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
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
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
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
Gate valve has various placements in the practical usages.Due to the effect of gravity,particle trajectories and erosions are distinct between placements.Thus in this study,gas-solid flow properties and erosion in gat...Gate valve has various placements in the practical usages.Due to the effect of gravity,particle trajectories and erosions are distinct between placements.Thus in this study,gas-solid flow properties and erosion in gate valve for horizontal placement and vertical placement are discussed and compared by using Euler-Lagrange simulation method.The structure of a gate valve and a simplified structure are investigated.The simulation procedure is validated in our published paper by comparing with the experiment data of a pipe and an elbow.The results show that for all investigated open degrees and Stokes numbers(St),there are little difference of gas flow properties and flow coefficients between two placements.It is also found that the trajectories of particles for two placements are mostly identical when St << 1,making the erosion independent of placement.With the increase of St,the distinction of trajectories between placements becomes more obvious,leading to an increasing difference of the erosion distributions.Besides,the total erosion ratio of surface T for horizontal placement is two orders of magnitudes larger than that for vertical placement when the particle diameter is 250 μm.展开更多
The application of a recent optimization technique,the artificial bee colony(ABC),was investigated in the context of finding the optimal well locations.The ABC performance was compared with the corresponding results f...The application of a recent optimization technique,the artificial bee colony(ABC),was investigated in the context of finding the optimal well locations.The ABC performance was compared with the corresponding results from the particle swarm optimization(PSO)algorithm,under essentially similar conditions.Treatment of out-of-boundary solution vectors was accomplished via the Periodic boundary condition(PBC),which presumably accelerates convergence towards the global optimum.Stochastic searches were initiated from several random staring points,to minimize starting-point dependency in the established results.The optimizations were aimed at maximizing the Net Present Value(NPV)objective function over the considered oilfield production durations.To deal with the issue of reservoir heterogeneity,random permeability was applied via normal/uniform distribution functions.In addition,the issue of increased number of optimization parameters was address,by considering scenarios with multiple injector and producer wells,and cases with deviated wells in a real reservoir model.The typical results prove ABC to excel PSO(in the cases studied)after relatively short optimization cycles,indicating the great premise of ABC methodology to be used for well-optimization purposes.展开更多
The drastic increase in engineering system complexity has spurred the development of highly efficient optimization techniques.Many real-world optimization problems have been identified as bilevel/multilevel as well as...The drastic increase in engineering system complexity has spurred the development of highly efficient optimization techniques.Many real-world optimization problems have been identified as bilevel/multilevel as well as multiobjective.The primary aim of this work is to present a framework to tackle the bilevel virtual machine(VM)placement problem in cloud systems.This is done using the coupled map lattice(CML)approach in conjunction with the Stackelberg game theory and weighted-sum frameworks.The VM placement problem was modified from the original multiobjective(MO)problem to an MO bilevel formulation to make it more realistic albeit more complicated.Additionally comparative analysis on the performance of the CML approach was carried out against the particle swarm optimization method.A new bilevel metric called the cascaded hypervolume indicator is introduced and applied to measure the dominance of the solutions produced by both methods.Detailed analysis on the computational results is presented.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
Placement optimization is a crucial phase in chip design,involving the strategic arrangement of cells within a limited region to enhance space utilization and reduce wirelength.Chip design enterprises need to optimize...Placement optimization is a crucial phase in chip design,involving the strategic arrangement of cells within a limited region to enhance space utilization and reduce wirelength.Chip design enterprises need to optimize the placement according to design rules to meet customer demands.While mixed-cell-height circuits are widely used in modern chip design,few studies have simultaneously considered the non-overlapping cells,rails alignment,and minimum implantation area constraints in the placement optimization problems.Hence,this study involves preprocessing the non-linear parts and developing a mixed-integer linear programming model to reduce the cost of legalizing chip placements for businesses.Furthermore,this study designs and implements an exact algorithm based on Benders decomposition,utilizing dual theory to obtain an optimal cut and iteratively solve for the coordinates of cells.Numerical experiments across various scales validate the performance of the algorithm.Through a detailed analysis of the shape of the chip region division,the proportion of different types of cells,the total number of cells and bins,and their impact on the placement,we derive some potentially useful design insights that can benefit chip design enterprises.展开更多
