The coupling effects among the flow field,temperature distribution and structural deformation in a turbine cannot be ignored,particularly during flight cycles when the turbine experiences varied operational states.Rel...The coupling effects among the flow field,temperature distribution and structural deformation in a turbine cannot be ignored,particularly during flight cycles when the turbine experiences varied operational states.Relying solely on steady-state solutions cannot predict the detrimental effects caused by hysteresis.Consequently,this paper employs a quasi-steady-state fluid-thermalstructure multidisciplinary coupling solution method,integrating transient solid heat conduction with steady-state flow field and static structural deformation solutions.After conducting a numerical simulation of a three-dimensional,five-stage,low-pressure turbine air system,the following conclusions are drawn:when boundary conditions attain high-power states through processes that are numerically identical but in opposite directions,slight variations in solid deformation significantly impact the flow field;when boundary conditions attain high-power states through processes that are directionally consistent but have different numerical values,the influence of the boundary condition change rate on the flow field surpasses that of solid deformation.In terms of turbine design parameters,a large difference in stage-reaction between adjacent stages at the lower radius of the turbine can lead to significant changes in the disc cavity flow field during flight cycles.The difference in the stage-reaction of 0.23 at 10%blade height in adjacent stages may induce severe gas ingress in the stator disc cavity.Thus,it is crucial to minimize this difference and to appropriately extend the duration of the deceleration phase to ensure the turbine's safe operation.展开更多
This article analyzes the application of co-management in establishing and zoning nature reserves, explains two types of participatory models, explains the main content and steps required to implement a co-management ...This article analyzes the application of co-management in establishing and zoning nature reserves, explains two types of participatory models, explains the main content and steps required to implement a co-management program, and suggests future direction of co-management. In China, great progress has been achieved since 1956 when the first nature reserve was established. However, conflicts between nature reserve officials and community members, and differences be-tween conservation and utilization of natural resources suggest that the traditional community affair model is unfit to some de-gree. A more workable and economically sustainable model is recommended. Co-management appears to be the preferred management model. International conservation organizations have carried out projects in Chinese nature reserves in recent years, and co-management is thought to be an effective approach to resolve conflicts coming from community and to improve nature reserves management.展开更多
The Crested Ibis(Nipponia Nippon) is endemic to Qinling Mountains of China and was once abundant over vast areas of north-east of Asia habitat.During the 20th century,however,the population declined greatly in numbers...The Crested Ibis(Nipponia Nippon) is endemic to Qinling Mountains of China and was once abundant over vast areas of north-east of Asia habitat.During the 20th century,however,the population declined greatly in numbers.Habitat quality used to be the main threat to this species but recent actions by the government and wildlife protection organizations have brought this under control.With the establishment of Crested Ibis Nature Reserve in China,conflicts between socio-economic development and Crested Ibis conservation have become more acute.How do we deal with the relation between Crested Ibis conservation and community development? In this study,the Crested Ibis Nature Reserve co-management model namely "companies + farmers + Nature Reserve" model is proposed and evaluated with demonstration investigation methods,including continuous six-year fixed-site socio-economic development data of surrounding community,company sales revenue data and monitored data of Crested Ibis Nature Reserve.The results show that farmers' income and conservation awareness increased greatly from 2003 to 2008;company sales revenue has increased by about 20% annually in the recent years;management level has noticeably improved in Nature Reserve,the scope of Crested Ibis habitat has expanded 50 hm2;chemical composition of habitat reduced year after year;and the number of Crested Ibis had been growing annually.At the end,the success of the model is evaluated,and problems in implementation of the model are discussed from the following aspects:management system,co-management concept,economic base of partners,marketing mechanism,technical capacity and so on.展开更多
In Cambodia,fishery co-management is an important process to transfer authority and ownership to the communities along the Tonle Sap Lake to manage fishery.This paper aims to determine why the co-management of small-s...In Cambodia,fishery co-management is an important process to transfer authority and ownership to the communities along the Tonle Sap Lake to manage fishery.This paper aims to determine why the co-management of small-scale fishery has not been implemented satisfactorily in the Tonle Sap Lake of Cambodia.The research was primarily based on a household survey among 404 house-holds for quantitative data,equally divided between the Cham(202 households)and Khmer(202 households).Participatory process was also applied to collect qualitative data from key stake-holders.We found that limited interaction among the involved stakeholders,i.e.,unequal distribution of authority and resources co-management,has impeded implementation.The engagement of fisherfolk was influenced by dependence on fishery,law enforcement,and events organized by the communities.While the Khmer had better opportunities to participate in planning at the provincial and district levels,the Cham were only engaged in local development activities initiated by their people.However,the latter evinced a higher rate of satisfaction due to their access tofishery resources and to a large quantity of fishing gear.In the future,efforts should be made to:(1)improve resource and authority sharing among all key stakeholders;(2)urgently resolve issues pertinent to capacity building,insufficient budgets for commune councils(CoCs)and community fishery(CFi);and(3)urge law enforcement regarding illegal fishing.展开更多
BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)...BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)as a new nursing model postsurgery remains uncertain.AIM To investigate the clinical effect of accelerated recovery nursing program based on multidisciplinary collaboration model in gastric cancer surgery.METHODS A total of 120 patients who underwent radical gastrectomy at our hospital from January 2023 to December 2024 were included in the study.They were divided into two groups of 60 each:The control group,which received routine care,and the study group,which received ERAS based on multidisciplinary collaboration.Both groups received care until discharge.We compared gastrointestinal recovery,psychological status,Short Form 36 Health Survey scores,Pittsburgh Sleep Quality Index,complications,and nursing satisfaction between the two groups.RESULTS The study group had significantly shorter defecation time,bowel sound recovery time,and flatus time compared to the control group(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Rating Scale scores were also significantly lower in the study group(P<0.05).Additionally,the study group reported better sleep quality(P<0.05)and had fewer postoperative complications.Their Short Form 36 Health Survey scores and nursing satisfaction were higher than those of the control group,with all differences being statistically significant(P<0.05).CONCLUSION The ERAS based on multidisciplinary collaboration in patients undergoing radical gastrectomy can accelerate postoperative recovery,reduce the occurrence of complications,and improve psychological state,quality of life,sleep quality and nursing satisfaction.展开更多
BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary appro...BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas,integrating neurosurgery,endocrinology,radiology,and pathology perspectives.AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis,management,and rehabilitation of individuals with pituitary adenomas,to add to already preexisting knowledge,in managing these cases enhancing better ocular and systemic outcomes.METHODS A search was conducted on an online publication database(PubMed)using the term“pituitary adenoma”including all results published over twenty years(2004-2024).Results were sorted for relevance,language,and completeness.RESULTS A total of 176 records were returned.The guidelines of the PRISMA 2020 statement were followed in this study.A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates.Another 17 records were not available as full-length articles and were also excluded.The references of each included record was further searched for relevant publications.A total of 141 records were therefore used in this minireview.CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact,modern therapeutic strategies offer effective management options.Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life.Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.展开更多
Objective:To explore the experiences of palliative care multidisciplinary teams from the perspective of pluralistic synergy theory,aiming to enhance team collaboration.Method:Utilizing a qualitative research methodolo...Objective:To explore the experiences of palliative care multidisciplinary teams from the perspective of pluralistic synergy theory,aiming to enhance team collaboration.Method:Utilizing a qualitative research methodology,we conducted in-depth interviews with 15 palliative care team members to collect data.Results:The operational framework of palliative care multidisciplinary teams under pluralistic synergy theory involves:enhancing collaboration among team members;developing a comprehensive management model for the team;rationalizing the allocation of work tasks and durations;improving team communication and interaction through effective communication mechanisms and platforms;cultivating skilled professionals;and establishing a robust health record management system.Conclusion:The operational mechanism,informed by pluralistic synergy theory,advances the development of palliative care.展开更多
Objective:To design a preoperative checklist for coronary interventional surgery based on multidisciplinary collaboration,and verify its effect on improving the completeness rate of preoperative preparation,surgical p...Objective:To design a preoperative checklist for coronary interventional surgery based on multidisciplinary collaboration,and verify its effect on improving the completeness rate of preoperative preparation,surgical punctuality,and medical staff satisfaction.Methods:A multidisciplinary team was established involving the Department of Cardiology,Anesthesiology,Clinical Laboratory,and Interventional Surgery.Referring to the latest clinical guidelines and nursing standards,a preoperative checklist covering 8 core modules and 61 sub-items was formulated,including“1 day before surgery+day of surgery”and“doctor+nurse+patient+family member”.A total of 213 patients undergoing coronary interventional surgery in our hospital from August 2023 to February 2024(observation group)were selected to apply the checklist.The completeness rate of preoperative preparation and the on-time operation start rate were compared with 197 patients(control group)before the checklist application.The satisfaction of 34 medical staff was evaluated using a Likert 5-point scale.Results:The overall completeness rate of preoperative preparation in the observation group reached 95.72%(78.17%in the control group),among which the completeness rates of 6 sub-items such as medication,health education,and laboratory examinations reached 100%,and the completeness rate of consumables and equipment preparation was 97.1%;the on-time operation start rate was 97.3%;the satisfaction of the medical team with the checklist was 94.12%,which was significantly higher than that of the control group(82.61%),with statistically significant differences(p<0.05).Conclusion:The preoperative checklist for coronary interventional surgery designed through multidisciplinary collaboration can significantly improve the quality of preoperative preparation and surgical efficiency,and is highly recognized by the medical team,providing practical reference for perioperative safety management of interventional diagnosis and treatment.展开更多
BACKGROUND Lynch syndrome(LS),an autosomal dominant genetic disorder,is distinguished by germline mutations in the DNA mismatch repair genes,including MLH1.These mutations confer an elevated risk for the development o...BACKGROUND Lynch syndrome(LS),an autosomal dominant genetic disorder,is distinguished by germline mutations in the DNA mismatch repair genes,including MLH1.These mutations confer an elevated risk for the development of colorectal cancer(CRC)and an array of other malignancies.Timely detection,facilitated by genetic profiling and stringent molecular surveillance,is crucial.It enables the implementation of customized therapeutic strategies,which have the potential to markedly enhance patient outcomes.Despite its significant public health impact,LS is frequently underdiagnosed,underscoring the necessity for increased vigilance and the adoption of precision medicine tactics.CASE SUMMARY This case presentation focuses on a 54-year-old male patient with a strong familial predisposition to colon cancer,who was identified to have LS-associated multiple colorectal neoplasms.Utilizing a comprehensive,multidisciplinary therapeutic strategy that encompassed precision medicine,immunotherapy with pembrolizumab,and stringent molecular residual disease monitoring,we effectively managed his advanced CRC.This tailored approach led to the achievement of sustained clinical remission exceeding 30 months,illustrating the promise of personalized treatment protocols in optimizing outcomes for individuals with LS and associated colorectal malignancies.CONCLUSION A synergistic,multidisciplinary approach is essential for managing LS-associated CRC,advocating for personalized care pathways in precision medicine.展开更多
BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma...BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma(HCC),underscoring the urgent need for higher-level research in this area.AIM To investigate the association of multidisciplinary treatment strategies with the immunological,coagulation,and tumor biomarker responses after post-TACE in HCC.METHODS This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control(patients treated with TACE alone)and experimental groups(patients receiving multidisciplinary treatment strategies post-TACE).Participant characteristics,short-term efficacy,and safety assessment as well as immunological,coagulation,and tumor biomarker res-ponses between the two groups were collected and compared.RESULTS Compared with the control group,the experimental group demonstrated a superior overall response rate,along with an increased fibrinogen,markedly improved immunological biomarker,lower prothrombin time,thrombin time,alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 199 levels,as well as a decreased abnormal prothrombin incidence,and a lower overall rate of adverse reactions.Notably,no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.CONCLUSION Multidisciplinary treatment strategies post-TACE have improved the treatment outcome,the immunological response,and the coagulation function,lowered the tumor biomarker response levels,and reduced the risk of adverse reactions in patients with HCC.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)ranks as the sixth most common cancer and the third-leading cause of cancer-related deaths worldwide.The multidisciplinary tumor board(MDTB)has been recognized for improving out...BACKGROUND Hepatocellular carcinoma(HCC)ranks as the sixth most common cancer and the third-leading cause of cancer-related deaths worldwide.The multidisciplinary tumor board(MDTB)has been recognized for improving outcomes in cancer management,but its role in patients with HCC undergoing liver transplantation(LT)remains underexplored.AIM To evaluate the impact of an MDTB on survival outcomes in patients with HCC undergoing LT.METHODS We retrospectively analyzed 393 patients with HCC who underwent LT at our institution from October 2015 to October 2021.Patients were categorized into the MDTB and non-MDTB groups.We compared preoperative and postoperative characteristics,overall survival(OS),and disease-free survival(DFS)between the two groups.RESULTS Within the University of California,San Francisco(UCSF)criteria,no significant differences in OS and DFS were noted between the MDTB and non-MDTB groups.However,for patients who exceeded the UCSF criteria,the MDTB group exhibited a substantial improvement in both OS and DFS.The 1-year,3-year,and 5-year OS rates for the MDTB group in this subgroup were 88.68%,75.29%,and 61.78%,respectively,compared to 83.02%,64.07%,and 38.25%,respectively in the non-MDTB group.Similarly,DFS rates were 89.47%,71.35%,and 63.52%,respectively,vs 82.18%,53.78%,and 34.04%,respectively.CONCLUSION The MDTB approach was particularly beneficial for patients with HCC exceeding the UCSF criteria,significantly improving OS and DFS.These findings advocate for integrating MDTB into clinical practice for optimizing the management of high-risk patients with HCC undergoing LT.展开更多
This letter discusses the critical yet underrecognized intersection of chronic renal insufficiency and Nocardia brasiliensis skin infection in the case reported by Zhang et al,emphasizing the diagnostic challenges and...This letter discusses the critical yet underrecognized intersection of chronic renal insufficiency and Nocardia brasiliensis skin infection in the case reported by Zhang et al,emphasizing the diagnostic challenges and therapeutic complexities in the context of advanced age,comorbidities,and immunocompromised populations.The study’s strengths included its integration of immunological profiling and precision medicine,demonstrating that a tailored low-dose trimethoprimsulfamethoxazole regimen with pharmacokinetic monitoring can improve outcomes in geriatric patients with chronic renal insufficiency while mitigating nephrotoxicity risks.However,its limitations included a single-case design,reliance on phenotypic diagnostics,and the lack of information regarding comorbidity interactions.The findings support the use of advanced molecular tools for rapid pathogen identification and identification of co-infection.Future studies should prioritize elucidating the synergistic effects of chronic kidney disease-uremia and immunosuppression on Nocardia colonization,developing biomarkers for early detection,and conducting global epidemiological studies in endemic regions.This case underscores the importance of interdisciplinary collaboration and innovative diagnostics to optimize management of nocardiosis in vulnerable populations.展开更多
Crush syndrome demands an integrated multidisciplinary approach that spans acute surgical decisions and long-term functional recovery.In response to Khan et al’s recent systematic review,we propose complementary pers...Crush syndrome demands an integrated multidisciplinary approach that spans acute surgical decisions and long-term functional recovery.In response to Khan et al’s recent systematic review,we propose complementary perspectives that address two underrepresented dimensions:Vascular surgical decision-making and psychiatric rehabilitation.We emphasize the use of intraoperative technologies such as indocyanine green fluorescence angiography and compartment pressure monitoring to guide limb salvage strategies and reperfusion management.Additionally,we advocate for the systematic integration of mental health screening and trauma-informed psychiatric care to address the high prevalence of psychological distress in survivors.Embedding these domains into standardized protocols could enhance both short-and long-term outcomes,particularly in highimpact trauma and disaster settings.展开更多
BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life...BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life.Multidisciplinary team(MDT)collaborative nursing has emerged as a comprehensive care approach that may address both physical and psychological needs.AIM To explored the impact of MDT collaborative nursing on wound healing and anxiety/depression symptoms in postoperative patients with gastrointestinal tumors.METHODS A retrospective analysis was conducted on 364 patients with gastrointestinal tumours admitted to our hospital between January 2022 and December 2024.Based on differing postoperative nursing approaches,two groups were established:the MDT group(n=196)and the control group(n=168).The control group received conventional nursing interventions,while the MDT group received MDT collaborative nursing.The study compared wound healing outcomes,pre-intervention and one-month post-intervention Hospital Anxiety and Depression Scale(HADS)scores,Functional Assessment of Cancer Therapy-General(FACT-G)quality of life scores,and complication rates between the two groups.RESULTS The MDT group demonstrated a Grade A wound healing rate of 88.27%and total treatment compliance of 99.49%,both significantly higher than the control group(75.00%and 95.83%,respectively).The complication incidence rate was 3.06%in the MDT group,lower than the control group(8.93%),with all differences statistically significant(P<0.05).After one month of intervention,patients in the MDT group demonstrated lower Anxiety Self-Rating Scale and Depression Self-Rating Scale scores on the HADS scale compared to the control group.Conversely,their scores on the FACT-G scale for physical,social/family,emotional,and functional domains were higher than those in the control group,with all differences being statistically significant(P<0.05).CONCLUSION MDT collaborative care promotes wound healing in patients undergoing gastrointestinal tumour surgery,alleviates anxiety and depressive symptoms,enhances treatment adherence and quality of life,and reduces the incidence of complications.展开更多
