In aerial photography, the primary factor is terrain undulation. However, most of the external aerial photography software used for aerial photography design do not take terrain undulation influence into consideration...In aerial photography, the primary factor is terrain undulation. However, most of the external aerial photography software used for aerial photography design do not take terrain undulation influence into consideration. Therefore, the design result has comparative randomicity and ＂gaps＂ are expected. An aerial photography design system is developed by analyzing the terrain undulation influence to the design result with DEM data so that the forward overlap and side overlap can be justified according to the block terrain undulation to meet specifications or standards. The data designed by this system is compared with the real flying data. The results show that making use of DEM to assist in aerial photography design can ensure that the designed result fits the real terrain better.展开更多
BACKGROUND The gold standard for colorectal polyp screening is currently colonoscopy,but the miss rate is still high and the adenoma detection rate and polyp detection rate are still low.The risk factors include the p...BACKGROUND The gold standard for colorectal polyp screening is currently colonoscopy,but the miss rate is still high and the adenoma detection rate and polyp detection rate are still low.The risk factors include the patient,operators,and the tools used.The use of artificial intelligence(AI)in colonoscopy has gained popularity by assisting endoscopists in the detection and characterization of polyps.AIM To evaluate the diagnostic performance of AI-assisted colonoscopy[computer assisted diagnosis(CAD)eye function]for colorectal polyp characterization.METHODS This study used a cross-sectional design conducted at the Gastrointestinal Endoscopy Center of Dr.Cipto Mangunkusumo Hospital in January-May 2024 on adult patients with suspected colorectal polyps.RESULTS A total of 60 patients with 100 polyps were involved in this study.Based on the results of the examination,it was found that the AI CAD eye function examination had a sensitivity of 79.17%,specificity of 75.00%,positive predictive value(PPV)of 89.06%,negative predictive value(NPV)of 58.33%,and accuracy of 78.00%.In polyps with diminutive size,sensitivity was 86.27%,specificity was 60.00%,PPV was 95.65%,NPV was 30.00%,and accuracy was 83.93%.Meanwhile,in polyps with non-diminutive size,sensitivity was 61.90%,specificity was 78.26%,PPV was 72.22%,NPV was 69.23%,and accuracy was 70.45%.In polyps on the left side of the colon,sensitivity was 78.85%,specificity was 81.25%,PPV was 93.18%,NPV was 54.17%,and accuracy was 79.41%.Meanwhile,in rightsided polyps the sensitivity was 80.00%,specificity was 66.67%,PPV was 80.00%,NPV was 66.67%,and accuracy was 75.00%.In sessile polyps the sensitivity was 81.54%,specificity was 50.00%,PPV was 91.38%,NPV was 29.41%,and accuracy was 77.33%.Meanwhile,in non-sessile polyps,the sensitivity was 57.14%,specificity was 88.89%,PPV was 66.67%,NPV was 84.21%,and accuracy was 80.00%.CONCLUSION AI CAD eye function examination had a high sensitivity value in diminutive,sessile polyps and right-sided polyps and a high specificity in non-diminutive,non-sessile polyps and left-sided polyps.展开更多
BACKGROUND Knowledge-based systems(KBS)are software applications based on a knowledge database and an inference engine.Various experimental KBS for computerassisted medical diagnosis and treatment were started to be u...BACKGROUND Knowledge-based systems(KBS)are software applications based on a knowledge database and an inference engine.Various experimental KBS for computerassisted medical diagnosis and treatment were started to be used since 70s(VisualDx,GIDEON,DXPlain,CADUCEUS,Internist-I,Mycin etc.).AIM To present in detail the“Electronic Pediatrician(EPed)”,a medical non-machine learning artificial intelligence(nml-AI)KBS in its prototype version created by the corresponding author(with database written in Romanian)that offers a physiopathology-based differential and positive diagnosis and treatment of ill children.METHODS EPed specifically focuses on the physiopathological reasoning of pediatric clinical cases.EPed has currently reached its prototype version 2.0,being able to diagnose 302 physiopathological macro-links(briefly named“clusters”)and 269 pediatric diseases:Some examples of diagnosis and a previous testing of EPed on a group of 34 patients are also presented in this paper.RESULTS The prototype EPed can currently diagnose 269 pediatric infectious and noninfectious diseases(based on 302 clusters),including the most frequent respiratory/digestive/renal/central nervous system infections,but also many other noninfectious pediatric diseases like autoimmune,oncological,genetical diseases and even intoxications,plus some important surgical pathologies.CONCLUSION EPed is the first and only physiopathology-based nml-AI KBS focused on general pediatrics and is the first and only pediatric Romanian KBS addressed to medical professionals.Furthermore,EPed is the first and only nml-AI KBS that offers not only both a physiopathology-based differential and positive disease diagnosis,but also identifies possible physiopathological“clusters”that may explain the signs and symptoms of any child-patient and may help treating that patient physiopathologically(until a final diagnosis is found),thus encouraging and developing the physiopathological reasoning of any clinician.展开更多
Against the backdrop of escalating global climate change and energy crises,the resource utilization of carbon dioxide(CO_(2)),a major greenhouse gas,has become a crucial pathway for achieving carbon peaking and carbon...Against the backdrop of escalating global climate change and energy crises,the resource utilization of carbon dioxide(CO_(2)),a major greenhouse gas,has become a crucial pathway for achieving carbon peaking and carbon neutrality goals.The hydrogenation of CO_(2)to methanol not only enables carbon sequestration and recycling,but also provides a route to produce high value-added fuels and basic chemical feedstocks,holding significant environmental and economic potential.However,this conversion process is thermodynamically and kinetically limited,and traditional catalyst systems(e.g.,Cu/ZnO/Al_(2)O_(3))exhibit inadequate activity,selectivity,and stability under mild conditions.Therefore,the development of novel high-performance catalysts with precisely tunable structures and functionalities is imperative.Metal-organic frameworks(MOFs),as crystalline porous materials with high surface area,tunable pore structures,and diverse metal-ligand compositions,have the great potential in CO_(2)hydrogenation catalysis.Their structural design flexibility allows for the construction of well-dispersed active sites,tailored electronic environments,and enhanced metal-support interactions.This review systematically summarizes the recent advances in MOF-based and MOF-derived catalysts for CO_(2)hydrogenation to methanol,focusing on four design strategies:(1)spatial confinement and in situ construction,(2)defect engineering and ion-exchange,(3)bimetallic synergy and hybrid structure design,and(4)MOF-derived nanomaterial synthesis.These approaches significantly improve CO_(2)conversion and methanol selectivity by optimizing metal dispersion,interfacial structures,and reaction pathways.The reaction mechanism is further explored by focusing on the three main reaction pathways:the formate pathway(HCOO*),the RWGS(Reverse Water Gas Shift reaction)+CO*hydrogenation pathway,and the trans-COOH pathway.In situ spectroscopic studies and density functional theory(DFT)calculations elucidate the formation and transformation of key intermediates,as well as the roles of active sites,metal-support interfaces,oxygen vacancies,and promoters.Additionally,representative catalytic performance data for MOFbased systems are compiled and compared,demonstrating their advantages over traditional catalysts in terms of CO_(2)conversion,methanol selectivity,and space-time yield.Future perspectives for MOF-based CO_(2)hydrogenation catalysts will prioritize two main directions:structural design and mechanistic understanding.The precise construction of active sites through multi-metallic synergy,defect engineering,and interfacial electronic modulation should be made to enhance catalyst selectivity and stability.In addition,advanced in situ characterization techniques combined with theoretical modeling are essential to unravel the detailed reaction mechanisms and intermediate behaviors,thereby guiding rational catalyst design.Moreover,to enable industrial application,challenges related to thermal/hydrothermal stability,catalyst recyclability,and cost-effective large-scale synthesis must be addressed.The development of green,scalable preparation methods and the integration of MOF catalysts into practical reaction systems(e.g.,flow reactors)will be crucial for bridging the gap between laboratory research and commercial deployment.Ultimately,multi-scale structure-performance optimization and catalytic system integration will be vital for accelerating the industrialization of MOF-based CO_(2)-to-methanol technologies.展开更多
