Breast augmentation with implants is a popular cosmetic surgery that enhances breast volume and contour through various placement planes.In this review,we examine the impact of subglandular,subpectoral,and subfascial ...Breast augmentation with implants is a popular cosmetic surgery that enhances breast volume and contour through various placement planes.In this review,we examine the impact of subglandular,subpectoral,and subfascial implant planes on postoperative outcomes and complication rates.Subglandular placement offers simplicity but is associated with higher risks of capsular contracture,hematoma,and rippling in patients with low tissue coverage.The subpectoral plane,widely adopted for its natural appearance and reduced capsular contracture risk,may cause dynamic deformity due to muscle contraction.Although technically challenging,the subfascial plane combines the benefits of soft tissue support and reduced implant displacement.We highlight the importance of choosing an optimal implant plane tailored to each patient’s anatomical and aesthetic needs to enhance surgical outcomes and minimize complications.Further research is needed to validate long-term efficacy,particularly for subfascial placement.展开更多
Objective: To investigate the short-term efficacy of laparoscopic radical resection of right-sided colon cancer with two different surgeon positions and trocar placements. Methods: The data of 78 patients who underwen...Objective: To investigate the short-term efficacy of laparoscopic radical resection of right-sided colon cancer with two different surgeon positions and trocar placements. Methods: The data of 78 patients who underwent laparoscopic radical resection of right-sided colon cancer between January 2018 and August 2019 were retrospectively analysed. The surgical method was selected by the patients. The patients were divided into two groups according to the surgeons’ positioning habits and trocar placements. The group with the lead surgeon standing between the patient’s legs had 35 patients, and the group with the lead surgeon standing at the left side of the patient had 43 patients. The operation time, intraoperative blood loss, postoperative anal gas evacuation time, postoperative urinary catheter indwelling time, postoperative hospital stay, C-reactive protein (CRP) level on the first day after surgery, and postoperative pathological data and complications were compared between the two groups. Results: All patients underwent the laparoscopic radical resection of right-sided colon cancer, none converting to laparotomy. No significant difference (P > 0.05) in intraoperative blood loss (57.6 ± 21.3 ml vs 60.2 ± 35.3 ml), postoperative anal gas evacuation time (3.5 ± 1.1 d vs 3.8 ± 1.3 d), postoperative urinary catheter indwelling time (2.6 ± 1.3 d vs 2.4 ± 1.2 d), postoperative hospital stay (7.1 ± 1.8 d vs 7.5 ± 2.1 d), or CRP level on the first day after surgery (54.7 ± 9.6 mg/L vs 53.9 ± 8.2 mg/L) was detected between the two groups. The operation time was shorter in the group with the lead surgeon standing between the patient’s legs (185.2 ± 25.6 min vs 196.2 ±19.7 min) (P < 0.05). The two groups did not differ significantly in the tumour length (4.2 ± 1.3 cm vs 3.9 ± 1.5 cm), number of dissected lymph nodes (27.5 ± 11.6 vs 25.1 ± 15.4), pathological type, or postoperative pathological tumour-node-metastasis stage (P > 0.05). No patients died or had anastomotic fistula during their postoperative hospital stay, and the incidence of postoperative complications did not differ between the two groups (22.9% (8/35) vs 23.3% (10/42);P > 0.05). Conclusion: Under the principle of radical resection, the surgeon should adopt the most suitable standing position and trocar placement according to the specific situation. If the surgeon stands between the patient’s legs, this might shorten the operation time and promote a smoother surgery.展开更多
Background:Horizontal violence has negatively affected the students’active learning,interpersonal relationship,and occupational belonging.However,little attention has been paid to the relationship between horizontal ...Background:Horizontal violence has negatively affected the students’active learning,interpersonal relationship,and occupational belonging.However,little attention has been paid to the relationship between horizontal violence and occupational belonging among nursing students.Objective:The objective of this study was to explore the frequency,types,perpetrators,effects,and responses of horizontal violence experienced by nursing students and the relationship between occupational belonging and horizontal violence.Materials and Methods:The present study used a descriptive,cross-sectional survey design.The data were collected from the 277 undergraduate nursing students selected by convenience sampling method using personal characteristics form,horizontal violence survey,and occupational belonging subscale at nursing faculty in Istanbul.Results:The first three horizontal violence behaviors experienced by nursing students were found,respectively:being forced to do trivial and unimportant work which are not the students’responsibility(84.1%),being exposed to sarcastic remarks by nurses(80.9%)and unwillingness of the nurse to help and lack of support(80.9%)and being ignored by nurses(77.3%).Nearly half of the students(48.4%)considered leaving nursing profession as a result of horizontal violence.There was a negative relation between horizontal violence and occupational belonging(P<0.05).As horizontal violence scores increased,occupational belonging scores decreased.Conclusions:Findings from this study shown that horizontal violence decreasing occupational belonging,and so nursing students consider leaving nursing profession or education.Further studies are needed to better demonstrate addressing the horizontal violence bilaterally and the effective preventive interventions.展开更多
With the gradual completion of the split-share structure reform,private placement has gradually become the mainstream of refinancing. One of the points that the practical and theoretical circles are widely concerned a...With the gradual completion of the split-share structure reform,private placement has gradually become the mainstream of refinancing. One of the points that the practical and theoretical circles are widely concerned about is that the private placement price is often higher than the market price at the time of the private placement. High discounts are often accompanied by the transmission of benefits,and the increase in insider information will lead to the risk of a stock market crash? This paper intends to use the data of A-share listed companies from 2006 to 2015 to empirically study the relationship between the discount on private placements and the risk of stock market crash. At the same time,this paper examines whether the degree of information asymmetry plays a regulatory role in the relationship between the discount on private placements and the risk of stock market crash. This paper provides a certain reference for the regulatory authorities to improve the relevant laws and regulations in the private placement,and to provide a certain reference for the protection of the interests of small and medium-sized investors.展开更多
