Peripheral Artery Disease (PAD) is a global disease that affects more than 200 million individuals worldwide with an ever-increasing prevalence rate from year to year. Peripheral Artery Disease treatments include ever...Peripheral Artery Disease (PAD) is a global disease that affects more than 200 million individuals worldwide with an ever-increasing prevalence rate from year to year. Peripheral Artery Disease treatments include everything from lifestyle interventions to surgical revascularization or percutaneous angioplasty (PTA). Percutaneous Angioplasty (PTA) has become the primary treatment for this disease with the use of focal force and scoring balloons for vessel prepping. The practice of vessel prepping looks to limit the effect of angioplasty on vessel dissection and recoiling in the infrainguinal region during the treatment of plaque buildup in the vessel. Plaque morphology and rise in incidence of in-stent restenosis can determine which balloon device is best used when restoring a vessel. Some of the different brands we review in this chapter include Peripheral Cutting Balloons by Boston Scientific, Chocolate PTA by Medtronic, Angiosculpt balloon by Philips, and VascuTrak by BARD. In review of Angiosculpt balloon by Philips: The study concluded that the one-year data supports the notion that the AngioSculpt Scoring Balloon is an effective and safe treatment option for infrapopliteal, atherosclerotic lesions in patients with critical limb ischemia. Whereas: Peripheral cutting balloons (PCBs) by Boston Scientific have been used for in-stent restenosis, resistant lesions, small vessels, bifurcations, aortaostial lesions, and saphenous vein graft lesions. This chapter will discuss different focal force and scoring balloon devices available to treat different plaque morphology and usefulness for in-stent restenosis resolution. We will review the evidence associated with each brand of device and the factors that should be accounted for before making a decision on which to use for your patient.展开更多
BACKGROUND Surgical site infection(SSI)is a major concern in orthopaedic surgery procedures as they can have devastating consequences for patients and their outcomes.Many infection prevention measures are routinely ta...BACKGROUND Surgical site infection(SSI)is a major concern in orthopaedic surgery procedures as they can have devastating consequences for patients and their outcomes.Many infection prevention measures are routinely taken in order to prevent infection during surgery,the main one being surgical skin preparation prior to any incision.AIM To investigate the efficacy of different perioperative surgical skin preparation products commonly used in orthopaedic surgery.METHODS Seven databases were searched from inception to January 25,2025,using a combination of keywords and medical subject headings terms,specifically for studies comparing any two surgical skin preparation products used at any point prior to skin incision for orthopaedic procedures.Titles and abstracts were screened and full texts reviewed based on inclusion criteria.Data was extracted on study design,interventions,and outcomes from studies that met inclusion criteria.Meta-analysis was not completed due to heterogeneity.RESULTS Thirty-two studies met the inclusion criteria in this systematic review.In extremity fracture surgery,evidence was mixed on whether iodine or chlorhexidine-based solutions are more effective at preventing SSI.No significant difference was found between iodine and chlorhexidine-based solutions in total joint arthroplasty,spine surgery,foot and ankle surgery,or upper extremity surgery.No tested preparation method was superior in reducing positive Cutibac terium acnes culture rates in upper extremity(shoulder)surgery.Adding adjuncts to iodine and chlorhexidine methods,such as isopropyl alcohol,hydrogen peroxide,or benzoyl peroxide showed no significant changes to SSI or bacterial cultures.CONCLUSION Current literature shows no significant difference between chlorhexidine-based and iodine-based skin preparation solutions in orthopaedic extremity or spine surgery regarding SSI prevention or culture results.Likewise,adding other antiseptic agents provided no clear benefit.While skin antisepsis is important,many different factors contribute to SSI risk outside of the skin preparation solution.展开更多
目的了解男男性行为人群（men who have sex with men，MSM）艾滋病暴露前预防用药（pre-exposure prophylaxis，PrEP）临床试验中队列的保持情况及其预测因子。方法采用非概率抽样的方法招募并筛选出167例受试对象，按1∶1比例随机分...目的了解男男性行为人群（men who have sex with men，MSM）艾滋病暴露前预防用药（pre-exposure prophylaxis，PrEP）临床试验中队列的保持情况及其预测因子。方法采用非概率抽样的方法招募并筛选出167例受试对象，按1∶1比例随机分配进入每日服药组或间歇服药组，在第0（基线）、4、8、12、16、20、24、28（±5 d内）周进行临床随访和问卷调查，采用基于Kaplan-Meier估计的生存曲线描述不同试验组队列保持概率，单因素和多因素Cox回归分析队列保持的预测因子。结果80.2%的受试对象完成了至少1次服药后随访，59.9%完成了28周的队列随访。间歇用药组（ARR=0.60，95% CI：0.36～0.99）、年龄〉24岁（ARR=0.46，95% CI：0.25～0.83）、中等收入相对于高收入（ARR=0.45，95%CI：0.21～0.96）、因希望能够推广一种预防艾滋病的药物而参加试验（ARR=0.59，95% CI：0.36～0.99）的参与者有更低的脱失率，即更高的队列保持力，因为能获得免费的预防药物而参加试验（ARR=1.90，95% CI：1.13～3.21）的受试者有更高的脱失率，即更低的队列保持力。结论MSM人群PrEP临床试验队列保持力不高，间歇服药组的队列保持力高于每日服药组，在进一步的PrEP临床试验中需制定相应策略以提高试验队列保持力。展开更多
