BACKGROUND Pedicle screw fixation is frequently used to treat unstable thoracolumbar injuries;however,the rate of instrumentation failure remains considerable.The primary contributing factor leading to instrumentation...BACKGROUND Pedicle screw fixation is frequently used to treat unstable thoracolumbar injuries;however,the rate of instrumentation failure remains considerable.The primary contributing factor leading to instrumentation failure is poor bone quality.On the other hand,some evidence suggests that surgical tactics can influence long-term instrumentation stability.AIM To assess factors that influence the stability of spinal instrumentation in patients with thoracolumbar injuries.METHODS This study is a non-randomized single center ambispective evaluation of 204 consecutive patients(117 men;87 women)with unstable thoracolumbar injuries.All patients underwent either stand-alone or combined with anterior column reconstruction instrumentation.In cases with spinal cord and nerve root injuries,either posterior or anterior decompression were performed.Patients with pedicle screw loosening were identified via computed tomography imaging.Out of those,cases with clinically significant instrumentation failure were registered.RESULTS The rate of pedicle screw loosening detected by computed tomography was inversely correlated with bone radiodensity figures and an increased association with the number of instrumented levels,residual kyphotic deformity,laminectomy,and lumbosacral fixation.Intermediate screws and anterior reconstruction were associated with a clinically relevant decreased risk of pedicle screw loosening development.Either complete or partial posterior fusion within instrumented levels was capable of decreasing instrumentation failure risk,while extensive decompression with laminectomy and at least one-level total facetectomy were associated with an increased risk of instrumentation failure.Anterior decompression does not have a negative impact on instrumentation stability.CONCLUSION Intermediate screws,anterior reconstruction and posterior tension band preservation are associated with decreased rates of instrumentation instability development.Posterior fusion is beneficial in terms of instrumentation failure prevention.展开更多
Introduction: The choice of adopting unilateral pedicle screw fixation or using bilateral pedicle screw fixation in lumbar spinal stenosis remains controversial. In our context, very few studies have been performed co...Introduction: The choice of adopting unilateral pedicle screw fixation or using bilateral pedicle screw fixation in lumbar spinal stenosis remains controversial. In our context, very few studies have been performed comparing the clinical effectiveness of unilateral versus bilateral fixation in the surgical management of lumbar spinal canal stenosis. Objective: Evaluate the impact on quality of life and clinical efficacy of unilateral spondylodesis compared to bilateral spondylodesis in the surgical management of lumbar spinal canal stenosis at the Yaounde Central Hospital. Methods: This was a retrospective descriptive cross-sectional study for a period of 4 years, from June 2015 to June 2019. It involved all patients operated for lumbar canal stenosis and who underwent spondylodesis or spinal fusion at the neurosurgery department of the Yaounde Central Hospital. Results: A total of 68 participants were recruited during our study period. 32 (47%) of the study population were in the 50 - 60 age group, with a mean age of 56.98 years ranging from 41 to 75 years. Females, housewives and farmers were the most affected. In our study, 72% of patients had unilateral spondylodesis and 28% had bilateral fusion. Preoperatively, 71% of patients had insurmountable pain, refractory to medical treatment. At 3 months postoperatively, 73.7% of patients with bilateral setup had moderate pain compared to 69% of those with unilateral setup. At 6 months postoperatively, 79% of patients with bilateral fusion had mild pain compared to 82% of patients with unilateral setup. At 1 year postoperatively, all patients had mild pain. Preoperatively, 66.2% of patients were unable to walk and 19.1% of patients were bedridden according to the Oswestry score. At 3 months postoperatively, 10.2% of patients with unilateral setup were unable to walk compared to 10.5% of patients with bilateral fixation, while 67.3% of patients with unilateral fixation had moderate disability compared to 52.6% of patients with bilateral fixation. At 6 months postoperatively, 51% of patients with unilateral setup had moderate disability compared to 47.4% of patients with bilateral fixation, while 42.9% of patients with unilateral fixation had mild disability compared to 42.1% of patients with bilateral fixation. At 1 year postoperatively, 81.6% of patients who underwent unilateral fixation had only mild disability compared to 73.7% of patients with bilateral fixation. Conclusion: The assessment of quality of life according to the set-up used shows similar results at 3 months, 6 months and 1 year, with no statistically significant differences. Single-sided pedicle screw fixation combined with transforaminal lumbar interbody fusion or mounting has the advantage of being faster, with less bleeding and is less expensive compared to bilateral fixation.展开更多
The response and performance of radiation detectors for accurate measurements and effective use for radiological safety in medical, industrial, and nuclear sectors are based on the optimal use, maintenance, repair and...The response and performance of radiation detectors for accurate measurements and effective use for radiological safety in medical, industrial, and nuclear sectors are based on the optimal use, maintenance, repair and calibration of radiation monitoring instruments in a secondary standard dosimetry laboratory. In Nigeria, the suboptimal performances of these instruments are attributed to inadequate maintenance practices, insufficient calibration, and limited awareness of proper equipment handling for optimal use. This study assesses the current practices related to the optimal use, maintenance, repair, and calibration of radiation detection equipment across Nigeria’s six geopolitical zones. Using a cross-sectional survey approach, data were collected from Ninety (90) radiation monitoring equipment operators, Radiation Safety Officers, and frontline responders to evaluate their knowledge, awareness, and practices concerning equipment usage, operation, storage, handling, and calibration. The findings reveal significant gaps in knowledge of usage (trained is 43.2%, not trained is 56.8%) and inconsistencies in maintenance practices (as indicated by the regression analysis (β = 0.51, p < 0.01), particularly regarding specialized instruments such as the PackEye, Mobile Detection System (MDS), Radionuclide Identifinder (RID), and Personal Radiation Detectors (PRD). While there is high awareness of the need for regular calibration and handling training, the lack of standardized protocols and training alignment poses challenges to the effective use of these instruments. This study underscores the importance of comprehensive training programs, standardized maintenance protocols, and enhanced awareness initiatives to optimize the usage, performance and safety of radiation monitoring instruments in Nigeria.展开更多