BACKGROUND For cases of middle and low biliary obstruction with left and right hepatic duct dilatation,the type of approach and whether different approaches affect the difficulty of puncture operation and intraoperati...BACKGROUND For cases of middle and low biliary obstruction with left and right hepatic duct dilatation,the type of approach and whether different approaches affect the difficulty of puncture operation and intraoperative and postoperative complications have not been discussed in detail.AIM To compare the efficacy of different percutaneous transhepatic biliary stent placements and catheter drainage in treating middle and low biliary obstruction.METHODS A retrospective analysis was performed on the medical records of 424 patients with middle and low biliary obstruction who underwent percutaneous liver puncture biliary stent placement and catheter drainage at the Department of Interventional Radiology,Shaanxi Provincial People’s Hospital between March 2016 and March 2022.Based on the puncture path,patients were categorized into two groups:Subxiphoid left hepatic lobe approach group(Group A,224 cases)and right intercostal,right hepatic lobe approach group(Group B,200 cases).Liver function improvement,postoperative biliary bleeding incidence,postoperative pain duration,and abdominal effusion leakage around the drainage tube were compared between the two groups at 3 d and 1 wk after the surgery.Patient survival time was recorded during follow-up.RESULTS All 424 surgeries were successful without adverse events.Group A comprised 224 cases,and Group B had 200 cases.There was no statistically significant difference in basic data between Group A and Group B(P>0.05).No significant difference in postoperative biliary bleeding incidence was observed between the groups(P>0.05).The decreased rates for total bilirubin(Group A:69.23±4.50,Group B:63.79±5.65),direct bilirubin(Group A:79.30±11.19,Group B:63.62±5.64),and alkaline phosphatase(Group A:60.51±12.23,Group B:42.68±23.56)in the 1st wk after surgery were significantly faster in Group A than in Group B.The decreased rate of gamma-glutamyl transpeptidase was also significantly faster in Group A at both 3 d(Group A:40.56±10.32,Group B:32.22±5.12)and 1 wk(Group A:73.19±7.05,Group B:58.81±18.98)after surgery(P<0.05).Group A experienced significantly less peritoneal effusion leakage around the drainage tube than Group B(P<0.05).The patient survival rate was higher in Group A compared to Group B(P<0.05).CONCLUSION In treating jaundice patients with middle and low biliary obstruction,a percutaneous left liver puncture demonstrated better clinical efficacy than a percutaneous right liver puncture.展开更多
The Artificial Bee Colony (ABC) is one of the numerous stochastic algorithms for optimization that has been written for solving constrained and unconstrained optimization problems. This novel optimization algorithm is...The Artificial Bee Colony (ABC) is one of the numerous stochastic algorithms for optimization that has been written for solving constrained and unconstrained optimization problems. This novel optimization algorithm is very efficient and as promising as it is;it can be favourably compared to other optimization algorithms and in some cases, it has been proven to be better than some known algorithms (like Particle Swarm Optimization (PSO)), especially when used in Well placement optimization problems that can be encountered in the Petroleum industry. In this paper, the ABC algorithm has been modified to improve its speed and convergence in finding the optimum solution to a well placement optimization problem. The effects of variations of the control parameters for both algorithms were studied, as well as the algorithms’ performances in the cases studied. The modified ABC (MABC) algorithm gave better results than the Artificial Bee Colony algorithm. It was noticed that the performance of the ABC algorithm increased with increase in the number of its optimization agents for both algorithms studied. The modified ABC algorithm overcame the challenge posed by the use of uniformly generated random numbers with very rough NPV surface. This new modified ABC algorithm proposed in this work will be a great tool in optimization for the Petroleum industry as it involves Well placements for optimum oil production.展开更多
Trend with an increase to EUR l67 mn(compared with minus EUR122.8 mn in 2023).Liquid assets decreased by 38.2 percent compared to December 3l,2023,to a level of EUR 451.7 mn as of December 31,2024,mainly dueto the rep...Trend with an increase to EUR l67 mn(compared with minus EUR122.8 mn in 2023).Liquid assets decreased by 38.2 percent compared to December 3l,2023,to a level of EUR 451.7 mn as of December 31,2024,mainly dueto the repayment of private placements and other loans and borrowings.展开更多
When the upper chord beam of the beam-string structure(BSS)is made of concrete-filled steel tube(CFST),its overall stiffness will change greatly with the construction of concrete placement,which will have an impact on ...When the upper chord beam of the beam-string structure(BSS)is made of concrete-filled steel tube(CFST),its overall stiffness will change greatly with the construction of concrete placement,which will have an impact on the design of the tensioning plans and selection of control measures for the BSS.In order to accurately obtain the bending stiffness of CFST beam and clarify its impact on the mechanical properties of composite BSS during con-struction,the influence of some factors such as height-width ratio,wall thickness of steel tube,elasticity modulus of concrete,and friction coefficient on the bending stiffness are analyzed parametrically by the numerical simula-tion technology based on an actual project.The calculation formula of the equivalent bending stiffness of CFST is also established through mathematical statistical simulation.Then,the equivalent bending stiffness is introduced into the construction and use stages of the composite BSS,respectively,and the mechanical properties such as prestress-tensioning control value,structural deformation,and internal force of key members are comparatively analyzed when adopting two different construction plans.Moreover,the optimal construction plan of concrete placementfirst and then prestress-tensioning is proposed.展开更多
This work presents a study on the use of cathodic protection as a measure against corrosion in pipelines.The cathodic protection,compliant with the API 5L standard,is implemented here by applying an impressed current,...This work presents a study on the use of cathodic protection as a measure against corrosion in pipelines.The cathodic protection,compliant with the API 5L standard,is implemented here by applying an impressed current,while carefully considering several essential variables,such as soil characteristics,the type and color of the pipeline material,as well as the placement and size of the anode.Therefore,it is crucial to optimize the location and values of anodic overflows or ground resistances to ensure a uniform distribution of potential across the entire structure.In this method,impressed current protection uses an auxiliary anode and an external direct current source to induce a current through the electrolyte and the pipeline,thus countering the resistance of the steel.This approach is advantageous as it allows for the adjustment of electrical characteristics,particularly current levels,to meet specific needs.The factors essential to the effectiveness of cathodic protection systems,which optimize the distribution of protection potential across the structure,largely depend on the precise management of ground resistances during anodic discharge,particularly the attenuation coefficient(α).These factors were studied,and the results obtained were presented and discussed based on their influence.展开更多
