BACKGROUND Operative reports(OP-Rs)are essential for communication among healthcare providers.They require accuracy and completeness to serve as a quality indicator of patient care.Objective assessment of primary tota...BACKGROUND Operative reports(OP-Rs)are essential for communication among healthcare providers.They require accuracy and completeness to serve as a quality indicator of patient care.Objective assessment of primary total knee replacement(TKR)OP-Rs has never been reported.Therefore,a standardized benchmark for assessment and factors affecting the completeness of TKR OP-Rs needs to be evaluated.AIM To evaluate the completeness rate of primary TKR OP-Rs in a teaching hospital and to assess the factors affecting completeness.METHODS A retrospective review of 58 consecutive primary TKR OP-Rs in a tertiary te-aching hospital were included in this study.We used document analysis to review the OP-Rs against a standardized list of six subsets of mandatory variables.The correlation between the percentage of completeness and the specific variables was determined.RESULTS After analyzing 58 cases,we found that the time to documentation was 1.5 hours.Out of the 52 mandatory variables,a median of 30 variables were documented yielding a completeness of 58%.Administrative,procedural,exposure,and im-plant variables were documented the most often,whereas clinical and process variables were most frequently left uncompleted.The documentation of the operative maneuver was variable.There was no association between the com-pleteness of the reports and the time to documentation,documenter level,com-plication rate,operative duration,or length of hospital stay.CONCLUSION Multiple variables were left undocumented on the unstructured primary TKR OP-Rs.The completeness percentage will likely improve after the implementation of a standardized structured OP-R.展开更多
Cooperative guidance is a method for achieving combat objectives through information sharing and cooperative effects,and has emerged as a significant research area in the fields of missile guidance and systematic warf...Cooperative guidance is a method for achieving combat objectives through information sharing and cooperative effects,and has emerged as a significant research area in the fields of missile guidance and systematic warfare.This study presents a systematic review and analysis of current research on cooperative guidance.First,a bibliometric analysis is conducted on 513 articles using the Scopus database and CiteSpace software to assess keyword clustering,keyword cooccurrence,and keyword burst,and to later visualize the results.Second,fundamental theories of cooperative guidance,including relative motion modeling methods,algebraic graph theory,and multi-agent consensus theory,are summarized.Subsequently,an overview of current cooperative laws and corresponding analysis methods is provided,with categorization based on the cooperative structure and convergence performance.Finally,we summarize current research developments based on five perspectives and propose a developmental framework based on five layers(cyber,physical,decision,information,and system),discussing potential future advancements in cooperative terminal guidance.This framework emphasizes five key areas of research:networked,heterogeneous,integrated,intelligent,and group cooperations,with the goal of offering trends and insights for futurework.展开更多
Operative management of humeral shaft fractures demonstrates superior early functional recovery(6-month Disabilities of the Arm,Shoulder,and Hand scores)and significantly lower nonunion rates(63.9%reduction)compared t...Operative management of humeral shaft fractures demonstrates superior early functional recovery(6-month Disabilities of the Arm,Shoulder,and Hand scores)and significantly lower nonunion rates(63.9%reduction)compared to functional bracing,particularly in complex cases,while conservative treatment remains viable for low-demand patients.Surgical techniques,including open reduction internal fixation,intramedullary nailing,and minimally invasive plate osteosynthesis,offer trade-offs between anatomic precision and complication risks(e.g.,radial nerve injury vs rotator cuff damage),with over 90%of radial nerve injuries resolving spontaneously.Ultrasound-guided diagnosis(89%sensitivity,95%specificity)optimizes decision-making for nerve entrapment.Individualized treatment selection,prioritizing fracture complexity and patient needs,is critical to balance accelerated rehabilitation with minimized complications.展开更多
A case of surgical nursing cooperation during extracorporeal membrane oxygenation(ECMO)-assisted hybrid sleeve left pneumonectomy,which included a right open carinal resection,tracheal bronchial anastomosis,and thorac...A case of surgical nursing cooperation during extracorporeal membrane oxygenation(ECMO)-assisted hybrid sleeve left pneumonectomy,which included a right open carinal resection,tracheal bronchial anastomosis,and thoracoscopic left pneumonectomy,has been documented.A thorough nursing intervention focused on patient safety and proactive measures to address potential complications was implemented throughout the surgical process.The procedure was completed without incident,and no postoperative complications were reported.展开更多
In this paper,a novel cooperative collision avoidance control strategy with relative velocity information for redundant robotic manipulators is derived to guarantee the behavioral safety of robots in the cooperative o...In this paper,a novel cooperative collision avoidance control strategy with relative velocity information for redundant robotic manipulators is derived to guarantee the behavioral safety of robots in the cooperative operational task.This strategy can generate the collision-free trajectory of the robotic links in real-time,which is to realize that the robot can avoid moving obstacles less conservatively and ensure tracking accuracy of terminal end-effector tasks in performing cooperative tasks.For the case where there is interference between the moving obstacle and the desired path of the robotic end-effector,the method inherits the null-space-based self-motion characteristics of the redundant manipulator,integrates the relative motion information,and uses the improved artificial potential field method to design the control items,which are used to generate the collision avoidance motion and carry out moving obstacles smoothly and less conservatively.At the same time,the strategy maintains the kinematic constraint relationship of dual-arm cooperatives,to meet the real-time collision avoidance task under collaborative tasks.Finally,the algorithm simulation indicates that the method can better ensure the tracking accuracy of the end-effector task and carry out moving obstacles smoothly.The experimental results show that the method can generate the real-time collision-free trajectory of the robot in the cooperative handling task,and the joint movement is continuous and stable.展开更多