The increase in bridge structure span and the complex stress characteristics directly affect the optimization of sensor placement,which in turn influences the data acquisition performance of the monitoring system.The ...The increase in bridge structure span and the complex stress characteristics directly affect the optimization of sensor placement,which in turn influences the data acquisition performance of the monitoring system.The key to the information acquisition of a bridge monitoring system is to obtain data that meets the health monitoring requirements of the bridge with a limited number of measurement points.To address this,a hybrid method based on multiple optimization criteria is proposed for optimal sensor placement(OSP).First,the minimum number of modes required for bridge monitoring is determined using the information entropy criterion(IE).Then,the number of measurement points is determined using a sequence method combined with the modal assurance criterion(MAC).Finally,the sensor placement is optimized using the generalized genetic algorithm(GGA)combined with double-structure encoding,and the optimization results are validated through finite element model analysis.The research results show that the hybrid method based on multiple optimization criteria can effectively determine the number of measurement points for bridge structures and optimize sensor placement,with a significant improvement in computational speed.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
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
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
In pedicle screw fixation,surgical robot and preoperative planning are enabling technologies to improve the accuracy and safety of pedicle screw placement.In this study,an automatic segmentation method for the pedicle...In pedicle screw fixation,surgical robot and preoperative planning are enabling technologies to improve the accuracy and safety of pedicle screw placement.In this study,an automatic segmentation method for the pedicle and vertebral body is proposed based on the 3D anatomical features of vertebrae.Further,an optimal insertion path is obtained to balance the safety of pedicle screw placement and the vertebral-screw interface strength.The pedicle screw radius is then determined based on the pedicle radius.A classification method is proposed to assess the accuracy of path planning.Finally,the surgical robot’s path can be updated based on the actual positions of the surgical robot and the patient.The CT data of 12 human vertebrae(T6−L5),10 porcine vertebrae(L1−L5)and 5 ovine vertebrae(L1−L5)are used to validate the effectiveness of the proposed method.All pedicle screw placement paths are successfully generated,achieving an excellence or good rate of 98%.Ex vivo pedicle screw placement experiments are conducted on human spine phantom,porcine and ovine spines,and in vivo experiment is conducted on a Bama miniature pig.In the proposed method,both safety and accuracy of pedicle screw placement are improved.According to the widely recognized Gertzbein-Robbins classification,93.18%of the outcomes achieve Grade A,showing promising potential in clinics.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
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.
基金supported by National Natural Science Foundation of China(Grant No.21276241)etc
文摘Gate valve has various placements in the practical usages.Due to the effect of gravity,particle trajectories and erosions are distinct between placements.Thus in this study,gas-solid flow properties and erosion in gate valve for horizontal placement and vertical placement are discussed and compared by using Euler-Lagrange simulation method.The structure of a gate valve and a simplified structure are investigated.The simulation procedure is validated in our published paper by comparing with the experiment data of a pipe and an elbow.The results show that for all investigated open degrees and Stokes numbers(St),there are little difference of gas flow properties and flow coefficients between two placements.It is also found that the trajectories of particles for two placements are mostly identical when St << 1,making the erosion independent of placement.With the increase of St,the distinction of trajectories between placements becomes more obvious,leading to an increasing difference of the erosion distributions.Besides,the total erosion ratio of surface T for horizontal placement is two orders of magnitudes larger than that for vertical placement when the particle diameter is 250 μm.
文摘The application of a recent optimization technique,the artificial bee colony(ABC),was investigated in the context of finding the optimal well locations.The ABC performance was compared with the corresponding results from the particle swarm optimization(PSO)algorithm,under essentially similar conditions.Treatment of out-of-boundary solution vectors was accomplished via the Periodic boundary condition(PBC),which presumably accelerates convergence towards the global optimum.Stochastic searches were initiated from several random staring points,to minimize starting-point dependency in the established results.The optimizations were aimed at maximizing the Net Present Value(NPV)objective function over the considered oilfield production durations.To deal with the issue of reservoir heterogeneity,random permeability was applied via normal/uniform distribution functions.In addition,the issue of increased number of optimization parameters was address,by considering scenarios with multiple injector and producer wells,and cases with deviated wells in a real reservoir model.The typical results prove ABC to excel PSO(in the cases studied)after relatively short optimization cycles,indicating the great premise of ABC methodology to be used for well-optimization purposes.