With the rapid development of 5G technology,the proportion of video traffic on the Internet is increasing,bringing pressure on the network infrastructure.Edge computing technology provides a feasible solution for opti...With the rapid development of 5G technology,the proportion of video traffic on the Internet is increasing,bringing pressure on the network infrastructure.Edge computing technology provides a feasible solution for optimizing video content distribution.However,the limited edge node cache capacity and dynamic user requests make edge caching more complex.Therefore,we propose a recommendation-driven edge Caching network architecture for the Full life cycle of video streaming(FlyCache)designed to improve users’Quality of Experience(QoE)and reduce backhaul traffic consumption.FlyCache implements intelligent caching management across three key stages:before-playback,during-playback,and after-playback.Specifically,we introduce a cache placement policy for the before-playback stage,a dynamic prefetching and cache admission policy for the during-playback stage,and a progressive cache eviction policy for the after-playback stage.To validate the effectiveness of FlyCache,we developed a user behavior-driven edge caching simulation framework incorporating recommendation mechanisms.Experiments conducted on the MovieLens and synthetic datasets demonstrate that FlyCache outperforms other caching strategies in terms of byte hit rate,backhaul traffic,and delayed startup rate.展开更多
BACKGROUND Both stent placement and endoscopic nasobiliary drainage(ENBD)are commonly used for treating bile leakage following liver transplantation.However,little research has compared the advantages of both methods....BACKGROUND Both stent placement and endoscopic nasobiliary drainage(ENBD)are commonly used for treating bile leakage following liver transplantation.However,little research has compared the advantages of both methods.AIM To compare the prognosis of stent placement and ENBD in treating bile leakage following liver transplantation.METHODS We retrospectively collected data for patients with bile leakage after liver tran-splantation in our center.The efficiency and prognosis were compared between the stent placement and ENBD groups.RESULTS We retrospectively collected data from 50 patients diagnosed with bile leakage within 1 month after liver transplantation.Forty patients underwent ENBD and nine received stent placement.Baseline patient characteristics,except white blood cell count,total bilirubin and direct bilirubin levels,were comparable between the two groups.Additionally,there was no significant difference in the rates of re-conveyance or postoperative biliary stricture.CONCLUSION Stent placement and ENBD are recommended for treating bile leakage after liver transplantation,with similar efficacy and prognosis.展开更多
Bile leakage remains a formidable challenge in post-liver transplantation management,posing significant risks to patient outcomes and graft survival.This editorial provides a critical appraisal of the recent clinical ...Bile leakage remains a formidable challenge in post-liver transplantation management,posing significant risks to patient outcomes and graft survival.This editorial provides a critical appraisal of the recent clinical study by Gu et al,which compared the efficacy of stent placement vs endoscopic nasobiliary drainage(ENBD)for treating post-transplant bile leaks.By retrospectively analyzing data from their institutional cohort of liver transplant recipients with bile leaks,the authors evaluated the therapeutic success rates and clinical outcomes between the stent and ENBD groups,with a focused discussion on the relative advantages of each approach.Gu et al demonstrated that both stent placement and ENBD were effective in managing post-transplant bile leaks,with comparable therapeutic outcomes.However,the study also recognized its limitations,such as the lack of an assessment of the impact of bile leak severity on outcome and the absence of long-term follow-up data.The editorial further highlights the pressing need for advancing research on long-term complications post-liver transplantation and underscores the pivotal role of clinical stratification and physician expertise in guiding therapeutic decisions.In summary,Gu et al’s study enhances our understanding of mitigating post-transplant complications like bile leaks and offers evidence-based insights to refine clinical protocols.This commentary aims to contextualize current research trends and future directions in the field,advocating for sustained innovation and evidence-driven practice.展开更多
Inflatable penile prosthesis(IPP)implantation is the gold standard treatment for patients with erectile dysfunction who are refractory to medical therapy.The standard placement of the reservoir in the space of Retzius...Inflatable penile prosthesis(IPP)implantation is the gold standard treatment for patients with erectile dysfunction who are refractory to medical therapy.The standard placement of the reservoir in the space of Retzius(SOR)may be contraindicated in patients with prior pelvic or abdominal surgery due to altered anatomy and increased risk of complications.This has led to the development of alternative ectopic reservoir placement techniques.In this narrative review,we summarize the literature on various ectopic reservoir approaches,including low and high submuscular placements,submuscular techniques with counter incisions or transfascial fixation,midline submuscular placement,subcutaneous placement,and lateral retroperitoneal approaches.We describe the surgical methods,outcomes,and complication rates associated with each technique.While most methods demonstrate low complication and revision rates,direct comparisons remain limited due to heterogeneity and lack of prospective data.This review highlights the importance of individualized technique selection based on prior surgical history,body habitus,and surgeon experience.As ectopic placement becomes more widely adopted,familiarity with multiple approaches is essential for prosthetic surgeons.展开更多
To transmit customer power data collected by smart meters(SMs)to utility companies,data must first be transmitted to the corresponding data aggregation point(DAP)of the SM.The number of DAPs installed and the installa...To transmit customer power data collected by smart meters(SMs)to utility companies,data must first be transmitted to the corresponding data aggregation point(DAP)of the SM.The number of DAPs installed and the installation location greatly impact the whole network.For the traditional DAP placement algorithm,the number of DAPs must be set in advance,but determining the best number of DAPs is difficult,which undoubtedly reduces the overall performance of the network.Moreover,the excessive gap between the loads of different DAPs is also an important factor affecting the quality of the network.To address the above problems,this paper proposes a DAP placement algorithm,APSSA,based on the improved affinity propagation(AP)algorithm and sparrow search(SSA)algorithm,which can select the appropriate number of DAPs to be installed and the corresponding installation locations according to the number of SMs and their distribution locations in different environments.The algorithm adds an allocation mechanism to optimize the subnetwork in the SSA.APSSA is evaluated under three different areas and compared with other DAP placement algorithms.The experimental results validated that the method in this paper can reduce the network cost,shorten the average transmission distance,and reduce the load gap.展开更多
