This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadi...This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.展开更多
The unavoidable dendrite growth and shuttle effect have long been stranglehold challenges limiting the safety and practicality of lithium-sulfur batteries.Herein,we propose a dual-action strategy to address the lithiu...The unavoidable dendrite growth and shuttle effect have long been stranglehold challenges limiting the safety and practicality of lithium-sulfur batteries.Herein,we propose a dual-action strategy to address the lithium dendrite issue in stages by constructing a multifunctional surface-negatively-charged nanodiamond layer with high ductility and robust puncture resistance on polypropylene (PP) separator.The uniformly loaded compact negative layer can not only significantly enhance electron transmission efficiency and promote uniform lithium deposition,but also reduce the formation of dendrite during early deposition stage.Most importantly,under the strong puncture stress encountered during the deterioration of lithium dendrite growth under limiting current,the high ductility and robust puncture resistance(145.88 MPa) of as-obtained nanodiamond layer can effectively prevent short circuits caused by unavoidable lithium dendrite.The Li||Li symmetrical cells assembled with nanodiamond layer modified PP demonstrated a stable cycle of over 1000 h at 2 mA cm^(-2)with a polarization voltage of only 29.3 mV.Additionally,the negative charged layer serves as a physical barrier blocking lithium polysulfide ions,effectively mitigating capacity attenuation.The improved cells achieved a capacity decay of only 0.042%per cycle after 700 cycles at 3 C,demonstrating effective suppression of dendrite growth and capacity attenuation,showing promising prospect.展开更多
The Yemaomian landslide,the largest near-dam accumulation landslide in the Three Gorges Reservoir area,is situated 17 km upstream of the Three Gorges Dam.Nearly 20 years of monitoring data indicate that the landslide ...The Yemaomian landslide,the largest near-dam accumulation landslide in the Three Gorges Reservoir area,is situated 17 km upstream of the Three Gorges Dam.Nearly 20 years of monitoring data indicate that the landslide has been undergoing slow deformation with a low deformation rate and magnitude.This paper applies a stepwise linear regression method and a mechanical model of hydrodynamics triggering to deeply explore the relationship between geological conditions,external factors,and deformation characteristics.Based on the stage transition characteristics of external triggering factors,the deformation evolution process of the landslide since the reservoir impoundment is divided into three stages:(1)June 2003-September 2006,the landslide was reactivated by the significant rise in reservoir water levels,in a retrogressive mode;(2)October 2006-September 2018,the deformation mode shifted from retrogressive mode to creep deformation as a whole,primarily due to the degradation effect on the landslide mass caused by immersion in reservoir water.(3)October 2018-February 2024,a further significant reduction in the overall deformation rate and the impact of seasonal rainfall on landslide deformation surpassed that of reservoir water level fluctuations.The main component of landslide deformation is convergent creep,and extreme rainfall will be an important triggering factor for the local instability.Identifying the deformation evolution stages and determining the dominant external influencing factors at each stage is crucial for landslide research,and this paper provides an effective research paradigm for this purpose.展开更多
BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)is a procedure used for patients with initially unresectable colorectal liver metastases(CRLM).However,the procedure has bee...BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)is a procedure used for patients with initially unresectable colorectal liver metastases(CRLM).However,the procedure has been reported to be associated with high morbidity and mortality.Laparoscopic ALPPS has recently been reported as a minimally invasive technique that reduces perioperative risks.AIM To assess the safety and feasibility of full laparoscopic ALPPS in patients with CRLM.METHODS A retrospective analysis was conducted on all consecutive patients with CRLM who underwent full laparoscopic ALPPS at the Sixth Affiliated Hospital of Sun Yat-sen University between March 2021 and July 2024.RESULTS Fifteen patients were included,13 with synchronous liver metastases.Nine patients had more than five liver tumors,with the highest count being 22.The median diameter of the largest lesion was 2.8 cm on preoperative imaging.No extrahepatic metastases were observed.RAS mutations were detected in nine patients,and 14 underwent preoperative chemotherapy.The median increase in future liver remnant volume during the interstage interval was 47.0%.All patients underwent R0 resection.Overall complication rates were 13.3%(stage 1)and 53.3%(stage 2),while major complication rates(Clavien-Dindo≥IIIa)were 13.3%(stage 1)and 33.3%(stage 2).No mortality occurred in either stage.The median hospital stay after stage 2 was 10 days.CONCLUSION Full laparoscopic ALPPS for CRLM is safe and feasible,with the potential for reduced morbidity and mortality,offering radical resection opportunities for patients with initially unresectable CRLM.展开更多
BACKGROUND The recovery of limb function after ankle fracture surgery is a gradual process.The main purpose of implementing early functional exercise,joint mobility,muscle contraction function,passive ankle flexion an...BACKGROUND The recovery of limb function after ankle fracture surgery is a gradual process.The main purpose of implementing early functional exercise,joint mobility,muscle contraction function,passive ankle flexion and extension exercises,or physical factor therapy techniques is to achieve the rapid recovery of normal physiological limb function.However,currently the most effective rehabilitation training method is staged limb functional exercise,which promotes rapid recovery of limb function while preventing adverse consequences caused by overwork or insufficient training.Staged limb functional exercise divides the rehabilitation process into multiple stages,each of which has specific training objectives and contents.This method helps patients gradually restore limb function.Nevertheless,some patients still exhibit poor limb function after standardized exercise.Therefore,a functional evaluation should be performed to analyze the impact of staged functional training after ankle fracture surgery.AIM To perform a functional evaluation and determine the influencing factors of staged functional training in patients with ankle fracture.METHODS A retrospective study enrolled 150 patients who underwent surgical treatment for ankle fracture from May 2020 to May 2022 at our hospital.Univariate and multivariate linear regression analyses were performed on general data,functional exercise compliance scale for orthopedic patients,Social Support Rating