Recent years have witnessed transformative changes brought about by artificial intelligence(AI)techniques with billions of parameters for the realization of high accuracy,proposing high demand for the advanced and AI ...Recent years have witnessed transformative changes brought about by artificial intelligence(AI)techniques with billions of parameters for the realization of high accuracy,proposing high demand for the advanced and AI chip to solve these AI tasks efficiently and powerfully.Rapid progress has been made in the field of advanced chips recently,such as the development of photonic computing,the advancement of the quantum processors,the boost of the biomimetic chips,and so on.Designs tactics of the advanced chips can be conducted with elaborated consideration of materials,algorithms,models,architectures,and so on.Though a few reviews present the development of the chips from their unique aspects,reviews in the view of the latest design for advanced and AI chips are few.Here,the newest development is systematically reviewed in the field of advanced chips.First,background and mechanisms are summarized,and subsequently most important considerations for co-design of the software and hardware are illustrated.Next,strategies are summed up to obtain advanced and AI chips with high excellent performance by taking the important information processing steps into consideration,after which the design thought for the advanced chips in the future is proposed.Finally,some perspectives are put forward.展开更多
The computer-assisted surgery (CAS)has significantly improved the accuracy, reliability and outcomes of traumatic,spinal,nerve surgery and many other operations with a less invasive way.The application of CAS for scap...The computer-assisted surgery (CAS)has significantly improved the accuracy, reliability and outcomes of traumatic,spinal,nerve surgery and many other operations with a less invasive way.The application of CAS for scaphoid fractures remains experimental.The related studies are scanty and most of them are cadaver researches.Some intrinsic defects from the registration procedure,scan and immobilization of limbs may inevitably result in deviations. Some deviations become more obvious with operations of small bones (such as scaphoid)although they are acceptable for spine and other orthopedic surgeries.We reviewed the current literatures on the applications of CAS for scaphoid operation and summarized technical principles,scan and registration methods,immobilization of limbs and their outcomes.On the basis of the data,we analyzed the limitations of this technique and envisioned its future development.展开更多
BACKGROUND Artificial intelligence in colonoscopy is an emerging field,and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas.Several deep learning-bas...BACKGROUND Artificial intelligence in colonoscopy is an emerging field,and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas.Several deep learning-based computer-assisted detection(CADe)techniques were established from small single-center datasets,and unrepresentative learning materials might confine their application and generalization in wide practice.Although CADes have been reported to identify polyps in colonoscopic images and videos in real time,their diagnostic performance deserves to be further validated in clinical practice.AIM To train and test a CADe based on multicenter high-quality images of polyps and preliminarily validate it in clinical colonoscopies.METHODS With high-quality screening and labeling from 55 qualified colonoscopists,a dataset consisting of over 71000 images from 20 centers was used to train and test a deep learning-based CADe.In addition,the real-time diagnostic performance of CADe was tested frame by frame in 47 unaltered full-ranged videos that contained 86 histologically confirmed polyps.Finally,we conducted a selfcontrolled observational study to validate the diagnostic performance of CADe in real-world colonoscopy with the main outcome measure of polyps per colonoscopy in Changhai Hospital.RESULTS The CADe was able to identify polyps in the test dataset with 95.0%sensitivity and 99.1%specificity.For colonoscopy videos,all 86 polyps were detected with 92.2%sensitivity and 93.6%specificity in frame-by-frame analysis.In the prospective validation,the sensitivity of CAD in identifying polyps was 98.4%(185/188).Folds,reflections of light and fecal fluid were the main causes of false positives in both the test dataset and clinical colonoscopies.Colonoscopists can detect more polyps(0.90 vs 0.82,P<0.001)and adenomas(0.32 vs 0.30,P=0.045)with the aid of CADe,particularly polyps<5 mm and flat polyps(0.65 vs 0.57,P<0.001;0.74 vs 0.67,P=0.001,respectively).However,high efficacy is not realized in colonoscopies with inadequate bowel preparation and withdrawal time(P=0.32;P=0.16,respectively).CONCLUSION CADe is feasible in the clinical setting and might help endoscopists detect more polyps and adenomas,and further confirmation is warranted.展开更多
The aim of the present study was to compare assessments of sperm concentration and sperm motility analysed by conventional semen analysis with those obtained by computer-assisted semen analysis （CASA） （Copenhagen R...The aim of the present study was to compare assessments of sperm concentration and sperm motility analysed by conventional semen analysis with those obtained by computer-assisted semen analysis （CASA） （Copenhagen Rigshospitalet Image House Sperm Motility Analysis System （CRISMAS） 4.6 software） using semen samples from 166 young Danish men. The CRISMAS software identifies sperm concentration and classifies spermatozoa into three motility categories. To enable comparison of the two methods, the four motility stages obtained by conventional semen analysis were, based on their velocity classifications, divided into three stages, comparable to the three CRISMAS motility categories： rapidly progressive （A）, slowly progressive （B） and non-progressive （C＋ D）. Differences between the two methods were large for all investigated parameters （P〈0.001）. CRISMAS overestimated sperm concentration and the proportion of rapidly progressive spermatozoa and, consequently, underestimated the percentages of slowly progressive and non-progressive spermatozoa, compared to the conventional method. To investigate whether results drifted according to time of semen analysis, results were pooled into quarters according to date of semen analysis. CRISMAS motility results appeared more stable over time compared to the conventional analysis; however, neither method showed any trends. Apparently, CRISMAS CASA results and results from the conventional method were not comparable with respect to sperm concentration and motility analysis. This needs to be accounted for in clinics using this software and in studies of determinants of these semen characteristics.展开更多
Glutathione peroxidase, the first example of selenoproteins identified in mammals, was subjected to force field calculations and molecular dynamics in order to enable a clearer comprehension of enzymatic selenium cata...Glutathione peroxidase, the first example of selenoproteins identified in mammals, was subjected to force field calculations and molecular dynamics in order to enable a clearer comprehension of enzymatic selenium catalysis. Starting from the established X-ray structure of bovine GPX, all kinetically defined intermediates and enzyme substrate complexes were modelled. The models thus obtained support the hypothesis that the essential steps of the catalysis are three distinct redox changes of the active site selenium which, in the ground state, presents itself at the surface of selenoperoxidases as the center of a characteristic triad built by selenocysteine, glutarnine and tryptophan. In GPX, four arginine residues and a lysine residue provide an electrostatic architecture which, in each reductive step, directs the donor substrate GSH towards the catalytic center in such a way that 1ts sulfhydryl group must react with the selenium moiety. To this end, different equally efficient modes of substrate binding appear possible. The models are consistent with substrate specificity data, kinetic pattern and other functional characteristics of the enzyme. Comparison of molecular models of GPX with those of other members of the GPX superfamily reveals that the cosubstrate binding mechanisrns are unique for the classical type of cytosolic glutathione peroxidases but cannot operate e. g. in plasma GPX and phospholipid hydroperoxide GPX. The structural differences between the selenoperoxidases, shown to be relevant to their specificities, are discussed in terms of functional diversification within the GPX superfamily展开更多
BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,e...BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,extreme liver resection can be considered a potential option.AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC.METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023.We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC.RESULTS Sixty-seven children diagnosed with HB underwent surgical resection.The age at diagnosis was 21.4±18.8 months,and 40 boys and 27 girls were included.Fifty-nine(88.1%)patients had a single tumor,39(58.2%)of which was located in the right lobe of the liver.A total of 47 patients(70.1%)had PRE-TEXT III or IV.Thirty-nine patients(58.2%)underwent delayed resection.After a full course of NAC,16 patients still had close PMV(within 1 cm in two patients,touching in 11 patients,compressing in four patients,and showing tumor thrombus in three patients).There were 6 patients of tumors in the middle lobe of the liver,and four of those patients exhibited liver anatomy variations.These 16 children underwent extreme liver resection after comprehensive preoperative evaluation.Intraoperative procedures were performed according to the preoperative plan,and the operations were successfully performed.Currently,the 3-year event-free survival of 67 children with HB is 88%.Among the 16 children who underwent extreme liver resection,three experienced recurrence,and one died due to multiple metastases.CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible.This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis.Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB,particularly for assessing vascular involvement,remnant liver volume and anatomical variations.展开更多
The aim of this study was to compare the sperm nuclear and acrosomal morphometry of three species of domestic artiodactyls; cattle （Bos taurus）, sheep （Ovis aries）, and pigs （Sus scrofa）. Semen smears of twenty ...The aim of this study was to compare the sperm nuclear and acrosomal morphometry of three species of domestic artiodactyls; cattle （Bos taurus）, sheep （Ovis aries）, and pigs （Sus scrofa）. Semen smears of twenty ejaculates from each species were fixed and labeled with a propidium iodide-Pisum sativum agglutinin （PI/PSA） combination. Digital images of the sperm nucleus, acrosome, and whole sperm head were captured and analyzed. The use of the PI/PSA combination and CASA-Morph fluorescence-based method allowed the capture, morphometric analysis, and differentiation of most sperm nuclei, acrosomes and whole heads, and the assessment of acrosomal integrity with a high precision in the three species studied. For the size of the head and nuclear area, the relationship between the three species may be summarized as bull 〉 ram 〉 boar. However, for the other morphometric parameters （length, width, and perimeter）, there were differences in the relationships between species for sperm nuclei and whole sperm heads. Bull sperm acrosomes were clearly smaller than those in the other species studied and covered a smaller proportion of the sperm head. The acrosomal morphology, small in the bull, large and broad in the sheep, and large, long, and with a pronounced equatorial segment curve in the boar, was species-characteristic. It was concluded that there are clear variations in the size and shape of the sperm head components between the three species studied, the acrosome being the structure showing the most variability, allowing a clear distinction of the spermatozoa of each species.展开更多
BACKGROUND Most complex renal stones are managed primarily with percutaneous nephrolithotomy(PCNL).However,PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent structures.Nove...BACKGROUND Most complex renal stones are managed primarily with percutaneous nephrolithotomy(PCNL).However,PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent structures.Novel techniques are required to assist in planning and navigation.AIM To apply and evaluate the Hisense computer-assisted surgery(CAS)system in PCNL.METHODS A total of 60 patients with complex renal stones were included.Thirty patients in the CAS group had three-dimensional(3 D)virtual models constructed with the CAS system.The model assisted in planning and navigating in the CAS system.Thirty patients in the control group planned and navigated as standard PCNL,without the application of the CAS system.Success rate of one attempt,operation time,initial stone-free rate,decrease in hemoglobin,and complications were collected and analyzed.RESULTS There were no statistically significant differences in the baseline characteristics or planning characteristics.The success rate of one puncturing attempt(90%vs 67%,P=0.028)and the initial stone-free rate(87%vs 63%,P=0.037)were significantly higher in the CAS group.However,there were no statistically significant differences in the operation time(89.20±29.60 min vs 92.33±33.08 min,P=0.859)or in the decrease in hemoglobin(11.07±8.32 g/L vs 9.03±11.72 g/L,P=0.300)between the CAS group and the control group.No statistically significant differences in the incidence of complications(Clavien-Dindo grade≥2)were found.CONCLUSION Compared with standard PCNL,CAS-assisted PCNL had advantages in terms of the puncturing success rate and stone-free rate.The Hisense CAS System was recommended to assist in preoperative planning and intraoperative navigation for an intuitive,precise and convenient PCNL.展开更多
BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon ...BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon in children,biopsy alone may lead to an inaccurate diagnosis,especially for giant tumors.However,surgical resection may be associated with significant complications.Here,we report a case of computer-assisted surgical resection of a giant GNB in a child and successful rescue of the inferior mesenteric artery.CASE SUMMARY A 4-year-old girl was admitted to our department for a giant retroperitoneal lesion,which was considered to be an NB by her local hospital.The symptoms of the girl disappeared spontaneously without treatment.On physical examination,a mass of about 10 cm×7 cm could be palpated in her abdomen.Ultrasonography and contrast-enhanced computed tomography performed in our hospital also showed an NB,and there was a very thick blood vessel inside the tumor.However,aspiration biopsy revealed GN.Surgical resection is the best treatment option for this giant benign tumor.For precise preoperative evaluation,threedimensional reconstruction was performed.It was clear that the tumor was close to the abdominal aorta.The superior mesenteric vein was pushed forward,and the inferior mesenteric artery passed through the tumor.Because GN generally does not invade blood vessels,we split the tumor with a CUSA knife during the operation and found that there was indeed a straight and intact vascular sheath.Arterial pulsation was observed in the completely exposed inferior mesenteric artery.The pathologists interpreting the tissue finally diagnosed it as a mixed GNB(GNBi),which is more malignant than GN.However,both GN and GNBi usually have a good prognosis.CONCLUSION This was a case of successful surgical resection of a giant GNB,and aspiration biopsy underestimated the pathological staging of the tumor.Preoperative three-dimensional reconstruction assisted with the radical resection of the tumor and rescue of the inferior mesenteric artery.展开更多
BACKGROUND Congenital maxillomandibular syngnathia is an extremely rare disorder characterized by craniofacial malformations and inability to open the mouth adequately, which leads to problems with feeding, swallowing...BACKGROUND Congenital maxillomandibular syngnathia is an extremely rare disorder characterized by craniofacial malformations and inability to open the mouth adequately, which leads to problems with feeding, swallowing, and breathing as well as temporomandibular joint ankylosis. The main goal of the surgery is to release the ankylosis, establish functioning mandible, and prevent re-fusion.However, surgical procedures for this disease are rarely reported.CASE SUMMARY Here, we report a 7-mo-old girl with bilateral maxillomandibular syngnathia. The patient presented with difficulty in feeding, breathing, sounding, and swallowing and had developmental dysplasia. For treatment, we performed bone isolation by computer-assisted navigation and used silicone to fix the wound surface to prevent refusion of bone. To our knowledge, this is the only syngnathia case in the literature treated using computer-assisted navigation. With the guidance of precise navigation, we were able to minimize operation time by at least one hour,the patient's blood vessels, nerves, and tooth germs were well protected, and excessive bleeding was avoided. After six weeks, the patient showed improvement in mouth opening and no major issues of feeding.CONCLUSION Application of computer-assisted navigation can significantly improve accuracy,effectiveness, and surgical safety in correcting congenital maxillomandibular syngnathia.展开更多
