Whipple shields as sacrificial bumpers,safeguard the satellites against extremely fast,different-sized projectiles traveling through space in the low earth orbit.Typical Whipple shields comprise a front and rear plate...Whipple shields as sacrificial bumpers,safeguard the satellites against extremely fast,different-sized projectiles traveling through space in the low earth orbit.Typical Whipple shields comprise a front and rear plate,separated by a gap or space.Recent advancements have explored the use of foam,cellular cores,and alternative materials such as ceramics instead of aluminium for the plates.In the current work,the effect of including fluid cores(air/water)sandwiched between the front and rear plates,on the response to hypervelocity impact was explored through a numerical approach.The numerical simulation consisted of hypervelocity impact by a 2 mm diameter,stainless steel projectile,launched at speeds of 3 e9 km/s with a normal impact trajectory towards the Whipple shield.The front and rear bumpers,made of AA6061-T6,were each 1 mm thick.A space of 10 mm was taken between the plates(occupied by fluid).The key metrics analyzed were the perforation characteristics,stages of the debris cloud generation and propagation,energy variations(internal,kinetic and plastic work),temperature variations,and the fragmentation summary.From the computational analysis,employing water-core in Whipple shields could prevent the rear bumper perforation till 6 km/s,lower the peak temperatures at the front bumper perforation zones and debris tip,and generate fewer,larger fragments.展开更多
A typical Whipple shield consists of double-layered plates with a certain gap.The space debris impacts the outer plate and is broken into a debris cloud(shattered,molten,vaporized)with dispersed energy and momentum,wh...A typical Whipple shield consists of double-layered plates with a certain gap.The space debris impacts the outer plate and is broken into a debris cloud(shattered,molten,vaporized)with dispersed energy and momentum,which reduces the risk of penetrating the bulkhead.In the realm of hypervelocity impact,strain rate(>10^(5)s^(-1))effects are negligible,and fluid dynamics is employed to describe the impact process.Efficient numerical tools for precisely predicting the damage degree can greatly accelerate the design and optimization of advanced protective structures.Current hypervelocity impact research primarily focuses on the interaction between projectile and front plate and the movement of debris cloud.However,the damage mechanism of debris cloud impacts on rear plates-the critical threat component-remains underexplored owing to complex multi-physics processes and prohibitive computational costs.Existing approaches,ranging from semi-empirical equations to a machine learningbased ballistic limit prediction method,are constrained to binary penetration classification.Alternatively,the uneven data from experiments and simulations caused these methods to be ineffective when the projectile has irregular shapes and complicate flight attitude.Therefore,it is urgent to develop a new damage prediction method for predicting the rear plate damage,which can help to gain a deeper understanding of the damage mechanism.In this study,a machine learning(ML)method is developed to predict the damage distribution in the rear plate.Based on the unit velocity space,the discretized information of debris cloud and rear plate damage from rare simulation cases is used as input data for training the ML models,while the generalization ability for damage distribution prediction is tested by other simulation cases with different attack angles.The results demonstrate that the training and prediction accuracies using the Random Forest(RF)algorithm significantly surpass those using Artificial Neural Networks(ANNs)and Support Vector Machine(SVM).The RF-based model effectively identifies damage features in sparsely distributed debris cloud and cumulative effect.This study establishes an expandable new dataset that accommodates additional parameters to improve the prediction accuracy.Results demonstrate the model's ability to overcome data imbalance limitations through debris cloud features,enabling rapid and accurate rear plate damage prediction across wider scenarios with minimal data requirements.展开更多
Background: Endoscopic treatment of biliopancreatic pathology is challenging due to surgically altered anatomy after Whipple's pancreaticoduodenectomy. This study aimed to evaluate the feasibility and safety of si...Background: Endoscopic treatment of biliopancreatic pathology is challenging due to surgically altered anatomy after Whipple's pancreaticoduodenectomy. This study aimed to evaluate the feasibility and safety of single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography(SBE-ERCP) to treat biliopancreatic pathology in patients with Whipple's pancreaticoduodenectomy surgical variants. Methods: We retrospectively analyzed 106 SBE-ERCP procedures in 46 patients with Whipple's variants. Technical and clinical success rates and adverse events were evaluated. Results: Biliary SBE-ERCP was performed in 34 patients and pancreatic SBE-ERCP in 17, including 5 with both indications. From a total of 106 SBE-ERCP procedures, 76 were biliary indication with technical success rate of 68/76(90%) procedures and clinical success rate of 30/34(88%) patients. Mild adverse event rate was 8/76(11%), without