Objective:To evaluate the effectiveness of quality nursing in the management of reusable instruments in the Central Sterile Supply Department(CSSD).Methods:Eleven nurses from the CSSD department were selected from Jan...Objective:To evaluate the effectiveness of quality nursing in the management of reusable instruments in the Central Sterile Supply Department(CSSD).Methods:Eleven nurses from the CSSD department were selected from January to October 2024,and quality nursing activities were implemented in the management of reusable instruments.The completion of quality indicators was analyzed.The instrument quality management scores,department satisfaction,and nurses’professional ability scores before and after nursing management were compared.Results:After nursing intervention,the qualified rates of initial cleaning and final cleaning of sterilization instruments were 99.66%and 100%,respectively.The qualified rate of packaging was 99.97%,the wet package rate was 0.1‰,the loading qualified rate was 99.88%,and the qualified rate of distribution was 99.99%.After nursing intervention,the nurses’instrument quality management scores,department satisfaction,and nurses’professional ability scores were all higher than those before nursing intervention(P<0.05).Conclusion:Quality nursing activities can improve the cleaning,packaging,and sterilization qualified rates of reusable instruments in the CSSD,enhance the effect of instrument quality management,obtain higher department satisfaction from nurses,cultivate their professional abilities,and possess significant nursing management advantages.展开更多
The efficacy requirements of cosmetic instruments and explored their efficacy evaluation methods was investigated.The efficacy and claims of common cosmetic instruments on the market were investigated,and human clinic...The efficacy requirements of cosmetic instruments and explored their efficacy evaluation methods was investigated.The efficacy and claims of common cosmetic instruments on the market were investigated,and human clinical trials were conducted to evaluate the efficacy of household cosmetic instruments.Household cosmetic instruments mainly include technologies such as sound wave,ion conduction,LED light,EMS microcurrent,RF radio frequency,and laser.This paper took microcurrent as an example to explore its efficacy claim methods.In human test I,the water content in the stratum corneum of the forearms of 31 subjects increased significantly compared with the blank control after 8 h.In human test II,30 subjects showed significant decreases in skin texture R5,transepidermal water loss TEWL,skin firmness F4 value,skin elasticity R2 value,overall size and depth of facial wrinkles,and facial jawline angle,and a significant increase in facial gloss value.The results showed that the cosmetic instrument had effects of moisturizing,improving facial evenness,repairing barrier,improving skin elasticity and firmness,and improving facial edema.展开更多
This study examined the development of technician teams on large-scale instrument platforms in universities,using the State Key Laboratory of Natural and Biomimetic Drugs in the Peking University School of Pharmaceuti...This study examined the development of technician teams on large-scale instrument platforms in universities,using the State Key Laboratory of Natural and Biomimetic Drugs in the Peking University School of Pharmaceutical Sciences as a case study.Data were collected through questionnaire surveys and interviews conducted in 2017,followed by a questionnaire survey in 2023,offering both subjective and objective insights.The evolution of the platform’s technician team over the past 5 years was analyzed,highlighting key experiences and identifying ongoing challenges.Recommendations to enhance technician team development include recruiting skilled faculty,clearly defining job responsibilities,and refining the assessment and incentive systems.展开更多
This paper introduces the key design aspects of automotive center console instrument systems,including hardware architecture,ergonomics,antenna layout,etc.It elaborates on the application and advantages of various adv...This paper introduces the key design aspects of automotive center console instrument systems,including hardware architecture,ergonomics,antenna layout,etc.It elaborates on the application and advantages of various advanced technologies,such as 3D printing and dual-color injection molding.Additionally,it discusses advancements in structural design,as well as future challenges and the trend of multidisciplinary collaborative innovation.展开更多
The presence of residual stresses in materials or engineering structures can significantly influence their mechanical per-formance.Accurate measurement of residual stresses is of great importance to ensure their in-se...The presence of residual stresses in materials or engineering structures can significantly influence their mechanical per-formance.Accurate measurement of residual stresses is of great importance to ensure their in-service reliability.Although numerous instrumented indentation methods have been proposed to evaluate residual stresses,the majority of them require a stress-free reference sample as a comparison benchmark,thereby limiting their applicability in scenarios where obtaining stress-free reference samples is challenging.In this work,through a number of finite element simulations,it was found that the loading exponent of the loading load-depth curve and the recovered depth during unloading are insensitive to residual stresses.The loading curve of the stress-free specimen was virtually reconstructed using such stress-insensitive parameters extracted from the load-depth curves of the stressed state,thus eliminating the requirement for stress-free reference samples.The residual stress was then correlated with the fractional change in loading work between stressed and stress-free loading curves through dimensional analysis and finite element simulations.Based on this correlation,an instrumented sharp indentation method for measuring equibiaxial residual stress without requiring a stress-free specimen was established.Both numerical and experimental verifications were carried out to demonstrate the accuracy and reliability of the newly proposed method.The maximum relative error and absolute error in measured residual stresses are typically within±20%and±20 MPa,respectively.展开更多
Aiming at node deployment in the monitoring area of the field observation instrument network in the cold and arid regions,we propose a virtual force algorithm based on Voronoi diagram(VFAVD),which adopts probabilistic...Aiming at node deployment in the monitoring area of the field observation instrument network in the cold and arid regions,we propose a virtual force algorithm based on Voronoi diagram(VFAVD),which adopts probabilistic sensing model that is more in line with the actual situation.First,the Voronoi diagram is constructed in the monitoring area to determine the Thiessen polygon of each node.Then,the virtual force on each node is calculated,and the node update its position according to the direction and size of the total force,so as to achieve the purpose of improving the network coverage rate.The simulation results show that the proposed algorithm can effectively improve the coverage rate of the network,and also has a good effect on the coverage uniformity.展开更多
On April 6th,the"Silk Road People-to-People Connectivity"China-Cambodia Traditional Instrument Concert was successfully held in Phnom Penh.The event was attended by Li Ji,Cultural Counsellor of the Chinese E...On April 6th,the"Silk Road People-to-People Connectivity"China-Cambodia Traditional Instrument Concert was successfully held in Phnom Penh.The event was attended by Li Ji,Cultural Counsellor of the Chinese Embassy in Cambodia,officials from Ministry of Culture and Fine Arts of Cambodia and Ministry of Commerce of Cambodia,along with vips from various sectors.展开更多
