Background/aims: Paediatric outpatients are often dilated with cyclopentolate drops. These cause discomfort and distress, which may impede subsequent examination. We aimed to determine the distress caused by cyclopent...Background/aims: Paediatric outpatients are often dilated with cyclopentolate drops. These cause discomfort and distress, which may impede subsequent examination. We aimed to determine the distress caused by cyclopentolate drops, and other factors in the clinic environment. Methods: Over an 8 week period, questionnaires were issued to guardians of all paediatric outpatients aged under 10 years receiving cyclopentolate. The childrens’distress was graded on a scale of 1 - 10 (1 = no distress, 10 = severe distress). Waiting time and ease of examination were recorded. Data was analysed using Stata statistics, and significant differences were reported at the P < 0.05 level. Results: The 72 children were grouped as under 4 years (n = 43, Group A), aged 4 - 7 years (n = 19, Group B), and aged 7-10 years (n = 10, Group C). Median distress levels at home (baseline), on arrival, on dilation, and on examination were as follows: Group A;1, 2, 7, 6 respectively;Group B;1, 1, 6, 2 and Group C;1, 1, 4.5, 1. All age groups were significantly more distressed on examination compared to baseline. Distress scores on examination were significantly greater for Group A, in keeping with the greatest number of suboptimal examinations. Guardians reported that a prolonged waiting time and bright examination lights also contributed to distress. Conclusions: This study confirms that cyclopentolate causes significant distress in young children, and in 45% of very young children, the examination is difficult. Proxymetacaine prior to cyclopentolate is a possible solution, but other distressing factors should also be addressed for optimal outcomes.展开更多
Objective: to study the clinical effect of balloon catheter and uterine cin in expired pregnancy. Methods: 60 expired patients were selected to compare the clinical effects of the two methods. Results: the clinical ef...Objective: to study the clinical effect of balloon catheter and uterine cin in expired pregnancy. Methods: 60 expired patients were selected to compare the clinical effects of the two methods. Results: the clinical effect of the observation group was better than the control group (P 0.05). Conclusion: patients with induced induction of expired pregnancy.展开更多
We investigate flow through an elastic tube which is constrained to a prescribed external forcing consisting of a progressive travelling wave.Such a flow dynamics is closely related to that in the oesophageal tube.The...We investigate flow through an elastic tube which is constrained to a prescribed external forcing consisting of a progressive travelling wave.Such a flow dynamics is closely related to that in the oesophageal tube.The mechanics of the tube is characterized by a relationship between transmural pressure difference and radial variation of the tube.Dimensionless radial variation,assumed to be small,is studied by perturbation techniques.Hesults demonstrate that the elasticity of the tube plays a significant role in the flow dynamics.An increment in the forcing amplitude of the inward radial force enhances pressure,time-averaged volume flow rate and hence axial and radial velocities.lt is revealed that the elastic nature of the oesophageal tube favors swallowing.展开更多
Objectives:One of the most notable challenges in endoscopic procedures is maintaining correct orientation.Mental rotation exercise(MRE)has been suggested as a potential aid for improving orientation.However,there is a...Objectives:One of the most notable challenges in endoscopic procedures is maintaining correct orientation.Mental rotation exercise(MRE)has been suggested as a potential aid for improving orientation.However,there is a lack of research on designing MREs with varying difficultylevels for training purposes.Furthermore,few studies provide solid evidence linking MRE difficultylevels with cognitive load measurements.This study aims to address this gap by investigating the correlation between the MRE difficultylevels and participants’cognitive load,as measured by pupil dilation.Method:We recruited 33 participants to perform MREs on a computer equipped with a screen-mounted eye-tracker.The test consisted of 15 MREs,with the first10 relatively easy(traditional cube)and the next 5 more complex(invented molecule).The participants’eye movements during MREs were recorded.The participants’MRE scores and pupil dilation were obtained and compared between two MRE difficultylevels.Results:The participants who performed traditional cube MREs achieved significantlybetter MRE scores(0.77±0.11 vs.0.58±0.03,p<0.001)and lower pupil dilation(0.27±0.04 pixels vs.0.47±0.09 pixels,p<0.001)than did those who performed the invented molecule MREs.Moreover,there were significant negative correlations(r=0.62,p=0.015)between pupil dilation and MRE scores.Conclusions:The results revealed a significantnegative correlation between MRE scores and pupil dilation.The more challenging MRE questions led to worse MRE scores but increased pupil dilation.The MRE difficultylevels can be evaluated not only by the degrees or dimensions with which the objects were rotated but also by the participants’MRE scores and pupil dilation.The results of this study provide a basis for training orientation skills in endoscopy using MREs.By incorporating MREs with varying difficultylevels,customized training programs can be developed to enhance camera navigation in endoscopic and laparoscopic procedures.展开更多
Two-dimensional endoscopic images are susceptible to interferences such as specular reflections and monotonous texture illumination,hindering accurate three-dimensional lesion reconstruction by surgical robots.This st...Two-dimensional endoscopic images are susceptible to interferences such as specular reflections and monotonous texture illumination,hindering accurate three-dimensional lesion reconstruction by surgical robots.This study proposes a novel end-to-end disparity estimation model to address these challenges.Our approach combines a Pseudo-Siamese neural network architecture with pyramid dilated convolutions,integrating multi-scale image information to enhance robustness against lighting interferences.This study introduces a Pseudo-Siamese structure-based disparity regression model that simplifies left-right image comparison,improving accuracy and efficiency.The model was evaluated using a dataset of stereo endoscopic videos captured by the Da Vinci surgical robot,comprising simulated silicone heart sequences and real heart video data.Experimental results demonstrate significant improvement in the network’s resistance to lighting interference without substantially increasing parameters.Moreover,the model exhibited faster convergence during training,contributing to overall performance enhancement.This study advances endoscopic image processing accuracy and has potential implications for surgical robot applications in complex environments.展开更多