Currently,the use of immune checkpoint inhibitors(ICIs)has shown notable clinical efficacy in treating various malignant tumors,significantly improving patient prognosis.However,while ICIs enhance the body’s anti-tum...Currently,the use of immune checkpoint inhibitors(ICIs)has shown notable clinical efficacy in treating various malignant tumors,significantly improving patient prognosis.However,while ICIs enhance the body’s anti-tumor effects,they can also trigger immune-related adverse events(irAEs),with ICI-associated colitis being one of the more prevalent forms.This condition can disrupt treatment,necessitate drug discontinuation,and adversely affect therapeutic outcomes.In severe cases,irAEs may even become life-threatening.A recent case report by Hong et al highlights the importance of vigilance for ICI-associated colitis in patients experiencing symptoms such as diarrhea and abdominal pain,which can arise both during and even after completion of ICI treatment.Early identification,multidisciplinary management,and continuous monitoring of patients are essential steps to further improve outcomes.展开更多
This paper summarizes the nursing experience of a 75-year-old patient who developed exfoliative dermatitis-type drug eruption induced by cold medicine and progressed to toxic epidermal necrolysis(TEN).The core nursing...This paper summarizes the nursing experience of a 75-year-old patient who developed exfoliative dermatitis-type drug eruption induced by cold medicine and progressed to toxic epidermal necrolysis(TEN).The core nursing measures included(1)Establishing a multidisciplinary team and implementing bundled care led by trauma specialist nurses;(2)Precise wound management using the“three-stage debridement method”and silver ion dressings;(3)Implementing multimodal analgesia based on dynamic pain assessment;(4)Strengthening fluid,electrolyte,and nutritional management;and(5)Providing individualized psychological support.After 14 days of treatment and nursing,the patient’s wounds were completely epithelialized,infection indicators returned to normal,pain was effectively controlled,and the patient was discharged successfully.No serious complications were observed during the 6-month follow-up.For elderly critically ill patients with TEN,constructing a systematic nursing model based on multidisciplinary collaboration and centered on trauma care is crucial for improving patient outcomes.展开更多
The rising prevalence of chronic multimorbidity poses substantial challenges to healthcare systems,necessitating the development of innovative management strategies to optimize patient care and system efficiency.The s...The rising prevalence of chronic multimorbidity poses substantial challenges to healthcare systems,necessitating the development of innovative management strategies to optimize patient care and system efficiency.The study by Fontalba-Navas et al investigates the implementation of a novel high complexity unit(HCU)specifically designed to improve the management of patients with chronic complex conditions.By adopting a multidisciplinary approach,the HCU aims to provide comprehensive,patient-centered care that enhances health outcomes and alleviates the strain on traditional hospital services.Utilizing a longitudinal analysis of data from the Basic Minimum Data Set,this study compares hospitalization metrics among the HCU,Internal Medicine,and other departments within a regional hospital throughout 2022.The findings reveal that the HCU's integrated care model significantly reduces readmission rates and boosts patient satisfaction compared to conventional care practices.The study highlights the HCU's potential as a replicable model for managing chronic multimorbidity,emphasizing its effectiveness in minimizing unnecessary hospitalizations and enhancing the overall quality of patient care.This innovative approach not only addresses the complexities associated with chronic multimorbid conditions but also offers a sustainable framework for healthcare systems confronting similar challenges.展开更多
Objectives:This study was conducted to determine the effect of multidisciplinary nursing intervention(MNI)on interdialytic weight gain(IDWG)and quality of life(QoL)among chronic hemodialysis patients.Materials and Met...Objectives:This study was conducted to determine the effect of multidisciplinary nursing intervention(MNI)on interdialytic weight gain(IDWG)and quality of life(QoL)among chronic hemodialysis patients.Materials and Methods:Quantitative research approach with randomized-controlled,single-blind trial was conducted among 120 chronic hemodialysis patients in Institute of Medical Sciences and SUM Hospital Bhubaneswar,Odisha,India from February 2023 to February 2024.Participants were randomly assigned into the experimental group(n1=65)and control group(n2=55)by block randomization methods.The experimental group received the intervention phase up to the 6th week,along with the usual treatment,and the control group received only standard treatment up to the end of the study.After that,they received the diet chart plan and fluid distribution timetable.Results:Significant improvements were found in IDWG and QoL for the experimental group.The experimental group exhibited a sharp decline in weight gain within the group(F=20.05,P<0.001)between the group(F=13.02,P<0.001),interaction effects between the groups across the time point(F=5.67,P<0.005).Kidney disease QoL scores(KDQOL^(TM)36)increased from 49.38±9.56 to 58.63±6.04 in the experimental group,compared to an increase from 50.84±9.25 to 52.04±8.02 in the control group.Conclusion:This trial showed that MNIs significantly reduced IDWG and improved KDQOL^(TM)36 scores,with the experimental group outperforming the control,highlighting the intervention’s effectiveness.展开更多
Unlike traditional propeller-driven underwater vehicles,blended-wing-body underwater gliders(BWBUGs)achieve zigzag gliding through periodic adjustments of their net buoyancy,enhancing their cruising capabilities while...Unlike traditional propeller-driven underwater vehicles,blended-wing-body underwater gliders(BWBUGs)achieve zigzag gliding through periodic adjustments of their net buoyancy,enhancing their cruising capabilities while mini-mizing energy consumption.However,enhancing gliding performance is challenging due to the complex system design and limited design experience.To address this challenge,this paper introduces a model-based,multidisciplinary system design optimization method for BWBUGs at the conceptual design stage.First,a model-based,multidisciplinary co-simulation design framework is established to evaluate both system-level and disciplinary indices of BWBUG performance.A data-driven,many-objective multidisciplinary optimization is subsequently employed to explore the design space,yielding 32 Pareto optimal solutions.Finally,a model-based physical system simulation,which represents the design with the largest hyper-volume contribution among the 32 final designs,is established.Its gliding perfor-mance,validated by component behavior,lays the groundwork for constructing the entire system’s digital prototype.In conclusion,this model-based,multidisciplinary design optimization method effectively generates design schemes for innovative underwater vehicles,facilitating the development of digital prototypes.展开更多
Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative ...Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.展开更多
基金supported by the National Science and Tech-nology Major Project,China(No.J2019-II-0012-0032)。
