The shortage of personal protective equipment and lack of proper nursing training have been endangering health care workers dealing with coronavirus disease 2019(COVID-19).In our treatment center,the implementation of...The shortage of personal protective equipment and lack of proper nursing training have been endangering health care workers dealing with coronavirus disease 2019(COVID-19).In our treatment center,the implementation of a holistic care model of time-sharing management for severe and critical COVID-19 patients has further aggravated the shortage of intensive care unit(ICU)professional nurses.Therefore,we developed a short-term specialized and targeted nursing training program to help ICU nurses to cope with stress and become more efficient,thus reducing the number of nurses required in the ICU.In order to avoid possible human-to-human spread,small teaching classes and remote training were applied.The procedural training mode included four steps:preparation,plan,implementation,and evaluation.An evaluation was conducted throughout the process of nursing training.In this study,we documented and shared experiences in transitioning from traditional face-to-face programs to remote combined with proceduralization nursing training mode from our daily work experiences during the COVID-19 pandemic,which has shown to be helpful for nurses working in the ICU.展开更多
Background 3D botanical tree reconstruction from a single image plays a vital role in the field of computer graphics.However,accurately capturing the intricate branching patterns and detailed morphologies of trees rem...Background 3D botanical tree reconstruction from a single image plays a vital role in the field of computer graphics.However,accurately capturing the intricate branching patterns and detailed morphologies of trees remains a challenge.Methods In this study,we proposed a novel approach for single-image tree reconstruction using a conditional generative adversarial network to infer the 3D skeleton of a tree in the form of a 2D skeleton depth map.Based on the 2D skeleton depth map,a corresponding branching structure(3D skeleton)that inherits the tree shape in the input image and leaves can be generated using a procedural modeling technique.Result Experimental results show that the proposed method accurately reconstructs diverse tree structures across species.Both quantitative and qualitative evaluations demonstrate improved skeleton completeness,branching accuracy,and visual realism over baseline methods,while requiring no user input.Conclusions Our proposed approach for generating lifelike 3D tree models from a single image with no user input shows its proficiency in achieving efficient and reliable reconstruction.These results showcase the capability of the proposed model to recreate complex tree architectures while capturing their visual authenticity.展开更多
BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints...BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.展开更多
Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 20...Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 2025,selecting 90 patients who underwent hydrofluoric acid-related treatments in the outpatient dental department of this hospital during this period as subjects.Forty-five patients treated between June 2023 and June 2024 received conventional protective care(pre-intervention group),while 45 patients treated between June 2024 and June 2025 underwent the standardized protective care protocol(post-intervention group).Thirteen healthcare personnel participated in both pre-and post-intervention treatment phases.Based on the different nursing models,indicators such as the incidence of adverse events in patients and the exposure rate of healthcare personnel before and after implementation were compared to evaluate the effectiveness of the nursing intervention.Results:The incidence of oral mucosal irritation reactions in patients was lower after implementation,p<0.05.Compared with the pre-implementation period,the incidence of procedure-related adverse events decreased after implementation,p<0.05.There was a significant difference in the occupational exposure rate of healthcare personnel before and after implementation,with a higher rate observed before implementation(p<0.05).Post-implementation,healthcare personnel achieved higher compliance scores for pre-procedure preparation,intra-procedure protection,and post-procedure handling(p<0.05).Patient satisfaction with treatment was lower pre-implementation than post-implementation(p<0.05).Conclusion:Adherence to standardized protective care procedures during hydrofluoric acid operations by dental department staff in outpatient settings standardizes practitioner techniques,effectively prevents oral mucosal irritation in patients,reduces occupational exposure risks for staff,minimizes adverse procedural events,and consequently enhances patient treatment satisfaction.This demonstrates significant practical value.展开更多