The aim of this study was to assess the potential of surgical guides as a complementary tool to augmented reality(AR)in enhancing the safety and precision of pedicle screw placement in spinal surgery.Four trainers wer...The aim of this study was to assess the potential of surgical guides as a complementary tool to augmented reality(AR)in enhancing the safety and precision of pedicle screw placement in spinal surgery.Four trainers were divided into the AR navigation group using surgical guides and the free-hand group.Each group consisted of a novice and an experienced spine surgeon.A total of 80 pedicle screws were implanted.First,the AR group reconstructed the 3D model and planned the screw insertion route according to the computed tomography data of L2 lumbar vertebrae.Then,the Microsoft HoloLens™2 was used to identify the vertebral model,and the planned virtual path was superimposed on the real cone model.Next,the screw was placed according to the projected trajectory.Finally,Micron Tracker was used to measure the deviation of screws from the preoperatively planned trajectory,and pedicle screws were evaluated using the Gertzbein-Robbins scale.In the AR group,the linear deviations of the experienced doctor and the novice were(1.59±0.39)mm and(1.73±0.52)mm respectively,and the angle deviations were 2.72°±0.61°and 2.87°±0.63°respectively.In the free-hand group,the linear deviations of the experienced doctor and the novice were(2.88±0.58)mm and(5.25±0.62)mm respectively,and the angle deviations were 4.41°±1.18°and 7.15°±1.45°respectively.Both kinds of deviations between the two groups were significantly different(P<0.05).The screw accuracy rate was 95%in the AR navigation group and 77.5%in the free-hand group.The results of this study indicate that the integration of surgical guides and AR is an innovative technique that can substantially enhance the safety and precision of spinal surgery and assist inexperienced doctors in completing the surgery.展开更多
Axle box bearings are critical components of high-speed trains.Localized defects,such as pitting and spalling,on raceways or rollers pose significant threats to the operational safety of railway vehicles.In this work,...Axle box bearings are critical components of high-speed trains.Localized defects,such as pitting and spalling,on raceways or rollers pose significant threats to the operational safety of railway vehicles.In this work,a novel bearing-flexible axle boxvehicle coupling model is established to explore the vibration characteristics of axle box bearings with irregular localized defects.First,based on the contact and kinematic relationship between rollers and raceways,the three-dimensional(3D)bearing force elements are analyzed and formulated.Second,the established model and a flexible axle box are integrated into the vehicle,and the responses of the normal and faulty bearings under the combined excitations of wheel roughness and track irregularities are simulated.Third,the simulation results are verified through a rolling-vibrating test bench for full-scale wheelsets of high-speed trains.The comparisons of the fault-induced repetitive transients in the time-domain and the fault characteristic frequencies in the envelope spectra demonstrate the efficiency of the proposed model.Finally,based on the flexible axle box model,a sensitivity analysis of the accelerometer placements to the bearing faults is carried out,and the optimal one is identified based on both the time-domain and frequency-domain signal-to-noise ratios(SNRs)for engineering applications.展开更多
BACKGROUND Ultrasound-guided peripherally inserted central catheter(PICC)placement is vital for cancer therapy,but lidocaine infiltration faces limitations like puncture pain and vasospasm.AIM To assess the clinical e...BACKGROUND Ultrasound-guided peripherally inserted central catheter(PICC)placement is vital for cancer therapy,but lidocaine infiltration faces limitations like puncture pain and vasospasm.AIM To assess the clinical efficacy of a no-pain intervention-combining compound lidocaine cream with warm compress-in reducing pain during ultrasound-guided PICC placement in cancer patients.METHODS A retrospective cohort study analyzed 88 cancer patients undergoing PICC placement(Shanghai Fourth People’s Hospital,2024).Patients were divided into control(lidocaine infiltration,n=44)and intervention(cream+warm compress,n=44)groups.Primary outcomes:Pain scores(numerical rating scale),procedural time,complications;secondary outcome:Satisfaction.RESULTS The intervention group showed significantly lower pain scores(1.2±0.4 vs 3.8±1.2,P=0.012)with comparable first-attempt success(95.5%vs 90.9%)and safety(P=0.672).Thermal activation of transient receptor potential vanilloid 1 channel enhanced drug penetration,achieving anesthesia within 8-10 minutes.Patient satisfaction reached 97.7%.CONCLUSION The combination of compound lidocaine cream with warm compress significantly alleviates procedural pain and enhances patient satisfaction during ultrasound-guided PICC placement in cancer patients,supporting its clinical application.展开更多
Nitrogen(N)serves as an essential nutrient for yield formation across diverse crop types.However,agricultural production encounters numerous challenges,notably high N fertilizer rates coupled with low N use efficiency...Nitrogen(N)serves as an essential nutrient for yield formation across diverse crop types.However,agricultural production encounters numerous challenges,notably high N fertilizer rates coupled with low N use efficiency and serious environmental pollution.Deep placement of nitrogen fertilizer(DPNF)is an agronomic measure that shows promise in addressing these issues.This review aims to offer a comprehensive understanding of DPNF,beginning with a succinct overview of its development and methodologies for implementation.Subsequently,the optimal fertilization depth and influencing factors for different crops are analyzed and discussed.Additionally,it investigates the regulation and mechanism underlying the DPNF on crop development,yield,N use efficiency and greenhouse gas emissions.Finally,the review delineates the limitations and challenges of this technology and provides suggestions for its improvement and application.This review provides valuable insight and reference for the promotion and adoption of DPNF in agricultural practice.展开更多
Response prediction is a fundamental yet challenging task in aeronautical engineering,requiring an accurate selection of sensor positions correlated with the target responses to achieve precise predictions. Unfortunat...Response prediction is a fundamental yet challenging task in aeronautical engineering,requiring an accurate selection of sensor positions correlated with the target responses to achieve precise predictions. Unfortunately, in large-scale structures, the rigorous selection of reliable sensor candidates for multi-target responses remains largely unexplored. In this paper, we propose a flexible and generalized framework for selecting the most relevant sensors to the multi-target response and predicting the target response, referred to as the Fast-aware Multi-Target Response Prediction(FMTRP) approach in the spirit of divide-and-conquer. Specifically, first, a multi-task learning module is designed to predict multi-point response tasks at the same time. Simultaneously, we meticulously devise adaptive mechanisms to facilitate loss-term reweighting and encourage prioritization of challenging tasks in multiple prediction tasks. Second, to ensure ease of interpretation,we introduce a hybrid penalty to select sensors at the group-sparsity, individual-sparsity and element-sparsity levels. Finally, due to the substantial number of candidate sensors posing a significant computational burden, we develop a more efficient search strategy and support computation to make the proposed approach applicable in practice, leading to substantial runtime improvements. Extensive experiments on aircraft standard model response datasets and large airliner test flight datasets validate the effectiveness of the proposed approach in identifying sensor locations and simultaneously predicting responses at multiple points. Compared to state-of-the-art methods,the proposed approach achieves an accuracy of over 99% in sinusoidal excitation and exhibits the shortest runtime(3.514 s).展开更多
基金supported by the Zhejiang Provincial Natural Science Foundation of China(grant no.LQ22H150005).