The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future car...The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future cardiovascular(CV)diseases.Chronic kidney disease,a state of chronic inflammation caused by oxidative stress,metabolic abnormalities,infection,and uremic toxins damages the endothelium.ED is also associated with a decline in estimated glomerular filtration rate.After kidney transplantation,endothelial functions undergo immediate but partial restoration,promising graft longevity and enhanced CV health.However,the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED,culminating in poor CV health and graft survival.ED in kidney transplant recipients is an underrecognized and poorly studied entity.CV diseases are the leading cause of death among kidney transplant candidates with functioning grafts.ED contributes to the pathogenesis of many of the CV diseases.Various biomarkers and vasoreactivity tests are available to study endothelial functions.With an increasing number of transplants happening every year,and improved graft rejection rates due to the availability of effective immunosuppressants,the focus has now shifted to endothelial protection for the prevention,early recognition,and treatment of CV diseases.展开更多
Triggered seismicity is a key hazard where fluids are injected or withdrawn from the subsurface and may impact permeability. Understanding the mechanisms that control fluid injection-triggered seismicity allows its mi...Triggered seismicity is a key hazard where fluids are injected or withdrawn from the subsurface and may impact permeability. Understanding the mechanisms that control fluid injection-triggered seismicity allows its mitigation. Key controls on seismicity are defined in terms of fault and fracture strength, second-order frictional response and stability, and competing fluid-driven mechanisms for arrest. We desire to constrain maximum event magnitudes in triggered earthquakes by relating pre-existing critical stresses to fluid injection volume to explain why some recorded events are significantly larger than anticipated seismic moment thresholds. This formalism is consistent with several uncharacteristically large fluid injection-triggered earthquakes. Such methods of reactivating fractures and faults by hydraulic stimulation in shear or tensile fracturing are routinely used to create permeability in the subsurface. Microearthquakes (MEQs) generated by such stimulations can be used to diagnose permeability evolution. Although high-fidelity data sets are scarce, the EGS-Collab and Utah FORGE hydraulic stimulation field demonstration projects provide high-fidelity data sets that concurrently track permeability evolution and triggered seismicity. Machine learning deciphers the principal features of MEQs and the resulting permeability evolution that best track permeability changes – with transfer learning methods allowing robust predictions across multiple eological settings. Changes in permeability at reactivated fractures in both shear and extensional modes suggest that permeability change (Δk) scales with the seismic moment (M) of individual MEQs as Δk∝M. This scaling relation is exact at early times but degrades with successive MEQs, but provides a method for characterizing crustal permeability evolution using MEQs, alone. Importantly, we quantify for the first time the role of prestress in defining the elevated magnitude and seismic moment of fluid injection-triggered events, and demonstrate that such MEQs can also be used as diagnostic in quantifying permeability evolution in the crust.展开更多
Abnormal network traffic, as a frequent security risk, requires a series of techniques to categorize and detect it. Existing network traffic anomaly detection still faces challenges: the inability to fully extract loc...Abnormal network traffic, as a frequent security risk, requires a series of techniques to categorize and detect it. Existing network traffic anomaly detection still faces challenges: the inability to fully extract local and global features, as well as the lack of effective mechanisms to capture complex interactions between features;Additionally, when increasing the receptive field to obtain deeper feature representations, the reliance on increasing network depth leads to a significant increase in computational resource consumption, affecting the efficiency and performance of detection. Based on these issues, firstly, this paper proposes a network traffic anomaly detection model based on parallel dilated convolution and residual learning (Res-PDC). To better explore the interactive relationships between features, the traffic samples are converted into two-dimensional matrix. A module combining parallel dilated convolutions and residual learning (res-pdc) was designed to extract local and global features of traffic at different scales. By utilizing res-pdc modules with different dilation rates, we can effectively capture spatial features at different scales and explore feature dependencies spanning wider regions without increasing computational resources. Secondly, to focus and integrate the information in different feature subspaces, further enhance and extract the interactions among the features, multi-head attention is added to Res-PDC, resulting in the final model: multi-head attention enhanced parallel dilated convolution and residual learning (MHA-Res-PDC) for network traffic anomaly detection. Finally, comparisons with other machine learning and deep learning algorithms are conducted on the NSL-KDD and CIC-IDS-2018 datasets. The experimental results demonstrate that the proposed method in this paper can effectively improve the detection performance.展开更多
A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity.However,regulatory mechanisms at the translational level under cardiac stress remain poorly und...A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity.However,regulatory mechanisms at the translational level under cardiac stress remain poorly understood.Here we examined the translational regulations in a mouse cardiac hypertrophy model induced by transaortic constriction(TAC)and explored the conservative networks versus the translatome pattern in human dilated cardiomyopathy(DCM).The results showed that the heart weight to body weight ratio was significantly elevated,and the ejection fraction and fractional shortening significantly decreased 8 weeks after TAC.Puromycin incorporation assay showed that TAC significantly increased protein synthesis rate in the left ventricle.RNAseq revealed 1,632 differentially expressed genes showing functional enrichment in pathways including extracellular matrix remodeling,metabolic processes,and signaling cascades associated with pathological cardiomyocyte growth.When combined with ribosome profiling analysis,we revealed that translation efficiency(TE)of 1,495 genes was enhanced,while the TE of 933 genes was inhibited following TAC.In DCM patients,1,354 genes were upregulated versus 1,213 genes were downregulated at the translation level.Although the majority of the genes were not shared between mouse and human,we identified 93 genes,including Nos3,Kcnj8,Adcy4,Itpr1,Fasn,Scd1,etc.,with highly conserved translational regulations.These genes were remarkably associated with myocardial function,signal transduction,and energy metabolism,particularly related to cGMP-PKG signaling and fatty acid metabolism.Motif analysis revealed enriched regulatory elements in the 5′untranslated regions(5′UTRs)of transcripts with differential TE,which exhibited strong cross-species sequence conservation.Our study revealed novel regulatory mechanisms at the translational level in cardiac hypertrophy and identified conserved translation-sensitive targets with potential applications to treat cardiac hypertrophy and heart failure in the clinic.展开更多