This study was designed to determine the ability of computer-assisted sperm morphometry analysis （CASA-Morph） with fluorescence to discriminate between spermatozoa carrying different sex chromosomes from the nuclear...This study was designed to determine the ability of computer-assisted sperm morphometry analysis （CASA-Morph） with fluorescence to discriminate between spermatozoa carrying different sex chromosomes from the nuclear morphometrics generated and different statistical procedures in the bovine species. The study was divided into two experiments. The first was to study the morphometric differences between X- and Y-chromosome-bearing spermatozoa （SX and SY, respectively）. Spermatozoa from eight bulls were processed to assess simultaneously the sex chromosome by FISH and sperm morphometry by fluorescence-based CASA-Morph. SX cells were larger than SY cells on average （P 〈 0.001） although with important differences between bulls. A simultaneous evaluation of all the measured features by discriminant analysis revealed that nuclear area and average fluorescence intensity were the variables selected by stepwise discriminant function analysis as the best discriminators between SX and SY. In the second experiment, the sperm nuclear morphometric results from CASA-Morph in nonsexed （mixed SX and SY） and sexed （SX） semen samples from four bulls were compared. FISH allowed a successful classification of spermatozoa according to their sex chromosome content. X-sexed spermatozoa displayed a larger size and fluorescence intensity than nonsexed spermatozoa （P 〈 0.05）. We conclude that the CASA-Morph fluorescence-based method has the potential to find differences between X- and Y-chromosome-bearing spermatozoa in bovine species although more studies are needed to increase the precision of sex determination by this technique.展开更多
AIM: To introduce the navigation system of software and instruments designed specifically for revision total knee arthroplasty(TKA).METHODS: We present an imageless navigation system for revision TKA,with optical poin...AIM: To introduce the navigation system of software and instruments designed specifically for revision total knee arthroplasty(TKA).METHODS: We present an imageless navigation system for revision TKA,with optical point and tracker identification to assess kinematic and anatomical landmarks.The system automatically positions the cutting guides with a motorized cutting unit.The cutting unit is placed on the distal femur with a femoral clamp and acts as a rigid body and the base for all femoral cuts.The surgical technique for using the navigation system for revision TKA is based on the technique used in primary TKA.However,there are some important differences.The most notable are:(1) differences in estimation of the position of the primary implant relative to the bone and the mechanical axes;(2) the specific possibilities the revision navigation software offers in terms of optimal joint level positioning; and(3) the suggested "best fit" position,in which the clock position,stem position and offset,femoral component size,and mediolateral position of the femoral component are taken into account to find the optimal femoral component position.We assessed the surgical technique,and accompanying software procedural steps,of the system,identifying any advantages or disadvantages that they present.RESULTS: The system aims to visualize critical steps of the procedure and is intended as a tool to support the surgeon in surgical decision-making.Combining a computer-assisted cutting device with navigation makes it possible to carry out precise cuts without pinning.Furthermore,the femoral clamp provides a stable fixation mechanism for the motorized cutting unit.A stable clamp is paramount in the presence of periarticular bony defects.The system allows the position of the primary implant relative to the bone and mechanical axes to be estimated,at which point any malalignments can be corrected.It also offers an optimal joint level position for implantation,and suggests a "best fit" position,in which the clock position,stem position and offset,femoral component size,and mediolateral position of the femoral component are considered.The surgeon can therefore make decisions intraoperatively to maximise alignment and,hence,outcomes.Based on the intraoperative findings of joint stability,the surgeon can modify the preoperative plan and switch from a constrained condylar system to a hinged version,or vice versa.CONCLUSION: The system is flexible and easy to learn and allows improvements in workflow during TKA.展开更多
Brazing filler metals are widely applied,which serve as an industrial adhesive in the joining of dissimilar structures.With the continuous emergence of new structures and materials,the demand for novel brazing filler ...Brazing filler metals are widely applied,which serve as an industrial adhesive in the joining of dissimilar structures.With the continuous emergence of new structures and materials,the demand for novel brazing filler metals is ever-increasing.It is of great significance to investigate the optimized composition design methods and to establish systematic design guidelines for brazing filler metals.This study elucidated the fundamental rules for the composition design of brazing filler metals from a three-dimensional perspective encompassing the basic properties of applied brazing filler metals,formability and processability,and overall cost.The basic properties of brazing filler metals refer to their mechanical properties,physicochemical properties,electromagnetic properties,corrosion resistance,and the wettability and fluidity during brazing.The formability and processability of brazing filler metals include the processes of smelting and casting,extrusion,rolling,drawing and ring-making,as well as the processes of granulation,powder production,and the molding of amorphous and microcrystalline structures.The cost of brazing filler metals corresponds to the sum of materials value and manufacturing cost.Improving the comprehensive properties of brazing filler metals requires a comprehensive and systematic consideration of design indicators.Highlighting the unique characteristics of brazing filler metals should focus on relevant technical indicators.Binary or ternary eutectic structures can effectively enhance the flow spreading ability of brazing filler metals,and solid solution structures contribute to the formability.By employing the proposed design guidelines,typical Ag based,Cu based,Zn based brazing filler metals,and Sn based solders were designed and successfully applied in major scientific and engineering projects.展开更多
In the area of computer-assisted language learning(CALL),although a number of studies have adopted various CALL-based devices(e.g.,blogs,gaming,and synthetic environments)to foster second language(L2)acquisition,the v...In the area of computer-assisted language learning(CALL),although a number of studies have adopted various CALL-based devices(e.g.,blogs,gaming,and synthetic environments)to foster second language(L2)acquisition,the vital component of instruction has received little attention.The present study explored the usefulness of CALL-based communication in conjunction with instruction on EFL learners’L2 pragmatic development.Sixty-two EFL students from a university in China were recruited for the current research.The experimental group communicated with a native English speaker through synchronous messaging via Skype and had two instructional sessions pertinent to compliment responses,while the control group interacted with a native English speaker via Skype without having the teaching intervention.Findings from an independent samples t-test demonstrated that the experimental group produced significantly more proper compliment responses in the immediate posttest than the control group(p<.001).Moreover,a significant difference(p<.001)was found for the experimental group between the preintervention and delayed post-intervention mean scores,suggesting that CALL coupled with teaching intervention had a long-term impact on learners’L2 pragmatic development.These findings enrich our understanding of the beneficial and lasting influence of combining CALL with instruction on EFL students’pragmatic development.In addition,pedagogical implications for deploying CALL paired with L2 pragmatics instruction are provided.展开更多
文摘In aerial photography, the primary factor is terrain undulation. However, most of the external aerial photography software used for aerial photography design do not take terrain undulation influence into consideration. Therefore, the design result has comparative randomicity and ＂gaps＂ are expected. An aerial photography design system is developed by analyzing the terrain undulation influence to the design result with DEM data so that the forward overlap and side overlap can be justified according to the block terrain undulation to meet specifications or standards. The data designed by this system is compared with the real flying data. The results show that making use of DEM to assist in aerial photography design can ensure that the designed result fits the real terrain better.