Scale(SSRS),American Orthopedic Foot and Ankle Score(AOFAS)Ankle-Hindfoot Score,and pain factors[serum bradykinin(BK),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)].RESULTS Based on the AOFAS Ankle-Hindfoot Scale,the cases were divided into the excellent function(n=111)and ordinary function(n=39)groups.Univariate analysis revealed that monthly family income,education level,diabetes mellitus,functional exercise compliance scale of orthopedic patients score,SSRS,BK,PGE2,and 5-HT significantly influenced limb function after ankle fracture(P<0.05);Multiple linear regression analysis showed that the functional exercise compliance scale score,SSRS,BK,PGE2,and 5-HT were independent risk factors affecting functional performance after staged functional exercise(P<0.05).CONCLUSION Exercise compliance,SSRS,and pain level are the independent risk factors affecting functional performance after staged functional training following ankle surgery.Clinical nursing care after ankle surgery should include analgesic and health education measures to ensure optimal recovery of limb function.展开更多
Objective:To investigate the application effect of staged health education in the care of patients with upper gastrointestinal bleeding.Methods:This study takes health education in the care of patients with upper gast...Objective:To investigate the application effect of staged health education in the care of patients with upper gastrointestinal bleeding.Methods:This study takes health education in the care of patients with upper gastrointestinal bleeding as the main direction.160 patients with upper gastrointestinal bleeding who received treatment in our hospital were selected as samples,and the grouping software was used to divide them into the reference group and the study group,with 80 patients each.The reference group and the study group used routine health education and staged health education respectively.Relevant research data were recorded during the nursing process,analyzed,and used as research indicators.Results:The compliance behavior of the study group was higher than that of the reference group after the staged nursing care,and at the same time,the nursing care satisfaction of the study group was higher than that of the reference group(P<0.05).Conclusion:The use of staged health education for the care of patients with upper gastrointestinal bleeding not only enhances the degree of patient awareness and compliance but also improves nursing satisfaction,which is worthy of promotion and application.展开更多
Teacher education at the foundational and preparatory stages plays a crucial role in shaping early childhood learning experiences.The National Curriculum Framework for School Education(NCFSE)2023 provides a structured...Teacher education at the foundational and preparatory stages plays a crucial role in shaping early childhood learning experiences.The National Curriculum Framework for School Education(NCFSE)2023 provides a structured pedagogical approach to address challenges in these stages.However,despite these policy frameworks,teachers in Kendriya Vidyalayas(KVs)continue to face numerous pedagogical challenges.This paper aims to explore and analyze the pedagogical challenges encountered by KV teachers in foundational and preparatory stage classrooms and compare them with the challenges addressed in NCFSE 2023.Using qualitative research methods,data were collected through structured online interviews with 10 KV teachers from different campuses.This paper investigated various challenges,including classroom management,language barriers,a lack of inclusive education strategies,insufficient infrastructure,limited parental involvement,and difficulties in integrating technology into teaching practices.The findings highlight the gap between policy recommendations and ground-level implementation.Based on these insights,the study suggests recommendations such as specialized teacher training,recruitment of special educators,improved infrastructure,enhanced parental engagement,and policy-driven interventions to bridge the gap between policy frameworks and real-world classroom experiences.The study concludes that addressing these challenges through targeted reforms can create a more inclusive and effective learning environment,fostering holistic student development at the foundational and preparatory stages.展开更多
Objective The aim of this study was to investigate the value of the 8th American Joint Committee on Cancer(AJCC)anatomic and prognostic stage groups for penile cancer patients and explore whether there is room for imp...Objective The aim of this study was to investigate the value of the 8th American Joint Committee on Cancer(AJCC)anatomic and prognostic stage groups for penile cancer patients and explore whether there is room for improvement.Methods The clinical and histopathologic data from 16 centers between January 2000 and December 2021 were assessed according to the 8th AJCC anatomic and prognostic stage groups.Kaplan–Meier plots were used to estimate the disease-specific survival(DSS)of the patients.The accuracy of the staging systems was investigated using the Harrell's concordance index(C-index).Results According to the 8th AJCC anatomic and prognostic stage groups,the 5-year DSS rates for patients with stages 0is/a,I,IIA,IIB,IIIA,IIIB,and IV disease were 100%,99%,86%,81%,66%,34%,and 23%,respectively(p_(0is/a–I)=0.8,p_(I–IIA)<0.001,p_(IIA–IIB)=0.5,p_(IIB–IIIA)<0.001,p_(IIIA–IIIB)<0.001,p_(IIIB–IV)=0.004,and p_(Total)<0.001).According to the modified model 1 system,the 5-year DSS rates without survivorship overlap for patients with stages 0is/a,I,II,IIIA,IIIB,and IV disease were 100%,99%,88%,66%,34%,and 23%,respectively(p_(0is/a–I)=0.8,p_(I–II)<0.001,p_(II–IIIA)=0.002,p_(IIIA–IIIB)<0.001,p_(IIIB–IV)=0.004,and p_(Total)<0.001).Similarly,according to the modified model 2 system,the 5-year DSS rates without survivorship overlap for patients with stages 0is/a,I,II,IIIA,IIIB,and IV disease were 100%,99%,86%,66%,34%,and 23%,respectively(p_(0is/a–I)=0.8,p_(I–II)<0.001,p_(II–IIIA)=0.008,p_(IIIA–IIIB)<0.001,p_(IIIB–IV)=0.004,and p_(Total)<0.001).The C-index scores of the simple modified staging systems were not inferior to those of the AJCC anatomic and prognostic stage groups.These results were confirmed by the bootstrap internal validation.Conclusion There is still room for improvement about the 8th AJCC anatomic and prognostic stage groups.The improved models,which are more concise and convenient,have similar prediction accuracy.展开更多