BACKGROUND Esophageal cancer is a clinically common malignant tumor of the digestive sys-tem.In 2022,it ranked fifth among the leading causes of cancer-related deaths in China.Its predominant symptom is dysphagia,and ...BACKGROUND Esophageal cancer is a clinically common malignant tumor of the digestive sys-tem.In 2022,it ranked fifth among the leading causes of cancer-related deaths in China.Its predominant symptom is dysphagia,and approximately 30%–40%of patients are prone to developing postoperative recurrent stenosis,necessitating repeated esophageal dilation,which significantly affects patients’quality of life.The self-dilation technique,performed by patients,enables preventive esophageal dilation and aims to reduce the frequency of recurrent stenosis.CASE SUMMARY We report the case of a 61-year-old man who underwent repeated esophageal di-lations following endoscopic submucosal dissection.During his eighth hospital admission,a multidisciplinary management team was established to implement an evidence-based self-help balloon dilation technique,facilitate early identifi-cation of nursing concerns and complications,and provide transitional care fo-llowing discharge.The patient reported a high level of satisfaction during the hospital stay.During the 6-month follow-up after discharge,the patient’s quality of life improved,with a substantial reduction in dysphagia.The esophageal stric-ture was successfully dilated from 5 mm to 6 mm,the interval between readmi-ssions was prolonged,and the patient’s weight increased from 49 kg to 50 kg.CONCLUSION The establishment of a multidisciplinary case management team,combined with the implementation of a self-help balloon dilation technique,early identification and management of nursing issues and complications,and person-alized extended care,can significantly enhance patient satisfaction during hospitalization,improve quality of life,and extend the interval between readmissions.These strategies can provide valuable practical guidance for the clinical treatment and nursing of patients with recurrent esophageal stenosis.展开更多
Pediatric dilated cardiomyopathy(DCM)isa leading cause of heart failure in children,presenting.significant therapeutic challenges due to the limited efficacy of pharmacological treatments,thescarcity of donor hearts f...Pediatric dilated cardiomyopathy(DCM)isa leading cause of heart failure in children,presenting.significant therapeutic challenges due to the limited efficacy of pharmacological treatments,thescarcity of donor hearts for transplantation,and the high costs associated with ventricular assistdevices.Also,the economic burden of DCM medical management is a critical topic for world wide.In this context,the development of a safe,effective,and economically viable surgical intervention isof paramount importance.A recent study published in CongenitalHeart Disease,titled"CardiacRehabilitation by Pulmonary Artery Banding after Induced Dilated Candiomyopathy:A Pilot Studyon a Rodent Model",represents a significant advancement in this field.This study evaluated thefeasibility and therapeutic potential of pulmonary artery banding(PAB)in a drug-induced DMrodent model,providing critical preclinical evidence to support its clinical translation[1].展开更多
The Mentawai Forearc Sliver(MFS)is characterized by oblique deformation formed as slip partitioned between normal and parallel trench plate convergence.The surge of great earthquakes from 2004 to2012 along the adjacen...The Mentawai Forearc Sliver(MFS)is characterized by oblique deformation formed as slip partitioned between normal and parallel trench plate convergence.The surge of great earthquakes from 2004 to2012 along the adjacent Sunda trench left a large unbroken segment known as the Mentawai Seismic Gap.Here,we adopted continuous Global Navigation Satellite System(GNSS)observation data to identify the present regional crustal deformation using geodetic strain rates.The principal strain rate,dilatation rate,and maximum shear strain rate are about 0.13 microstrain/yr,0.2 microstrain/yr,and 0.1 microstrain/yr,respectively,with the range of its uncertainties between 0.01 and 0.04 microstrain/yr.The dilatation and maximum shear strain rates reveal the spatial coverage of strike-slip duplex and backthrust tectonics along the Mentawai Forearc Sliver.展开更多
AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study wa...AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study was conducted.Children in Group 1 received CTE 3 times with a 3min interval between each application.Children in Group 2 received CTE 4 times with a 5min interval between each application.We measured their pupil diameters at baseline(pre-drug instillation)and 30min and 60min post-drug instillation and assessed the pupillary light reflex at 60min post-drug instillation.RESULTS:In total,194 eyes of 101 children were enrolled.The changes of pupil diameter at 30min and 60min post-drug instillation were 1.2±0.6 mm and 2.3±1.0 mm in Group 1,and 2.3±0.9 mm and 3.7±1.0 mm in Group 2,respectively.Group 2 showed a larger change in pupil size than Group 1 at 30min(P<0.01)and 60min(P<0.01).The effect of pupil dilation in Group 2 was 1.25 times that in Group 1.The change in pupil size was positively associated with age.A higher proportion of children in Group 1 had smaller pupil diameter and reactive pupils at the final time point,with only 33 children(33.7%)had final pupil size≥6.5 mm,and only 9 children(9.2%)had non-reactive pupils.Children in Group 2 achieved larger pupil diameter and more nonreactive pupils at the final time point,with 84 children(87.5%)had final pupil size≥6.5 mm,and only 22 children(22.9%)had reactive pupils.CONCLUSION:Increasing the frequency of compound tropicamide and lengthening the interval between eye drop applications can produce stronger mydriatic effects.展开更多