文摘BACKGROUND The gold standard for colorectal polyp screening is currently colonoscopy,but the miss rate is still high and the adenoma detection rate and polyp detection rate are still low.The risk factors include the patient,operators,and the tools used.The use of artificial intelligence(AI)in colonoscopy has gained popularity by assisting endoscopists in the detection and characterization of polyps.AIM To evaluate the diagnostic performance of AI-assisted colonoscopy[computer assisted diagnosis(CAD)eye function]for colorectal polyp characterization.METHODS This study used a cross-sectional design conducted at the Gastrointestinal Endoscopy Center of Dr.Cipto Mangunkusumo Hospital in January-May 2024 on adult patients with suspected colorectal polyps.RESULTS A total of 60 patients with 100 polyps were involved in this study.Based on the results of the examination,it was found that the AI CAD eye function examination had a sensitivity of 79.17%,specificity of 75.00%,positive predictive value(PPV)of 89.06%,negative predictive value(NPV)of 58.33%,and accuracy of 78.00%.In polyps with diminutive size,sensitivity was 86.27%,specificity was 60.00%,PPV was 95.65%,NPV was 30.00%,and accuracy was 83.93%.Meanwhile,in polyps with non-diminutive size,sensitivity was 61.90%,specificity was 78.26%,PPV was 72.22%,NPV was 69.23%,and accuracy was 70.45%.In polyps on the left side of the colon,sensitivity was 78.85%,specificity was 81.25%,PPV was 93.18%,NPV was 54.17%,and accuracy was 79.41%.Meanwhile,in rightsided polyps the sensitivity was 80.00%,specificity was 66.67%,PPV was 80.00%,NPV was 66.67%,and accuracy was 75.00%.In sessile polyps the sensitivity was 81.54%,specificity was 50.00%,PPV was 91.38%,NPV was 29.41%,and accuracy was 77.33%.Meanwhile,in non-sessile polyps,the sensitivity was 57.14%,specificity was 88.89%,PPV was 66.67%,NPV was 84.21%,and accuracy was 80.00%.CONCLUSION AI CAD eye function examination had a high sensitivity value in diminutive,sessile polyps and right-sided polyps and a high specificity in non-diminutive,non-sessile polyps and left-sided polyps.
文摘BACKGROUND Knowledge-based systems(KBS)are software applications based on a knowledge database and an inference engine.Various experimental KBS for computerassisted medical diagnosis and treatment were started to be used since 70s(VisualDx,GIDEON,DXPlain,CADUCEUS,Internist-I,Mycin etc.).AIM To present in detail the“Electronic Pediatrician(EPed)”,a medical non-machine learning artificial intelligence(nml-AI)KBS in its prototype version created by the corresponding author(with database written in Romanian)that offers a physiopathology-based differential and positive diagnosis and treatment of ill children.METHODS EPed specifically focuses on the physiopathological reasoning of pediatric clinical cases.EPed has currently reached its prototype version 2.0,being able to diagnose 302 physiopathological macro-links(briefly named“clusters”)and 269 pediatric diseases:Some examples of diagnosis and a previous testing of EPed on a group of 34 patients are also presented in this paper.RESULTS The prototype EPed can currently diagnose 269 pediatric infectious and noninfectious diseases(based on 302 clusters),including the most frequent respiratory/digestive/renal/central nervous system infections,but also many other noninfectious pediatric diseases like autoimmune,oncological,genetical diseases and even intoxications,plus some important surgical pathologies.CONCLUSION EPed is the first and only physiopathology-based nml-AI KBS focused on general pediatrics and is the first and only pediatric Romanian KBS addressed to medical professionals.Furthermore,EPed is the first and only nml-AI KBS that offers not only both a physiopathology-based differential and positive disease diagnosis,but also identifies possible physiopathological“clusters”that may explain the signs and symptoms of any child-patient and may help treating that patient physiopathologically(until a final diagnosis is found),thus encouraging and developing the physiopathological reasoning of any clinician.
基金Supported by the National Key Research and Development Program of China(2023YFB4104500,2023YFB4104502)the National Natural Science Foundation of China(22138013)the Taishan Scholar Project(ts201712020).
文摘Against the backdrop of escalating global climate change and energy crises,the resource utilization of carbon dioxide(CO_(2)),a major greenhouse gas,has become a crucial pathway for achieving carbon peaking and carbon neutrality goals.The hydrogenation of CO_(2)to methanol not only enables carbon sequestration and recycling,but also provides a route to produce high value-added fuels and basic chemical feedstocks,holding significant environmental and economic potential.However,this conversion process is thermodynamically and kinetically limited,and traditional catalyst systems(e.g.,Cu/ZnO/Al_(2)O_(3))exhibit inadequate activity,selectivity,and stability under mild conditions.Therefore,the development of novel high-performance catalysts with precisely tunable structures and functionalities is imperative.Metal-organic frameworks(MOFs),as crystalline porous materials with high surface area,tunable pore structures,and diverse metal-ligand compositions,have the great potential in CO_(2)hydrogenation catalysis.Their structural design flexibility allows for the construction of well-dispersed active sites,tailored electronic environments,and enhanced metal-support interactions.This review systematically summarizes the recent advances in MOF-based and MOF-derived catalysts for CO_(2)hydrogenation to methanol,focusing on four design strategies:(1)spatial confinement and in situ construction,(2)defect engineering and ion-exchange,(3)bimetallic synergy and hybrid structure design,and(4)MOF-derived nanomaterial synthesis.These approaches significantly improve CO_(2)conversion and methanol selectivity by optimizing metal dispersion,interfacial structures,and reaction pathways.The reaction mechanism is further explored by focusing on the three main reaction pathways:the formate pathway(HCOO*),the RWGS(Reverse Water Gas Shift reaction)+CO*hydrogenation pathway,and the trans-COOH pathway.In situ spectroscopic studies and density functional theory(DFT)calculations elucidate the formation and transformation of key intermediates,as well as the roles of active sites,metal-support interfaces,oxygen vacancies,and promoters.Additionally,representative catalytic performance data for MOFbased systems are compiled and compared,demonstrating their advantages over traditional catalysts in terms of CO_(2)conversion,methanol selectivity,and space-time yield.Future perspectives for MOF-based CO_(2)hydrogenation catalysts will prioritize two main directions:structural design and mechanistic understanding.The precise construction of active sites through multi-metallic synergy,defect engineering,and interfacial electronic modulation should be made to enhance catalyst selectivity and stability.In addition,advanced in situ characterization techniques combined with theoretical modeling are essential to unravel the detailed reaction mechanisms and intermediate behaviors,thereby guiding rational catalyst design.Moreover,to enable industrial application,challenges related to thermal/hydrothermal stability,catalyst recyclability,and cost-effective large-scale synthesis must be addressed.The development of green,scalable preparation methods and the integration of MOF catalysts into practical reaction systems(e.g.,flow reactors)will be crucial for bridging the gap between laboratory research and commercial deployment.Ultimately,multi-scale structure-performance optimization and catalytic system integration will be vital for accelerating the industrialization of MOF-based CO_(2)-to-methanol technologies.