BACKGROUND Bariatric surgery is one of the most effective ways to treat morbid obesity,and postoperative nausea and vomiting(PONV)is one of the common complications after bariatric surgery.At present,the mechanism of ...BACKGROUND Bariatric surgery is one of the most effective ways to treat morbid obesity,and postoperative nausea and vomiting(PONV)is one of the common complications after bariatric surgery.At present,the mechanism of the high incidence of PONV after weight-loss surgery has not been clearly explained,and this study aims to investigate the effect of surgical position on PONV in patients undergoing bariatric surgery.AIM To explore the effect of the operative position during bariatric surgery on PONV.METHODS Data from obese patients,who underwent laparoscopic sleeve gastrectomy(LSG)in the authors’hospital between June 2020 and February 2022 were divided into 2 groups and retrospectively analyzed.Multivariable logistic regression analysis and the t-test were used to study the influence of operative position on PONV.RESULTS There were 15 cases of PONV in the supine split-leg group(incidence rate,50%)and 11 in the supine group(incidence rate,36.7%)(P=0.297).The mean operative duration in the supine split-leg group was 168.23±46.24 minutes and 140.60±32.256 minutes in the supine group(P<0.05).Multivariate analysis revealed that operative position was not an independent risk factor for PONV(odds ratio=1.192,95%confidence interval:0.376-3.778,P=0.766).CONCLUSION Operative position during LSG may affect PONV;however,the difference in the incidence of PONV was not statistically significant.Operative position should be carefully considered for obese patients before surgery.展开更多
In this editorial,we reviewed the article by Li et al.We aimed to explore various perspectives to further mitigate the risk factors for postoperative nausea and vomiting(PONV),which could significantly reduce its inci...In this editorial,we reviewed the article by Li et al.We aimed to explore various perspectives to further mitigate the risk factors for postoperative nausea and vomiting(PONV),which could significantly reduce its incidence and related post-operative complications.PONV is highly prevalent among patients undergoing bariatric surgery,yet there are relatively few related studies.Currently,the main-stream bariatric surgery methods include laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy.Despite the effectiveness of surgery in helping patients lose weight,postoperative PONV may occur,potentially leading to various complications(such as aspiration and wound dehiscence).A retro-spective study by Li et al has compared the impact of different operative positions during laparoscopic sleeve gastroplasty on the incidence of PONV,providing new insights into the clinical practice aimed at reducing PONV incidence and thereby improving patient’s postoperative experience.展开更多
This paper investigates an analytical optimal pose tracking control problem for chaser spacecraft during the close-range proximity operations with a non-cooperative space target subject to attitude tumbling and unknow...This paper investigates an analytical optimal pose tracking control problem for chaser spacecraft during the close-range proximity operations with a non-cooperative space target subject to attitude tumbling and unknown orbital maneuvering.Firstly,the relative translational motion between the orbital target and the chaser spacecraft is described in the Line-of-Sight(LOS)coordinate frame along with attitude quaternion dynamics.Then,based on the coupled 6-Degree of Freedom(DOF)pose dynamic model,an analytical optimal control action consisting of constrained optimal control value,application time and its duration are proposed via exploring the iterative sequential action control algorithm.Meanwhile,the global closed-loop asymptotic stability of the proposed predictive control action is presented and discussed.Compared with traditional proximity control schemes,the highlighting advantages are that the application time and duration of the devised controller is applied discretely in light of the influence of the instantaneous pose configuration on the pose tracking performance with less energy consumptions rather than at each sample time.Finally,three groups of illustrative examples are organized to validate the effectiveness of the proposed analytical optimal pose tracking control scheme.展开更多
Objective:Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity.We aimed to assess the operative time(OT)in patients undergoing radical cystectomy and its impact on 90-day postopera...Objective:Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity.We aimed to assess the operative time(OT)in patients undergoing radical cystectomy and its impact on 90-day postoperative complications and readmission rates.Methods:The retrospective cohort study included 296 patients undergoing radical cystectomy and urinary diversion from May 2010 to December 2018 in our institution.The OT of 369 min was set as a cutoff value between short and long OT groups.The primary outcome was 90-day postoperative complication rates.Secondary outcomes were gastrointestinal recovery time,length of hospital stay,and 90-day readmission rates.Results:The overall incidence of 90-day postoperative complications was 79.7%where 43.2%representing low-grade complications according to the ClavieneDindo classification(Grade 1 and Grade 2),and 36.5%representing high-grade complications(Grade3).Gastrointestinal tract and infectious complications are the most common complications in our data set(45.9%and 45.6%,respectively).On multivariable analysis,prolonged OT was significantly associated with odds of high-grade complications(odds ratio 2.340,95%confidence interval 1.288e4.250,p=0.005).After propensity score-matched analysis,a higher incidence of major complications was identified in the long OT group 55(51.4%)compared to 35(32.7%)in the short OT group(p=0.006).A shorter gastrointestinal tract recovery time was noticed in the short OT group(p=0.009).Prolonged OT was associated with a higher 90-day readmission rate on univariate and multivariate analyses(p<0.001,p=0.001,respectively).展开更多