This article presents a case study of a 20-year-old male patient diagnosed with dilated cardiomyopathy(DCM)(NYHA IV).This condition was diagnosed as"heart failure disease"(water overflowing due to yang defic...This article presents a case study of a 20-year-old male patient diagnosed with dilated cardiomyopathy(DCM)(NYHA IV).This condition was diagnosed as"heart failure disease"(water overflowing due to yang deficiency,intermingled phlegm and stasis)in traditional Chinese medicine(TCM).The treatment approach employed a combination of TCM and Western medicine.Western medicine involved the administration of sacubitril valsartan sodium tablets to inhibit ventricular remodeling,in conjunction with diuretics and cardiotonic agents.Initially,TCM utilized a static infusion of Shenfu injection,which was subsequently supplemented with Qiliqiangxin capsules to invigorate qi,warm yang,activate blood circulation,and promote diuresis.After a follow-up period of 3 years,the patient's ejection fraction(EF)improved from 23%to 51%,and the left ventricular end diastolic diameter(LVed)decreased from 68 to 52 mm,accompanied by a significant alleviation of symptoms.These findings indicate that the combined treatment of TCM and Western medicine can synergistically enhance cardiac function and impede the progression of the disease,thereby offering valuable insights for the optimal management of DCM.展开更多
A series of suction-controlled triaxial tests was conducted on Nanyang expansive clay to investigate the effects of dry density and suction on dilatancy and strength.The suction of the soil samples was controlled usin...A series of suction-controlled triaxial tests was conducted on Nanyang expansive clay to investigate the effects of dry density and suction on dilatancy and strength.The suction of the soil samples was controlled using a vapour equilibrium technique,with four suction levels ranging from 3.29 MPa to 198.14 MPa,where water retention is dominated by adsorption.The experimental results show that the tested soil exhibits a brittle failure mode under high suction,significantly distinguishing the hydro-mechanical behaviour of the soil at high suction from that observed at low suction.This brittle failure mode significantly increases the contribution of suction to peak strength compared to residual strength,causes the soil to fail before reaching the critical state,a phenomenon not observed in soils under high suction,and results in dilatancy caused by damage to the soil particle aggregates rather than particle rearrangement.The dilatancy data obtained from the triaxial tests reveal that significant soil dilatancy occurs during shear after reaching peak strength,with the maximum dilatancy angle increasing with suction and decreasing with confining pressure.However,the initial dry density has a negligible impact on the soil's dilatancy under high suction levels.This observation further supports that,for unsaturated soils under high suction levels,dilatancy is attributed to damage to soil particle aggregates rather than the rearrangement of soil particles.展开更多
Introduction Choledochal cysts(CCs)are cystic dilatations of the intrahepatic and/or extrahepatic biliary ducts that affect primarily female infants[1-3].CCs vary markedly in incidence worldwide:the incidence is appro...Introduction Choledochal cysts(CCs)are cystic dilatations of the intrahepatic and/or extrahepatic biliary ducts that affect primarily female infants[1-3].CCs vary markedly in incidence worldwide:the incidence is approximately 1 in 100,000 to 1 in 150,000 live births in Western countries and 1 in 1,000 people in Asian countries[4].展开更多
We study certain weighted Bergman and weighted Besov spaces of holomorphic functions in the polydisk and in the unit ball.We seek conditions on the weight functions to guarantee that the dilations of a given function ...We study certain weighted Bergman and weighted Besov spaces of holomorphic functions in the polydisk and in the unit ball.We seek conditions on the weight functions to guarantee that the dilations of a given function converge to the same function in norm;in particular,we seek conditions on the weights to ensure that the analytic polynomials are dense in the space.展开更多
The counterflow burner is a combustion device used for research on combustion.By utilizing deep convolutional models to identify the combustion state of a counter flow burner through visible flame images,it facilitate...The counterflow burner is a combustion device used for research on combustion.By utilizing deep convolutional models to identify the combustion state of a counter flow burner through visible flame images,it facilitates the optimization of the combustion process and enhances combustion efficiency.Among existing deep convolutional models,InceptionNeXt is a deep learning architecture that integrates the ideas of the Inception series and ConvNeXt.It has garnered significant attention for its computational efficiency,remarkable model accuracy,and exceptional feature extraction capabilities.However,since this model still has limitations in the combustion state recognition task,we propose a Triple-Scale Multi-Stage InceptionNeXt(TSMS-InceptionNeXt)combustion state recognitionmethod based on feature extraction optimization.First,to address the InceptionNeXt model’s limited ability to capture dynamic features in flame images,we introduce Triplet Attention,which applies attention to the width,height,and Red Green Blue(RGB)dimensions of the flame images to enhance its ability to model dynamic features.Secondly,to address the issue of key information loss in the Inception deep convolution layers,we propose a Similarity-based Feature Concentration(SimC)mechanism to enhance the model’s capability to concentrate on critical features.Next,to address the insufficient receptive field of the model,we propose a Multi-Scale Dilated Channel Parallel Integration(MDCPI)mechanism to enhance the model’s ability to extract multi-scale contextual information.Finally,to address the issue of the model’s Multi-Layer Perceptron Head(MlpHead)neglecting channel interactions,we propose a Channel Shuffle-Guided Channel-Spatial Attention(ShuffleCS)mechanism,which integrates information from different channels to further enhance the representational power of the input features.To validate the effectiveness of the method,experiments are conducted on the counterflow burner flame visible light image dataset.The experimental results show that the TSMS-InceptionNeXt model achieved an accuracy of 85.71%on the dataset,improving by 2.38%over the baseline model and outperforming the baseline model’s performance.It achieved accuracy improvements of 10.47%,4.76%,11.19%,and 9.28%compared to the Reparameterized Visual Geometry Group(RepVGG),Squeeze-erunhanced Axial Transoformer(SeaFormer),Simplified Graph Transformers(SGFormer),and VanillaNet models,respectively,effectively enhancing the recognition performance for combustion states in counterflow burners.展开更多