Group living is widespread across diverse taxa,and the mechanisms underlying collective decision-making in contexts of variable role division are critical for understanding the dynamics of group stability.While studie...Group living is widespread across diverse taxa,and the mechanisms underlying collective decision-making in contexts of variable role division are critical for understanding the dynamics of group stability.While studies on collective behavior in small animals such as fish and insects are well-established,similar research on large wild animals remains challenging due to the limited availability of sufficient and systematic field data.Here,we aimed to explore the collective decision-making pattern and its sexual difference for the dimorphic Tibetan antelopes Pantholops hodgsonii(chiru)in Xizang Autonomous Region,China,by analyzing individual leadership distribution,as well as the joining process,considering factors such as calving stages and joining ranks.The distinct correlations of decision participants’ratio with group size and decision duration underscore the trade-off between accuracy and speed in decision-making.Male antelopes display a more democratic decision-making pattern,while females exhibit more prompt responses after calving at an early stage.This study uncovers a partially shared decision-making strategy among Tibetan antelopes,suggesting flexible self-organization in group decision processes aligned with animal life cycle progression.展开更多
With the growth of the construction industry,risk management in construction projects has garnered significant attention from the academic community.Effective risk management during the decision-making stage can great...With the growth of the construction industry,risk management in construction projects has garnered significant attention from the academic community.Effective risk management during the decision-making stage can greatly enhance project management efficiency.This paper integrates the AHP-entropy value method and constructs a risk management model based on the DPSIR framework for construction projects.The model is applied to evaluate and analyze the risk level of the decision-making stage in a navigation and electricity hub project in Chongqing Municipality.The results demonstrate the scientific validity and effectiveness of the proposed model.展开更多
The wheat above-ground biomass(AGB)is an important index that shows the life activity of vegetation,which is of great significance for wheat growth monitoring and yield prediction.Traditional biomass estimation method...The wheat above-ground biomass(AGB)is an important index that shows the life activity of vegetation,which is of great significance for wheat growth monitoring and yield prediction.Traditional biomass estimation methods specifically include sample surveys and harvesting statistics.Although these methods have high estimation accuracy,they are time-consuming,destructive,and difficult to implement to monitor the biomass at a large scale.The main objective of this study is to optimize the traditional remote sensing methods to estimate the wheat AGBbased on improved convolutional features(CFs).Low-cost unmanned aerial vehicles(UAV)were used as the main data acquisition equipment.This study acquired image data acquired by RGB camera(RGB)and multi-spectral(MS)image data of the wheat population canopy for two wheat varieties and five key growth stages.Then,field measurements were conducted to obtain the actual wheat biomass data for validation.Based on the remote sensing indices(RSIs),structural features(SFs),and CFs,this study proposed a new feature named AUR-50(multi-source combination based on convolutional feature optimization)to estimate the wheat AGB.The results show that AUR-50 could estimate the wheat AGB more accurately than RSIs and SFs,and the average R^(2) exceeded 0.77.In the overwintering period,AUR-50_(MS)(multi-source combination with convolutional feature optimization using multispectral imagery)had the highest estimation accuracy(R^(2) of 0.88).In addition,AUR-50 reduced the effect of the vegetation index saturation on the biomass estimation accuracy by adding CFs,where the highest R^(2) was 0.69 at the flowering stage.The results of this study provide an effective method to evaluate the AGB in wheat with high throughput and a research reference for the phenotypic parameters of other crops.展开更多
This paper addresses the design problem of an embedded mobile stage location system based on a two-dimensional laser radar.The mobile stage is a piece of important performance equipment in art performances,and the pos...This paper addresses the design problem of an embedded mobile stage location system based on a two-dimensional laser radar.The mobile stage is a piece of important performance equipment in art performances,and the positioning problem is one of the key issues in the control of the mobile stage.Both hardware and software are developed for the mobile stage.The hardware of the location system consists of a laser radar,an embedded control board,a wireless router,and a motion control unit.The software of the location system includes embedded software and human-machine interface(HMI),and they are designed to achieve the functions of real-time positioning and monitoring.First,a novel landmark identification method is presented based on the landmark reflection intensities and shapes.Then,the initial pose of the mobile stage is calculated by using the triangle matching algorithm and the least squares method.A distributed fusion Kalman filtering algorithm is applied to fuse landmark information and odometer information to achieve real-time positioning of the mobile stage.The designed system has been implemented in a practical mobile stage,and the results demonstrate that the location system can achieve a high positioning precision in both the stationary and moving scenarios.展开更多
Pigs have emerged as valuable large-animal models for cardiac xenotransplantation;however,the temporal dynamics of myocardial development in this species remains insufficiently defined.This study analyzed gene express...Pigs have emerged as valuable large-animal models for cardiac xenotransplantation;however,the temporal dynamics of myocardial development in this species remains insufficiently defined.This study analyzed gene expression patterns across four key developmental stages(neonatal,juvenile,sexual maturity,and adulthood)to delineate the molecular mechanisms driving porcine myocardial development.Increases in heart weight were accompanied by proportional expansion of myocardial fiber area and chamber size,reflecting coordinated structural development.Transcriptomic profiling of myocardial tissue by RNA sequencing(RNA-seq)identified 2189 differentially expressed genes(DEGs)across stage comparisons.Short time-series expression miner(STEM)analysis classified these DEGs into four major expression clusters enriched in pathways associated with myocardial development,immune responses,cell proliferation,and metabolic processes.Among 359 DEGs conserved across all developmental stages,six candidate genes were strongly associated with myocardial development.Reverse transcription-quantitative real-time polymerase chain reaction(RT-qPCR)confirmed a significant correlation between the expression of these candidate genes and myocardial development in porcine tissue.These findings establish a transcriptomic framework for porcine myocardial maturation and provide a molecular basis for advancing cardiac xenotransplantation.展开更多