Developing supercapacitors(SCs)with long cycling life and wide operative voltage window is a significant topic in the field of aqueous electrolytes.Although the design of water in salt(WIS)electrolytes has pushed the ...Developing supercapacitors(SCs)with long cycling life and wide operative voltage window is a significant topic in the field of aqueous electrolytes.Although the design of water in salt(WIS)electrolytes has pushed the development of aqueous electrolytes to a new height,the WIS electrolytes with an operative voltage window of up to 2.5 V is still very scarce.Herein,in order to enrich the type of aqueous electrolyte with high operative voltage,tetramethylammonium trifluoromethanesulfonate(TMAOTf)based WIS electrolyte was used as a model to construct WIS based hybrid electrolyte with acetonitrile(ACN)co-solvent and LiTFSI co-solute.In view of the coordination effect of ACN and Lit on free water in TMAOTf based WIS electrolyte,the TMAt-Lit-AWIS electrolyte has the electrochemical stabilization window of up to 3.35 V.Further coupled with the commercial YP-50F electrodes,TMAt-Lit-AWIS based SCs exhibited wide operative voltage window(2.5 V),long cycling life(45,000 cycles)and good low-temperature performance(99.99%capacitance retention after 2000 cycles at20℃).The design of this hybrid electrolyte will enrich the types of aqueous hybrid electrolytes with long cycling life and wide operative voltage window.展开更多
This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse ...This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.展开更多
This article is a comment on the article by Jia et al,aiming at establishing a predictive model to predict the occurrence of preoperative gastric retention in endoscopic retrograde cholangiopancreatography preparation...This article is a comment on the article by Jia et al,aiming at establishing a predictive model to predict the occurrence of preoperative gastric retention in endoscopic retrograde cholangiopancreatography preparation.We share our perspectives on this predictive model.First,further differentiation in predicting the severity of gastric retention could enhance clinical outcomes.Second,we ponder whether this predictive model can be generalized to predictions of gastric retention before various endoscopic procedures.Third,large datasets and pro-spective clinical validation are needed to improve the prediction model.展开更多
The operating room is a unique environment where surgery exposes patients to non-physiological changes that can compromise lung mechanics.Therefore,raising clinicians’awareness of the potential risk of ventilator-ind...The operating room is a unique environment where surgery exposes patients to non-physiological changes that can compromise lung mechanics.Therefore,raising clinicians’awareness of the potential risk of ventilator-induced lung injury(VILI)is mandatory.Driving pressure is a useful tool for reducing lung complications in patients with acute respiratory distress syndrome and those undergoing elective surgery.Driving pressure has been most extensively studied in the context of single-lung ventilation during thoracic surgery.However,the awareness of association of VILI risk and patient positioning(prone,beach-chair,parkbench)and type of surgery must be raised.展开更多
Venipuncture is an indispensable nursing procedure for intravenous infusion,but it is also an invasive procedure that is highly resisted by hospitalised children due to pain or fear.Non-pharmacological interventions a...Venipuncture is an indispensable nursing procedure for intravenous infusion,but it is also an invasive procedure that is highly resisted by hospitalised children due to pain or fear.Non-pharmacological interventions are widely used in clinical practice due to their low cost,low risk and simplicity.This article provides a review with the aim of providing a reference for the selection of optimal analgesic interventions in the future.展开更多
Background: Laparoscopic cholecystectomy (LC) remains the preferred me-thod for treating benign gallbladder diseases. However, clinical presentations of cholecystitis vary widely. For severely inflamed cases, LC can b...Background: Laparoscopic cholecystectomy (LC) remains the preferred me-thod for treating benign gallbladder diseases. However, clinical presentations of cholecystitis vary widely. For severely inflamed cases, LC can be challenging. Objectives: This study aimed to explore intraoperative strategies and postoperative management of complications during difficult LC to further enhance its safety. Methods: We retrospectively analyzed data from difficult LC procedures performed by the same expert at our hospital between January 2016 and December 2022. The surgical approach, handling methods, operative time, and postoperative complications were evaluated. Results: Utilizing techniques such as thin-layer progressive dissection, suction and blunt dissection, reverse resection, partial cystectomy, we successfully completed difficult LC in 278 cases. All surgeries were accomplished under laparoscopy. Five cases (0.72%) experienced bile leakage which was managed through drainage tube fistula formation before removal;there were no incidences of hemorrhage, abdominal infection, or biliary tract injury. Conclusion: Our series showed that difficult LC had high safety and low rates of conversion to open surgery and complications. The safety of complex gallbladder removal is related to the surgeon’s experience and proficiency in laparoscopic skills. Postoperative bile leakage can be effectively treated through drainage tube fistula formation.展开更多
AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality ...AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), and to evaluate its efficacy. METHODS: Eighty-four patients with postoperative complications or death and 172 patients without postoperative complications, who underwent surgery in our department during the previous 2 years, were retrospectively analyzed by logistic regression. Fifteen indexes were investigated including age, cardiovascular function, respiratory function, blood test results, endocrine function, central nervous system function, hepatic function, renal function, nutritional status, extent of operative trauma, and course of anesthesia. Modified POSSUM (M-POSSUM) was developed using significant risk factors with its efficacy evaluated. RESULTS: The significant risk factors were found to be age, cardiovascular function, respiratory function, hepatic function, renal function, blood test results, endocrine function, nutritional status, duration of operation, intraoperative blood loss, and course of anesthesia. These factors were all included in the scoring system. There were significant differences in the scores between the patients with and without postoperative complications, between the patients died and survived with complications, and between the patients died and survived without complications. The receiver operating characteristic curves showed that the M-POSSUM could accurately predict postoperative complications and mortality.CONCLUSION: M-POSSUM correlates well with postoperative complications and mortality, and is more accurate than POSSUM.展开更多
BACKGROUND Whether operation is superior to non-operation for humeral shaft fracture remains debatable.We hypothesized that operation could decrease the nonunion and reintervention rates and increase the functional ou...BACKGROUND Whether operation is superior to non-operation for humeral shaft fracture remains debatable.We hypothesized that operation could decrease the nonunion and reintervention rates and increase the functional outcomes.AIM To compare the clinical efficacy between operative and nonoperative approaches for humeral shaft fractures.METHODS We searched the PubMed,Web of Science,ScienceDirect,and Cochrane databases from 1990 to December 2023 for clinical trials and cohort studies comparing the effects of operative and conservative methods on humeral shaft fractures.Two investigators independently extracted data from the eligible studies,and the other two assessed the methodological quality of each study.The quality of the included studies was assessed using the Cochrane risk bias or Newcastle-Ottawa Scale.The nonunion,reintervention and the overall complications and functional scores were pooled and analyzed using Review Manager software(version 5.3).RESULTS A total of four randomized control trials and 13 cohort studies were included,with 1285 and 1346 patients in the operative and nonoperative groups,respectively.Patients in the operative group were treated with a plate or nail,whereas those in the conservative group were managed with splint or functional bracing.Four studies were assessed as having a high risk of bias,and the other 13 were of a low risk of bias according to the Newcastle-Ottawa Scale or Cochrane risk bias tool.The operative group had a significantly decreased rate of nonunion[odds ratio(OR)0.30;95%CI:0.23 to 0.40,reintervention(OR:0.33;95%CI:0.24 to 0.47),and overall complications(OR:0.62;95%CI:0.49 to 0.78)].The pooled effect of the Disabilities of Arm,Shoulder,and Hand score showed a significant difference at 3[mean difference(MD)-8.26;95%CI:-13.60 to-2.92],6(MD:-6.72;95%CI:-11.34 to-2.10),and 12 months(MD:-2.55;95%CI:-4.36 to-0.74).The pooled effect of Visual Analog Scale scores and the Constant-Murley score did not significantly differ between the two groups.CONCLUSION This systematic review and meta-analysis revealed a trend of rapid functional recovery and decreased rates of nonunion and reintervention after operation for humeral shaft fracture compared to conservative treatment.展开更多
Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating r...Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.展开更多
Objective: To investigate the operative timing and indi-cations for severe acute pancreatitis(SAP).Methods: Data collected from 172 patients with SAPtreated in our hospital since 1980 were analyzed retro-spectively.Re...Objective: To investigate the operative timing and indi-cations for severe acute pancreatitis(SAP).Methods: Data collected from 172 patients with SAPtreated in our hospital since 1980 were analyzed retro-spectively.Results: In the 94 patients who had undergone early op-eration before June 1992, 57 (62.8%) healed, 35 (37.2%)died, and 16 (17.0%) had no postoperative compli-cations. In the 78 patients who had been treated after July1992 according to the principle of individualization, 66(84.6%) healed, 12 (15.4%) died, and 37 (47.4%)had no postoperative complications. In the 78 patients32 received non-operative treatment but 30 (93.8%)cured, 12 early operation but 7(58.3%)cured, 18 lateoperation but 13 (72.2%) cured, and 16 selected timeoperation but all cured.Conclusions: It is concluded that individualized thera-py is effective and reasonable for treating SAP. Theindications for early, late and selected time operationshould be emphasized.展开更多