文摘The coupling effects among the flow field,temperature distribution and structural deformation in a turbine cannot be ignored,particularly during flight cycles when the turbine experiences varied operational states.Relying solely on steady-state solutions cannot predict the detrimental effects caused by hysteresis.Consequently,this paper employs a quasi-steady-state fluid-thermalstructure multidisciplinary coupling solution method,integrating transient solid heat conduction with steady-state flow field and static structural deformation solutions.After conducting a numerical simulation of a three-dimensional,five-stage,low-pressure turbine air system,the following conclusions are drawn:when boundary conditions attain high-power states through processes that are numerically identical but in opposite directions,slight variations in solid deformation significantly impact the flow field;when boundary conditions attain high-power states through processes that are directionally consistent but have different numerical values,the influence of the boundary condition change rate on the flow field surpasses that of solid deformation.In terms of turbine design parameters,a large difference in stage-reaction between adjacent stages at the lower radius of the turbine can lead to significant changes in the disc cavity flow field during flight cycles.The difference in the stage-reaction of 0.23 at 10%blade height in adjacent stages may induce severe gas ingress in the stator disc cavity.Thus,it is crucial to minimize this difference and to appropriately extend the duration of the deceleration phase to ensure the turbine's safe operation.
文摘This article analyzes the application of co-management in establishing and zoning nature reserves, explains two types of participatory models, explains the main content and steps required to implement a co-management program, and suggests future direction of co-management. In China, great progress has been achieved since 1956 when the first nature reserve was established. However, conflicts between nature reserve officials and community members, and differences be-tween conservation and utilization of natural resources suggest that the traditional community affair model is unfit to some de-gree. A more workable and economically sustainable model is recommended. Co-management appears to be the preferred management model. International conservation organizations have carried out projects in Chinese nature reserves in recent years, and co-management is thought to be an effective approach to resolve conflicts coming from community and to improve nature reserves management.
基金supported by State Forestry Administration (China) Research and Development Plan(Grant NoSD0639)the Community Comanagement Project of WWF-China
文摘The Crested Ibis(Nipponia Nippon) is endemic to Qinling Mountains of China and was once abundant over vast areas of north-east of Asia habitat.During the 20th century,however,the population declined greatly in numbers.Habitat quality used to be the main threat to this species but recent actions by the government and wildlife protection organizations have brought this under control.With the establishment of Crested Ibis Nature Reserve in China,conflicts between socio-economic development and Crested Ibis conservation have become more acute.How do we deal with the relation between Crested Ibis conservation and community development? In this study,the Crested Ibis Nature Reserve co-management model namely "companies + farmers + Nature Reserve" model is proposed and evaluated with demonstration investigation methods,including continuous six-year fixed-site socio-economic development data of surrounding community,company sales revenue data and monitored data of Crested Ibis Nature Reserve.The results show that farmers' income and conservation awareness increased greatly from 2003 to 2008;company sales revenue has increased by about 20% annually in the recent years;management level has noticeably improved in Nature Reserve,the scope of Crested Ibis habitat has expanded 50 hm2;chemical composition of habitat reduced year after year;and the number of Crested Ibis had been growing annually.At the end,the success of the model is evaluated,and problems in implementation of the model are discussed from the following aspects:management system,co-management concept,economic base of partners,marketing mechanism,technical capacity and so on.
文摘In Cambodia,fishery co-management is an important process to transfer authority and ownership to the communities along the Tonle Sap Lake to manage fishery.This paper aims to determine why the co-management of small-scale fishery has not been implemented satisfactorily in the Tonle Sap Lake of Cambodia.The research was primarily based on a household survey among 404 house-holds for quantitative data,equally divided between the Cham(202 households)and Khmer(202 households).Participatory process was also applied to collect qualitative data from key stake-holders.We found that limited interaction among the involved stakeholders,i.e.,unequal distribution of authority and resources co-management,has impeded implementation.The engagement of fisherfolk was influenced by dependence on fishery,law enforcement,and events organized by the communities.While the Khmer had better opportunities to participate in planning at the provincial and district levels,the Cham were only engaged in local development activities initiated by their people.However,the latter evinced a higher rate of satisfaction due to their access tofishery resources and to a large quantity of fishing gear.In the future,efforts should be made to:(1)improve resource and authority sharing among all key stakeholders;(2)urgently resolve issues pertinent to capacity building,insufficient budgets for commune councils(CoCs)and community fishery(CFi);and(3)urge law enforcement regarding illegal fishing.
文摘BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)as a new nursing model postsurgery remains uncertain.AIM To investigate the clinical effect of accelerated recovery nursing program based on multidisciplinary collaboration model in gastric cancer surgery.METHODS A total of 120 patients who underwent radical gastrectomy at our hospital from January 2023 to December 2024 were included in the study.They were divided into two groups of 60 each:The control group,which received routine care,and the study group,which received ERAS based on multidisciplinary collaboration.Both groups received care until discharge.We compared gastrointestinal recovery,psychological status,Short Form 36 Health Survey scores,Pittsburgh Sleep Quality Index,complications,and nursing satisfaction between the two groups.RESULTS The study group had significantly shorter defecation time,bowel sound recovery time,and flatus time compared to the control group(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Rating Scale scores were also significantly lower in the study group(P<0.05).Additionally,the study group reported better sleep quality(P<0.05)and had fewer postoperative complications.Their Short Form 36 Health Survey scores and nursing satisfaction were higher than those of the control group,with all differences being statistically significant(P<0.05).CONCLUSION The ERAS based on multidisciplinary collaboration in patients undergoing radical gastrectomy can accelerate postoperative recovery,reduce the occurrence of complications,and improve psychological state,quality of life,sleep quality and nursing satisfaction.
