be carried out at the right place,time,and intensity.Such mechanisms include axonal transport,local synthesis,and liquid-liquid phase separations.Alterations and malfunctions in these processes are correlated to neurodegenerative diseases such as amyotrophic lateral sclerosis(ALS).
文摘Finger Knuckle Print biometric plays a vital role in establishing security for real-time environments. The success of human authentication depends on high speed and accuracy. This paper proposed an integrated approach of personal authentication using texture based Finger Knuckle Print (FKP) recognition in multiresolution domain. FKP images are rich in texture patterns. Recently, many texture patterns are proposed for biometric feature extraction. Hence, it is essential to review whether Local Binary Patterns or its variants perform well for FKP recognition. In this paper, Local Directional Pattern (LDP), Local Derivative Ternary Pattern (LDTP) and Local Texture Description Framework based Modified Local Directional Pattern (LTDF_MLDN) based feature extraction in multiresolution domain are experimented with Nearest Neighbor and Extreme Learning Machine (ELM) Classifier for FKP recognition. Experiments were conducted on PolYU database. The result shows that LDTP in Contourlet domain achieves a promising performance. It also proves that Soft classifier performs better than the hard classifier.