In semiconductor precision packaging and other applications involving alignment of automated equipment,the nonlinear motion caused by structural characteristics and friction effects on torque-type rotating motion stag...In semiconductor precision packaging and other applications involving alignment of automated equipment,the nonlinear motion caused by structural characteristics and friction effects on torque-type rotating motion stages seriously affects output accuracy and stability.To solve this problem,the motion characteristics of a rotating stage and the mechanism by which friction nonlinearity influences accuracy are analyzed in detail.In addition,a compound control strategy based on a kinematic model and the Stribeck friction model is designed.A friction disturbance observer based on output position feedback is improved for simple parameter tuning.Finally,an experimental system is constructed to carry out validation tests,including identification of nonlinear characteristics and performance comparisons.The experimental results show that the linear tracking error of the torque-type rotating stage is less than 1.47µm after adoption of the proposed model-based composite control strategy,and the corresponding rotary angle deviation is less than 0.0153°.The linearity of output motion is increased to 97.59%and the error compensation effect is improved by 51.6%compared with the PID control method.The experimental results confirm that the analysis method adopted here and the proposed compensation strategy can effectively reduce frictional nonlinearity and improve motion accuracy.The proposed method can also be applied to other precision electromechanical systems.展开更多
Objectives A systematic review and network meta-analysis was conducted to evaluate the effectiveness of different childbirth positions in reducing the duration of the second stage of labor,providing evidence-based ins...Objectives A systematic review and network meta-analysis was conducted to evaluate the effectiveness of different childbirth positions in reducing the duration of the second stage of labor,providing evidence-based insights for obstetric institutions to guide interventions related to childbirth positions.Methods A comprehensive literature search was conducted in databases,including PubMed,Web of Science,the Cochrane Library,Embase,Wanfang Databases,China National Knowledge Infrastructure Databases(CNKI),China Science and Technology Journal Database(CSTJ),and China Biology Medicine disc(CBMdisc)to identify studies on the effectiveness of different childbirth positions in reducing the duration of the second stage of labor.The search included randomized controlled trials published from database inception to September 30,2024.The Cochrane risk-of-bias tool was used to assess the quality of the studies.Two independent reviewers screened the literature,extracted data,and evaluated study quality.Subsequently,a network meta-analysis was performed using STATA software.The study protocol has been registered in PROSPERO(CRD42023428217).Results This study analyzed data from 25 randomized controlled trials involving 9,844 women.The findings indicated that in comparison to lithotomy position,free position(MD=20.53,95%CI[11.38,29.68])and upright position(MD=−24.13,95%CI[−42.94,-5.32])were found to be superior in reducing the duration of the second stage of labor.Free position outperformed kneeling position(MD=21.48,95%CI[4.67,38.28])and squatting position(MD=23.43,95%CI[1.88,44.97]);upright position was superior to kneeling position(MD=−25.08,95%CI[−46.93,−3.22]);semirecumbent position surpassed squatting position(MD=19.71,95%CI[2.05,37.38]);and upright position was also superior to squatting position(MD=−27.03,95%CI[−51.48,−2.57]).According to the surface under the cumulative ranking curve(SUCRA),the upright position emerged as the most effective for reducing the duration of the second stage of labor(87.4%),followed by free position(81.1%),semirecumbent position(70.0%),and lateral position(62.3%).Conclusion These findings offer valuable insights for midwifery practice and help inform future research directions.Considering the limitations of this review,more larger-scale,multicenter randomized controlled trials are warranted to further evaluate the relative effectiveness of different childbirth positions in reducing the duration of the second stage of labor.展开更多
The rhizosphere bacteria play crucial roles in plant health and growth as they are involved in assimilating nutrients and resisting adverse conditions such as nutrient stress,drought,and wind erosion.Agriophyllum squa...The rhizosphere bacteria play crucial roles in plant health and growth as they are involved in assimilating nutrients and resisting adverse conditions such as nutrient stress,drought,and wind erosion.Agriophyllum squarrosum(L.)Moq.is a pioneer plant used in sand fixation due to its strong resistance to drought and wind erosion.However,the bacterial community characteristics and ecological function in the rhizosphere of A.squarrosum are poorly understood.In this study,soil samples were collected from different developmental stages(seedling stage,vegetative stage,reproductive stage,and withering stage)of A.squarrosum.Illumina Miseq sequencing was used to detect differences in soil bacterial abundance.The Phylogenetic Investigation of Communities by Reconstruction of Unobserved States(PICRUSt)program was used to predict bacterial functions,and the relationships among bacteria,functional populations,and soil nutrients were examined using a heatmap analysis.The results showed that the Shannon and Sobs indices of rhizosphere bacteria were significantly higher during the reproductive stage than during the other stages.Pantoea sp.(7.03%)was the dominant genus during the seedling stage;Arthrobacter sp.was the dominant genus during the vegetative(13.94%),reproductive(7.57%),and withering(12.30%)stages.The relative abundances of Chloroflexi,Acidobacteria,and Gemmatimonadetes were significantly high during the reproductive stage.According to the PICRUSt analysis,membrane transport,signal transduction,and environmental adaptation of the bacterial functional population occurred during the seedling stage.Carbohydrate metabolism increased during the vegetative stage,while energy metabolism,lipid metabolism,and biosynthesis of other secondary metabolites of the bacterial functional population significantly increased during the reproductive stage.The abundances of bacterial communities,functional genes,and soil nutrients were synergistically altered during various developmental stages.Our findings suggest that the developmental stages of A.squarrosum play a significant role in defining the composition and structure of bacterial communities in the rhizosphere.The results will provide a basis for better prediction and understanding of soil bacterial metabolic potential and functions of A.squarrosum rhizosphere in sandy areas.展开更多
基金supported by funding from the Medical Research Funding of Guangdong(No.A2022499 to QGX)the National Natural Science Foundation of China(No.82301796 to PL)the Guangdong Province Regional Joint Fund-Youth Fund Project of China(No.2022A1515111201 to PL).
文摘This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.