文摘BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas,integrating neurosurgery,endocrinology,radiology,and pathology perspectives.AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis,management,and rehabilitation of individuals with pituitary adenomas,to add to already preexisting knowledge,in managing these cases enhancing better ocular and systemic outcomes.METHODS A search was conducted on an online publication database(PubMed)using the term“pituitary adenoma”including all results published over twenty years(2004-2024).Results were sorted for relevance,language,and completeness.RESULTS A total of 176 records were returned.The guidelines of the PRISMA 2020 statement were followed in this study.A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates.Another 17 records were not available as full-length articles and were also excluded.The references of each included record was further searched for relevant publications.A total of 141 records were therefore used in this minireview.CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact,modern therapeutic strategies offer effective management options.Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life.Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.
文摘Objective:To explore the experiences of palliative care multidisciplinary teams from the perspective of pluralistic synergy theory,aiming to enhance team collaboration.Method:Utilizing a qualitative research methodology,we conducted in-depth interviews with 15 palliative care team members to collect data.Results:The operational framework of palliative care multidisciplinary teams under pluralistic synergy theory involves:enhancing collaboration among team members;developing a comprehensive management model for the team;rationalizing the allocation of work tasks and durations;improving team communication and interaction through effective communication mechanisms and platforms;cultivating skilled professionals;and establishing a robust health record management system.Conclusion:The operational mechanism,informed by pluralistic synergy theory,advances the development of palliative care.
基金Taikang Xianlin Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University(Project No.:TKKYZX20231016)。
文摘Objective:To design a preoperative checklist for coronary interventional surgery based on multidisciplinary collaboration,and verify its effect on improving the completeness rate of preoperative preparation,surgical punctuality,and medical staff satisfaction.Methods:A multidisciplinary team was established involving the Department of Cardiology,Anesthesiology,Clinical Laboratory,and Interventional Surgery.Referring to the latest clinical guidelines and nursing standards,a preoperative checklist covering 8 core modules and 61 sub-items was formulated,including“1 day before surgery+day of surgery”and“doctor+nurse+patient+family member”.A total of 213 patients undergoing coronary interventional surgery in our hospital from August 2023 to February 2024(observation group)were selected to apply the checklist.The completeness rate of preoperative preparation and the on-time operation start rate were compared with 197 patients(control group)before the checklist application.The satisfaction of 34 medical staff was evaluated using a Likert 5-point scale.Results:The overall completeness rate of preoperative preparation in the observation group reached 95.72%(78.17%in the control group),among which the completeness rates of 6 sub-items such as medication,health education,and laboratory examinations reached 100%,and the completeness rate of consumables and equipment preparation was 97.1%;the on-time operation start rate was 97.3%;the satisfaction of the medical team with the checklist was 94.12%,which was significantly higher than that of the control group(82.61%),with statistically significant differences(p<0.05).Conclusion:The preoperative checklist for coronary interventional surgery designed through multidisciplinary collaboration can significantly improve the quality of preoperative preparation and surgical efficiency,and is highly recognized by the medical team,providing practical reference for perioperative safety management of interventional diagnosis and treatment.
基金Supported by the National Natural Science Foundation of China,No.81972790the Natural Science Foundation of Gansu Province,China,No.22JR5RA004.
文摘BACKGROUND Lynch syndrome(LS),an autosomal dominant genetic disorder,is distinguished by germline mutations in the DNA mismatch repair genes,including MLH1.These mutations confer an elevated risk for the development of colorectal cancer(CRC)and an array of other malignancies.Timely detection,facilitated by genetic profiling and stringent molecular surveillance,is crucial.It enables the implementation of customized therapeutic strategies,which have the potential to markedly enhance patient outcomes.Despite its significant public health impact,LS is frequently underdiagnosed,underscoring the necessity for increased vigilance and the adoption of precision medicine tactics.CASE SUMMARY This case presentation focuses on a 54-year-old male patient with a strong familial predisposition to colon cancer,who was identified to have LS-associated multiple colorectal neoplasms.Utilizing a comprehensive,multidisciplinary therapeutic strategy that encompassed precision medicine,immunotherapy with pembrolizumab,and stringent molecular residual disease monitoring,we effectively managed his advanced CRC.This tailored approach led to the achievement of sustained clinical remission exceeding 30 months,illustrating the promise of personalized treatment protocols in optimizing outcomes for individuals with LS and associated colorectal malignancies.CONCLUSION A synergistic,multidisciplinary approach is essential for managing LS-associated CRC,advocating for personalized care pathways in precision medicine.
文摘BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma(HCC),underscoring the urgent need for higher-level research in this area.AIM To investigate the association of multidisciplinary treatment strategies with the immunological,coagulation,and tumor biomarker responses after post-TACE in HCC.METHODS This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control(patients treated with TACE alone)and experimental groups(patients receiving multidisciplinary treatment strategies post-TACE).Participant characteristics,short-term efficacy,and safety assessment as well as immunological,coagulation,and tumor biomarker res-ponses between the two groups were collected and compared.RESULTS Compared with the control group,the experimental group demonstrated a superior overall response rate,along with an increased fibrinogen,markedly improved immunological biomarker,lower prothrombin time,thrombin time,alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 199 levels,as well as a decreased abnormal prothrombin incidence,and a lower overall rate of adverse reactions.Notably,no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.CONCLUSION Multidisciplinary treatment strategies post-TACE have improved the treatment outcome,the immunological response,and the coagulation function,lowered the tumor biomarker response levels,and reduced the risk of adverse reactions in patients with HCC.