基金supported by the Hong Kong Polytechnic University(1-WZ1Y,1-W34U,4-YWER).
文摘Recent years have witnessed transformative changes brought about by artificial intelligence(AI)techniques with billions of parameters for the realization of high accuracy,proposing high demand for the advanced and AI chip to solve these AI tasks efficiently and powerfully.Rapid progress has been made in the field of advanced chips recently,such as the development of photonic computing,the advancement of the quantum processors,the boost of the biomimetic chips,and so on.Designs tactics of the advanced chips can be conducted with elaborated consideration of materials,algorithms,models,architectures,and so on.Though a few reviews present the development of the chips from their unique aspects,reviews in the view of the latest design for advanced and AI chips are few.Here,the newest development is systematically reviewed in the field of advanced chips.First,background and mechanisms are summarized,and subsequently most important considerations for co-design of the software and hardware are illustrated.Next,strategies are summed up to obtain advanced and AI chips with high excellent performance by taking the important information processing steps into consideration,after which the design thought for the advanced chips in the future is proposed.Finally,some perspectives are put forward.
基金the National Natural Science Foundation of China(No.51675036)the Innovation and Development Project of Intelligent Manufacturing Technique from Beijing Municipal Science and Technology Commission(No.Z161100001516012).
文摘The computer-assisted surgery (CAS)has significantly improved the accuracy, reliability and outcomes of traumatic,spinal,nerve surgery and many other operations with a less invasive way.The application of CAS for scaphoid fractures remains experimental.The related studies are scanty and most of them are cadaver researches.Some intrinsic defects from the registration procedure,scan and immobilization of limbs may inevitably result in deviations. Some deviations become more obvious with operations of small bones (such as scaphoid)although they are acceptable for spine and other orthopedic surgeries.We reviewed the current literatures on the applications of CAS for scaphoid operation and summarized technical principles,scan and registration methods,immobilization of limbs and their outcomes.On the basis of the data,we analyzed the limitations of this technique and envisioned its future development.
基金the National Key R&D Program of China,No.2018YFC1313103the National Natural Science Foundation of China,No.81670473 and No.81873546+1 种基金the“Shu Guang”Project of Shanghai Municipal Education Commission and Shanghai Education Development Foundation,No.19SG30the Key Area Research and Development Program of Guangdong Province,China,No.2018B010111001.
文摘BACKGROUND Artificial intelligence in colonoscopy is an emerging field,and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas.Several deep learning-based computer-assisted detection(CADe)techniques were established from small single-center datasets,and unrepresentative learning materials might confine their application and generalization in wide practice.Although CADes have been reported to identify polyps in colonoscopic images and videos in real time,their diagnostic performance deserves to be further validated in clinical practice.AIM To train and test a CADe based on multicenter high-quality images of polyps and preliminarily validate it in clinical colonoscopies.METHODS With high-quality screening and labeling from 55 qualified colonoscopists,a dataset consisting of over 71000 images from 20 centers was used to train and test a deep learning-based CADe.In addition,the real-time diagnostic performance of CADe was tested frame by frame in 47 unaltered full-ranged videos that contained 86 histologically confirmed polyps.Finally,we conducted a selfcontrolled observational study to validate the diagnostic performance of CADe in real-world colonoscopy with the main outcome measure of polyps per colonoscopy in Changhai Hospital.RESULTS The CADe was able to identify polyps in the test dataset with 95.0%sensitivity and 99.1%specificity.For colonoscopy videos,all 86 polyps were detected with 92.2%sensitivity and 93.6%specificity in frame-by-frame analysis.In the prospective validation,the sensitivity of CAD in identifying polyps was 98.4%(185/188).Folds,reflections of light and fecal fluid were the main causes of false positives in both the test dataset and clinical colonoscopies.Colonoscopists can detect more polyps(0.90 vs 0.82,P<0.001)and adenomas(0.32 vs 0.30,P=0.045)with the aid of CADe,particularly polyps<5 mm and flat polyps(0.65 vs 0.57,P<0.001;0.74 vs 0.67,P=0.001,respectively).However,high efficacy is not realized in colonoscopies with inadequate bowel preparation and withdrawal time(P=0.32;P=0.16,respectively).CONCLUSION CADe is feasible in the clinical setting and might help endoscopists detect more polyps and adenomas,and further confirmation is warranted.
文摘The aim of the present study was to compare assessments of sperm concentration and sperm motility analysed by conventional semen analysis with those obtained by computer-assisted semen analysis （CASA） （Copenhagen Rigshospitalet Image House Sperm Motility Analysis System （CRISMAS） 4.6 software） using semen samples from 166 young Danish men. The CRISMAS software identifies sperm concentration and classifies spermatozoa into three motility categories. To enable comparison of the two methods, the four motility stages obtained by conventional semen analysis were, based on their velocity classifications, divided into three stages, comparable to the three CRISMAS motility categories： rapidly progressive （A）, slowly progressive （B） and non-progressive （C＋ D）. Differences between the two methods were large for all investigated parameters （P〈0.001）. CRISMAS overestimated sperm concentration and the proportion of rapidly progressive spermatozoa and, consequently, underestimated the percentages of slowly progressive and non-progressive spermatozoa, compared to the conventional method. To investigate whether results drifted according to time of semen analysis, results were pooled into quarters according to date of semen analysis. CRISMAS motility results appeared more stable over time compared to the conventional analysis; however, neither method showed any trends. Apparently, CRISMAS CASA results and results from the conventional method were not comparable with respect to sperm concentration and motility analysis. This needs to be accounted for in clinics using this software and in studies of determinants of these semen characteristics.