文摘The drastic increase in engineering system complexity has spurred the development of highly efficient optimization techniques.Many real-world optimization problems have been identified as bilevel/multilevel as well as multiobjective.The primary aim of this work is to present a framework to tackle the bilevel virtual machine(VM)placement problem in cloud systems.This is done using the coupled map lattice(CML)approach in conjunction with the Stackelberg game theory and weighted-sum frameworks.The VM placement problem was modified from the original multiobjective(MO)problem to an MO bilevel formulation to make it more realistic albeit more complicated.Additionally comparative analysis on the performance of the CML approach was carried out against the particle swarm optimization method.A new bilevel metric called the cascaded hypervolume indicator is introduced and applied to measure the dominance of the solutions produced by both methods.Detailed analysis on the computational results is presented.
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.
基金supported by the National Natural Science Foundation of China(72025103,72394360,72394362,and 72361137001)the Project of Science and Technology Commission of Shanghai Municipality,China(23JC1402200).
文摘Placement optimization is a crucial phase in chip design,involving the strategic arrangement of cells within a limited region to enhance space utilization and reduce wirelength.Chip design enterprises need to optimize the placement according to design rules to meet customer demands.While mixed-cell-height circuits are widely used in modern chip design,few studies have simultaneously considered the non-overlapping cells,rails alignment,and minimum implantation area constraints in the placement optimization problems.Hence,this study involves preprocessing the non-linear parts and developing a mixed-integer linear programming model to reduce the cost of legalizing chip placements for businesses.Furthermore,this study designs and implements an exact algorithm based on Benders decomposition,utilizing dual theory to obtain an optimal cut and iteratively solve for the coordinates of cells.Numerical experiments across various scales validate the performance of the algorithm.Through a detailed analysis of the shape of the chip region division,the proportion of different types of cells,the total number of cells and bins,and their impact on the placement,we derive some potentially useful design insights that can benefit chip design enterprises.
文摘The increase in bridge structure span and the complex stress characteristics directly affect the optimization of sensor placement,which in turn influences the data acquisition performance of the monitoring system.The key to the information acquisition of a bridge monitoring system is to obtain data that meets the health monitoring requirements of the bridge with a limited number of measurement points.To address this,a hybrid method based on multiple optimization criteria is proposed for optimal sensor placement(OSP).First,the minimum number of modes required for bridge monitoring is determined using the information entropy criterion(IE).Then,the number of measurement points is determined using a sequence method combined with the modal assurance criterion(MAC).Finally,the sensor placement is optimized using the generalized genetic algorithm(GGA)combined with double-structure encoding,and the optimization results are validated through finite element model analysis.The research results show that the hybrid method based on multiple optimization criteria can effectively determine the number of measurement points for bridge structures and optimize sensor placement,with a significant improvement in computational speed.
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.
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.
基金Supported by Guangdong Basic and Applied Basic Research Foundation(Grant No.2024A1515011897)Shenzhen Science and Technology Program(Grant No.KQTD20210811090143060)+1 种基金Sustainable Development Science and Technology Special Project of Shenzhen(Grant No.KCXFZ20230731100900002)Tianjin Municipal Science and Technology Program(Grant No.22JCYBJC01240).
文摘In pedicle screw fixation,surgical robot and preoperative planning are enabling technologies to improve the accuracy and safety of pedicle screw placement.In this study,an automatic segmentation method for the pedicle and vertebral body is proposed based on the 3D anatomical features of vertebrae.Further,an optimal insertion path is obtained to balance the safety of pedicle screw placement and the vertebral-screw interface strength.The pedicle screw radius is then determined based on the pedicle radius.A classification method is proposed to assess the accuracy of path planning.Finally,the surgical robot’s path can be updated based on the actual positions of the surgical robot and the patient.The CT data of 12 human vertebrae(T6−L5),10 porcine vertebrae(L1−L5)and 5 ovine vertebrae(L1−L5)are used to validate the effectiveness of the proposed method.All pedicle screw placement paths are successfully generated,achieving an excellence or good rate of 98%.Ex vivo pedicle screw placement experiments are conducted on human spine phantom,porcine and ovine spines,and in vivo experiment is conducted on a Bama miniature pig.In the proposed method,both safety and accuracy of pedicle screw placement are improved.According to the widely recognized Gertzbein-Robbins classification,93.18%of the outcomes achieve Grade A,showing promising potential in clinics.
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.