BACKGROUND Utilizing failure mode and effects analysis(FMEA)in operating room nursing provides valuable insights for the care of patients undergoing radical gastric cancer surgery.AIM To evaluate the impact of FMEA on...BACKGROUND Utilizing failure mode and effects analysis(FMEA)in operating room nursing provides valuable insights for the care of patients undergoing radical gastric cancer surgery.AIM To evaluate the impact of FMEA on the risk of adverse events and nursing-care quality in patients undergoing radical surgery.METHODS Among 230 patients receiving radical cancer surgery between May 2019 and May 2024,115 were assigned to a control group that received standard intraoperative thermoregulation,while the observation group benefited from FMEA-modeled operating room care.Clinical indicators,stress responses,postoperative gastroin-testinal function recovery,nursing quality,and the incidence of adverse events were compared between the two groups.RESULTS Significant differences were observed in bed and hospital stay durations between the groups(P<0.05).There were no significant differences in intraoperative blood loss or postoperative body temperature(P>0.05).Stress scores improved in both groups post-nursing(P<0.05),with the observation group showing lower stress scores than the control group(P<0.05).Gastrointestinal function recovery and nursing quality scores also differed significantly(P<0.05).Additionally,the incidence of adverse events such as stress injuries and surgical infections varied notably between the groups(P<0.05).CONCLUSION Incorporating FMEA into operating room nursing significantly enhances patient care by improving safety,expediting recovery,and reducing healthcare-associated risks.展开更多
文摘BACKGROUND Operative reports(OP-Rs)are essential for communication among healthcare providers.They require accuracy and completeness to serve as a quality indicator of patient care.Objective assessment of primary total knee replacement(TKR)OP-Rs has never been reported.Therefore,a standardized benchmark for assessment and factors affecting the completeness of TKR OP-Rs needs to be evaluated.AIM To evaluate the completeness rate of primary TKR OP-Rs in a teaching hospital and to assess the factors affecting completeness.METHODS A retrospective review of 58 consecutive primary TKR OP-Rs in a tertiary te-aching hospital were included in this study.We used document analysis to review the OP-Rs against a standardized list of six subsets of mandatory variables.The correlation between the percentage of completeness and the specific variables was determined.RESULTS After analyzing 58 cases,we found that the time to documentation was 1.5 hours.Out of the 52 mandatory variables,a median of 30 variables were documented yielding a completeness of 58%.Administrative,procedural,exposure,and im-plant variables were documented the most often,whereas clinical and process variables were most frequently left uncompleted.The documentation of the operative maneuver was variable.There was no association between the com-pleteness of the reports and the time to documentation,documenter level,com-plication rate,operative duration,or length of hospital stay.CONCLUSION Multiple variables were left undocumented on the unstructured primary TKR OP-Rs.The completeness percentage will likely improve after the implementation of a standardized structured OP-R.
基金supported by the National Natural Science Foundation of China(No.62173274)the National Key R&D Program of China(No.2019YFA0405300)+4 种基金the Natural Science Foundation of Hunan Province of China(Nos.2021JJ10045 and 2025JJ60072)the Open Research Subject of State Key Laboratory of Intelligent Game(No.ZBKF-24-01)the Postdoctoral Fellowship Program of CPSF(No.GZB20240989)the China Postdoctoral Science Foundation(No.2024M754304)the Aeronautical Science Foundation of China(No.2023Z005030001).
文摘Cooperative guidance is a method for achieving combat objectives through information sharing and cooperative effects,and has emerged as a significant research area in the fields of missile guidance and systematic warfare.This study presents a systematic review and analysis of current research on cooperative guidance.First,a bibliometric analysis is conducted on 513 articles using the Scopus database and CiteSpace software to assess keyword clustering,keyword cooccurrence,and keyword burst,and to later visualize the results.Second,fundamental theories of cooperative guidance,including relative motion modeling methods,algebraic graph theory,and multi-agent consensus theory,are summarized.Subsequently,an overview of current cooperative laws and corresponding analysis methods is provided,with categorization based on the cooperative structure and convergence performance.Finally,we summarize current research developments based on five perspectives and propose a developmental framework based on five layers(cyber,physical,decision,information,and system),discussing potential future advancements in cooperative terminal guidance.This framework emphasizes five key areas of research:networked,heterogeneous,integrated,intelligent,and group cooperations,with the goal of offering trends and insights for futurework.
文摘Operative management of humeral shaft fractures demonstrates superior early functional recovery(6-month Disabilities of the Arm,Shoulder,and Hand scores)and significantly lower nonunion rates(63.9%reduction)compared to functional bracing,particularly in complex cases,while conservative treatment remains viable for low-demand patients.Surgical techniques,including open reduction internal fixation,intramedullary nailing,and minimally invasive plate osteosynthesis,offer trade-offs between anatomic precision and complication risks(e.g.,radial nerve injury vs rotator cuff damage),with over 90%of radial nerve injuries resolving spontaneously.Ultrasound-guided diagnosis(89%sensitivity,95%specificity)optimizes decision-making for nerve entrapment.Individualized treatment selection,prioritizing fracture complexity and patient needs,is critical to balance accelerated rehabilitation with minimized complications.
文摘A case of surgical nursing cooperation during extracorporeal membrane oxygenation(ECMO)-assisted hybrid sleeve left pneumonectomy,which included a right open carinal resection,tracheal bronchial anastomosis,and thoracoscopic left pneumonectomy,has been documented.A thorough nursing intervention focused on patient safety and proactive measures to address potential complications was implemented throughout the surgical process.The procedure was completed without incident,and no postoperative complications were reported.
基金supported in part by the Advanced Equipment Manufacturing Technology Innovation Project of Hebei Province under Grant No.22311801D,23311807D,and 236Z1816Gin part by the National Natural Science Foundation of China under Grant No.U20A20283.