文摘Glutathione peroxidase, the first example of selenoproteins identified in mammals, was subjected to force field calculations and molecular dynamics in order to enable a clearer comprehension of enzymatic selenium catalysis. Starting from the established X-ray structure of bovine GPX, all kinetically defined intermediates and enzyme substrate complexes were modelled. The models thus obtained support the hypothesis that the essential steps of the catalysis are three distinct redox changes of the active site selenium which, in the ground state, presents itself at the surface of selenoperoxidases as the center of a characteristic triad built by selenocysteine, glutarnine and tryptophan. In GPX, four arginine residues and a lysine residue provide an electrostatic architecture which, in each reductive step, directs the donor substrate GSH towards the catalytic center in such a way that 1ts sulfhydryl group must react with the selenium moiety. To this end, different equally efficient modes of substrate binding appear possible. The models are consistent with substrate specificity data, kinetic pattern and other functional characteristics of the enzyme. Comparison of molecular models of GPX with those of other members of the GPX superfamily reveals that the cosubstrate binding mechanisrns are unique for the classical type of cytosolic glutathione peroxidases but cannot operate e. g. in plasma GPX and phospholipid hydroperoxide GPX. The structural differences between the selenoperoxidases, shown to be relevant to their specificities, are discussed in terms of functional diversification within the GPX superfamily
基金Supported by National Natural Science Foundation of China,No.82293665Anhui Provincial Department of Education University Research Project,No.2023AH051763.
文摘BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,extreme liver resection can be considered a potential option.AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC.METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023.We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC.RESULTS Sixty-seven children diagnosed with HB underwent surgical resection.The age at diagnosis was 21.4±18.8 months,and 40 boys and 27 girls were included.Fifty-nine(88.1%)patients had a single tumor,39(58.2%)of which was located in the right lobe of the liver.A total of 47 patients(70.1%)had PRE-TEXT III or IV.Thirty-nine patients(58.2%)underwent delayed resection.After a full course of NAC,16 patients still had close PMV(within 1 cm in two patients,touching in 11 patients,compressing in four patients,and showing tumor thrombus in three patients).There were 6 patients of tumors in the middle lobe of the liver,and four of those patients exhibited liver anatomy variations.These 16 children underwent extreme liver resection after comprehensive preoperative evaluation.Intraoperative procedures were performed according to the preoperative plan,and the operations were successfully performed.Currently,the 3-year event-free survival of 67 children with HB is 88%.Among the 16 children who underwent extreme liver resection,three experienced recurrence,and one died due to multiple metastases.CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible.This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis.Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB,particularly for assessing vascular involvement,remnant liver volume and anatomical variations.
文摘The aim of this study was to compare the sperm nuclear and acrosomal morphometry of three species of domestic artiodactyls; cattle （Bos taurus）, sheep （Ovis aries）, and pigs （Sus scrofa）. Semen smears of twenty ejaculates from each species were fixed and labeled with a propidium iodide-Pisum sativum agglutinin （PI/PSA） combination. Digital images of the sperm nucleus, acrosome, and whole sperm head were captured and analyzed. The use of the PI/PSA combination and CASA-Morph fluorescence-based method allowed the capture, morphometric analysis, and differentiation of most sperm nuclei, acrosomes and whole heads, and the assessment of acrosomal integrity with a high precision in the three species studied. For the size of the head and nuclear area, the relationship between the three species may be summarized as bull 〉 ram 〉 boar. However, for the other morphometric parameters （length, width, and perimeter）, there were differences in the relationships between species for sperm nuclei and whole sperm heads. Bull sperm acrosomes were clearly smaller than those in the other species studied and covered a smaller proportion of the sperm head. The acrosomal morphology, small in the bull, large and broad in the sheep, and large, long, and with a pronounced equatorial segment curve in the boar, was species-characteristic. It was concluded that there are clear variations in the size and shape of the sperm head components between the three species studied, the acrosome being the structure showing the most variability, allowing a clear distinction of the spermatozoa of each species.
基金Supported by the Science and Technology Program in Chinese Medicine of Shandong Province,No.2020M074。
文摘BACKGROUND Most complex renal stones are managed primarily with percutaneous nephrolithotomy(PCNL).However,PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent structures.Novel techniques are required to assist in planning and navigation.AIM To apply and evaluate the Hisense computer-assisted surgery(CAS)system in PCNL.METHODS A total of 60 patients with complex renal stones were included.Thirty patients in the CAS group had three-dimensional(3 D)virtual models constructed with the CAS system.The model assisted in planning and navigating in the CAS system.Thirty patients in the control group planned and navigated as standard PCNL,without the application of the CAS system.Success rate of one attempt,operation time,initial stone-free rate,decrease in hemoglobin,and complications were collected and analyzed.RESULTS There were no statistically significant differences in the baseline characteristics or planning characteristics.The success rate of one puncturing attempt(90%vs 67%,P=0.028)and the initial stone-free rate(87%vs 63%,P=0.037)were significantly higher in the CAS group.However,there were no statistically significant differences in the operation time(89.20±29.60 min vs 92.33±33.08 min,P=0.859)or in the decrease in hemoglobin(11.07±8.32 g/L vs 9.03±11.72 g/L,P=0.300)between the CAS group and the control group.No statistically significant differences in the incidence of complications(Clavien-Dindo grade≥2)were found.CONCLUSION Compared with standard PCNL,CAS-assisted PCNL had advantages in terms of the puncturing success rate and stone-free rate.The Hisense CAS System was recommended to assist in preoperative planning and intraoperative navigation for an intuitive,precise and convenient PCNL.
基金Supported by Qingdao Civic Science and Technology Program,No.17-3-3-8-nsh.
文摘BACKGROUND Ganglioneuroblastoma(GNB)is a peripheral neuroblastoma(NB)with malignant degree between highly malignant NB and benign ganglioma(GN).Pathology is the gold standard of diagnosis.Although GNB is not uncommon in children,biopsy alone may lead to an inaccurate diagnosis,especially for giant tumors.However,surgical resection may be associated with significant complications.Here,we report a case of computer-assisted surgical resection of a giant GNB in a child and successful rescue of the inferior mesenteric artery.CASE SUMMARY A 4-year-old girl was admitted to our department for a giant retroperitoneal lesion,which was considered to be an NB by her local hospital.The symptoms of the girl disappeared spontaneously without treatment.On physical examination,a mass of about 10 cm×7 cm could be palpated in her abdomen.Ultrasonography and contrast-enhanced computed tomography performed in our hospital also showed an NB,and there was a very thick blood vessel inside the tumor.However,aspiration biopsy revealed GN.Surgical resection is the best treatment option for this giant benign tumor.For precise preoperative evaluation,threedimensional reconstruction was performed.It was clear that the tumor was close to the abdominal aorta.The superior mesenteric vein was pushed forward,and the inferior mesenteric artery passed through the tumor.Because GN generally does not invade blood vessels,we split the tumor with a CUSA knife during the operation and found that there was indeed a straight and intact vascular sheath.Arterial pulsation was observed in the completely exposed inferior mesenteric artery.The pathologists interpreting the tissue finally diagnosed it as a mixed GNB(GNBi),which is more malignant than GN.However,both GN and GNBi usually have a good prognosis.CONCLUSION This was a case of successful surgical resection of a giant GNB,and aspiration biopsy underestimated the pathological staging of the tumor.Preoperative three-dimensional reconstruction assisted with the radical resection of the tumor and rescue of the inferior mesenteric artery.