文摘Breast augmentation with implants is a popular cosmetic surgery that enhances breast volume and contour through various placement planes.In this review,we examine the impact of subglandular,subpectoral,and subfascial implant planes on postoperative outcomes and complication rates.Subglandular placement offers simplicity but is associated with higher risks of capsular contracture,hematoma,and rippling in patients with low tissue coverage.The subpectoral plane,widely adopted for its natural appearance and reduced capsular contracture risk,may cause dynamic deformity due to muscle contraction.Although technically challenging,the subfascial plane combines the benefits of soft tissue support and reduced implant displacement.We highlight the importance of choosing an optimal implant plane tailored to each patient’s anatomical and aesthetic needs to enhance surgical outcomes and minimize complications.Further research is needed to validate long-term efficacy,particularly for subfascial placement.
文摘Objective: To investigate the short-term efficacy of laparoscopic radical resection of right-sided colon cancer with two different surgeon positions and trocar placements. Methods: The data of 78 patients who underwent laparoscopic radical resection of right-sided colon cancer between January 2018 and August 2019 were retrospectively analysed. The surgical method was selected by the patients. The patients were divided into two groups according to the surgeons’ positioning habits and trocar placements. The group with the lead surgeon standing between the patient’s legs had 35 patients, and the group with the lead surgeon standing at the left side of the patient had 43 patients. The operation time, intraoperative blood loss, postoperative anal gas evacuation time, postoperative urinary catheter indwelling time, postoperative hospital stay, C-reactive protein (CRP) level on the first day after surgery, and postoperative pathological data and complications were compared between the two groups. Results: All patients underwent the laparoscopic radical resection of right-sided colon cancer, none converting to laparotomy. No significant difference (P > 0.05) in intraoperative blood loss (57.6 ± 21.3 ml vs 60.2 ± 35.3 ml), postoperative anal gas evacuation time (3.5 ± 1.1 d vs 3.8 ± 1.3 d), postoperative urinary catheter indwelling time (2.6 ± 1.3 d vs 2.4 ± 1.2 d), postoperative hospital stay (7.1 ± 1.8 d vs 7.5 ± 2.1 d), or CRP level on the first day after surgery (54.7 ± 9.6 mg/L vs 53.9 ± 8.2 mg/L) was detected between the two groups. The operation time was shorter in the group with the lead surgeon standing between the patient’s legs (185.2 ± 25.6 min vs 196.2 ±19.7 min) (P < 0.05). The two groups did not differ significantly in the tumour length (4.2 ± 1.3 cm vs 3.9 ± 1.5 cm), number of dissected lymph nodes (27.5 ± 11.6 vs 25.1 ± 15.4), pathological type, or postoperative pathological tumour-node-metastasis stage (P > 0.05). No patients died or had anastomotic fistula during their postoperative hospital stay, and the incidence of postoperative complications did not differ between the two groups (22.9% (8/35) vs 23.3% (10/42);P > 0.05). Conclusion: Under the principle of radical resection, the surgeon should adopt the most suitable standing position and trocar placement according to the specific situation. If the surgeon stands between the patient’s legs, this might shorten the operation time and promote a smoother surgery.
文摘Background:Horizontal violence has negatively affected the students’active learning,interpersonal relationship,and occupational belonging.However,little attention has been paid to the relationship between horizontal violence and occupational belonging among nursing students.Objective:The objective of this study was to explore the frequency,types,perpetrators,effects,and responses of horizontal violence experienced by nursing students and the relationship between occupational belonging and horizontal violence.Materials and Methods:The present study used a descriptive,cross-sectional survey design.The data were collected from the 277 undergraduate nursing students selected by convenience sampling method using personal characteristics form,horizontal violence survey,and occupational belonging subscale at nursing faculty in Istanbul.Results:The first three horizontal violence behaviors experienced by nursing students were found,respectively:being forced to do trivial and unimportant work which are not the students’responsibility(84.1%),being exposed to sarcastic remarks by nurses(80.9%)and unwillingness of the nurse to help and lack of support(80.9%)and being ignored by nurses(77.3%).Nearly half of the students(48.4%)considered leaving nursing profession as a result of horizontal violence.There was a negative relation between horizontal violence and occupational belonging(P<0.05).As horizontal violence scores increased,occupational belonging scores decreased.Conclusions:Findings from this study shown that horizontal violence decreasing occupational belonging,and so nursing students consider leaving nursing profession or education.Further studies are needed to better demonstrate addressing the horizontal violence bilaterally and the effective preventive interventions.
文摘With the gradual completion of the split-share structure reform,private placement has gradually become the mainstream of refinancing. One of the points that the practical and theoretical circles are widely concerned about is that the private placement price is often higher than the market price at the time of the private placement. High discounts are often accompanied by the transmission of benefits,and the increase in insider information will lead to the risk of a stock market crash? This paper intends to use the data of A-share listed companies from 2006 to 2015 to empirically study the relationship between the discount on private placements and the risk of stock market crash. At the same time,this paper examines whether the degree of information asymmetry plays a regulatory role in the relationship between the discount on private placements and the risk of stock market crash. This paper provides a certain reference for the regulatory authorities to improve the relevant laws and regulations in the private placement,and to provide a certain reference for the protection of the interests of small and medium-sized investors.