In this paper,we focus on the channel estimation for multi-user MIMO-OFDM systems in rich scattering environments.We find that channel sparsity in the delay-angle domain is severely compromised in rich scattering envi...In this paper,we focus on the channel estimation for multi-user MIMO-OFDM systems in rich scattering environments.We find that channel sparsity in the delay-angle domain is severely compromised in rich scattering environments,so that most existing compressed sensing(CS)based techniques can harvest a very limited gain(if any)in reducing the channel estimation overhead.To address the problem,we propose the learning-based turbo message passing(LTMP)algorithm.Instead of exploiting the channel sparsity,LTMP is able to efficiently extract the channel feature via deep learning as well as to exploit the channel continuity in the frequency domain via block-wise linear modelling.More specifically,as a component of LTMP,we develop a multi-scale parallel dilated convolutional neural network(MPDCNN),which leverages frequency-space channel correlation in different scales for channel denoising.We evaluate the LTMP’s performance in MIMO-OFDM channels using the 3rd generation partnership project(3GPP)clustered delay line(CDL)channel models.Simulation results show that the proposed channel estimation method has more than 5 dB power gain than the existing algorithms when the normalized mean-square error of the channel estimation is-20 dB.The proposed algorithm also exhibits strong robustness in various environments.展开更多
文摘Background/aims: Paediatric outpatients are often dilated with cyclopentolate drops. These cause discomfort and distress, which may impede subsequent examination. We aimed to determine the distress caused by cyclopentolate drops, and other factors in the clinic environment. Methods: Over an 8 week period, questionnaires were issued to guardians of all paediatric outpatients aged under 10 years receiving cyclopentolate. The childrens’distress was graded on a scale of 1 - 10 (1 = no distress, 10 = severe distress). Waiting time and ease of examination were recorded. Data was analysed using Stata statistics, and significant differences were reported at the P < 0.05 level. Results: The 72 children were grouped as under 4 years (n = 43, Group A), aged 4 - 7 years (n = 19, Group B), and aged 7-10 years (n = 10, Group C). Median distress levels at home (baseline), on arrival, on dilation, and on examination were as follows: Group A;1, 2, 7, 6 respectively;Group B;1, 1, 6, 2 and Group C;1, 1, 4.5, 1. All age groups were significantly more distressed on examination compared to baseline. Distress scores on examination were significantly greater for Group A, in keeping with the greatest number of suboptimal examinations. Guardians reported that a prolonged waiting time and bright examination lights also contributed to distress. Conclusions: This study confirms that cyclopentolate causes significant distress in young children, and in 45% of very young children, the examination is difficult. Proxymetacaine prior to cyclopentolate is a possible solution, but other distressing factors should also be addressed for optimal outcomes.
文摘Objective: to study the clinical effect of balloon catheter and uterine cin in expired pregnancy. Methods: 60 expired patients were selected to compare the clinical effects of the two methods. Results: the clinical effect of the observation group was better than the control group (P 0.05). Conclusion: patients with induced induction of expired pregnancy.
文摘We investigate flow through an elastic tube which is constrained to a prescribed external forcing consisting of a progressive travelling wave.Such a flow dynamics is closely related to that in the oesophageal tube.The mechanics of the tube is characterized by a relationship between transmural pressure difference and radial variation of the tube.Dimensionless radial variation,assumed to be small,is studied by perturbation techniques.Hesults demonstrate that the elasticity of the tube plays a significant role in the flow dynamics.An increment in the forcing amplitude of the inward radial force enhances pressure,time-averaged volume flow rate and hence axial and radial velocities.lt is revealed that the elastic nature of the oesophageal tube favors swallowing.
文摘Objectives:One of the most notable challenges in endoscopic procedures is maintaining correct orientation.Mental rotation exercise(MRE)has been suggested as a potential aid for improving orientation.However,there is a lack of research on designing MREs with varying difficultylevels for training purposes.Furthermore,few studies provide solid evidence linking MRE difficultylevels with cognitive load measurements.This study aims to address this gap by investigating the correlation between the MRE difficultylevels and participants’cognitive load,as measured by pupil dilation.Method:We recruited 33 participants to perform MREs on a computer equipped with a screen-mounted eye-tracker.The test consisted of 15 MREs,with the first10 relatively easy(traditional cube)and the next 5 more complex(invented molecule).The participants’eye movements during MREs were recorded.The participants’MRE scores and pupil dilation were obtained and compared between two MRE difficultylevels.Results:The participants who performed traditional cube MREs achieved significantlybetter MRE scores(0.77±0.11 vs.0.58±0.03,p<0.001)and lower pupil dilation(0.27±0.04 pixels vs.0.47±0.09 pixels,p<0.001)than did those who performed the invented molecule MREs.Moreover,there were significant negative correlations(r=0.62,p=0.015)between pupil dilation and MRE scores.Conclusions:The results revealed a significantnegative correlation between MRE scores and pupil dilation.The more challenging MRE questions led to worse MRE scores but increased pupil dilation.The MRE difficultylevels can be evaluated not only by the degrees or dimensions with which the objects were rotated but also by the participants’MRE scores and pupil dilation.The results of this study provide a basis for training orientation skills in endoscopy using MREs.By incorporating MREs with varying difficultylevels,customized training programs can be developed to enhance camera navigation in endoscopic and laparoscopic procedures.
基金Supported by Sichuan Science and Technology Program(2023YFSY0026,2023YFH0004)Supported by the Institute of Information&Communications Technology Planning&Evaluation(IITP)grant funded by the Korean government(MSIT)(No.RS-2022-00155885,Artificial Intelligence Convergence Innovation Human Resources Development(Hanyang University ERICA)).
文摘Two-dimensional endoscopic images are susceptible to interferences such as specular reflections and monotonous texture illumination,hindering accurate three-dimensional lesion reconstruction by surgical robots.This study proposes a novel end-to-end disparity estimation model to address these challenges.Our approach combines a Pseudo-Siamese neural network architecture with pyramid dilated convolutions,integrating multi-scale image information to enhance robustness against lighting interferences.This study introduces a Pseudo-Siamese structure-based disparity regression model that simplifies left-right image comparison,improving accuracy and efficiency.The model was evaluated using a dataset of stereo endoscopic videos captured by the Da Vinci surgical robot,comprising simulated silicone heart sequences and real heart video data.Experimental results demonstrate significant improvement in the network’s resistance to lighting interference without substantially increasing parameters.Moreover,the model exhibited faster convergence during training,contributing to overall performance enhancement.This study advances endoscopic image processing accuracy and has potential implications for surgical robot applications in complex environments.