基金National Natural Science Foundation of China (Grant 52372083, 52173255)Opening Project of the Jiangsu Key Laboratory for Chemistry of Low-Dimensional Materials (JSKC24025)+1 种基金Special Funds for the Trans-formation of Scientific and Technological Achievements in Jiangsu Province(BA2023003)Collaborative Innovation Center for Advanced Micro/nanomaterials and Equipment (Co-constructed by Jiangsu Province and Ministry of Education)。
文摘The unavoidable dendrite growth and shuttle effect have long been stranglehold challenges limiting the safety and practicality of lithium-sulfur batteries.Herein,we propose a dual-action strategy to address the lithium dendrite issue in stages by constructing a multifunctional surface-negatively-charged nanodiamond layer with high ductility and robust puncture resistance on polypropylene (PP) separator.The uniformly loaded compact negative layer can not only significantly enhance electron transmission efficiency and promote uniform lithium deposition,but also reduce the formation of dendrite during early deposition stage.Most importantly,under the strong puncture stress encountered during the deterioration of lithium dendrite growth under limiting current,the high ductility and robust puncture resistance(145.88 MPa) of as-obtained nanodiamond layer can effectively prevent short circuits caused by unavoidable lithium dendrite.The Li||Li symmetrical cells assembled with nanodiamond layer modified PP demonstrated a stable cycle of over 1000 h at 2 mA cm^(-2)with a polarization voltage of only 29.3 mV.Additionally,the negative charged layer serves as a physical barrier blocking lithium polysulfide ions,effectively mitigating capacity attenuation.The improved cells achieved a capacity decay of only 0.042%per cycle after 700 cycles at 3 C,demonstrating effective suppression of dendrite growth and capacity attenuation,showing promising prospect.
基金supported by the National Natural Science Foundation of China(Nos.U2340226,12072047,42277186)China Three Gorges Corporation under the contract of No.0799291(SXSN/5115)the Fundamental Research Funds for Central Public Welfare Research Institutes(CKSF20241014/YT,CKSF20241016/YT).
文摘The Yemaomian landslide,the largest near-dam accumulation landslide in the Three Gorges Reservoir area,is situated 17 km upstream of the Three Gorges Dam.Nearly 20 years of monitoring data indicate that the landslide has been undergoing slow deformation with a low deformation rate and magnitude.This paper applies a stepwise linear regression method and a mechanical model of hydrodynamics triggering to deeply explore the relationship between geological conditions,external factors,and deformation characteristics.Based on the stage transition characteristics of external triggering factors,the deformation evolution process of the landslide since the reservoir impoundment is divided into three stages:(1)June 2003-September 2006,the landslide was reactivated by the significant rise in reservoir water levels,in a retrogressive mode;(2)October 2006-September 2018,the deformation mode shifted from retrogressive mode to creep deformation as a whole,primarily due to the degradation effect on the landslide mass caused by immersion in reservoir water.(3)October 2018-February 2024,a further significant reduction in the overall deformation rate and the impact of seasonal rainfall on landslide deformation surpassed that of reservoir water level fluctuations.The main component of landslide deformation is convergent creep,and extreme rainfall will be an important triggering factor for the local instability.Identifying the deformation evolution stages and determining the dominant external influencing factors at each stage is crucial for landslide research,and this paper provides an effective research paradigm for this purpose.
基金Supported by Natural Science Foundation of Guangdong Province of China,No.2024A1515012862.
文摘BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)is a procedure used for patients with initially unresectable colorectal liver metastases(CRLM).However,the procedure has been reported to be associated with high morbidity and mortality.Laparoscopic ALPPS has recently been reported as a minimally invasive technique that reduces perioperative risks.AIM To assess the safety and feasibility of full laparoscopic ALPPS in patients with CRLM.METHODS A retrospective analysis was conducted on all consecutive patients with CRLM who underwent full laparoscopic ALPPS at the Sixth Affiliated Hospital of Sun Yat-sen University between March 2021 and July 2024.RESULTS Fifteen patients were included,13 with synchronous liver metastases.Nine patients had more than five liver tumors,with the highest count being 22.The median diameter of the largest lesion was 2.8 cm on preoperative imaging.No extrahepatic metastases were observed.RAS mutations were detected in nine patients,and 14 underwent preoperative chemotherapy.The median increase in future liver remnant volume during the interstage interval was 47.0%.All patients underwent R0 resection.Overall complication rates were 13.3%(stage 1)and 53.3%(stage 2),while major complication rates(Clavien-Dindo≥IIIa)were 13.3%(stage 1)and 33.3%(stage 2).No mortality occurred in either stage.The median hospital stay after stage 2 was 10 days.CONCLUSION Full laparoscopic ALPPS for CRLM is safe and feasible,with the potential for reduced morbidity and mortality,offering radical resection opportunities for patients with initially unresectable CRLM.
文摘BACKGROUND The recovery of limb function after ankle fracture surgery is a gradual process.The main purpose of implementing early functional exercise,joint mobility,muscle contraction function,passive ankle flexion and extension exercises,or physical factor therapy techniques is to achieve the rapid recovery of normal physiological limb function.However,currently the most effective rehabilitation training method is staged limb functional exercise,which promotes rapid recovery of limb function while preventing adverse consequences caused by overwork or insufficient training.Staged limb functional exercise divides the rehabilitation process into multiple stages,each of which has specific training objectives and contents.This method helps patients gradually restore limb function.Nevertheless,some patients still exhibit poor limb function after standardized exercise.Therefore,a functional evaluation should be performed to analyze the impact of staged functional training after ankle fracture surgery.AIM To perform a functional evaluation and determine the influencing factors of staged functional training in patients with ankle fracture.METHODS A retrospective study enrolled 150 patients who underwent surgical treatment for ankle fracture from May 2020 to May 2022 at our hospital.Univariate and multivariate linear regression analyses were performed on general data,functional exercise compliance scale for orthopedic patients,Social Support Rating Scale(SSRS),American Orthopedic Foot and Ankle Score(AOFAS)Ankle-Hindfoot Score,and pain factors[serum bradykinin(BK),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)].RESULTS Based on the AOFAS Ankle-Hindfoot Scale,the cases were divided into the excellent function(n=111)and ordinary function(n=39)groups.Univariate analysis revealed that monthly family income,education level,diabetes mellitus,functional exercise compliance scale of orthopedic patients score,SSRS,BK,PGE2,and 5-HT significantly influenced limb function after ankle fracture(P<0.05);Multiple linear regression analysis showed that the functional exercise compliance scale score,SSRS,BK,PGE2,and 5-HT were independent risk factors affecting functional performance after staged functional exercise(P<0.05).CONCLUSION Exercise compliance,SSRS,and pain level are the independent risk factors affecting functional performance after staged functional training following ankle surgery.Clinical nursing care after ankle surgery should include analgesic and health education measures to ensure optimal recovery of limb function.