文摘BACKGROUND For cases of middle and low biliary obstruction with left and right hepatic duct dilatation,the type of approach and whether different approaches affect the difficulty of puncture operation and intraoperative and postoperative complications have not been discussed in detail.AIM To compare the efficacy of different percutaneous transhepatic biliary stent placements and catheter drainage in treating middle and low biliary obstruction.METHODS A retrospective analysis was performed on the medical records of 424 patients with middle and low biliary obstruction who underwent percutaneous liver puncture biliary stent placement and catheter drainage at the Department of Interventional Radiology,Shaanxi Provincial People’s Hospital between March 2016 and March 2022.Based on the puncture path,patients were categorized into two groups:Subxiphoid left hepatic lobe approach group(Group A,224 cases)and right intercostal,right hepatic lobe approach group(Group B,200 cases).Liver function improvement,postoperative biliary bleeding incidence,postoperative pain duration,and abdominal effusion leakage around the drainage tube were compared between the two groups at 3 d and 1 wk after the surgery.Patient survival time was recorded during follow-up.RESULTS All 424 surgeries were successful without adverse events.Group A comprised 224 cases,and Group B had 200 cases.There was no statistically significant difference in basic data between Group A and Group B(P>0.05).No significant difference in postoperative biliary bleeding incidence was observed between the groups(P>0.05).The decreased rates for total bilirubin(Group A:69.23±4.50,Group B:63.79±5.65),direct bilirubin(Group A:79.30±11.19,Group B:63.62±5.64),and alkaline phosphatase(Group A:60.51±12.23,Group B:42.68±23.56)in the 1st wk after surgery were significantly faster in Group A than in Group B.The decreased rate of gamma-glutamyl transpeptidase was also significantly faster in Group A at both 3 d(Group A:40.56±10.32,Group B:32.22±5.12)and 1 wk(Group A:73.19±7.05,Group B:58.81±18.98)after surgery(P<0.05).Group A experienced significantly less peritoneal effusion leakage around the drainage tube than Group B(P<0.05).The patient survival rate was higher in Group A compared to Group B(P<0.05).CONCLUSION In treating jaundice patients with middle and low biliary obstruction,a percutaneous left liver puncture demonstrated better clinical efficacy than a percutaneous right liver puncture.
文摘The Artificial Bee Colony (ABC) is one of the numerous stochastic algorithms for optimization that has been written for solving constrained and unconstrained optimization problems. This novel optimization algorithm is very efficient and as promising as it is;it can be favourably compared to other optimization algorithms and in some cases, it has been proven to be better than some known algorithms (like Particle Swarm Optimization (PSO)), especially when used in Well placement optimization problems that can be encountered in the Petroleum industry. In this paper, the ABC algorithm has been modified to improve its speed and convergence in finding the optimum solution to a well placement optimization problem. The effects of variations of the control parameters for both algorithms were studied, as well as the algorithms’ performances in the cases studied. The modified ABC (MABC) algorithm gave better results than the Artificial Bee Colony algorithm. It was noticed that the performance of the ABC algorithm increased with increase in the number of its optimization agents for both algorithms studied. The modified ABC algorithm overcame the challenge posed by the use of uniformly generated random numbers with very rough NPV surface. This new modified ABC algorithm proposed in this work will be a great tool in optimization for the Petroleum industry as it involves Well placements for optimum oil production.
文摘Trend with an increase to EUR l67 mn(compared with minus EUR122.8 mn in 2023).Liquid assets decreased by 38.2 percent compared to December 3l,2023,to a level of EUR 451.7 mn as of December 31,2024,mainly dueto the repayment of private placements and other loans and borrowings.
基金supported by the Project on Excellent Post-Graduate Dissertation of Hohai University,Nanjing,China(422003508)the Postgraduate Research&Practice Innovation Program of Jiangsu Province,China(SJCX23_0187+2 种基金422003287)the National Natural Science Foundation of China(52250410359)Young Elite Scientists Sponsorship Program by Jiangsu Provincial Association for Science and Technology(TJ-2023-043).
文摘When the upper chord beam of the beam-string structure(BSS)is made of concrete-filled steel tube(CFST),its overall stiffness will change greatly with the construction of concrete placement,which will have an impact on the design of the tensioning plans and selection of control measures for the BSS.In order to accurately obtain the bending stiffness of CFST beam and clarify its impact on the mechanical properties of composite BSS during con-struction,the influence of some factors such as height-width ratio,wall thickness of steel tube,elasticity modulus of concrete,and friction coefficient on the bending stiffness are analyzed parametrically by the numerical simula-tion technology based on an actual project.The calculation formula of the equivalent bending stiffness of CFST is also established through mathematical statistical simulation.Then,the equivalent bending stiffness is introduced into the construction and use stages of the composite BSS,respectively,and the mechanical properties such as prestress-tensioning control value,structural deformation,and internal force of key members are comparatively analyzed when adopting two different construction plans.Moreover,the optimal construction plan of concrete placementfirst and then prestress-tensioning is proposed.
文摘This work presents a study on the use of cathodic protection as a measure against corrosion in pipelines.The cathodic protection,compliant with the API 5L standard,is implemented here by applying an impressed current,while carefully considering several essential variables,such as soil characteristics,the type and color of the pipeline material,as well as the placement and size of the anode.Therefore,it is crucial to optimize the location and values of anodic overflows or ground resistances to ensure a uniform distribution of potential across the entire structure.In this method,impressed current protection uses an auxiliary anode and an external direct current source to induce a current through the electrolyte and the pipeline,thus countering the resistance of the steel.This approach is advantageous as it allows for the adjustment of electrical characteristics,particularly current levels,to meet specific needs.The factors essential to the effectiveness of cathodic protection systems,which optimize the distribution of protection potential across the structure,largely depend on the precise management of ground resistances during anodic discharge,particularly the attenuation coefficient(α).These factors were studied,and the results obtained were presented and discussed based on their influence.