文摘The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future cardiovascular(CV)diseases.Chronic kidney disease,a state of chronic inflammation caused by oxidative stress,metabolic abnormalities,infection,and uremic toxins damages the endothelium.ED is also associated with a decline in estimated glomerular filtration rate.After kidney transplantation,endothelial functions undergo immediate but partial restoration,promising graft longevity and enhanced CV health.However,the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED,culminating in poor CV health and graft survival.ED in kidney transplant recipients is an underrecognized and poorly studied entity.CV diseases are the leading cause of death among kidney transplant candidates with functioning grafts.ED contributes to the pathogenesis of many of the CV diseases.Various biomarkers and vasoreactivity tests are available to study endothelial functions.With an increasing number of transplants happening every year,and improved graft rejection rates due to the availability of effective immunosuppressants,the focus has now shifted to endothelial protection for the prevention,early recognition,and treatment of CV diseases.
基金Derek Elsworth acknowledges the support from a Gledden Visiting Fellowship from the Institute of Advanced Studies at the University of Western Australia,Australia,and the G.Albert Shoemaker Endowment at Pennsylvania State University,USA.
文摘Triggered seismicity is a key hazard where fluids are injected or withdrawn from the subsurface and may impact permeability. Understanding the mechanisms that control fluid injection-triggered seismicity allows its mitigation. Key controls on seismicity are defined in terms of fault and fracture strength, second-order frictional response and stability, and competing fluid-driven mechanisms for arrest. We desire to constrain maximum event magnitudes in triggered earthquakes by relating pre-existing critical stresses to fluid injection volume to explain why some recorded events are significantly larger than anticipated seismic moment thresholds. This formalism is consistent with several uncharacteristically large fluid injection-triggered earthquakes. Such methods of reactivating fractures and faults by hydraulic stimulation in shear or tensile fracturing are routinely used to create permeability in the subsurface. Microearthquakes (MEQs) generated by such stimulations can be used to diagnose permeability evolution. Although high-fidelity data sets are scarce, the EGS-Collab and Utah FORGE hydraulic stimulation field demonstration projects provide high-fidelity data sets that concurrently track permeability evolution and triggered seismicity. Machine learning deciphers the principal features of MEQs and the resulting permeability evolution that best track permeability changes – with transfer learning methods allowing robust predictions across multiple eological settings. Changes in permeability at reactivated fractures in both shear and extensional modes suggest that permeability change (Δk) scales with the seismic moment (M) of individual MEQs as Δk∝M. This scaling relation is exact at early times but degrades with successive MEQs, but provides a method for characterizing crustal permeability evolution using MEQs, alone. Importantly, we quantify for the first time the role of prestress in defining the elevated magnitude and seismic moment of fluid injection-triggered events, and demonstrate that such MEQs can also be used as diagnostic in quantifying permeability evolution in the crust.
基金supported by the Xiamen Science and Technology Subsidy Project(No.2023CXY0318).
文摘Abnormal network traffic, as a frequent security risk, requires a series of techniques to categorize and detect it. Existing network traffic anomaly detection still faces challenges: the inability to fully extract local and global features, as well as the lack of effective mechanisms to capture complex interactions between features;Additionally, when increasing the receptive field to obtain deeper feature representations, the reliance on increasing network depth leads to a significant increase in computational resource consumption, affecting the efficiency and performance of detection. Based on these issues, firstly, this paper proposes a network traffic anomaly detection model based on parallel dilated convolution and residual learning (Res-PDC). To better explore the interactive relationships between features, the traffic samples are converted into two-dimensional matrix. A module combining parallel dilated convolutions and residual learning (res-pdc) was designed to extract local and global features of traffic at different scales. By utilizing res-pdc modules with different dilation rates, we can effectively capture spatial features at different scales and explore feature dependencies spanning wider regions without increasing computational resources. Secondly, to focus and integrate the information in different feature subspaces, further enhance and extract the interactions among the features, multi-head attention is added to Res-PDC, resulting in the final model: multi-head attention enhanced parallel dilated convolution and residual learning (MHA-Res-PDC) for network traffic anomaly detection. Finally, comparisons with other machine learning and deep learning algorithms are conducted on the NSL-KDD and CIC-IDS-2018 datasets. The experimental results demonstrate that the proposed method in this paper can effectively improve the detection performance.
基金supported by grants from National Natural Science Foundation of China(No.82370392)Shenzhen Medical Research Fund(No.B2302026)+4 种基金Science,Technology and Innovation Commission of Shenzhen Municipality(No.RCJC20210706091947009)National Key R&D Program of China(No.2022YFA1104500)CAMS Innovation Fund for Medical Sciences(No.2023-I2M-1-003 and 2022-I2M-2-001)Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2019PT320026)National High Level Hospital Clinical Research Funding(No.2022-GSP-GG-7)。
文摘A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity.However,regulatory mechanisms at the translational level under cardiac stress remain poorly understood.Here we examined the translational regulations in a mouse cardiac hypertrophy model induced by transaortic constriction(TAC)and explored the conservative networks versus the translatome pattern in human dilated cardiomyopathy(DCM).The results showed that the heart weight to body weight ratio was significantly elevated,and the ejection fraction and fractional shortening significantly decreased 8 weeks after TAC.Puromycin incorporation assay showed that TAC significantly increased protein synthesis rate in the left ventricle.RNAseq revealed 1,632 differentially expressed genes showing functional enrichment in pathways including extracellular matrix remodeling,metabolic processes,and signaling cascades associated with pathological cardiomyocyte growth.When combined with ribosome profiling analysis,we revealed that translation efficiency(TE)of 1,495 genes was enhanced,while the TE of 933 genes was inhibited following TAC.In DCM patients,1,354 genes were upregulated versus 1,213 genes were downregulated at the translation level.Although the majority of the genes were not shared between mouse and human,we identified 93 genes,including Nos3,Kcnj8,Adcy4,Itpr1,Fasn,Scd1,etc.,with highly conserved translational regulations.These genes were remarkably associated with myocardial function,signal transduction,and energy metabolism,particularly related to cGMP-PKG signaling and fatty acid metabolism.Motif analysis revealed enriched regulatory elements in the 5′untranslated regions(5′UTRs)of transcripts with differential TE,which exhibited strong cross-species sequence conservation.Our study revealed novel regulatory mechanisms at the translational level in cardiac hypertrophy and identified conserved translation-sensitive targets with potential applications to treat cardiac hypertrophy and heart failure in the clinic.