The research topic of the author’s PhD dissertation is“The Impact of Motivation Cultivation on English Autonomous Learning among University Students in Hunan,China—A Mediating Role of Learning Strategy.”Within thi...The research topic of the author’s PhD dissertation is“The Impact of Motivation Cultivation on English Autonomous Learning among University Students in Hunan,China—A Mediating Role of Learning Strategy.”Within this topic,three key variables are identified:the dependent variable(DV),the independent variable(IV),and the mediating variable(MV).Specifically,the DV refers to English autonomous learning,the IV refers to motivation,and the MV refers to learning strategy.The research establishes that the MV(learning strategy)is an integral component of information processing theory(IPT).Consequently,the dissertation incorporates integrative and instrumental motivation theories alongside IPT as its foundational theoretical framework.This paper aims to explore the theoretical framework of the PhD dissertation in detail,focusing on the interplay of these three theories.展开更多
Instrument separation is a critical complication during root canal therapy,impacting treatment success and long-term tooth preservation.The etiology of instrument separation is multifactorial,involving the intricate a...Instrument separation is a critical complication during root canal therapy,impacting treatment success and long-term tooth preservation.The etiology of instrument separation is multifactorial,involving the intricate anatomy of the root canal system,instrument-related factors,and instrumentation techniques.Instrument separation can hinder thorough cleaning,shaping,and obturation of the root canal,posing challenges to successful treatment outcomes.Although retrieval of separated instrument is often feasible,it carries risks including perforation,excessive removal of tooth structure and root fractures.Effective management of separated instruments requires a comprehensive understanding of the contributing factors,meticulous preoperative assessment,and precise evaluation of the retrieval difficulty.The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes.The current manuscript provides a framework for understanding the causes,risk factors,and clinical management principles of instrument separation.By integrating effective strategies,endodontists can enhance decision-making,improve endodontic treatment success and ensure the preservation of natural dentition.展开更多
AIM: To summarise and compare currently available evidence regarding accuracy of pre-operative imaging, which is one of the key choices for surgeons contemplating patient-specific instrumentation(PSI) surgery.METHODS:...AIM: To summarise and compare currently available evidence regarding accuracy of pre-operative imaging, which is one of the key choices for surgeons contemplating patient-specific instrumentation(PSI) surgery.METHODS: The MEDLINE and EMBASE medical literature databases were searched, from January 1990 to December 2013, to identify relevant studies. The data from several clinical studies was assimilated to allow appreciation and comparison of the accuracy of each modality. The overall accuracy of each modality was calculated as proportion of outliers > 3% in the coronal plane of both computerised tomography(CT) or magnetic resonance imaging(MRI). RESULTS: Seven clinical studies matched our inclusion criteria for comparison and were included in our study for statistical analysis. Three of these reported series using MRI and four with CT. Overall percentage of outliers > 3% in patients with CT-based PSI systems was 12.5% vs 16.9% for MRI-based systems. These results were not statistically significant. CONCLUSION: Although many studies have been undertaken to determine the ideal pre-operative imaging modality, conclusions remain speculative in the absence of long term data. Ultimately, information regarding accuracy of CT and MRI will be the main determining factor. Increased accuracy of pre-operative imaging could result in longer-term savings, and reduced accumulated dose of radiation by eliminating the need for post-operative imaging and revision surgery.展开更多
Patient specific instrumentation(PSI) in total knee arthroplasty(TKA) promises faster operation time(by using less instruments and individual cutting jigs), less blood loss, faster rehabilitation, better implant sizin...Patient specific instrumentation(PSI) in total knee arthroplasty(TKA) promises faster operation time(by using less instruments and individual cutting jigs), less blood loss, faster rehabilitation, better implant sizing and accuracy, superior overall outcome, and at the end- less costs. However, as evident for every new development, its superiority remains to be provenover the conventional systems. Whilst dissatisfaction is reported to be eminent in up to 30% of patients having undergone conventional TKA, it is unclear, whether PSI can address to these patients as a suitable option in the future. The author believes that the current evidence does not support superiority of PSI in TKA over conventional systems. However, future long-term level I and II studies might aid to show its cost-effectiveness stating same results, accuracy, and overall outcome with less operation time.展开更多
In this study,the behavior of Gavoshan dam was evaluated during construction and the first impounding.A two-dimensional（2D） numerical analysis was conducted based on a finite difference method on the largest cross-s...In this study,the behavior of Gavoshan dam was evaluated during construction and the first impounding.A two-dimensional（2D） numerical analysis was conducted based on a finite difference method on the largest cross-section of the dam using the results of instrument measurements and back analysis.These evaluations will be completed in the case that back analysis is carried out in order to control the degree of the accuracy and the level of confidence of the measured behavior since each of the measurements could be controlled by comparing it to the result obtained from the numerical model.Following that,by comparing the results of the numerical analysis with the measured values,it is indicated that there is a proper consistency between these two values.Moreover,it was observed that the dam performance was suitable regarding the induced pore water pressure,the pore water pressure ratio r;,settlement,induced stresses,arching degree,and hydraulic fracturing probability during the construction and initial impounding periods.The results demonstrated that the maximum settlement of the core was 238 cm at the end of construction.In the following 6 years after construction（initial impounding and exploitation period）,the accumulative settlement of the dam was 270 cm.It is clear that 88% of the total settlement of the dam took place during dam construction.The reason is that the clay core was smashed in the wet side,i.e.the optimum moisture content.Whereas the average curving ratio was 0.64 during dam construction; at the end of the initial impounding,the maximum amount of curving ratio in the upstream was 0.81,and the minimum（critical） amount in the downstream was 0.52.It was also concluded that this dam is safe in comparison with the behaviors of other similar dams in the world.展开更多