基金supported by the National Natural Science Foundation of China(NSFC)[Grant No.62072469].
文摘With the rapid development of 5G technology,the proportion of video traffic on the Internet is increasing,bringing pressure on the network infrastructure.Edge computing technology provides a feasible solution for optimizing video content distribution.However,the limited edge node cache capacity and dynamic user requests make edge caching more complex.Therefore,we propose a recommendation-driven edge Caching network architecture for the Full life cycle of video streaming(FlyCache)designed to improve users’Quality of Experience(QoE)and reduce backhaul traffic consumption.FlyCache implements intelligent caching management across three key stages:before-playback,during-playback,and after-playback.Specifically,we introduce a cache placement policy for the before-playback stage,a dynamic prefetching and cache admission policy for the during-playback stage,and a progressive cache eviction policy for the after-playback stage.To validate the effectiveness of FlyCache,we developed a user behavior-driven edge caching simulation framework incorporating recommendation mechanisms.Experiments conducted on the MovieLens and synthetic datasets demonstrate that FlyCache outperforms other caching strategies in terms of byte hit rate,backhaul traffic,and delayed startup rate.
文摘BACKGROUND Both stent placement and endoscopic nasobiliary drainage(ENBD)are commonly used for treating bile leakage following liver transplantation.However,little research has compared the advantages of both methods.AIM To compare the prognosis of stent placement and ENBD in treating bile leakage following liver transplantation.METHODS We retrospectively collected data for patients with bile leakage after liver tran-splantation in our center.The efficiency and prognosis were compared between the stent placement and ENBD groups.RESULTS We retrospectively collected data from 50 patients diagnosed with bile leakage within 1 month after liver transplantation.Forty patients underwent ENBD and nine received stent placement.Baseline patient characteristics,except white blood cell count,total bilirubin and direct bilirubin levels,were comparable between the two groups.Additionally,there was no significant difference in the rates of re-conveyance or postoperative biliary stricture.CONCLUSION Stent placement and ENBD are recommended for treating bile leakage after liver transplantation,with similar efficacy and prognosis.
文摘Bile leakage remains a formidable challenge in post-liver transplantation management,posing significant risks to patient outcomes and graft survival.This editorial provides a critical appraisal of the recent clinical study by Gu et al,which compared the efficacy of stent placement vs endoscopic nasobiliary drainage(ENBD)for treating post-transplant bile leaks.By retrospectively analyzing data from their institutional cohort of liver transplant recipients with bile leaks,the authors evaluated the therapeutic success rates and clinical outcomes between the stent and ENBD groups,with a focused discussion on the relative advantages of each approach.Gu et al demonstrated that both stent placement and ENBD were effective in managing post-transplant bile leaks,with comparable therapeutic outcomes.However,the study also recognized its limitations,such as the lack of an assessment of the impact of bile leak severity on outcome and the absence of long-term follow-up data.The editorial further highlights the pressing need for advancing research on long-term complications post-liver transplantation and underscores the pivotal role of clinical stratification and physician expertise in guiding therapeutic decisions.In summary,Gu et al’s study enhances our understanding of mitigating post-transplant complications like bile leaks and offers evidence-based insights to refine clinical protocols.This commentary aims to contextualize current research trends and future directions in the field,advocating for sustained innovation and evidence-driven practice.
文摘Inflatable penile prosthesis(IPP)implantation is the gold standard treatment for patients with erectile dysfunction who are refractory to medical therapy.The standard placement of the reservoir in the space of Retzius(SOR)may be contraindicated in patients with prior pelvic or abdominal surgery due to altered anatomy and increased risk of complications.This has led to the development of alternative ectopic reservoir placement techniques.In this narrative review,we summarize the literature on various ectopic reservoir approaches,including low and high submuscular placements,submuscular techniques with counter incisions or transfascial fixation,midline submuscular placement,subcutaneous placement,and lateral retroperitoneal approaches.We describe the surgical methods,outcomes,and complication rates associated with each technique.While most methods demonstrate low complication and revision rates,direct comparisons remain limited due to heterogeneity and lack of prospective data.This review highlights the importance of individualized technique selection based on prior surgical history,body habitus,and surgeon experience.As ectopic placement becomes more widely adopted,familiarity with multiple approaches is essential for prosthetic surgeons.
基金supported by the Fujian University of Technology under Grant GYZ20016,GY-Z18183,and GY-Z19005partially supported by the National Science and Technology Council under Grant NSTC 113-2221-E-224-056-.
文摘To transmit customer power data collected by smart meters(SMs)to utility companies,data must first be transmitted to the corresponding data aggregation point(DAP)of the SM.The number of DAPs installed and the installation location greatly impact the whole network.For the traditional DAP placement algorithm,the number of DAPs must be set in advance,but determining the best number of DAPs is difficult,which undoubtedly reduces the overall performance of the network.Moreover,the excessive gap between the loads of different DAPs is also an important factor affecting the quality of the network.To address the above problems,this paper proposes a DAP placement algorithm,APSSA,based on the improved affinity propagation(AP)algorithm and sparrow search(SSA)algorithm,which can select the appropriate number of DAPs to be installed and the corresponding installation locations according to the number of SMs and their distribution locations in different environments.The algorithm adds an allocation mechanism to optimize the subnetwork in the SSA.APSSA is evaluated under three different areas and compared with other DAP placement algorithms.The experimental results validated that the method in this paper can reduce the network cost,shorten the average transmission distance,and reduce the load gap.