文摘In this paper,a novel cooperative collision avoidance control strategy with relative velocity information for redundant robotic manipulators is derived to guarantee the behavioral safety of robots in the cooperative operational task.This strategy can generate the collision-free trajectory of the robotic links in real-time,which is to realize that the robot can avoid moving obstacles less conservatively and ensure tracking accuracy of terminal end-effector tasks in performing cooperative tasks.For the case where there is interference between the moving obstacle and the desired path of the robotic end-effector,the method inherits the null-space-based self-motion characteristics of the redundant manipulator,integrates the relative motion information,and uses the improved artificial potential field method to design the control items,which are used to generate the collision avoidance motion and carry out moving obstacles smoothly and less conservatively.At the same time,the strategy maintains the kinematic constraint relationship of dual-arm cooperatives,to meet the real-time collision avoidance task under collaborative tasks.Finally,the algorithm simulation indicates that the method can better ensure the tracking accuracy of the end-effector task and carry out moving obstacles smoothly.The experimental results show that the method can generate the real-time collision-free trajectory of the robot in the cooperative handling task,and the joint movement is continuous and stable.
文摘BACKGROUND Bariatric surgery is one of the most effective ways to treat morbid obesity,and postoperative nausea and vomiting(PONV)is one of the common complications after bariatric surgery.At present,the mechanism of the high incidence of PONV after weight-loss surgery has not been clearly explained,and this study aims to investigate the effect of surgical position on PONV in patients undergoing bariatric surgery.AIM To explore the effect of the operative position during bariatric surgery on PONV.METHODS Data from obese patients,who underwent laparoscopic sleeve gastrectomy(LSG)in the authors’hospital between June 2020 and February 2022 were divided into 2 groups and retrospectively analyzed.Multivariable logistic regression analysis and the t-test were used to study the influence of operative position on PONV.RESULTS There were 15 cases of PONV in the supine split-leg group(incidence rate,50%)and 11 in the supine group(incidence rate,36.7%)(P=0.297).The mean operative duration in the supine split-leg group was 168.23±46.24 minutes and 140.60±32.256 minutes in the supine group(P<0.05).Multivariate analysis revealed that operative position was not an independent risk factor for PONV(odds ratio=1.192,95%confidence interval:0.376-3.778,P=0.766).CONCLUSION Operative position during LSG may affect PONV;however,the difference in the incidence of PONV was not statistically significant.Operative position should be carefully considered for obese patients before surgery.
文摘In this editorial,we reviewed the article by Li et al.We aimed to explore various perspectives to further mitigate the risk factors for postoperative nausea and vomiting(PONV),which could significantly reduce its incidence and related post-operative complications.PONV is highly prevalent among patients undergoing bariatric surgery,yet there are relatively few related studies.Currently,the main-stream bariatric surgery methods include laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy.Despite the effectiveness of surgery in helping patients lose weight,postoperative PONV may occur,potentially leading to various complications(such as aspiration and wound dehiscence).A retro-spective study by Li et al has compared the impact of different operative positions during laparoscopic sleeve gastroplasty on the incidence of PONV,providing new insights into the clinical practice aimed at reducing PONV incidence and thereby improving patient’s postoperative experience.
基金This study was co-supported by the National Natural Science Foundation of China(Nos.62003371,62373379,62103446,61273351,62073343)the Outstanding Youth Fund of Hunan Provincial Natural Science,China(No.2022JJ20081)the Innovation Driven Project of Central South University,China(No.2023CXQD066).
文摘This paper investigates an analytical optimal pose tracking control problem for chaser spacecraft during the close-range proximity operations with a non-cooperative space target subject to attitude tumbling and unknown orbital maneuvering.Firstly,the relative translational motion between the orbital target and the chaser spacecraft is described in the Line-of-Sight(LOS)coordinate frame along with attitude quaternion dynamics.Then,based on the coupled 6-Degree of Freedom(DOF)pose dynamic model,an analytical optimal control action consisting of constrained optimal control value,application time and its duration are proposed via exploring the iterative sequential action control algorithm.Meanwhile,the global closed-loop asymptotic stability of the proposed predictive control action is presented and discussed.Compared with traditional proximity control schemes,the highlighting advantages are that the application time and duration of the devised controller is applied discretely in light of the influence of the instantaneous pose configuration on the pose tracking performance with less energy consumptions rather than at each sample time.Finally,three groups of illustrative examples are organized to validate the effectiveness of the proposed analytical optimal pose tracking control scheme.
基金Earlier version of this article was presented as a poster in the bladder section:invasive(MP 13-12)AUA-2021.