Hainan Province in south China is the country’s second-largest island and the largest free trade port by area.It has entered a historic phase in China’s drive to promote high-level institutional opening up.On 18 Dec...Hainan Province in south China is the country’s second-largest island and the largest free trade port by area.It has entered a historic phase in China’s drive to promote high-level institutional opening up.On 18 December 2025,Hainan officially launched island-wide special customs operations,commonly referred to as“customs closure.”From that date,goods entering or leaving the island,except those traded with the Chinese mainland,are subject to simplified customs procedures and potentially reduced or zero tariffs.展开更多
The original online version of this article was revised:Several errors occurred in the published version of the article.These have now been corrected as follows:Page 2,section"2.2 Laser Texturing Procedure of Sur...The original online version of this article was revised:Several errors occurred in the published version of the article.These have now been corrected as follows:Page 2,section"2.2 Laser Texturing Procedure of Surfaces",line 2:The device name was corrected from"YDFLP-E-50-M8"to"YDFLP-50-M8."Page 3,Section 2.4:The phrase"95%confidence interval"has been corrected to"95%confidence level."Page 3,Figure 1 caption:The phrase"fandg"has been corrected to"f and g."The order"C4 and C12"has been reversed to"C12 and C4,"in accordance with the display order in the figure.Page 4,Figure reference:The phrase"Figs.4c and d"has been corrected to"Figs.5b and c."Page 5,paragraph starting with"The ANOVA results are presented...":The phrase"95%confidence interval"has been corrected to"95%confidence level."展开更多
Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocke...Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocked or damaged lymphatic vessels.In early 2024,Dr.Qingping Xie from Hangzhou Qiushi Hospital,China,and Dr.Wei F.Chen from the Cleveland Clinic,USA,adapted LVA for the treatment of patients with Alzheimer’s disease(AD).As a VIEWPOINT,they presented a video showcasing the post-surgery cognitive recovery of an 84-year-old AD patient(Xie et al.,2024).展开更多
Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and...Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.展开更多
Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and t...Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.展开更多
Non-contact debris removal methods are fuel-efficient in a single operation compared to contact-based strategies as spacecraft don’t need to match debris velocity.To comprehensively analyze this scheme,maneuvering sc...Non-contact debris removal methods are fuel-efficient in a single operation compared to contact-based strategies as spacecraft don’t need to match debris velocity.To comprehensively analyze this scheme,maneuvering schemes for maximum debris removal with minimum fuel consumption,including task assignment,sequence planning,and trajectory planning,must be formulated.The coupling between variables’dimensions and optimization results in task assignment poses challenges,as debris removal is repetitive and uncertain,leading to a vast search space.This paper proposes a novel Greedy Randomized Adaptive Search Procedure with Large Neighborhood and Crossover Mechanisms(GRASP-LNCM)to address this problem.The hybrid dynamic iteration mechanism improves computational efficiency and enhances the optimality of results.The model innovatively considers unsuccessful single removal by using a quantitative method to assess removal percentage.In addition,to improve the efficiency of sequence and trajectory planning,a Suboptimal Search Algorithm(SSA)based on the Lambert property and accelerated Multi-Revolution Lambert Problem(MRLP)solving strategy is established.Finally,a real Iridium-33 debris removal mission is studied.The simulation demonstrates that the proposed algorithm achieves state-of-the-art performance in several typical scenarios.Compared to the contact-based scheme,the new one is simpler,saving more fuel under certain conditions.展开更多
BACKGROUND The spectrum of gastric submucosal tumors(SMTs)in the upper gastrointestinal system ranges from non-neoplastic to malignant lesions,with gastrointestinal stromal tumors exhibiting inherent malignant potenti...BACKGROUND The spectrum of gastric submucosal tumors(SMTs)in the upper gastrointestinal system ranges from non-neoplastic to malignant lesions,with gastrointestinal stromal tumors exhibiting inherent malignant potential.However,the diagnosis of SMTs remains challenging,and treatment methods,especially for tumors located at the cardia or esophagogastric junction(EGJ),are not well established.Minimally invasive techniques-such as endoscopic submucosal dissection(ESD),submucosal tunneling endoscopic resection(STER),and laparoscopic wedge resection(LWR)-have been developed for these lesions.However,comparative data on their feasibility,safety,and clinical outcomes in these locations remain limited.AIM To compare