文摘Objective:To investigate the application effect of staged health education in the care of patients with upper gastrointestinal bleeding.Methods:This study takes health education in the care of patients with upper gastrointestinal bleeding as the main direction.160 patients with upper gastrointestinal bleeding who received treatment in our hospital were selected as samples,and the grouping software was used to divide them into the reference group and the study group,with 80 patients each.The reference group and the study group used routine health education and staged health education respectively.Relevant research data were recorded during the nursing process,analyzed,and used as research indicators.Results:The compliance behavior of the study group was higher than that of the reference group after the staged nursing care,and at the same time,the nursing care satisfaction of the study group was higher than that of the reference group(P<0.05).Conclusion:The use of staged health education for the care of patients with upper gastrointestinal bleeding not only enhances the degree of patient awareness and compliance but also improves nursing satisfaction,which is worthy of promotion and application.
文摘Teacher education at the foundational and preparatory stages plays a crucial role in shaping early childhood learning experiences.The National Curriculum Framework for School Education(NCFSE)2023 provides a structured pedagogical approach to address challenges in these stages.However,despite these policy frameworks,teachers in Kendriya Vidyalayas(KVs)continue to face numerous pedagogical challenges.This paper aims to explore and analyze the pedagogical challenges encountered by KV teachers in foundational and preparatory stage classrooms and compare them with the challenges addressed in NCFSE 2023.Using qualitative research methods,data were collected through structured online interviews with 10 KV teachers from different campuses.This paper investigated various challenges,including classroom management,language barriers,a lack of inclusive education strategies,insufficient infrastructure,limited parental involvement,and difficulties in integrating technology into teaching practices.The findings highlight the gap between policy recommendations and ground-level implementation.Based on these insights,the study suggests recommendations such as specialized teacher training,recruitment of special educators,improved infrastructure,enhanced parental engagement,and policy-driven interventions to bridge the gap between policy frameworks and real-world classroom experiences.The study concludes that addressing these challenges through targeted reforms can create a more inclusive and effective learning environment,fostering holistic student development at the foundational and preparatory stages.
基金supported by the Guangdong Province Nature Foundation of China Project (No. 2022A1515012200 to Li Z)Shenzhen Science and Technology Program (No. RCYX20221008093032008 to Li Z)Shenzhen People's Hospital Clinician Scientist Training Program (No. SYWGSJCYJ202405 to Li Z).
文摘Objective The aim of this study was to investigate the value of the 8th American Joint Committee on Cancer(AJCC)anatomic and prognostic stage groups for penile cancer patients and explore whether there is room for improvement.Methods The clinical and histopathologic data from 16 centers between January 2000 and December 2021 were assessed according to the 8th AJCC anatomic and prognostic stage groups.Kaplan–Meier plots were used to estimate the disease-specific survival(DSS)of the patients.The accuracy of the staging systems was investigated using the Harrell's concordance index(C-index).Results According to the 8th AJCC anatomic and prognostic stage groups,the 5-year DSS rates for patients with stages 0is/a,I,IIA,IIB,IIIA,IIIB,and IV disease were 100%,99%,86%,81%,66%,34%,and 23%,respectively(p_(0is/a–I)=0.8,p_(I–IIA)<0.001,p_(IIA–IIB)=0.5,p_(IIB–IIIA)<0.001,p_(IIIA–IIIB)<0.001,p_(IIIB–IV)=0.004,and p_(Total)<0.001).According to the modified model 1 system,the 5-year DSS rates without survivorship overlap for patients with stages 0is/a,I,II,IIIA,IIIB,and IV disease were 100%,99%,88%,66%,34%,and 23%,respectively(p_(0is/a–I)=0.8,p_(I–II)<0.001,p_(II–IIIA)=0.002,p_(IIIA–IIIB)<0.001,p_(IIIB–IV)=0.004,and p_(Total)<0.001).Similarly,according to the modified model 2 system,the 5-year DSS rates without survivorship overlap for patients with stages 0is/a,I,II,IIIA,IIIB,and IV disease were 100%,99%,86%,66%,34%,and 23%,respectively(p_(0is/a–I)=0.8,p_(I–II)<0.001,p_(II–IIIA)=0.008,p_(IIIA–IIIB)<0.001,p_(IIIB–IV)=0.004,and p_(Total)<0.001).The C-index scores of the simple modified staging systems were not inferior to those of the AJCC anatomic and prognostic stage groups.These results were confirmed by the bootstrap internal validation.Conclusion There is still room for improvement about the 8th AJCC anatomic and prognostic stage groups.The improved models,which are more concise and convenient,have similar prediction accuracy.
基金supported by the National Natural Science Foundation of China(Grant no.32101237)the China Postdoctoral Science Foundation(Grant no.2021M691522)+1 种基金the National Key Research and Development Program(Grant no.2022YFC3202104)the Tibet Major Science and Technology Project(Grant no.XZ201901-GA-06).