基金the National Natural Science Foundation of China(No.11502146)the 1 Batch of 2021 MOE of PRC Industry University Collaborative Education Program(No.202101042008)。
文摘The aim of this study was to assess the potential of surgical guides as a complementary tool to augmented reality(AR)in enhancing the safety and precision of pedicle screw placement in spinal surgery.Four trainers were divided into the AR navigation group using surgical guides and the free-hand group.Each group consisted of a novice and an experienced spine surgeon.A total of 80 pedicle screws were implanted.First,the AR group reconstructed the 3D model and planned the screw insertion route according to the computed tomography data of L2 lumbar vertebrae.Then,the Microsoft HoloLens™2 was used to identify the vertebral model,and the planned virtual path was superimposed on the real cone model.Next,the screw was placed according to the projected trajectory.Finally,Micron Tracker was used to measure the deviation of screws from the preoperatively planned trajectory,and pedicle screws were evaluated using the Gertzbein-Robbins scale.In the AR group,the linear deviations of the experienced doctor and the novice were(1.59±0.39)mm and(1.73±0.52)mm respectively,and the angle deviations were 2.72°±0.61°and 2.87°±0.63°respectively.In the free-hand group,the linear deviations of the experienced doctor and the novice were(2.88±0.58)mm and(5.25±0.62)mm respectively,and the angle deviations were 4.41°±1.18°and 7.15°±1.45°respectively.Both kinds of deviations between the two groups were significantly different(P<0.05).The screw accuracy rate was 95%in the AR navigation group and 77.5%in the free-hand group.The results of this study indicate that the integration of surgical guides and AR is an innovative technique that can substantially enhance the safety and precision of spinal surgery and assist inexperienced doctors in completing the surgery.
基金supported by the National Natural Science Foundation of China(Nos.12372056,12032017,12393783)the S&T Program of Hebei of China(No.24465001D)。
文摘Axle box bearings are critical components of high-speed trains.Localized defects,such as pitting and spalling,on raceways or rollers pose significant threats to the operational safety of railway vehicles.In this work,a novel bearing-flexible axle boxvehicle coupling model is established to explore the vibration characteristics of axle box bearings with irregular localized defects.First,based on the contact and kinematic relationship between rollers and raceways,the three-dimensional(3D)bearing force elements are analyzed and formulated.Second,the established model and a flexible axle box are integrated into the vehicle,and the responses of the normal and faulty bearings under the combined excitations of wheel roughness and track irregularities are simulated.Third,the simulation results are verified through a rolling-vibrating test bench for full-scale wheelsets of high-speed trains.The comparisons of the fault-induced repetitive transients in the time-domain and the fault characteristic frequencies in the envelope spectra demonstrate the efficiency of the proposed model.Finally,based on the flexible axle box model,a sensitivity analysis of the accelerometer placements to the bearing faults is carried out,and the optimal one is identified based on both the time-domain and frequency-domain signal-to-noise ratios(SNRs)for engineering applications.
基金Supported by the Discipline Promotion Program of Shanghai Fourth People’s Hospital,No.SY-XKZT-2021-2006.
文摘BACKGROUND Ultrasound-guided peripherally inserted central catheter(PICC)placement is vital for cancer therapy,but lidocaine infiltration faces limitations like puncture pain and vasospasm.AIM To assess the clinical efficacy of a no-pain intervention-combining compound lidocaine cream with warm compress-in reducing pain during ultrasound-guided PICC placement in cancer patients.METHODS A retrospective cohort study analyzed 88 cancer patients undergoing PICC placement(Shanghai Fourth People’s Hospital,2024).Patients were divided into control(lidocaine infiltration,n=44)and intervention(cream+warm compress,n=44)groups.Primary outcomes:Pain scores(numerical rating scale),procedural time,complications;secondary outcome:Satisfaction.RESULTS The intervention group showed significantly lower pain scores(1.2±0.4 vs 3.8±1.2,P=0.012)with comparable first-attempt success(95.5%vs 90.9%)and safety(P=0.672).Thermal activation of transient receptor potential vanilloid 1 channel enhanced drug penetration,achieving anesthesia within 8-10 minutes.Patient satisfaction reached 97.7%.CONCLUSION The combination of compound lidocaine cream with warm compress significantly alleviates procedural pain and enhances patient satisfaction during ultrasound-guided PICC placement in cancer patients,supporting its clinical application.
基金funded by grants from the National Natural Science Foundation of China(32301947,32272220 and 32172120)the China Postdoctoral Science Foundation(2023M730909).
文摘Nitrogen(N)serves as an essential nutrient for yield formation across diverse crop types.However,agricultural production encounters numerous challenges,notably high N fertilizer rates coupled with low N use efficiency and serious environmental pollution.Deep placement of nitrogen fertilizer(DPNF)is an agronomic measure that shows promise in addressing these issues.This review aims to offer a comprehensive understanding of DPNF,beginning with a succinct overview of its development and methodologies for implementation.Subsequently,the optimal fertilization depth and influencing factors for different crops are analyzed and discussed.Additionally,it investigates the regulation and mechanism underlying the DPNF on crop development,yield,N use efficiency and greenhouse gas emissions.Finally,the review delineates the limitations and challenges of this technology and provides suggestions for its improvement and application.This review provides valuable insight and reference for the promotion and adoption of DPNF in agricultural practice.
基金sponsored by the Innovation Foundation for National Natural Science Foundation of China(No.11872312)。
文摘Response prediction is a fundamental yet challenging task in aeronautical engineering,requiring an accurate selection of sensor positions correlated with the target responses to achieve precise predictions. Unfortunately, in large-scale structures, the rigorous selection of reliable sensor candidates for multi-target responses remains largely unexplored. In this paper, we propose a flexible and generalized framework for selecting the most relevant sensors to the multi-target response and predicting the target response, referred to as the Fast-aware Multi-Target Response Prediction(FMTRP) approach in the spirit of divide-and-conquer. Specifically, first, a multi-task learning module is designed to predict multi-point response tasks at the same time. Simultaneously, we meticulously devise adaptive mechanisms to facilitate loss-term reweighting and encourage prioritization of challenging tasks in multiple prediction tasks. Second, to ensure ease of interpretation,we introduce a hybrid penalty to select sensors at the group-sparsity, individual-sparsity and element-sparsity levels. Finally, due to the substantial number of candidate sensors posing a significant computational burden, we develop a more efficient search strategy and support computation to make the proposed approach applicable in practice, leading to substantial runtime improvements. Extensive experiments on aircraft standard model response datasets and large airliner test flight datasets validate the effectiveness of the proposed approach in identifying sensor locations and simultaneously predicting responses at multiple points. Compared to state-of-the-art methods,the proposed approach achieves an accuracy of over 99% in sinusoidal excitation and exhibits the shortest runtime(3.514 s).