ESD,STER,and LWR for SMTs at the EGJ or cardia,focusing on procedural feasibility.METHODS This single-center retrospective study included patients with SMTs less than 45 mm from the muscularis propria,growing intraluminally at the EGJ or cardia,and treated with ESD,STER,or LWR between July 2014 and September 2022.The primary outcome was relapse-free survival during follow-up.RESULTS The median age(interquartile range)was 53.0(40.0-57.5),43.0(39.0-57.0),and 56.0(43.0-64.0)years for ESD,STER,and LWR,respectively.The median follow-up time(interquartile range)was 60.0(26.5-66.5),24.0(13.0-38.0),and 35.0(21.0-60.0)months.LWR had the largest tumors(30.0 mm)and the highest rate of high-risk gastrointestinal stromal tumors(68.0%,P<0.001).Tumor recurrence occurred in one LWR patient(4.0%,P=0.600).En bloc and macroscopic resection rates were 100%(P=1.000),but microscopic resection rates differed(P=0.021).Significant minor complications occurred in 5 patients(10.0%),all grade IIIa.Tumor location(cardia/fundus,P=0.006)and prolonged procedure time(P<0.001)were significantly associated with complications.CONCLUSION ESD,STER,and LWR are effective for SMTs at the EGJ and cardia,with minor complications associated with tumor location and procedure time,and comparable recurrence rates.展开更多
This paper provides a comprehensive review of various experimental methods used to study carbon corrosion in automotive polymer exchange membrane fuel cells.Quantifying the extent of carbon corrosion is essential for ...This paper provides a comprehensive review of various experimental methods used to study carbon corrosion in automotive polymer exchange membrane fuel cells.Quantifying the extent of carbon corrosion is essential for advancing the technology and implementing effective mitigation strategies.While studying degradation events directly within a real-world fuel cell vehicle offers the most reliable insights,the high costs and time demands make it necessary to develop specialised experimental techniques that provide high-resolution data more efficiently and cost-effectively.This review explores the various experimental approaches utilised in automotive application induced carbon corrosion studies globally,including load profiles,test setups,break-in procedures,and cell recovery protocols.In this paper,emphasis is placed on the standardised procedures proposed by leading institutions worldwide,accompanied by critical discussions on these protocols.Furthermore,the paper highlights modified or innovative procedures developed by smaller institutions,universities,and individual researchers,thereby offering a comprehensive overview essential for carbon corrosion analysis.The review also discusses the fundamental principles,benefits,and limitations of various procedures,offering guidance on selecting the most appropriate approach for a given study.Lastly,it addresses the limitations within the current body of literature and outlines potential future prospects.展开更多
Advances in fetal surgery techniques have enabled the treatment of certain congenital defects before birth.A critical area of focus is the role of perinatal imaging in optimizing prenatal interventions within the prec...Advances in fetal surgery techniques have enabled the treatment of certain congenital defects before birth.A critical area of focus is the role of perinatal imaging in optimizing prenatal interventions within the precision medicine framework.Magnetic resonance imaging(MRI)is emerging as an indispensable tool for guiding these intricate procedures with the potential to significantly enhance the standard of care and outcomes for affected fetuses.This review begins with an overview of the classification and indications for fetal surgical interventions.It then explores the detailed applications of prenatal MRI scanning and diagnostic techniques across various categories of fetal surgery.A key focus is how fetal MRI provides critical insights into specific lesion characteristics and tissue involvement,thereby aiding healthcare professionals in selecting the optimal surgical strategies for prenatal and postnatal interventions.Fetal MRI offers detailed visualizations that complement traditional ultra-sound findings,enhancing the precision of radiological planning for fetal surgery.Finally,the review highlights how integration of fetal MRI into the decision-making process enables healthcare providers to make well-informed choices,ultimately improving the prognosis and outcomes for both the mother and fetus.展开更多
Peri-implant keratinized mucosa(PIKM)augmentation refers to surgical procedures aimed at increasing the width of PIKM.Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-ter...Peri-implant keratinized mucosa(PIKM)augmentation refers to surgical procedures aimed at increasing the width of PIKM.Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health.Currently,several surgical techniques have been validated for their effectiveness in increasing PIKM.However,the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques,variations in clinical scenarios,and anatomical differences.Therefore,clear guidelines and considerations for PIKM augmentation are needed.This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery.It aims to establish a standardized framework for assessing,planning,and executing PIKM augmentation procedures,with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.展开更多