文摘Group living is widespread across diverse taxa,and the mechanisms underlying collective decision-making in contexts of variable role division are critical for understanding the dynamics of group stability.While studies on collective behavior in small animals such as fish and insects are well-established,similar research on large wild animals remains challenging due to the limited availability of sufficient and systematic field data.Here,we aimed to explore the collective decision-making pattern and its sexual difference for the dimorphic Tibetan antelopes Pantholops hodgsonii(chiru)in Xizang Autonomous Region,China,by analyzing individual leadership distribution,as well as the joining process,considering factors such as calving stages and joining ranks.The distinct correlations of decision participants’ratio with group size and decision duration underscore the trade-off between accuracy and speed in decision-making.Male antelopes display a more democratic decision-making pattern,while females exhibit more prompt responses after calving at an early stage.This study uncovers a partially shared decision-making strategy among Tibetan antelopes,suggesting flexible self-organization in group decision processes aligned with animal life cycle progression.
文摘With the growth of the construction industry,risk management in construction projects has garnered significant attention from the academic community.Effective risk management during the decision-making stage can greatly enhance project management efficiency.This paper integrates the AHP-entropy value method and constructs a risk management model based on the DPSIR framework for construction projects.The model is applied to evaluate and analyze the risk level of the decision-making stage in a navigation and electricity hub project in Chongqing Municipality.The results demonstrate the scientific validity and effectiveness of the proposed model.
基金supported by the Postgraduate Research&Practice Innovation Program of Jiangsu Province,China(SJCX23_1973)the National Natural Science Foundation of China(32172110,32071945)+7 种基金the Key Research and Development Program(Modern Agriculture)of Jiangsu Province,China(BE2022342-2,BE2020319)the Anhui Province Crop Intelligent Planting and Processing Technology Engineering Research Center Open Project,China(ZHKF04)the National Key Research and Development Program of China(2023YFD2300201,2023YFD1202200)the Special Funds for Scientific and Technological Innovation of Jiangsu Province,China(BE2022425)the Priority Academic Program Development of Jiangsu Higher Education Institutions,China(PAPD)the Central Publicinterest Scientific Institution Basal Research Fund,China(JBYW-AII-2023-08)the Science and Technology Innovation Project of the Chinese Academy of Agricultural Sciences(CAAS-CS-202201)the Special Fund for Independent Innovation of Agriculture Science and Technology in Jiangsu Province,China(CX(22)3112)。
文摘The wheat above-ground biomass(AGB)is an important index that shows the life activity of vegetation,which is of great significance for wheat growth monitoring and yield prediction.Traditional biomass estimation methods specifically include sample surveys and harvesting statistics.Although these methods have high estimation accuracy,they are time-consuming,destructive,and difficult to implement to monitor the biomass at a large scale.The main objective of this study is to optimize the traditional remote sensing methods to estimate the wheat AGBbased on improved convolutional features(CFs).Low-cost unmanned aerial vehicles(UAV)were used as the main data acquisition equipment.This study acquired image data acquired by RGB camera(RGB)and multi-spectral(MS)image data of the wheat population canopy for two wheat varieties and five key growth stages.Then,field measurements were conducted to obtain the actual wheat biomass data for validation.Based on the remote sensing indices(RSIs),structural features(SFs),and CFs,this study proposed a new feature named AUR-50(multi-source combination based on convolutional feature optimization)to estimate the wheat AGB.The results show that AUR-50 could estimate the wheat AGB more accurately than RSIs and SFs,and the average R^(2) exceeded 0.77.In the overwintering period,AUR-50_(MS)(multi-source combination with convolutional feature optimization using multispectral imagery)had the highest estimation accuracy(R^(2) of 0.88).In addition,AUR-50 reduced the effect of the vegetation index saturation on the biomass estimation accuracy by adding CFs,where the highest R^(2) was 0.69 at the flowering stage.The results of this study provide an effective method to evaluate the AGB in wheat with high throughput and a research reference for the phenotypic parameters of other crops.
基金Supported by the Philosophy and Social Sciences Planning Project of Zhejiang Province(No.23NDJC374YB)the Major Humanities and Social Sciences Research Projects in Zhejiang Higher Education Institutions(No.2024QN067).
文摘This paper addresses the design problem of an embedded mobile stage location system based on a two-dimensional laser radar.The mobile stage is a piece of important performance equipment in art performances,and the positioning problem is one of the key issues in the control of the mobile stage.Both hardware and software are developed for the mobile stage.The hardware of the location system consists of a laser radar,an embedded control board,a wireless router,and a motion control unit.The software of the location system includes embedded software and human-machine interface(HMI),and they are designed to achieve the functions of real-time positioning and monitoring.First,a novel landmark identification method is presented based on the landmark reflection intensities and shapes.Then,the initial pose of the mobile stage is calculated by using the triangle matching algorithm and the least squares method.A distributed fusion Kalman filtering algorithm is applied to fuse landmark information and odometer information to achieve real-time positioning of the mobile stage.The designed system has been implemented in a practical mobile stage,and the results demonstrate that the location system can achieve a high positioning precision in both the stationary and moving scenarios.
基金supported by the National Natural Science Foundation of China(32222079 to L.J.and 32202621 to D.D.W.)。
文摘Pigs have emerged as valuable large-animal models for cardiac xenotransplantation;however,the temporal dynamics of myocardial development in this species remains insufficiently defined.This study analyzed gene expression patterns across four key developmental stages(neonatal,juvenile,sexual maturity,and adulthood)to delineate the molecular mechanisms driving porcine myocardial development.Increases in heart weight were accompanied by proportional expansion of myocardial fiber area and chamber size,reflecting coordinated structural development.Transcriptomic profiling of myocardial tissue by RNA sequencing(RNA-seq)identified 2189 differentially expressed genes(DEGs)across stage comparisons.Short time-series expression miner(STEM)analysis classified these DEGs into four major expression clusters enriched in pathways associated with myocardial development,immune responses,cell proliferation,and metabolic processes.Among 359 DEGs conserved across all developmental stages,six candidate genes were strongly associated with myocardial development.Reverse transcription-quantitative real-time polymerase chain reaction(RT-qPCR)confirmed a significant correlation between the expression of these candidate genes and myocardial development in porcine tissue.These findings establish a transcriptomic framework for porcine myocardial maturation and provide a molecular basis for advancing cardiac xenotransplantation.