Ventilation fans are one of the most important pieces of equipment in coal mines. Their performance plays an important role in the safety of staff and production. Given the actual requirements of coal mine production,...Ventilation fans are one of the most important pieces of equipment in coal mines. Their performance plays an important role in the safety of staff and production. Given the actual requirements of coal mine production,we instituted a research project on the measurement methods of key performance parameters such as wind pressure,amount of ventilation and power. At the end a virtual instrument for mine ventilation fans performance evaluation was developed using a USB interface. The practical performance and analytical results of our experiments show that it is feasible,reliable and effective to use the proposed instrumentation for mine ventilation performance evaluation.展开更多
Capillary electrophoresis-mass spectrometry（CE-MS） is a powerful separation and analytical technique in the field of analytical chemistry. This review provides an update of instrumentation developments in the method...Capillary electrophoresis-mass spectrometry（CE-MS） is a powerful separation and analytical technique in the field of analytical chemistry. This review provides an update of instrumentation developments in the methodology of CE-MS systems. A selection of relevant articles covers the literatures published from Jan. 2013 to Feb. 2017. Special attentions were paid to the sample injection and ionization processes.Applications of these CE-MS systems were also introduced through representative examples. General conclusions and perspectives were given at the last.展开更多
Pelvic instrumentation for neuromuscular scoliosis has been part of neuromuscular scoliosis surgery since the era of the Luque Galveston construct. Unit Rod(Medtronic Sofamor-Danek, Nashville, TN) instrumentation brou...Pelvic instrumentation for neuromuscular scoliosis has been part of neuromuscular scoliosis surgery since the era of the Luque Galveston construct. Unit Rod(Medtronic Sofamor-Danek, Nashville, TN) instrumentation brought with it the concept of cantilever correction by placing the implants in the pelvis and then gradually bringing the rod to the spine by sequentially tightening the sublaminar wires, with the goal of creating a level pelvis over a straight spine. More recently surgeons have utilized pedicle screw constructs in which the corrective strategies have varied. Challenges with pelvic fixation using iliac screws linked to the spinal rod have led to the development of the S2-alariliac technique(S2 AI) in which the spinal rod connects to the pelvic screw. The screw is placed in the S2 ala, crosses the sacro-iliac joint and into the ilium through a large column of supra-acetabular bone. This column is the same area used for anterior inferior iliac spine external fixation frames used in trauma surgery. S2 AI screw placement can be technically difficult and can require experienced radiology technologists to provide the appropriate views. Additionally, although the technique was originally described being placed via freehand technique with intra-operative flouroscopy, the freehand technique suffers from the anatomic anomalies present in the pelvis in neuromuscular scoliosis. As such, we prefer to place them using intra-operative navigation for all pediatric spinal deformity cases. Below in detail we report our intra-operative technique and an illustrative case example.展开更多
Seismic networks have significantly improved in the last decade in terms of coverage density,data quality,and instrumental diversity.Moreover,revolutionary advances in ultra-dense seismic instruments,such as nodes and...Seismic networks have significantly improved in the last decade in terms of coverage density,data quality,and instrumental diversity.Moreover,revolutionary advances in ultra-dense seismic instruments,such as nodes and fiber-optic sensing technologies,have recently provided unprecedented high-resolution data for regional and local earthquake monitoring.Nodal arrays have characteristics such as easy installation and flexible apertures,but are limited in power efficiency and data storage and thus most suitable as temporary networks.Fiber-optic sensing techniques,including distributed acoustic sensing,can be operated in real time with an in-house power supply and connected data storage,thereby exhibiting the potential of becoming next-generation permanent networks.Fiber-optic sensing techniques offer a powerful way of filling the observation gap particularly in submarine environments.Despite these technological advancements,various challenges remain.First,the data characteristics of fiber-optic sensing are still unclear.Second,it is challenging to construct software infrastructures to store,transfer,visualize,and process large amount of seismic data.Finally,innovative detection methods are required to exploit the potential of numerous channels.With improved knowledge about data characteristics,enhanced software infrastructures,and suitable data processing techniques,these innovations in seismic instrumentation could profoundly impact observational seismology.展开更多
BACKGROUND Over the past years,patient specific instrumentation(PSI)for total knee arthroplasty(TKA)has been implemented and routinely used.No clear answer has been given on its associated cost and cost-effectiveness ...BACKGROUND Over the past years,patient specific instrumentation(PSI)for total knee arthroplasty(TKA)has been implemented and routinely used.No clear answer has been given on its associated cost and cost-effectiveness when compared to conventional instrumentation(CI)for TKA.AIM To compare the cost and cost-effectiveness of PSI TKA compared to CI TKA.METHODS A literature search was performed in healthcare,economical healthcare,and medical databases(MEDLINE,EMBASE,CINAHL,Web of Science,Cochrane Library,EconLit).It was conducted in April 2021 and again in January 2022.Relevant literature included randomised controlled trials,retrospective studies,prospective studies,observational studies,and case control studies.All studies were assessed on methodological quality.Relevant outcomes included incremental cost-effectiveness ratio,quality-adjusted life years,total costs,imaging costs,production costs,sterilization associated costs,surgery duration costs and readmission rate costs.All eligible studies were assessed for risk of bias.Meta-analysis was performed for outcomes with sufficient data.RESULTS Thirty-two studies were included into the systematic review.Two were included in the metaanalysis.3994 PSI TKAs and 13267 CI TKAs were included in the sample size.The methodological quality of the included studies,based on Consensus on Health Economic Criteria-scores and risk of bias,ranged from average to good.PSI TKA costs less than CI TKA when considering mean operating room time and its associated costs and tray sterilization per patient case.PSI TKA costs more compared to CI TKA when considering imaging and production costs.Considering total costs per patient case,PSI TKA is more expensive in comparison to CI TKA.Meta-analysis comparing total costs for PSI TKA,and CI TKA showed a significant higher cost for PSI TKA.CONCLUSION Cost for PSI and CI TKA can differ when considering distinct aspects of their implementation.Total costs per patient case are increased for PSI TKA when compared to CI TKA.展开更多
基金Supported by AI For Spinal Surgery Planning and Results Assessment Project under the“Priority 2030”Academic Leadership Initiative,No.6.18-01/240724-15.