文摘Objective:Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity.We aimed to assess the operative time(OT)in patients undergoing radical cystectomy and its impact on 90-day postoperative complications and readmission rates.Methods:The retrospective cohort study included 296 patients undergoing radical cystectomy and urinary diversion from May 2010 to December 2018 in our institution.The OT of 369 min was set as a cutoff value between short and long OT groups.The primary outcome was 90-day postoperative complication rates.Secondary outcomes were gastrointestinal recovery time,length of hospital stay,and 90-day readmission rates.Results:The overall incidence of 90-day postoperative complications was 79.7%where 43.2%representing low-grade complications according to the ClavieneDindo classification(Grade 1 and Grade 2),and 36.5%representing high-grade complications(Grade3).Gastrointestinal tract and infectious complications are the most common complications in our data set(45.9%and 45.6%,respectively).On multivariable analysis,prolonged OT was significantly associated with odds of high-grade complications(odds ratio 2.340,95%confidence interval 1.288e4.250,p=0.005).After propensity score-matched analysis,a higher incidence of major complications was identified in the long OT group 55(51.4%)compared to 35(32.7%)in the short OT group(p=0.006).A shorter gastrointestinal tract recovery time was noticed in the short OT group(p=0.009).Prolonged OT was associated with a higher 90-day readmission rate on univariate and multivariate analyses(p<0.001,p=0.001,respectively).
基金supported by the Longkou City Science and Technology Research and Development Plan(No.2020KJJH061).
文摘Developing supercapacitors(SCs)with long cycling life and wide operative voltage window is a significant topic in the field of aqueous electrolytes.Although the design of water in salt(WIS)electrolytes has pushed the development of aqueous electrolytes to a new height,the WIS electrolytes with an operative voltage window of up to 2.5 V is still very scarce.Herein,in order to enrich the type of aqueous electrolyte with high operative voltage,tetramethylammonium trifluoromethanesulfonate(TMAOTf)based WIS electrolyte was used as a model to construct WIS based hybrid electrolyte with acetonitrile(ACN)co-solvent and LiTFSI co-solute.In view of the coordination effect of ACN and Lit on free water in TMAOTf based WIS electrolyte,the TMAt-Lit-AWIS electrolyte has the electrochemical stabilization window of up to 3.35 V.Further coupled with the commercial YP-50F electrodes,TMAt-Lit-AWIS based SCs exhibited wide operative voltage window(2.5 V),long cycling life(45,000 cycles)and good low-temperature performance(99.99%capacitance retention after 2000 cycles at20℃).The design of this hybrid electrolyte will enrich the types of aqueous hybrid electrolytes with long cycling life and wide operative voltage window.
文摘This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.
基金Supported by National Natural Science Foundation of China,No.82170675.
文摘This article is a comment on the article by Jia et al,aiming at establishing a predictive model to predict the occurrence of preoperative gastric retention in endoscopic retrograde cholangiopancreatography preparation.We share our perspectives on this predictive model.First,further differentiation in predicting the severity of gastric retention could enhance clinical outcomes.Second,we ponder whether this predictive model can be generalized to predictions of gastric retention before various endoscopic procedures.Third,large datasets and pro-spective clinical validation are needed to improve the prediction model.
文摘The operating room is a unique environment where surgery exposes patients to non-physiological changes that can compromise lung mechanics.Therefore,raising clinicians’awareness of the potential risk of ventilator-induced lung injury(VILI)is mandatory.Driving pressure is a useful tool for reducing lung complications in patients with acute respiratory distress syndrome and those undergoing elective surgery.Driving pressure has been most extensively studied in the context of single-lung ventilation during thoracic surgery.However,the awareness of association of VILI risk and patient positioning(prone,beach-chair,parkbench)and type of surgery must be raised.
文摘Venipuncture is an indispensable nursing procedure for intravenous infusion,but it is also an invasive procedure that is highly resisted by hospitalised children due to pain or fear.Non-pharmacological interventions are widely used in clinical practice due to their low cost,low risk and simplicity.This article provides a review with the aim of providing a reference for the selection of optimal analgesic interventions in the future.
文摘Background: Laparoscopic cholecystectomy (LC) remains the preferred me-thod for treating benign gallbladder diseases. However, clinical presentations of cholecystitis vary widely. For severely inflamed cases, LC can be challenging. Objectives: This study aimed to explore intraoperative strategies and postoperative management of complications during difficult LC to further enhance its safety. Methods: We retrospectively analyzed data from difficult LC procedures performed by the same expert at our hospital between January 2016 and December 2022. The surgical approach, handling methods, operative time, and postoperative complications were evaluated. Results: Utilizing techniques such as thin-layer progressive dissection, suction and blunt dissection, reverse resection, partial cystectomy, we successfully completed difficult LC in 278 cases. All surgeries were accomplished under laparoscopy. Five cases (0.72%) experienced bile leakage which was managed through drainage tube fistula formation before removal;there were no incidences of hemorrhage, abdominal infection, or biliary tract injury. Conclusion: Our series showed that difficult LC had high safety and low rates of conversion to open surgery and complications. The safety of complex gallbladder removal is related to the surgeon’s experience and proficiency in laparoscopic skills. Postoperative bile leakage can be effectively treated through drainage tube fistula formation.