BACKGROUND Fungal balls within the nasal cavity are an exceedingly rare clinical entity,typically presenting with nonspecific symptoms or being identified incidentally.CASE SUMMARY This report presents an incidental d...BACKGROUND Fungal balls within the nasal cavity are an exceedingly rare clinical entity,typically presenting with nonspecific symptoms or being identified incidentally.CASE SUMMARY This report presents an incidental discovery of a fungal ball in the nasal cavity during routine imaging,with no associated clinical symptoms.CONCLUSION This case underscores the importance of considering the possibility of asympto-matic presentations of nasal fungal balls,which may be detected incidentally during imaging evaluations.展开更多
The accuracy of thermal analysis measurements is critical to analyze material properties correctly,making the improvement of measurement precision and proper uncertainty analysis of test results absolutely essential.A...The accuracy of thermal analysis measurements is critical to analyze material properties correctly,making the improvement of measurement precision and proper uncertainty analysis of test results absolutely essential.As a primary thermal analysis instrument,the simultaneous thermal analyzer(STA)has unique advantages,which combines the functionalities of thermogravimetric(TG)analyzersand differential scanning calorimeters(DSC).However,the absence of standard quality control procedures has resulted in poor measurement reproducibility,low accuracy,and inadequate traceability of analytical results.This study utilized a multi-point temperature calibration method based on national certified reference materials to reduce instrument temperature indication errors.On this basis,we innovatively established a comprehensive quality control system encompassing laboratory environmental control,standard method selection,instrument performance verification,reference material traceability,and uncertainty analysis,thereby achieving standardized operational procedures for thermal analysis measurement.Taking the"determination of initial melting temperature of unknown substances"as a representative case study,a component resolution model for thermal analysis test uncertainty was developed.Through systematic analysis of both the reference material-introduced component and measurement repeatability component,complete traceability of test results was achieved.This approach ensures data validity and enhances the accuracy of test results.This provides crucial technical support and practical reference for the standardization of thermal analysis measurement procedure and assessment of result reliability.展开更多
Objective The lack of clarity regarding the application performance of a hybrid operating room(HOR)and the uncertainty of surgical scheduling often lead to its inefficient application.This study aimed to review the cl...Objective The lack of clarity regarding the application performance of a hybrid operating room(HOR)and the uncertainty of surgical scheduling often lead to its inefficient application.This study aimed to review the clinical application of our neurosurgical HOR and propose a scale to score cases clearly.Methods We reviewed the operating procedures and duration of stay in 1865 HOR cases.The actual procedures of each case were summarized into 5 application types,and numerical assignment was used to distinguish the dependence of each type on our HOR:surgical procedures combined with interventional procedures(4 points,the highest dependence),surgical procedures combined with imaging procedures(3 points),interventional procedures(2 points),imaging procedures(1 point),and surgical procedures(0 points,the lowest dependence).Results A novel scale that could score 1865 cases into those 5 grades was developed.The percentages by grade were as follows:4 points,4.24%;3 points,4.88%;2 points,20.75%;1 point,69.38%;and 0 points,0.75%.The cumulative usage time was 4241.9 h,the duration of which was as follows:4 points,16.17%;3 points,15.50%;2 points,31.32%;1 point,35.62%;and 0 points,1.39%.Conclusions The HOR serves as a multifunctional room to treat neurosurgical diseases.The scale helps to quickly prioritize cases that rely more on HOR,providing guidelines for surgical scheduling.Although our HOR is unsuitable for emergency cases,it clearly shows the application performance of our HOR to provide a reference for promoting its efficient application.展开更多
基金Supported by The National Natural Science Foundation of China,No.81772045 and No.81902000Teaching project of the First Affiliated Hospital of Harbin Medical University,No.2017014.