文摘BACKGROUND Pedicle screw fixation is frequently used to treat unstable thoracolumbar injuries;however,the rate of instrumentation failure remains considerable.The primary contributing factor leading to instrumentation failure is poor bone quality.On the other hand,some evidence suggests that surgical tactics can influence long-term instrumentation stability.AIM To assess factors that influence the stability of spinal instrumentation in patients with thoracolumbar injuries.METHODS This study is a non-randomized single center ambispective evaluation of 204 consecutive patients(117 men;87 women)with unstable thoracolumbar injuries.All patients underwent either stand-alone or combined with anterior column reconstruction instrumentation.In cases with spinal cord and nerve root injuries,either posterior or anterior decompression were performed.Patients with pedicle screw loosening were identified via computed tomography imaging.Out of those,cases with clinically significant instrumentation failure were registered.RESULTS The rate of pedicle screw loosening detected by computed tomography was inversely correlated with bone radiodensity figures and an increased association with the number of instrumented levels,residual kyphotic deformity,laminectomy,and lumbosacral fixation.Intermediate screws and anterior reconstruction were associated with a clinically relevant decreased risk of pedicle screw loosening development.Either complete or partial posterior fusion within instrumented levels was capable of decreasing instrumentation failure risk,while extensive decompression with laminectomy and at least one-level total facetectomy were associated with an increased risk of instrumentation failure.Anterior decompression does not have a negative impact on instrumentation stability.CONCLUSION Intermediate screws,anterior reconstruction and posterior tension band preservation are associated with decreased rates of instrumentation instability development.Posterior fusion is beneficial in terms of instrumentation failure prevention.
文摘Introduction: The choice of adopting unilateral pedicle screw fixation or using bilateral pedicle screw fixation in lumbar spinal stenosis remains controversial. In our context, very few studies have been performed comparing the clinical effectiveness of unilateral versus bilateral fixation in the surgical management of lumbar spinal canal stenosis. Objective: Evaluate the impact on quality of life and clinical efficacy of unilateral spondylodesis compared to bilateral spondylodesis in the surgical management of lumbar spinal canal stenosis at the Yaounde Central Hospital. Methods: This was a retrospective descriptive cross-sectional study for a period of 4 years, from June 2015 to June 2019. It involved all patients operated for lumbar canal stenosis and who underwent spondylodesis or spinal fusion at the neurosurgery department of the Yaounde Central Hospital. Results: A total of 68 participants were recruited during our study period. 32 (47%) of the study population were in the 50 - 60 age group, with a mean age of 56.98 years ranging from 41 to 75 years. Females, housewives and farmers were the most affected. In our study, 72% of patients had unilateral spondylodesis and 28% had bilateral fusion. Preoperatively, 71% of patients had insurmountable pain, refractory to medical treatment. At 3 months postoperatively, 73.7% of patients with bilateral setup had moderate pain compared to 69% of those with unilateral setup. At 6 months postoperatively, 79% of patients with bilateral fusion had mild pain compared to 82% of patients with unilateral setup. At 1 year postoperatively, all patients had mild pain. Preoperatively, 66.2% of patients were unable to walk and 19.1% of patients were bedridden according to the Oswestry score. At 3 months postoperatively, 10.2% of patients with unilateral setup were unable to walk compared to 10.5% of patients with bilateral fixation, while 67.3% of patients with unilateral fixation had moderate disability compared to 52.6% of patients with bilateral fixation. At 6 months postoperatively, 51% of patients with unilateral setup had moderate disability compared to 47.4% of patients with bilateral fixation, while 42.9% of patients with unilateral fixation had mild disability compared to 42.1% of patients with bilateral fixation. At 1 year postoperatively, 81.6% of patients who underwent unilateral fixation had only mild disability compared to 73.7% of patients with bilateral fixation. Conclusion: The assessment of quality of life according to the set-up used shows similar results at 3 months, 6 months and 1 year, with no statistically significant differences. Single-sided pedicle screw fixation combined with transforaminal lumbar interbody fusion or mounting has the advantage of being faster, with less bleeding and is less expensive compared to bilateral fixation.