针对高维数据集,文中提出一种PREP(PCA-Relief F for EP)算法:首先采用PCA和Relief F算法实现特征降维;然后利用EP模式思想,构造精度更高、规模更小的EP模式分类器;最后利用标准数据集对文中的方法进行测试。实验结果表明,在对高维数据...针对高维数据集,文中提出一种PREP(PCA-Relief F for EP)算法:首先采用PCA和Relief F算法实现特征降维;然后利用EP模式思想,构造精度更高、规模更小的EP模式分类器;最后利用标准数据集对文中的方法进行测试。实验结果表明,在对高维数据进行分类时,该方法构造的分类器在预测精度和运行时间上均有较大幅度的提升。展开更多
文摘Peripheral Artery Disease (PAD) is a global disease that affects more than 200 million individuals worldwide with an ever-increasing prevalence rate from year to year. Peripheral Artery Disease treatments include everything from lifestyle interventions to surgical revascularization or percutaneous angioplasty (PTA). Percutaneous Angioplasty (PTA) has become the primary treatment for this disease with the use of focal force and scoring balloons for vessel prepping. The practice of vessel prepping looks to limit the effect of angioplasty on vessel dissection and recoiling in the infrainguinal region during the treatment of plaque buildup in the vessel. Plaque morphology and rise in incidence of in-stent restenosis can determine which balloon device is best used when restoring a vessel. Some of the different brands we review in this chapter include Peripheral Cutting Balloons by Boston Scientific, Chocolate PTA by Medtronic, Angiosculpt balloon by Philips, and VascuTrak by BARD. In review of Angiosculpt balloon by Philips: The study concluded that the one-year data supports the notion that the AngioSculpt Scoring Balloon is an effective and safe treatment option for infrapopliteal, atherosclerotic lesions in patients with critical limb ischemia. Whereas: Peripheral cutting balloons (PCBs) by Boston Scientific have been used for in-stent restenosis, resistant lesions, small vessels, bifurcations, aortaostial lesions, and saphenous vein graft lesions. This chapter will discuss different focal force and scoring balloon devices available to treat different plaque morphology and usefulness for in-stent restenosis resolution. We will review the evidence associated with each brand of device and the factors that should be accounted for before making a decision on which to use for your patient.
文摘BACKGROUND Surgical site infection(SSI)is a major concern in orthopaedic surgery procedures as they can have devastating consequences for patients and their outcomes.Many infection prevention measures are routinely taken in order to prevent infection during surgery,the main one being surgical skin preparation prior to any incision.AIM To investigate the efficacy of different perioperative surgical skin preparation products commonly used in orthopaedic surgery.METHODS Seven databases were searched from inception to January 25,2025,using a combination of keywords and medical subject headings terms,specifically for studies comparing any two surgical skin preparation products used at any point prior to skin incision for orthopaedic procedures.Titles and abstracts were screened and full texts reviewed based on inclusion criteria.Data was extracted on study design,interventions,and outcomes from studies that met inclusion criteria.Meta-analysis was not completed due to heterogeneity.RESULTS Thirty-two studies met the inclusion criteria in this systematic review.In extremity fracture surgery,evidence was mixed on whether iodine or chlorhexidine-based solutions are more effective at preventing SSI.No significant difference was found between iodine and chlorhexidine-based solutions in total joint arthroplasty,spine surgery,foot and ankle surgery,or upper extremity surgery.No tested preparation method was superior in reducing positive Cutibac terium acnes culture rates in upper extremity(shoulder)surgery.Adding adjuncts to iodine and chlorhexidine methods,such as isopropyl alcohol,hydrogen peroxide,or benzoyl peroxide showed no significant changes to SSI or bacterial cultures.CONCLUSION Current literature shows no significant difference between chlorhexidine-based and iodine-based skin preparation solutions in orthopaedic extremity or spine surgery regarding SSI prevention or culture results.Likewise,adding other antiseptic agents provided no clear benefit.While skin antisepsis is important,many different factors contribute to SSI risk outside of the skin preparation solution.
文摘目的了解男男性行为人群（men who have sex with men，MSM）艾滋病暴露前预防用药（pre-exposure prophylaxis，PrEP）临床试验中队列的保持情况及其预测因子。方法采用非概率抽样的方法招募并筛选出167例受试对象，按1∶1比例随机分配进入每日服药组或间歇服药组，在第0（基线）、4、8、12、16、20、24、28（±5 d内）周进行临床随访和问卷调查，采用基于Kaplan-Meier估计的生存曲线描述不同试验组队列保持概率，单因素和多因素Cox回归分析队列保持的预测因子。结果80.2%的受试对象完成了至少1次服药后随访，59.9%完成了28周的队列随访。间歇用药组（ARR=0.60，95% CI：0.36～0.99）、年龄〉24岁（ARR=0.46，95% CI：0.25～0.83）、中等收入相对于高收入（ARR=0.45，95%CI：0.21～0.96）、因希望能够推广一种预防艾滋病的药物而参加试验（ARR=0.59，95% CI：0.36～0.99）的参与者有更低的脱失率，即更高的队列保持力，因为能获得免费的预防药物而参加试验（ARR=1.90，95% CI：1.13～3.21）的受试者有更高的脱失率，即更低的队列保持力。结论MSM人群PrEP临床试验队列保持力不高，间歇服药组的队列保持力高于每日服药组，在进一步的PrEP临床试验中需制定相应策略以提高试验队列保持力。
文摘针对高维数据集,文中提出一种PREP(PCA-Relief F for EP)算法:首先采用PCA和Relief F算法实现特征降维;然后利用EP模式思想,构造精度更高、规模更小的EP模式分类器;最后利用标准数据集对文中的方法进行测试。实验结果表明,在对高维数据进行分类时,该方法构造的分类器在预测精度和运行时间上均有较大幅度的提升。