文摘The shortage of personal protective equipment and lack of proper nursing training have been endangering health care workers dealing with coronavirus disease 2019(COVID-19).In our treatment center,the implementation of a holistic care model of time-sharing management for severe and critical COVID-19 patients has further aggravated the shortage of intensive care unit(ICU)professional nurses.Therefore,we developed a short-term specialized and targeted nursing training program to help ICU nurses to cope with stress and become more efficient,thus reducing the number of nurses required in the ICU.In order to avoid possible human-to-human spread,small teaching classes and remote training were applied.The procedural training mode included four steps:preparation,plan,implementation,and evaluation.An evaluation was conducted throughout the process of nursing training.In this study,we documented and shared experiences in transitioning from traditional face-to-face programs to remote combined with proceduralization nursing training mode from our daily work experiences during the COVID-19 pandemic,which has shown to be helpful for nurses working in the ICU.
文摘Background 3D botanical tree reconstruction from a single image plays a vital role in the field of computer graphics.However,accurately capturing the intricate branching patterns and detailed morphologies of trees remains a challenge.Methods In this study,we proposed a novel approach for single-image tree reconstruction using a conditional generative adversarial network to infer the 3D skeleton of a tree in the form of a 2D skeleton depth map.Based on the 2D skeleton depth map,a corresponding branching structure(3D skeleton)that inherits the tree shape in the input image and leaves can be generated using a procedural modeling technique.Result Experimental results show that the proposed method accurately reconstructs diverse tree structures across species.Both quantitative and qualitative evaluations demonstrate improved skeleton completeness,branching accuracy,and visual realism over baseline methods,while requiring no user input.Conclusions Our proposed approach for generating lifelike 3D tree models from a single image with no user input shows its proficiency in achieving efficient and reliable reconstruction.These results showcase the capability of the proposed model to recreate complex tree architectures while capturing their visual authenticity.
文摘BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.
基金Construction of Standardized Protective Nursing Plan for Hydrofluoric Acid Operation in Stomatology and Re search on Injury Prevention Effect(Project No.:FZ2025101)。
文摘Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 2025,selecting 90 patients who underwent hydrofluoric acid-related treatments in the outpatient dental department of this hospital during this period as subjects.Forty-five patients treated between June 2023 and June 2024 received conventional protective care(pre-intervention group),while 45 patients treated between June 2024 and June 2025 underwent the standardized protective care protocol(post-intervention group).Thirteen healthcare personnel participated in both pre-and post-intervention treatment phases.Based on the different nursing models,indicators such as the incidence of adverse events in patients and the exposure rate of healthcare personnel before and after implementation were compared to evaluate the effectiveness of the nursing intervention.Results:The incidence of oral mucosal irritation reactions in patients was lower after implementation,p<0.05.Compared with the pre-implementation period,the incidence of procedure-related adverse events decreased after implementation,p<0.05.There was a significant difference in the occupational exposure rate of healthcare personnel before and after implementation,with a higher rate observed before implementation(p<0.05).Post-implementation,healthcare personnel achieved higher compliance scores for pre-procedure preparation,intra-procedure protection,and post-procedure handling(p<0.05).Patient satisfaction with treatment was lower pre-implementation than post-implementation(p<0.05).Conclusion:Adherence to standardized protective care procedures during hydrofluoric acid operations by dental department staff in outpatient settings standardizes practitioner techniques,effectively prevents oral mucosal irritation in patients,reduces occupational exposure risks for staff,minimizes adverse procedural events,and consequently enhances patient treatment satisfaction.This demonstrates significant practical value.