文摘The response and performance of radiation detectors for accurate measurements and effective use for radiological safety in medical, industrial, and nuclear sectors are based on the optimal use, maintenance, repair and calibration of radiation monitoring instruments in a secondary standard dosimetry laboratory. In Nigeria, the suboptimal performances of these instruments are attributed to inadequate maintenance practices, insufficient calibration, and limited awareness of proper equipment handling for optimal use. This study assesses the current practices related to the optimal use, maintenance, repair, and calibration of radiation detection equipment across Nigeria’s six geopolitical zones. Using a cross-sectional survey approach, data were collected from Ninety (90) radiation monitoring equipment operators, Radiation Safety Officers, and frontline responders to evaluate their knowledge, awareness, and practices concerning equipment usage, operation, storage, handling, and calibration. The findings reveal significant gaps in knowledge of usage (trained is 43.2%, not trained is 56.8%) and inconsistencies in maintenance practices (as indicated by the regression analysis (β = 0.51, p < 0.01), particularly regarding specialized instruments such as the PackEye, Mobile Detection System (MDS), Radionuclide Identifinder (RID), and Personal Radiation Detectors (PRD). While there is high awareness of the need for regular calibration and handling training, the lack of standardized protocols and training alignment poses challenges to the effective use of these instruments. This study underscores the importance of comprehensive training programs, standardized maintenance protocols, and enhanced awareness initiatives to optimize the usage, performance and safety of radiation monitoring instruments in Nigeria.
文摘Objective:To evaluate the effectiveness of quality nursing in the management of reusable instruments in the Central Sterile Supply Department(CSSD).Methods:Eleven nurses from the CSSD department were selected from January to October 2024,and quality nursing activities were implemented in the management of reusable instruments.The completion of quality indicators was analyzed.The instrument quality management scores,department satisfaction,and nurses’professional ability scores before and after nursing management were compared.Results:After nursing intervention,the qualified rates of initial cleaning and final cleaning of sterilization instruments were 99.66%and 100%,respectively.The qualified rate of packaging was 99.97%,the wet package rate was 0.1‰,the loading qualified rate was 99.88%,and the qualified rate of distribution was 99.99%.After nursing intervention,the nurses’instrument quality management scores,department satisfaction,and nurses’professional ability scores were all higher than those before nursing intervention(P<0.05).Conclusion:Quality nursing activities can improve the cleaning,packaging,and sterilization qualified rates of reusable instruments in the CSSD,enhance the effect of instrument quality management,obtain higher department satisfaction from nurses,cultivate their professional abilities,and possess significant nursing management advantages.
文摘The efficacy requirements of cosmetic instruments and explored their efficacy evaluation methods was investigated.The efficacy and claims of common cosmetic instruments on the market were investigated,and human clinical trials were conducted to evaluate the efficacy of household cosmetic instruments.Household cosmetic instruments mainly include technologies such as sound wave,ion conduction,LED light,EMS microcurrent,RF radio frequency,and laser.This paper took microcurrent as an example to explore its efficacy claim methods.In human test I,the water content in the stratum corneum of the forearms of 31 subjects increased significantly compared with the blank control after 8 h.In human test II,30 subjects showed significant decreases in skin texture R5,transepidermal water loss TEWL,skin firmness F4 value,skin elasticity R2 value,overall size and depth of facial wrinkles,and facial jawline angle,and a significant increase in facial gloss value.The results showed that the cosmetic instrument had effects of moisturizing,improving facial evenness,repairing barrier,improving skin elasticity and firmness,and improving facial edema.
文摘This study examined the development of technician teams on large-scale instrument platforms in universities,using the State Key Laboratory of Natural and Biomimetic Drugs in the Peking University School of Pharmaceutical Sciences as a case study.Data were collected through questionnaire surveys and interviews conducted in 2017,followed by a questionnaire survey in 2023,offering both subjective and objective insights.The evolution of the platform’s technician team over the past 5 years was analyzed,highlighting key experiences and identifying ongoing challenges.Recommendations to enhance technician team development include recruiting skilled faculty,clearly defining job responsibilities,and refining the assessment and incentive systems.
文摘This paper introduces the key design aspects of automotive center console instrument systems,including hardware architecture,ergonomics,antenna layout,etc.It elaborates on the application and advantages of various advanced technologies,such as 3D printing and dual-color injection molding.Additionally,it discusses advancements in structural design,as well as future challenges and the trend of multidisciplinary collaborative innovation.
基金support from the National Natural Science Foundation of China(Grant Nos.12172332,11727803 and 12072009)the Zhejiang Provincial Natural Science Foundation of China(Grant No.LZ23A020007)the Fundamental Research Funds for the Provincial Universities of Zhejiang(Grant No.RF-C2022003).
文摘The presence of residual stresses in materials or engineering structures can significantly influence their mechanical per-formance.Accurate measurement of residual stresses is of great importance to ensure their in-service reliability.Although numerous instrumented indentation methods have been proposed to evaluate residual stresses,the majority of them require a stress-free reference sample as a comparison benchmark,thereby limiting their applicability in scenarios where obtaining stress-free reference samples is challenging.In this work,through a number of finite element simulations,it was found that the loading exponent of the loading load-depth curve and the recovered depth during unloading are insensitive to residual stresses.The loading curve of the stress-free specimen was virtually reconstructed using such stress-insensitive parameters extracted from the load-depth curves of the stressed state,thus eliminating the requirement for stress-free reference samples.The residual stress was then correlated with the fractional change in loading work between stressed and stress-free loading curves through dimensional analysis and finite element simulations.Based on this correlation,an instrumented sharp indentation method for measuring equibiaxial residual stress without requiring a stress-free specimen was established.Both numerical and experimental verifications were carried out to demonstrate the accuracy and reliability of the newly proposed method.The maximum relative error and absolute error in measured residual stresses are typically within±20%and±20 MPa,respectively.
基金supported by National Natural Science Foundation of China(No.61862038)Lanzhou Talent Innovation and Entrepreneurship Technology Plan Project(No.2019-RC-14).