文摘AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), and to evaluate its efficacy. METHODS: Eighty-four patients with postoperative complications or death and 172 patients without postoperative complications, who underwent surgery in our department during the previous 2 years, were retrospectively analyzed by logistic regression. Fifteen indexes were investigated including age, cardiovascular function, respiratory function, blood test results, endocrine function, central nervous system function, hepatic function, renal function, nutritional status, extent of operative trauma, and course of anesthesia. Modified POSSUM (M-POSSUM) was developed using significant risk factors with its efficacy evaluated. RESULTS: The significant risk factors were found to be age, cardiovascular function, respiratory function, hepatic function, renal function, blood test results, endocrine function, nutritional status, duration of operation, intraoperative blood loss, and course of anesthesia. These factors were all included in the scoring system. There were significant differences in the scores between the patients with and without postoperative complications, between the patients died and survived with complications, and between the patients died and survived without complications. The receiver operating characteristic curves showed that the M-POSSUM could accurately predict postoperative complications and mortality.CONCLUSION: M-POSSUM correlates well with postoperative complications and mortality, and is more accurate than POSSUM.
基金Supported by Natural Science Foundation of Chongqing,China,No.CSTB2023NSCQ-MSX1080.
文摘BACKGROUND Whether operation is superior to non-operation for humeral shaft fracture remains debatable.We hypothesized that operation could decrease the nonunion and reintervention rates and increase the functional outcomes.AIM To compare the clinical efficacy between operative and nonoperative approaches for humeral shaft fractures.METHODS We searched the PubMed,Web of Science,ScienceDirect,and Cochrane databases from 1990 to December 2023 for clinical trials and cohort studies comparing the effects of operative and conservative methods on humeral shaft fractures.Two investigators independently extracted data from the eligible studies,and the other two assessed the methodological quality of each study.The quality of the included studies was assessed using the Cochrane risk bias or Newcastle-Ottawa Scale.The nonunion,reintervention and the overall complications and functional scores were pooled and analyzed using Review Manager software(version 5.3).RESULTS A total of four randomized control trials and 13 cohort studies were included,with 1285 and 1346 patients in the operative and nonoperative groups,respectively.Patients in the operative group were treated with a plate or nail,whereas those in the conservative group were managed with splint or functional bracing.Four studies were assessed as having a high risk of bias,and the other 13 were of a low risk of bias according to the Newcastle-Ottawa Scale or Cochrane risk bias tool.The operative group had a significantly decreased rate of nonunion[odds ratio(OR)0.30;95%CI:0.23 to 0.40,reintervention(OR:0.33;95%CI:0.24 to 0.47),and overall complications(OR:0.62;95%CI:0.49 to 0.78)].The pooled effect of the Disabilities of Arm,Shoulder,and Hand score showed a significant difference at 3[mean difference(MD)-8.26;95%CI:-13.60 to-2.92],6(MD:-6.72;95%CI:-11.34 to-2.10),and 12 months(MD:-2.55;95%CI:-4.36 to-0.74).The pooled effect of Visual Analog Scale scores and the Constant-Murley score did not significantly differ between the two groups.CONCLUSION This systematic review and meta-analysis revealed a trend of rapid functional recovery and decreased rates of nonunion and reintervention after operation for humeral shaft fracture compared to conservative treatment.
基金Hebei University Affiliated Hospital Youth Fund Scientific Research Project Project Number:2019Q017。
文摘Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.
文摘Objective: To investigate the operative timing and indi-cations for severe acute pancreatitis(SAP).Methods: Data collected from 172 patients with SAPtreated in our hospital since 1980 were analyzed retro-spectively.Results: In the 94 patients who had undergone early op-eration before June 1992, 57 (62.8%) healed, 35 (37.2%)died, and 16 (17.0%) had no postoperative compli-cations. In the 78 patients who had been treated after July1992 according to the principle of individualization, 66(84.6%) healed, 12 (15.4%) died, and 37 (47.4%)had no postoperative complications. In the 78 patients32 received non-operative treatment but 30 (93.8%)cured, 12 early operation but 7(58.3%)cured, 18 lateoperation but 13 (72.2%) cured, and 16 selected timeoperation but all cured.Conclusions: It is concluded that individualized thera-py is effective and reasonable for treating SAP. Theindications for early, late and selected time operationshould be emphasized.
文摘BACKGROUND Utilizing failure mode and effects analysis(FMEA)in operating room nursing provides valuable insights for the care of patients undergoing radical gastric cancer surgery.AIM To evaluate the impact of FMEA on the risk of adverse events and nursing-care quality in patients undergoing radical surgery.METHODS Among 230 patients receiving radical cancer surgery between May 2019 and May 2024,115 were assigned to a control group that received standard intraoperative thermoregulation,while the observation group benefited from FMEA-modeled operating room care.Clinical indicators,stress responses,postoperative gastroin-testinal function recovery,nursing quality,and the incidence of adverse events were compared between the two groups.RESULTS Significant differences were observed in bed and hospital stay durations between the groups(P<0.05).There were no significant differences in intraoperative blood loss or postoperative body temperature(P>0.05).Stress scores improved in both groups post-nursing(P<0.05),with the observation group showing lower stress scores than the control group(P<0.05).Gastrointestinal function recovery and nursing quality scores also differed significantly(P<0.05).Additionally,the incidence of adverse events such as stress injuries and surgical infections varied notably between the groups(P<0.05).CONCLUSION Incorporating FMEA into operating room nursing significantly enhances patient care by improving safety,expediting recovery,and reducing healthcare-associated risks.