文摘Hainan Province in south China is the country’s second-largest island and the largest free trade port by area.It has entered a historic phase in China’s drive to promote high-level institutional opening up.On 18 December 2025,Hainan officially launched island-wide special customs operations,commonly referred to as“customs closure.”From that date,goods entering or leaving the island,except those traded with the Chinese mainland,are subject to simplified customs procedures and potentially reduced or zero tariffs.
文摘The original online version of this article was revised:Several errors occurred in the published version of the article.These have now been corrected as follows:Page 2,section"2.2 Laser Texturing Procedure of Surfaces",line 2:The device name was corrected from"YDFLP-E-50-M8"to"YDFLP-50-M8."Page 3,Section 2.4:The phrase"95%confidence interval"has been corrected to"95%confidence level."Page 3,Figure 1 caption:The phrase"fandg"has been corrected to"f and g."The order"C4 and C12"has been reversed to"C12 and C4,"in accordance with the display order in the figure.Page 4,Figure reference:The phrase"Figs.4c and d"has been corrected to"Figs.5b and c."Page 5,paragraph starting with"The ANOVA results are presented...":The phrase"95%confidence interval"has been corrected to"95%confidence level."
基金supported by AG057842 from the National Institutes of Health,TRIBA/Physiology Faculty Startup Fund from Augusta University (to FF)the National Natural Science Foundation of China (82173384)(to MG)
文摘Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocked or damaged lymphatic vessels.In early 2024,Dr.Qingping Xie from Hangzhou Qiushi Hospital,China,and Dr.Wei F.Chen from the Cleveland Clinic,USA,adapted LVA for the treatment of patients with Alzheimer’s disease(AD).As a VIEWPOINT,they presented a video showcasing the post-surgery cognitive recovery of an 84-year-old AD patient(Xie et al.,2024).
文摘Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.
文摘Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.
基金co-supported by the National Natural Science Foundation of China(Nos.U23B6001,62273118,12150008)the Fundamental Research Funds for the Central Universities,China(No.2023FRFK02043)+1 种基金the Natural Science Foundation of Heilongjiang Province,China(No.LH2022F023)China Aerospace Science and Technology Corporation Youth Talent Support Program.
文摘Non-contact debris removal methods are fuel-efficient in a single operation compared to contact-based strategies as spacecraft don’t need to match debris velocity.To comprehensively analyze this scheme,maneuvering schemes for maximum debris removal with minimum fuel consumption,including task assignment,sequence planning,and trajectory planning,must be formulated.The coupling between variables’dimensions and optimization results in task assignment poses challenges,as debris removal is repetitive and uncertain,leading to a vast search space.This paper proposes a novel Greedy Randomized Adaptive Search Procedure with Large Neighborhood and Crossover Mechanisms(GRASP-LNCM)to address this problem.The hybrid dynamic iteration mechanism improves computational efficiency and enhances the optimality of results.The model innovatively considers unsuccessful single removal by using a quantitative method to assess removal percentage.In addition,to improve the efficiency of sequence and trajectory planning,a Suboptimal Search Algorithm(SSA)based on the Lambert property and accelerated Multi-Revolution Lambert Problem(MRLP)solving strategy is established.Finally,a real Iridium-33 debris removal mission is studied.The simulation demonstrates that the proposed algorithm achieves state-of-the-art performance in several typical scenarios.Compared to the contact-based scheme,the new one is simpler,saving more fuel under certain conditions.