文摘Aiming at node deployment in the monitoring area of the field observation instrument network in the cold and arid regions,we propose a virtual force algorithm based on Voronoi diagram(VFAVD),which adopts probabilistic sensing model that is more in line with the actual situation.First,the Voronoi diagram is constructed in the monitoring area to determine the Thiessen polygon of each node.Then,the virtual force on each node is calculated,and the node update its position according to the direction and size of the total force,so as to achieve the purpose of improving the network coverage rate.The simulation results show that the proposed algorithm can effectively improve the coverage rate of the network,and also has a good effect on the coverage uniformity.
文摘On April 6th,the"Silk Road People-to-People Connectivity"China-Cambodia Traditional Instrument Concert was successfully held in Phnom Penh.The event was attended by Li Ji,Cultural Counsellor of the Chinese Embassy in Cambodia,officials from Ministry of Culture and Fine Arts of Cambodia and Ministry of Commerce of Cambodia,along with vips from various sectors.
基金Swan College of Central South University of Forestry and Technology Teaching Reform Research Project“The Impact of Teachers’Task-Based Teaching Method on English Interpreting Learning among University Students in Hunan,China”(SWXYJGPJ27)Swan College of Central South University of Forestry and Technology Scientific Research Project“The Impact of Integrative Motivation and Instrumental Motivation on English Autonomous Learning among University Students in Hunan,China--A Mediating Role of Learning Strategy”(SYXY202441)。
文摘The research topic of the author’s PhD dissertation is“The Impact of Motivation Cultivation on English Autonomous Learning among University Students in Hunan,China—A Mediating Role of Learning Strategy.”Within this topic,three key variables are identified:the dependent variable(DV),the independent variable(IV),and the mediating variable(MV).Specifically,the DV refers to English autonomous learning,the IV refers to motivation,and the MV refers to learning strategy.The research establishes that the MV(learning strategy)is an integral component of information processing theory(IPT).Consequently,the dissertation incorporates integrative and instrumental motivation theories alongside IPT as its foundational theoretical framework.This paper aims to explore the theoretical framework of the PhD dissertation in detail,focusing on the interplay of these three theories.
文摘Instrument separation is a critical complication during root canal therapy,impacting treatment success and long-term tooth preservation.The etiology of instrument separation is multifactorial,involving the intricate anatomy of the root canal system,instrument-related factors,and instrumentation techniques.Instrument separation can hinder thorough cleaning,shaping,and obturation of the root canal,posing challenges to successful treatment outcomes.Although retrieval of separated instrument is often feasible,it carries risks including perforation,excessive removal of tooth structure and root fractures.Effective management of separated instruments requires a comprehensive understanding of the contributing factors,meticulous preoperative assessment,and precise evaluation of the retrieval difficulty.The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes.The current manuscript provides a framework for understanding the causes,risk factors,and clinical management principles of instrument separation.By integrating effective strategies,endodontists can enhance decision-making,improve endodontic treatment success and ensure the preservation of natural dentition.
文摘AIM: To summarise and compare currently available evidence regarding accuracy of pre-operative imaging, which is one of the key choices for surgeons contemplating patient-specific instrumentation(PSI) surgery.METHODS: The MEDLINE and EMBASE medical literature databases were searched, from January 1990 to December 2013, to identify relevant studies. The data from several clinical studies was assimilated to allow appreciation and comparison of the accuracy of each modality. The overall accuracy of each modality was calculated as proportion of outliers > 3% in the coronal plane of both computerised tomography(CT) or magnetic resonance imaging(MRI). RESULTS: Seven clinical studies matched our inclusion criteria for comparison and were included in our study for statistical analysis. Three of these reported series using MRI and four with CT. Overall percentage of outliers > 3% in patients with CT-based PSI systems was 12.5% vs 16.9% for MRI-based systems. These results were not statistically significant. CONCLUSION: Although many studies have been undertaken to determine the ideal pre-operative imaging modality, conclusions remain speculative in the absence of long term data. Ultimately, information regarding accuracy of CT and MRI will be the main determining factor. Increased accuracy of pre-operative imaging could result in longer-term savings, and reduced accumulated dose of radiation by eliminating the need for post-operative imaging and revision surgery.
文摘Patient specific instrumentation(PSI) in total knee arthroplasty(TKA) promises faster operation time(by using less instruments and individual cutting jigs), less blood loss, faster rehabilitation, better implant sizing and accuracy, superior overall outcome, and at the end- less costs. However, as evident for every new development, its superiority remains to be provenover the conventional systems. Whilst dissatisfaction is reported to be eminent in up to 30% of patients having undergone conventional TKA, it is unclear, whether PSI can address to these patients as a suitable option in the future. The author believes that the current evidence does not support superiority of PSI in TKA over conventional systems. However, future long-term level I and II studies might aid to show its cost-effectiveness stating same results, accuracy, and overall outcome with less operation time.
文摘In this study,the behavior of Gavoshan dam was evaluated during construction and the first impounding.A two-dimensional（2D） numerical analysis was conducted based on a finite difference method on the largest cross-section of the dam using the results of instrument measurements and back analysis.These evaluations will be completed in the case that back analysis is carried out in order to control the degree of the accuracy and the level of confidence of the measured behavior since each of the measurements could be controlled by comparing it to the result obtained from the numerical model.Following that,by comparing the results of the numerical analysis with the measured values,it is indicated that there is a proper consistency between these two values.Moreover,it was observed that the dam performance was suitable regarding the induced pore water pressure,the pore water pressure ratio r;,settlement,induced stresses,arching degree,and hydraulic fracturing probability during the construction and initial impounding periods.The results demonstrated that the maximum settlement of the core was 238 cm at the end of construction.In the following 6 years after construction（initial impounding and exploitation period）,the accumulative settlement of the dam was 270 cm.It is clear that 88% of the total settlement of the dam took place during dam construction.The reason is that the clay core was smashed in the wet side,i.e.the optimum moisture content.Whereas the average curving ratio was 0.64 during dam construction; at the end of the initial impounding,the maximum amount of curving ratio in the upstream was 0.81,and the minimum（critical） amount in the downstream was 0.52.It was also concluded that this dam is safe in comparison with the behaviors of other similar dams in the world.