文摘BACKGROUND Esophageal cancer is a clinically common malignant tumor of the digestive sys-tem.In 2022,it ranked fifth among the leading causes of cancer-related deaths in China.Its predominant symptom is dysphagia,and approximately 30%–40%of patients are prone to developing postoperative recurrent stenosis,necessitating repeated esophageal dilation,which significantly affects patients’quality of life.The self-dilation technique,performed by patients,enables preventive esophageal dilation and aims to reduce the frequency of recurrent stenosis.CASE SUMMARY We report the case of a 61-year-old man who underwent repeated esophageal di-lations following endoscopic submucosal dissection.During his eighth hospital admission,a multidisciplinary management team was established to implement an evidence-based self-help balloon dilation technique,facilitate early identifi-cation of nursing concerns and complications,and provide transitional care fo-llowing discharge.The patient reported a high level of satisfaction during the hospital stay.During the 6-month follow-up after discharge,the patient’s quality of life improved,with a substantial reduction in dysphagia.The esophageal stric-ture was successfully dilated from 5 mm to 6 mm,the interval between readmi-ssions was prolonged,and the patient’s weight increased from 49 kg to 50 kg.CONCLUSION The establishment of a multidisciplinary case management team,combined with the implementation of a self-help balloon dilation technique,early identification and management of nursing issues and complications,and person-alized extended care,can significantly enhance patient satisfaction during hospitalization,improve quality of life,and extend the interval between readmissions.These strategies can provide valuable practical guidance for the clinical treatment and nursing of patients with recurrent esophageal stenosis.
文摘Pediatric dilated cardiomyopathy(DCM)isa leading cause of heart failure in children,presenting.significant therapeutic challenges due to the limited efficacy of pharmacological treatments,thescarcity of donor hearts for transplantation,and the high costs associated with ventricular assistdevices.Also,the economic burden of DCM medical management is a critical topic for world wide.In this context,the development of a safe,effective,and economically viable surgical intervention isof paramount importance.A recent study published in CongenitalHeart Disease,titled"CardiacRehabilitation by Pulmonary Artery Banding after Induced Dilated Candiomyopathy:A Pilot Studyon a Rodent Model",represents a significant advancement in this field.This study evaluated thefeasibility and therapeutic potential of pulmonary artery banding(PAB)in a drug-induced DMrodent model,providing critical preclinical evidence to support its clinical translation[1].
基金supported by Universitas Gadjah Mada through the 2022 Indonesian Collaborative Research Program.
文摘The Mentawai Forearc Sliver(MFS)is characterized by oblique deformation formed as slip partitioned between normal and parallel trench plate convergence.The surge of great earthquakes from 2004 to2012 along the adjacent Sunda trench left a large unbroken segment known as the Mentawai Seismic Gap.Here,we adopted continuous Global Navigation Satellite System(GNSS)observation data to identify the present regional crustal deformation using geodetic strain rates.The principal strain rate,dilatation rate,and maximum shear strain rate are about 0.13 microstrain/yr,0.2 microstrain/yr,and 0.1 microstrain/yr,respectively,with the range of its uncertainties between 0.01 and 0.04 microstrain/yr.The dilatation and maximum shear strain rates reveal the spatial coverage of strike-slip duplex and backthrust tectonics along the Mentawai Forearc Sliver.
基金Supported by the National Natural Science Foundation of China(No.82371093,No.72342015)R&D Program of Beijing Municipal Education Commission(No.KZ202110025039).
文摘AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study was conducted.Children in Group 1 received CTE 3 times with a 3min interval between each application.Children in Group 2 received CTE 4 times with a 5min interval between each application.We measured their pupil diameters at baseline(pre-drug instillation)and 30min and 60min post-drug instillation and assessed the pupillary light reflex at 60min post-drug instillation.RESULTS:In total,194 eyes of 101 children were enrolled.The changes of pupil diameter at 30min and 60min post-drug instillation were 1.2±0.6 mm and 2.3±1.0 mm in Group 1,and 2.3±0.9 mm and 3.7±1.0 mm in Group 2,respectively.Group 2 showed a larger change in pupil size than Group 1 at 30min(P<0.01)and 60min(P<0.01).The effect of pupil dilation in Group 2 was 1.25 times that in Group 1.The change in pupil size was positively associated with age.A higher proportion of children in Group 1 had smaller pupil diameter and reactive pupils at the final time point,with only 33 children(33.7%)had final pupil size≥6.5 mm,and only 9 children(9.2%)had non-reactive pupils.Children in Group 2 achieved larger pupil diameter and more nonreactive pupils at the final time point,with 84 children(87.5%)had final pupil size≥6.5 mm,and only 22 children(22.9%)had reactive pupils.CONCLUSION:Increasing the frequency of compound tropicamide and lengthening the interval between eye drop applications can produce stronger mydriatic effects.
文摘This article presents a case study of a 20-year-old male patient diagnosed with dilated cardiomyopathy(DCM)(NYHA IV).This condition was diagnosed as"heart failure disease"(water overflowing due to yang deficiency,intermingled phlegm and stasis)in traditional Chinese medicine(TCM).The treatment approach employed a combination of TCM and Western medicine.Western medicine involved the administration of sacubitril valsartan sodium tablets to inhibit ventricular remodeling,in conjunction with diuretics and cardiotonic agents.Initially,TCM utilized a static infusion of Shenfu injection,which was subsequently supplemented with Qiliqiangxin capsules to invigorate qi,warm yang,activate blood circulation,and promote diuresis.After a follow-up period of 3 years,the patient's ejection fraction(EF)improved from 23%to 51%,and the left ventricular end diastolic diameter(LVed)decreased from 68 to 52 mm,accompanied by a significant alleviation of symptoms.These findings indicate that the combined treatment of TCM and Western medicine can synergistically enhance cardiac function and impede the progression of the disease,thereby offering valuable insights for the optimal management of DCM.