文摘BACKGROUND The spectrum of gastric submucosal tumors(SMTs)in the upper gastrointestinal system ranges from non-neoplastic to malignant lesions,with gastrointestinal stromal tumors exhibiting inherent malignant potential.However,the diagnosis of SMTs remains challenging,and treatment methods,especially for tumors located at the cardia or esophagogastric junction(EGJ),are not well established.Minimally invasive techniques-such as endoscopic submucosal dissection(ESD),submucosal tunneling endoscopic resection(STER),and laparoscopic wedge resection(LWR)-have been developed for these lesions.However,comparative data on their feasibility,safety,and clinical outcomes in these locations remain limited.AIM To compare ESD,STER,and LWR for SMTs at the EGJ or cardia,focusing on procedural feasibility.METHODS This single-center retrospective study included patients with SMTs less than 45 mm from the muscularis propria,growing intraluminally at the EGJ or cardia,and treated with ESD,STER,or LWR between July 2014 and September 2022.The primary outcome was relapse-free survival during follow-up.RESULTS The median age(interquartile range)was 53.0(40.0-57.5),43.0(39.0-57.0),and 56.0(43.0-64.0)years for ESD,STER,and LWR,respectively.The median follow-up time(interquartile range)was 60.0(26.5-66.5),24.0(13.0-38.0),and 35.0(21.0-60.0)months.LWR had the largest tumors(30.0 mm)and the highest rate of high-risk gastrointestinal stromal tumors(68.0%,P<0.001).Tumor recurrence occurred in one LWR patient(4.0%,P=0.600).En bloc and macroscopic resection rates were 100%(P=1.000),but microscopic resection rates differed(P=0.021).Significant minor complications occurred in 5 patients(10.0%),all grade IIIa.Tumor location(cardia/fundus,P=0.006)and prolonged procedure time(P<0.001)were significantly associated with complications.CONCLUSION ESD,STER,and LWR are effective for SMTs at the EGJ and cardia,with minor complications associated with tumor location and procedure time,and comparable recurrence rates.
文摘This paper provides a comprehensive review of various experimental methods used to study carbon corrosion in automotive polymer exchange membrane fuel cells.Quantifying the extent of carbon corrosion is essential for advancing the technology and implementing effective mitigation strategies.While studying degradation events directly within a real-world fuel cell vehicle offers the most reliable insights,the high costs and time demands make it necessary to develop specialised experimental techniques that provide high-resolution data more efficiently and cost-effectively.This review explores the various experimental approaches utilised in automotive application induced carbon corrosion studies globally,including load profiles,test setups,break-in procedures,and cell recovery protocols.In this paper,emphasis is placed on the standardised procedures proposed by leading institutions worldwide,accompanied by critical discussions on these protocols.Furthermore,the paper highlights modified or innovative procedures developed by smaller institutions,universities,and individual researchers,thereby offering a comprehensive overview essential for carbon corrosion analysis.The review also discusses the fundamental principles,benefits,and limitations of various procedures,offering guidance on selecting the most appropriate approach for a given study.Lastly,it addresses the limitations within the current body of literature and outlines potential future prospects.
基金supported by Zhejiang Provincial Natural Science Foundation of China(Grant No.ZCLTGY24H0401)Technology Program of Jiaxing(Grant No.2024AD30125).
文摘Advances in fetal surgery techniques have enabled the treatment of certain congenital defects before birth.A critical area of focus is the role of perinatal imaging in optimizing prenatal interventions within the precision medicine framework.Magnetic resonance imaging(MRI)is emerging as an indispensable tool for guiding these intricate procedures with the potential to significantly enhance the standard of care and outcomes for affected fetuses.This review begins with an overview of the classification and indications for fetal surgical interventions.It then explores the detailed applications of prenatal MRI scanning and diagnostic techniques across various categories of fetal surgery.A key focus is how fetal MRI provides critical insights into specific lesion characteristics and tissue involvement,thereby aiding healthcare professionals in selecting the optimal surgical strategies for prenatal and postnatal interventions.Fetal MRI offers detailed visualizations that complement traditional ultra-sound findings,enhancing the precision of radiological planning for fetal surgery.Finally,the review highlights how integration of fetal MRI into the decision-making process enables healthcare providers to make well-informed choices,ultimately improving the prognosis and outcomes for both the mother and fetus.