基金Project 2007E237 supported by the Science Fund Program of Shaanxi Province of China
文摘Ventilation fans are one of the most important pieces of equipment in coal mines. Their performance plays an important role in the safety of staff and production. Given the actual requirements of coal mine production,we instituted a research project on the measurement methods of key performance parameters such as wind pressure,amount of ventilation and power. At the end a virtual instrument for mine ventilation fans performance evaluation was developed using a USB interface. The practical performance and analytical results of our experiments show that it is feasible,reliable and effective to use the proposed instrumentation for mine ventilation performance evaluation.
基金supported by Ministry of Science and Technology(MOST)instrumentation program of China(No.2012YQ04014007)National Natural Science Foundation of China(NSF)(No.21475010)+1 种基金Beijing Natural Science Foundation(BNSF)(No.16L00065)State Key Laboratory Explosion Science and Technology(No.YBKT16-17)
文摘Capillary electrophoresis-mass spectrometry（CE-MS） is a powerful separation and analytical technique in the field of analytical chemistry. This review provides an update of instrumentation developments in the methodology of CE-MS systems. A selection of relevant articles covers the literatures published from Jan. 2013 to Feb. 2017. Special attentions were paid to the sample injection and ionization processes.Applications of these CE-MS systems were also introduced through representative examples. General conclusions and perspectives were given at the last.
文摘Pelvic instrumentation for neuromuscular scoliosis has been part of neuromuscular scoliosis surgery since the era of the Luque Galveston construct. Unit Rod(Medtronic Sofamor-Danek, Nashville, TN) instrumentation brought with it the concept of cantilever correction by placing the implants in the pelvis and then gradually bringing the rod to the spine by sequentially tightening the sublaminar wires, with the goal of creating a level pelvis over a straight spine. More recently surgeons have utilized pedicle screw constructs in which the corrective strategies have varied. Challenges with pelvic fixation using iliac screws linked to the spinal rod have led to the development of the S2-alariliac technique(S2 AI) in which the spinal rod connects to the pelvic screw. The screw is placed in the S2 ala, crosses the sacro-iliac joint and into the ilium through a large column of supra-acetabular bone. This column is the same area used for anterior inferior iliac spine external fixation frames used in trauma surgery. S2 AI screw placement can be technically difficult and can require experienced radiology technologists to provide the appropriate views. Additionally, although the technique was originally described being placed via freehand technique with intra-operative flouroscopy, the freehand technique suffers from the anatomic anomalies present in the pelvis in neuromuscular scoliosis. As such, we prefer to place them using intra-operative navigation for all pediatric spinal deformity cases. Below in detail we report our intra-operative technique and an illustrative case example.
基金the USTC Research Funds of the Double First-Class Initiative(No.YD2080002006)。
文摘Seismic networks have significantly improved in the last decade in terms of coverage density,data quality,and instrumental diversity.Moreover,revolutionary advances in ultra-dense seismic instruments,such as nodes and fiber-optic sensing technologies,have recently provided unprecedented high-resolution data for regional and local earthquake monitoring.Nodal arrays have characteristics such as easy installation and flexible apertures,but are limited in power efficiency and data storage and thus most suitable as temporary networks.Fiber-optic sensing techniques,including distributed acoustic sensing,can be operated in real time with an in-house power supply and connected data storage,thereby exhibiting the potential of becoming next-generation permanent networks.Fiber-optic sensing techniques offer a powerful way of filling the observation gap particularly in submarine environments.Despite these technological advancements,various challenges remain.First,the data characteristics of fiber-optic sensing are still unclear.Second,it is challenging to construct software infrastructures to store,transfer,visualize,and process large amount of seismic data.Finally,innovative detection methods are required to exploit the potential of numerous channels.With improved knowledge about data characteristics,enhanced software infrastructures,and suitable data processing techniques,these innovations in seismic instrumentation could profoundly impact observational seismology.
文摘BACKGROUND Over the past years,patient specific instrumentation(PSI)for total knee arthroplasty(TKA)has been implemented and routinely used.No clear answer has been given on its associated cost and cost-effectiveness when compared to conventional instrumentation(CI)for TKA.AIM To compare the cost and cost-effectiveness of PSI TKA compared to CI TKA.METHODS A literature search was performed in healthcare,economical healthcare,and medical databases(MEDLINE,EMBASE,CINAHL,Web of Science,Cochrane Library,EconLit).It was conducted in April 2021 and again in January 2022.Relevant literature included randomised controlled trials,retrospective studies,prospective studies,observational studies,and case control studies.All studies were assessed on methodological quality.Relevant outcomes included incremental cost-effectiveness ratio,quality-adjusted life years,total costs,imaging costs,production costs,sterilization associated costs,surgery duration costs and readmission rate costs.All eligible studies were assessed for risk of bias.Meta-analysis was performed for outcomes with sufficient data.RESULTS Thirty-two studies were included into the systematic review.Two were included in the metaanalysis.3994 PSI TKAs and 13267 CI TKAs were included in the sample size.The methodological quality of the included studies,based on Consensus on Health Economic Criteria-scores and risk of bias,ranged from average to good.PSI TKA costs less than CI TKA when considering mean operating room time and its associated costs and tray sterilization per patient case.PSI TKA costs more compared to CI TKA when considering imaging and production costs.Considering total costs per patient case,PSI TKA is more expensive in comparison to CI TKA.Meta-analysis comparing total costs for PSI TKA,and CI TKA showed a significant higher cost for PSI TKA.CONCLUSION Cost for PSI and CI TKA can differ when considering distinct aspects of their implementation.Total costs per patient case are increased for PSI TKA when compared to CI TKA.