基金Supported by Natural Science Foundation of Tianjin,No.21JCYBJC01140Key Project of Tianjin Science and Technology Bureau Applied Basic Research,No.23JCZDJC01200+1 种基金Key Project of Scientific Research Plan of Tianjin Municipal Education Commission,No.2023YXZD07Project of Tianjin Science and Technology Bureau Applied Basic Research,No.23JCYBJC01800.
文摘BACKGROUND Hepatocellular carcinoma(HCC)ranks as the sixth most common cancer and the third-leading cause of cancer-related deaths worldwide.The multidisciplinary tumor board(MDTB)has been recognized for improving outcomes in cancer management,but its role in patients with HCC undergoing liver transplantation(LT)remains underexplored.AIM To evaluate the impact of an MDTB on survival outcomes in patients with HCC undergoing LT.METHODS We retrospectively analyzed 393 patients with HCC who underwent LT at our institution from October 2015 to October 2021.Patients were categorized into the MDTB and non-MDTB groups.We compared preoperative and postoperative characteristics,overall survival(OS),and disease-free survival(DFS)between the two groups.RESULTS Within the University of California,San Francisco(UCSF)criteria,no significant differences in OS and DFS were noted between the MDTB and non-MDTB groups.However,for patients who exceeded the UCSF criteria,the MDTB group exhibited a substantial improvement in both OS and DFS.The 1-year,3-year,and 5-year OS rates for the MDTB group in this subgroup were 88.68%,75.29%,and 61.78%,respectively,compared to 83.02%,64.07%,and 38.25%,respectively in the non-MDTB group.Similarly,DFS rates were 89.47%,71.35%,and 63.52%,respectively,vs 82.18%,53.78%,and 34.04%,respectively.CONCLUSION The MDTB approach was particularly beneficial for patients with HCC exceeding the UCSF criteria,significantly improving OS and DFS.These findings advocate for integrating MDTB into clinical practice for optimizing the management of high-risk patients with HCC undergoing LT.
文摘This letter discusses the critical yet underrecognized intersection of chronic renal insufficiency and Nocardia brasiliensis skin infection in the case reported by Zhang et al,emphasizing the diagnostic challenges and therapeutic complexities in the context of advanced age,comorbidities,and immunocompromised populations.The study’s strengths included its integration of immunological profiling and precision medicine,demonstrating that a tailored low-dose trimethoprimsulfamethoxazole regimen with pharmacokinetic monitoring can improve outcomes in geriatric patients with chronic renal insufficiency while mitigating nephrotoxicity risks.However,its limitations included a single-case design,reliance on phenotypic diagnostics,and the lack of information regarding comorbidity interactions.The findings support the use of advanced molecular tools for rapid pathogen identification and identification of co-infection.Future studies should prioritize elucidating the synergistic effects of chronic kidney disease-uremia and immunosuppression on Nocardia colonization,developing biomarkers for early detection,and conducting global epidemiological studies in endemic regions.This case underscores the importance of interdisciplinary collaboration and innovative diagnostics to optimize management of nocardiosis in vulnerable populations.
文摘Crush syndrome demands an integrated multidisciplinary approach that spans acute surgical decisions and long-term functional recovery.In response to Khan et al’s recent systematic review,we propose complementary perspectives that address two underrepresented dimensions:Vascular surgical decision-making and psychiatric rehabilitation.We emphasize the use of intraoperative technologies such as indocyanine green fluorescence angiography and compartment pressure monitoring to guide limb salvage strategies and reperfusion management.Additionally,we advocate for the systematic integration of mental health screening and trauma-informed psychiatric care to address the high prevalence of psychological distress in survivors.Embedding these domains into standardized protocols could enhance both short-and long-term outcomes,particularly in highimpact trauma and disaster settings.
文摘BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life.Multidisciplinary team(MDT)collaborative nursing has emerged as a comprehensive care approach that may address both physical and psychological needs.AIM To explored the impact of MDT collaborative nursing on wound healing and anxiety/depression symptoms in postoperative patients with gastrointestinal tumors.METHODS A retrospective analysis was conducted on 364 patients with gastrointestinal tumours admitted to our hospital between January 2022 and December 2024.Based on differing postoperative nursing approaches,two groups were established:the MDT group(n=196)and the control group(n=168).The control group received conventional nursing interventions,while the MDT group received MDT collaborative nursing.The study compared wound healing outcomes,pre-intervention and one-month post-intervention Hospital Anxiety and Depression Scale(HADS)scores,Functional Assessment of Cancer Therapy-General(FACT-G)quality of life scores,and complication rates between the two groups.RESULTS The MDT group demonstrated a Grade A wound healing rate of 88.27%and total treatment compliance of 99.49%,both significantly higher than the control group(75.00%and 95.83%,respectively).The complication incidence rate was 3.06%in the MDT group,lower than the control group(8.93%),with all differences statistically significant(P<0.05).After one month of intervention,patients in the MDT group demonstrated lower Anxiety Self-Rating Scale and Depression Self-Rating Scale scores on the HADS scale compared to the control group.Conversely,their scores on the FACT-G scale for physical,social/family,emotional,and functional domains were higher than those in the control group,with all differences being statistically significant(P<0.05).CONCLUSION MDT collaborative care promotes wound healing in patients undergoing gastrointestinal tumour surgery,alleviates anxiety and depressive symptoms,enhances treatment adherence and quality of life,and reduces the incidence of complications.
基金Supported by 2021 Key Topic of Qinghai Provincial Health System–Guiding Plan Topic,No.2021-WJZDX-43.