基金funded by the European Union’s Horizon 2020 Research and Innovation Program under the Marie Sklodowska-Curie Grant Agreement(Grant No.101026104)by the National Natural Science Foundation of China(Grant No.U20A6004)in part by the State Key Laboratory of Precision Electronics Manufacturing Technology and Equipment(Grant No.JMDZ202314).
文摘In semiconductor precision packaging and other applications involving alignment of automated equipment,the nonlinear motion caused by structural characteristics and friction effects on torque-type rotating motion stages seriously affects output accuracy and stability.To solve this problem,the motion characteristics of a rotating stage and the mechanism by which friction nonlinearity influences accuracy are analyzed in detail.In addition,a compound control strategy based on a kinematic model and the Stribeck friction model is designed.A friction disturbance observer based on output position feedback is improved for simple parameter tuning.Finally,an experimental system is constructed to carry out validation tests,including identification of nonlinear characteristics and performance comparisons.The experimental results show that the linear tracking error of the torque-type rotating stage is less than 1.47µm after adoption of the proposed model-based composite control strategy,and the corresponding rotary angle deviation is less than 0.0153°.The linearity of output motion is increased to 97.59%and the error compensation effect is improved by 51.6%compared with the PID control method.The experimental results confirm that the analysis method adopted here and the proposed compensation strategy can effectively reduce frictional nonlinearity and improve motion accuracy.The proposed method can also be applied to other precision electromechanical systems.
基金the Obstetrics and Gynecology Hospital of Fudan University for supporting this project。
文摘Objectives A systematic review and network meta-analysis was conducted to evaluate the effectiveness of different childbirth positions in reducing the duration of the second stage of labor,providing evidence-based insights for obstetric institutions to guide interventions related to childbirth positions.Methods A comprehensive literature search was conducted in databases,including PubMed,Web of Science,the Cochrane Library,Embase,Wanfang Databases,China National Knowledge Infrastructure Databases(CNKI),China Science and Technology Journal Database(CSTJ),and China Biology Medicine disc(CBMdisc)to identify studies on the effectiveness of different childbirth positions in reducing the duration of the second stage of labor.The search included randomized controlled trials published from database inception to September 30,2024.The Cochrane risk-of-bias tool was used to assess the quality of the studies.Two independent reviewers screened the literature,extracted data,and evaluated study quality.Subsequently,a network meta-analysis was performed using STATA software.The study protocol has been registered in PROSPERO(CRD42023428217).Results This study analyzed data from 25 randomized controlled trials involving 9,844 women.The findings indicated that in comparison to lithotomy position,free position(MD=20.53,95%CI[11.38,29.68])and upright position(MD=−24.13,95%CI[−42.94,-5.32])were found to be superior in reducing the duration of the second stage of labor.Free position outperformed kneeling position(MD=21.48,95%CI[4.67,38.28])and squatting position(MD=23.43,95%CI[1.88,44.97]);upright position was superior to kneeling position(MD=−25.08,95%CI[−46.93,−3.22]);semirecumbent position surpassed squatting position(MD=19.71,95%CI[2.05,37.38]);and upright position was also superior to squatting position(MD=−27.03,95%CI[−51.48,−2.57]).According to the surface under the cumulative ranking curve(SUCRA),the upright position emerged as the most effective for reducing the duration of the second stage of labor(87.4%),followed by free position(81.1%),semirecumbent position(70.0%),and lateral position(62.3%).Conclusion These findings offer valuable insights for midwifery practice and help inform future research directions.Considering the limitations of this review,more larger-scale,multicenter randomized controlled trials are warranted to further evaluate the relative effectiveness of different childbirth positions in reducing the duration of the second stage of labor.
基金supported by the Natural Science Foundation Project of Inner Mongolia Autonomous Region(2024LHMS03017)Research Capacity Enhancement“Unveiling and Leading”Project of Inner Mongolia Forestry Science Research Institute(2024NLTS03).
文摘The rhizosphere bacteria play crucial roles in plant health and growth as they are involved in assimilating nutrients and resisting adverse conditions such as nutrient stress,drought,and wind erosion.Agriophyllum squarrosum(L.)Moq.is a pioneer plant used in sand fixation due to its strong resistance to drought and wind erosion.However,the bacterial community characteristics and ecological function in the rhizosphere of A.squarrosum are poorly understood.In this study,soil samples were collected from different developmental stages(seedling stage,vegetative stage,reproductive stage,and withering stage)of A.squarrosum.Illumina Miseq sequencing was used to detect differences in soil bacterial abundance.The Phylogenetic Investigation of Communities by Reconstruction of Unobserved States(PICRUSt)program was used to predict bacterial functions,and the relationships among bacteria,functional populations,and soil nutrients were examined using a heatmap analysis.The results showed that the Shannon and Sobs indices of rhizosphere bacteria were significantly higher during the reproductive stage than during the other stages.Pantoea sp.(7.03%)was the dominant genus during the seedling stage;Arthrobacter sp.was the dominant genus during the vegetative(13.94%),reproductive(7.57%),and withering(12.30%)stages.The relative abundances of Chloroflexi,Acidobacteria,and Gemmatimonadetes were significantly high during the reproductive stage.According to the PICRUSt analysis,membrane transport,signal transduction,and environmental adaptation of the bacterial functional population occurred during the seedling stage.Carbohydrate metabolism increased during the vegetative stage,while energy metabolism,lipid metabolism,and biosynthesis of other secondary metabolites of the bacterial functional population significantly increased during the reproductive stage.The abundances of bacterial communities,functional genes,and soil nutrients were synergistically altered during various developmental stages.Our findings suggest that the developmental stages of A.squarrosum play a significant role in defining the composition and structure of bacterial communities in the rhizosphere.The results will provide a basis for better prediction and understanding of soil bacterial metabolic potential and functions of A.squarrosum rhizosphere in sandy areas.