基金Supported by Ninth People's Hospital affiliated to Shanghai Jiao Tong University,School of Medicine "Multi-Disciplinary Team" Clinical Research Project,No.201701011
文摘BACKGROUND Congenital maxillomandibular syngnathia is an extremely rare disorder characterized by craniofacial malformations and inability to open the mouth adequately, which leads to problems with feeding, swallowing, and breathing as well as temporomandibular joint ankylosis. The main goal of the surgery is to release the ankylosis, establish functioning mandible, and prevent re-fusion.However, surgical procedures for this disease are rarely reported.CASE SUMMARY Here, we report a 7-mo-old girl with bilateral maxillomandibular syngnathia. The patient presented with difficulty in feeding, breathing, sounding, and swallowing and had developmental dysplasia. For treatment, we performed bone isolation by computer-assisted navigation and used silicone to fix the wound surface to prevent refusion of bone. To our knowledge, this is the only syngnathia case in the literature treated using computer-assisted navigation. With the guidance of precise navigation, we were able to minimize operation time by at least one hour,the patient's blood vessels, nerves, and tooth germs were well protected, and excessive bleeding was avoided. After six weeks, the patient showed improvement in mouth opening and no major issues of feeding.CONCLUSION Application of computer-assisted navigation can significantly improve accuracy,effectiveness, and surgical safety in correcting congenital maxillomandibular syngnathia.
文摘This study was designed to determine the ability of computer-assisted sperm morphometry analysis （CASA-Morph） with fluorescence to discriminate between spermatozoa carrying different sex chromosomes from the nuclear morphometrics generated and different statistical procedures in the bovine species. The study was divided into two experiments. The first was to study the morphometric differences between X- and Y-chromosome-bearing spermatozoa （SX and SY, respectively）. Spermatozoa from eight bulls were processed to assess simultaneously the sex chromosome by FISH and sperm morphometry by fluorescence-based CASA-Morph. SX cells were larger than SY cells on average （P 〈 0.001） although with important differences between bulls. A simultaneous evaluation of all the measured features by discriminant analysis revealed that nuclear area and average fluorescence intensity were the variables selected by stepwise discriminant function analysis as the best discriminators between SX and SY. In the second experiment, the sperm nuclear morphometric results from CASA-Morph in nonsexed （mixed SX and SY） and sexed （SX） semen samples from four bulls were compared. FISH allowed a successful classification of spermatozoa according to their sex chromosome content. X-sexed spermatozoa displayed a larger size and fluorescence intensity than nonsexed spermatozoa （P 〈 0.05）. We conclude that the CASA-Morph fluorescence-based method has the potential to find differences between X- and Y-chromosome-bearing spermatozoa in bovine species although more studies are needed to increase the precision of sex determination by this technique.
基金Supported by Smith and Nephew Gmb H,Marl,Germany
文摘AIM: To introduce the navigation system of software and instruments designed specifically for revision total knee arthroplasty(TKA).METHODS: We present an imageless navigation system for revision TKA,with optical point and tracker identification to assess kinematic and anatomical landmarks.The system automatically positions the cutting guides with a motorized cutting unit.The cutting unit is placed on the distal femur with a femoral clamp and acts as a rigid body and the base for all femoral cuts.The surgical technique for using the navigation system for revision TKA is based on the technique used in primary TKA.However,there are some important differences.The most notable are:(1) differences in estimation of the position of the primary implant relative to the bone and the mechanical axes;(2) the specific possibilities the revision navigation software offers in terms of optimal joint level positioning; and(3) the suggested "best fit" position,in which the clock position,stem position and offset,femoral component size,and mediolateral position of the femoral component are taken into account to find the optimal femoral component position.We assessed the surgical technique,and accompanying software procedural steps,of the system,identifying any advantages or disadvantages that they present.RESULTS: The system aims to visualize critical steps of the procedure and is intended as a tool to support the surgeon in surgical decision-making.Combining a computer-assisted cutting device with navigation makes it possible to carry out precise cuts without pinning.Furthermore,the femoral clamp provides a stable fixation mechanism for the motorized cutting unit.A stable clamp is paramount in the presence of periarticular bony defects.The system allows the position of the primary implant relative to the bone and mechanical axes to be estimated,at which point any malalignments can be corrected.It also offers an optimal joint level position for implantation,and suggests a "best fit" position,in which the clock position,stem position and offset,femoral component size,and mediolateral position of the femoral component are considered.The surgeon can therefore make decisions intraoperatively to maximise alignment and,hence,outcomes.Based on the intraoperative findings of joint stability,the surgeon can modify the preoperative plan and switch from a constrained condylar system to a hinged version,or vice versa.CONCLUSION: The system is flexible and easy to learn and allows improvements in workflow during TKA.
基金National Natural Science Foundation of China(U22A20191)。
文摘Brazing filler metals are widely applied,which serve as an industrial adhesive in the joining of dissimilar structures.With the continuous emergence of new structures and materials,the demand for novel brazing filler metals is ever-increasing.It is of great significance to investigate the optimized composition design methods and to establish systematic design guidelines for brazing filler metals.This study elucidated the fundamental rules for the composition design of brazing filler metals from a three-dimensional perspective encompassing the basic properties of applied brazing filler metals,formability and processability,and overall cost.The basic properties of brazing filler metals refer to their mechanical properties,physicochemical properties,electromagnetic properties,corrosion resistance,and the wettability and fluidity during brazing.The formability and processability of brazing filler metals include the processes of smelting and casting,extrusion,rolling,drawing and ring-making,as well as the processes of granulation,powder production,and the molding of amorphous and microcrystalline structures.The cost of brazing filler metals corresponds to the sum of materials value and manufacturing cost.Improving the comprehensive properties of brazing filler metals requires a comprehensive and systematic consideration of design indicators.Highlighting the unique characteristics of brazing filler metals should focus on relevant technical indicators.Binary or ternary eutectic structures can effectively enhance the flow spreading ability of brazing filler metals,and solid solution structures contribute to the formability.By employing the proposed design guidelines,typical Ag based,Cu based,Zn based brazing filler metals,and Sn based solders were designed and successfully applied in major scientific and engineering projects.
文摘In the area of computer-assisted language learning(CALL),although a number of studies have adopted various CALL-based devices(e.g.,blogs,gaming,and synthetic environments)to foster second language(L2)acquisition,the vital component of instruction has received little attention.The present study explored the usefulness of CALL-based communication in conjunction with instruction on EFL learners’L2 pragmatic development.Sixty-two EFL students from a university in China were recruited for the current research.The experimental group communicated with a native English speaker through synchronous messaging via Skype and had two instructional sessions pertinent to compliment responses,while the control group interacted with a native English speaker via Skype without having the teaching intervention.Findings from an independent samples t-test demonstrated that the experimental group produced significantly more proper compliment responses in the immediate posttest than the control group(p<.001).Moreover,a significant difference(p<.001)was found for the experimental group between the preintervention and delayed post-intervention mean scores,suggesting that CALL coupled with teaching intervention had a long-term impact on learners’L2 pragmatic development.These findings enrich our understanding of the beneficial and lasting influence of combining CALL with instruction on EFL students’pragmatic development.In addition,pedagogical implications for deploying CALL paired with L2 pragmatics instruction are provided.