基金supported by the Natural Science Foundation of Sichuan Province(grant number:25NSFSC0265).
文摘Peri-implant keratinized mucosa(PIKM)augmentation refers to surgical procedures aimed at increasing the width of PIKM.Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health.Currently,several surgical techniques have been validated for their effectiveness in increasing PIKM.However,the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques,variations in clinical scenarios,and anatomical differences.Therefore,clear guidelines and considerations for PIKM augmentation are needed.This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery.It aims to establish a standardized framework for assessing,planning,and executing PIKM augmentation procedures,with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
文摘BACKGROUND Fungal balls within the nasal cavity are an exceedingly rare clinical entity,typically presenting with nonspecific symptoms or being identified incidentally.CASE SUMMARY This report presents an incidental discovery of a fungal ball in the nasal cavity during routine imaging,with no associated clinical symptoms.CONCLUSION This case underscores the importance of considering the possibility of asympto-matic presentations of nasal fungal balls,which may be detected incidentally during imaging evaluations.
文摘The accuracy of thermal analysis measurements is critical to analyze material properties correctly,making the improvement of measurement precision and proper uncertainty analysis of test results absolutely essential.As a primary thermal analysis instrument,the simultaneous thermal analyzer(STA)has unique advantages,which combines the functionalities of thermogravimetric(TG)analyzersand differential scanning calorimeters(DSC).However,the absence of standard quality control procedures has resulted in poor measurement reproducibility,low accuracy,and inadequate traceability of analytical results.This study utilized a multi-point temperature calibration method based on national certified reference materials to reduce instrument temperature indication errors.On this basis,we innovatively established a comprehensive quality control system encompassing laboratory environmental control,standard method selection,instrument performance verification,reference material traceability,and uncertainty analysis,thereby achieving standardized operational procedures for thermal analysis measurement.Taking the"determination of initial melting temperature of unknown substances"as a representative case study,a component resolution model for thermal analysis test uncertainty was developed.Through systematic analysis of both the reference material-introduced component and measurement repeatability component,complete traceability of test results was achieved.This approach ensures data validity and enhances the accuracy of test results.This provides crucial technical support and practical reference for the standardization of thermal analysis measurement procedure and assessment of result reliability.
基金supported by the Technology Innovation Special Major Project of Hubei Province(grant number 2022BCA003).
文摘Objective The lack of clarity regarding the application performance of a hybrid operating room(HOR)and the uncertainty of surgical scheduling often lead to its inefficient application.This study aimed to review the clinical application of our neurosurgical HOR and propose a scale to score cases clearly.Methods We reviewed the operating procedures and duration of stay in 1865 HOR cases.The actual procedures of each case were summarized into 5 application types,and numerical assignment was used to distinguish the dependence of each type on our HOR:surgical procedures combined with interventional procedures(4 points,the highest dependence),surgical procedures combined with imaging procedures(3 points),interventional procedures(2 points),imaging procedures(1 point),and surgical procedures(0 points,the lowest dependence).Results A novel scale that could score 1865 cases into those 5 grades was developed.The percentages by grade were as follows:4 points,4.24%;3 points,4.88%;2 points,20.75%;1 point,69.38%;and 0 points,0.75%.The cumulative usage time was 4241.9 h,the duration of which was as follows:4 points,16.17%;3 points,15.50%;2 points,31.32%;1 point,35.62%;and 0 points,1.39%.Conclusions The HOR serves as a multifunctional room to treat neurosurgical diseases.The scale helps to quickly prioritize cases that rely more on HOR,providing guidelines for surgical scheduling.Although our HOR is unsuitable for emergency cases,it clearly shows the application performance of our HOR to provide a reference for promoting its efficient application.