文摘Currently,the use of immune checkpoint inhibitors(ICIs)has shown notable clinical efficacy in treating various malignant tumors,significantly improving patient prognosis.However,while ICIs enhance the body’s anti-tumor effects,they can also trigger immune-related adverse events(irAEs),with ICI-associated colitis being one of the more prevalent forms.This condition can disrupt treatment,necessitate drug discontinuation,and adversely affect therapeutic outcomes.In severe cases,irAEs may even become life-threatening.A recent case report by Hong et al highlights the importance of vigilance for ICI-associated colitis in patients experiencing symptoms such as diarrhea and abdominal pain,which can arise both during and even after completion of ICI treatment.Early identification,multidisciplinary management,and continuous monitoring of patients are essential steps to further improve outcomes.
基金Hospital-level Young and Middle-aged Cultivation Project of Xiangyang No.1 People’s Hospital(Project No.:XYY2025QN2)。
文摘This paper summarizes the nursing experience of a 75-year-old patient who developed exfoliative dermatitis-type drug eruption induced by cold medicine and progressed to toxic epidermal necrolysis(TEN).The core nursing measures included(1)Establishing a multidisciplinary team and implementing bundled care led by trauma specialist nurses;(2)Precise wound management using the“three-stage debridement method”and silver ion dressings;(3)Implementing multimodal analgesia based on dynamic pain assessment;(4)Strengthening fluid,electrolyte,and nutritional management;and(5)Providing individualized psychological support.After 14 days of treatment and nursing,the patient’s wounds were completely epithelialized,infection indicators returned to normal,pain was effectively controlled,and the patient was discharged successfully.No serious complications were observed during the 6-month follow-up.For elderly critically ill patients with TEN,constructing a systematic nursing model based on multidisciplinary collaboration and centered on trauma care is crucial for improving patient outcomes.
基金Supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education,No.NRF-RS-2023-00237287.
文摘The rising prevalence of chronic multimorbidity poses substantial challenges to healthcare systems,necessitating the development of innovative management strategies to optimize patient care and system efficiency.The study by Fontalba-Navas et al investigates the implementation of a novel high complexity unit(HCU)specifically designed to improve the management of patients with chronic complex conditions.By adopting a multidisciplinary approach,the HCU aims to provide comprehensive,patient-centered care that enhances health outcomes and alleviates the strain on traditional hospital services.Utilizing a longitudinal analysis of data from the Basic Minimum Data Set,this study compares hospitalization metrics among the HCU,Internal Medicine,and other departments within a regional hospital throughout 2022.The findings reveal that the HCU's integrated care model significantly reduces readmission rates and boosts patient satisfaction compared to conventional care practices.The study highlights the HCU's potential as a replicable model for managing chronic multimorbidity,emphasizing its effectiveness in minimizing unnecessary hospitalizations and enhancing the overall quality of patient care.This innovative approach not only addresses the complexities associated with chronic multimorbid conditions but also offers a sustainable framework for healthcare systems confronting similar challenges.
文摘Objectives:This study was conducted to determine the effect of multidisciplinary nursing intervention(MNI)on interdialytic weight gain(IDWG)and quality of life(QoL)among chronic hemodialysis patients.Materials and Methods:Quantitative research approach with randomized-controlled,single-blind trial was conducted among 120 chronic hemodialysis patients in Institute of Medical Sciences and SUM Hospital Bhubaneswar,Odisha,India from February 2023 to February 2024.Participants were randomly assigned into the experimental group(n1=65)and control group(n2=55)by block randomization methods.The experimental group received the intervention phase up to the 6th week,along with the usual treatment,and the control group received only standard treatment up to the end of the study.After that,they received the diet chart plan and fluid distribution timetable.Results:Significant improvements were found in IDWG and QoL for the experimental group.The experimental group exhibited a sharp decline in weight gain within the group(F=20.05,P<0.001)between the group(F=13.02,P<0.001),interaction effects between the groups across the time point(F=5.67,P<0.005).Kidney disease QoL scores(KDQOL^(TM)36)increased from 49.38±9.56 to 58.63±6.04 in the experimental group,compared to an increase from 50.84±9.25 to 52.04±8.02 in the control group.Conclusion:This trial showed that MNIs significantly reduced IDWG and improved KDQOL^(TM)36 scores,with the experimental group outperforming the control,highlighting the intervention’s effectiveness.
基金supported by the Postdoctoral Fellowship Program of CPSF(Grant No.GZC20242194)the National Natural Science Foundation of China(Grant Nos.52175251 and 52205268)+1 种基金the Industry Key Technology Research Fund Project of Northwestern Polytechnical University(Grant No.HYGJXM202318)the National Basic Scientific Research Program(Grant No.JCKY2021206B005).
文摘Unlike traditional propeller-driven underwater vehicles,blended-wing-body underwater gliders(BWBUGs)achieve zigzag gliding through periodic adjustments of their net buoyancy,enhancing their cruising capabilities while mini-mizing energy consumption.However,enhancing gliding performance is challenging due to the complex system design and limited design experience.To address this challenge,this paper introduces a model-based,multidisciplinary system design optimization method for BWBUGs at the conceptual design stage.First,a model-based,multidisciplinary co-simulation design framework is established to evaluate both system-level and disciplinary indices of BWBUG performance.A data-driven,many-objective multidisciplinary optimization is subsequently employed to explore the design space,yielding 32 Pareto optimal solutions.Finally,a model-based physical system simulation,which represents the design with the largest hyper-volume contribution among the 32 final designs,is established.Its gliding perfor-mance,validated by component behavior,lays the groundwork for constructing the entire system’s digital prototype.In conclusion,this model-based,multidisciplinary design optimization method effectively generates design schemes for innovative underwater vehicles,facilitating the development of digital prototypes.
文摘Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.