基金support from the China Scholarship Council(CSC)-University of Technology Sydney joint scholarship and the National Key R&D Program of China(Grant No.2016YFC0800200)is gratefully acknowledged.
文摘A series of suction-controlled triaxial tests was conducted on Nanyang expansive clay to investigate the effects of dry density and suction on dilatancy and strength.The suction of the soil samples was controlled using a vapour equilibrium technique,with four suction levels ranging from 3.29 MPa to 198.14 MPa,where water retention is dominated by adsorption.The experimental results show that the tested soil exhibits a brittle failure mode under high suction,significantly distinguishing the hydro-mechanical behaviour of the soil at high suction from that observed at low suction.This brittle failure mode significantly increases the contribution of suction to peak strength compared to residual strength,causes the soil to fail before reaching the critical state,a phenomenon not observed in soils under high suction,and results in dilatancy caused by damage to the soil particle aggregates rather than particle rearrangement.The dilatancy data obtained from the triaxial tests reveal that significant soil dilatancy occurs during shear after reaching peak strength,with the maximum dilatancy angle increasing with suction and decreasing with confining pressure.However,the initial dry density has a negligible impact on the soil's dilatancy under high suction levels.This observation further supports that,for unsaturated soils under high suction levels,dilatancy is attributed to damage to soil particle aggregates rather than the rearrangement of soil particles.
基金Funding support for this article was provided by the Key R&D Program of Zhejiang(2023C03029).
文摘Introduction Choledochal cysts(CCs)are cystic dilatations of the intrahepatic and/or extrahepatic biliary ducts that affect primarily female infants[1-3].CCs vary markedly in incidence worldwide:the incidence is approximately 1 in 100,000 to 1 in 150,000 live births in Western countries and 1 in 1,000 people in Asian countries[4].
文摘We study certain weighted Bergman and weighted Besov spaces of holomorphic functions in the polydisk and in the unit ball.We seek conditions on the weight functions to guarantee that the dilations of a given function converge to the same function in norm;in particular,we seek conditions on the weights to ensure that the analytic polynomials are dense in the space.
文摘The counterflow burner is a combustion device used for research on combustion.By utilizing deep convolutional models to identify the combustion state of a counter flow burner through visible flame images,it facilitates the optimization of the combustion process and enhances combustion efficiency.Among existing deep convolutional models,InceptionNeXt is a deep learning architecture that integrates the ideas of the Inception series and ConvNeXt.It has garnered significant attention for its computational efficiency,remarkable model accuracy,and exceptional feature extraction capabilities.However,since this model still has limitations in the combustion state recognition task,we propose a Triple-Scale Multi-Stage InceptionNeXt(TSMS-InceptionNeXt)combustion state recognitionmethod based on feature extraction optimization.First,to address the InceptionNeXt model’s limited ability to capture dynamic features in flame images,we introduce Triplet Attention,which applies attention to the width,height,and Red Green Blue(RGB)dimensions of the flame images to enhance its ability to model dynamic features.Secondly,to address the issue of key information loss in the Inception deep convolution layers,we propose a Similarity-based Feature Concentration(SimC)mechanism to enhance the model’s capability to concentrate on critical features.Next,to address the insufficient receptive field of the model,we propose a Multi-Scale Dilated Channel Parallel Integration(MDCPI)mechanism to enhance the model’s ability to extract multi-scale contextual information.Finally,to address the issue of the model’s Multi-Layer Perceptron Head(MlpHead)neglecting channel interactions,we propose a Channel Shuffle-Guided Channel-Spatial Attention(ShuffleCS)mechanism,which integrates information from different channels to further enhance the representational power of the input features.To validate the effectiveness of the method,experiments are conducted on the counterflow burner flame visible light image dataset.The experimental results show that the TSMS-InceptionNeXt model achieved an accuracy of 85.71%on the dataset,improving by 2.38%over the baseline model and outperforming the baseline model’s performance.It achieved accuracy improvements of 10.47%,4.76%,11.19%,and 9.28%compared to the Reparameterized Visual Geometry Group(RepVGG),Squeeze-erunhanced Axial Transoformer(SeaFormer),Simplified Graph Transformers(SGFormer),and VanillaNet models,respectively,effectively enhancing the recognition performance for combustion states in counterflow burners.
基金supported in part by the National Key Research and Development Program of China under Grant 2020YFB1804800.
文摘In this paper,we focus on the channel estimation for multi-user MIMO-OFDM systems in rich scattering environments.We find that channel sparsity in the delay-angle domain is severely compromised in rich scattering environments,so that most existing compressed sensing(CS)based techniques can harvest a very limited gain(if any)in reducing the channel estimation overhead.To address the problem,we propose the learning-based turbo message passing(LTMP)algorithm.Instead of exploiting the channel sparsity,LTMP is able to efficiently extract the channel feature via deep learning as well as to exploit the channel continuity in the frequency domain via block-wise linear modelling.More specifically,as a component of LTMP,we develop a multi-scale parallel dilated convolutional neural network(MPDCNN),which leverages frequency-space channel correlation in different scales for channel denoising.We evaluate the LTMP’s performance in MIMO-OFDM channels using the 3rd generation partnership project(3GPP)clustered delay line(CDL)channel models.Simulation results show that the proposed channel estimation method has more than 5 dB power gain than the existing algorithms when the normalized mean-square error of the channel estimation is-20 dB.The proposed algorithm also exhibits strong robustness in various environments.