serious adverse events. From a total of 106 SBE-ERCP procedures, 30 were pancreatic indication with technical success rate of 24/30(80%) procedures( P = 0.194 vs. biliary SBEERCP) and clinical success rate of 11/17(65%) patients( P = 0.016 vs. biliary SBE-ERCP). Mild adverse event rate was 6/30(20%)( P = 0.194 vs. biliary SBE-ERCP), without serious adverse events. After SBE-ERCP failure, endoscopic ultrasound-guided drainage, percutaneous drainage and redo surgery were alternative therapeutic options. Conclusions: Biliopancreatic pathology after Whipple's pancreaticoduodenectomy variants can be treated using SBE-ERCP without serious adverse events. Technical and clinical success rates are high for biliary indications, whereas clinical success rate of pancreatic indications is significantly lower. SBE-ERCP can be considered as first-line treatment option in this patient group with surgically altered anatomy.展开更多
To the Editor:Biliary stricture formation at the bilioenteric anastomosis is an infrequent complication(2%-3%)after pancreaticoduodenectomy;the average presentation is within 13-14 months(range from 1 month to 9 years...To the Editor:Biliary stricture formation at the bilioenteric anastomosis is an infrequent complication(2%-3%)after pancreaticoduodenectomy;the average presentation is within 13-14 months(range from 1 month to 9 years)after surgery[1,2].While the etiology is unknown,development of biliary stricture has shown to be more likely if a bile leak occurs in the postoperative period[3,4]and with younger patients[5].展开更多
BACKGROUND Currently,perioperative complications of classic Whipple surgery occur at a rate of approximately 40%.Common complications include delayed gastric emptying,pancreatic fistula,and bile leakage,whereas gastro...BACKGROUND Currently,perioperative complications of classic Whipple surgery occur at a rate of approximately 40%.Common complications include delayed gastric emptying,pancreatic fistula,and bile leakage,whereas gastrojejunostomy(GJ)leakage is rare.CASE SUMMARY This case report will assess the management of a GJ leak in a 71-year-old male patient following the Whipple procedure.After surgery,the patient was trans-ferred to the clinic after four days of intensive care,where vacuum therapy was used to handle a developing subcutaneous collection.The patient,who had bile in the drains and incision during follow-up,underwent endoscopic examination on the 21st day after the operation.An opening of approximately 4 mm was observed in the GJ anastomosis during endoscopy.Five titanium clips were used to close the openings.The drainage of bile decreased to less than 50 mL on the first day after the procedure,and the patient's oral intake was opened.CONCLUSION Current literature reports a GJ leakage rate of 0.54%following Whipple surgery,with clinical findings lasting on average between 4-34 days.Surgery was the main form of therapy for this case,with a success rate of 84%,and percutaneous drai-nage was also utilized as a treatment option.This case report is the first to docu-ment endoscopic treatment of GJ leaks following the classic Whipple procedure.展开更多
BACKGROUND Whipple’s disease is a rare systemic infection caused by Tropheryma whipplei.Most patients present with nonspecific symptoms,and routine laboratory and imaging examination results also lack specificity.The...BACKGROUND Whipple’s disease is a rare systemic infection caused by Tropheryma whipplei.Most patients present with nonspecific symptoms,and routine laboratory and imaging examination results also lack specificity.The diagnosis often relies on invasive manipulation,pathological examination,and molecular techniques.These difficulties in diagnosing Whipple’s disease often result in misdiagnosis and inappropriate treatments.CASE SUMMARY This paper reports on the case of a 58-year-old male patient who complained of fatigue and decreased exercise capacity.The results of routine blood tests indicated hypochromic microcytic anemia.Results of gastroscopy and capsule endoscopy showed multiple polypoid bulges distributed in the duodenal and proximal jejunum.A diagnosis of small intestinal adenomatosis was initially considered;hence,the Whipple procedure,a pylorus-preserving pancreaticoduodenectomy,was performed.Pathological manifestations showed many periodic acid-Schiff-positive macrophages aggregated in the intestinal mucosa of the duodenum,upper jejunum,and surrounding lymph nodes.Based on comprehensive analysis of symptoms,laboratory findings,and pathological manifestations,the patient was finally diagnosed with Whipple’s disease.After receiving 1 mo of antibiotic treatment,the fatigue and anemia were significantly improved.CONCLUSION This case presented with atypical gastrointestinal manifestations and small intestinal polypoid bulges,which provided new insight on the diagnosis of Whipple’s disease.展开更多
文摘Whipple shields as sacrificial bumpers,safeguard the satellites against extremely fast,different-sized projectiles traveling through space in the low earth orbit.Typical Whipple shields comprise a front and rear plate,separated by a gap or space.Recent advancements have explored the use of foam,cellular cores,and alternative materials such as ceramics instead of aluminium for the plates.In the current work,the effect of including fluid cores(air/water)sandwiched between the front and rear plates,on the response to hypervelocity impact was explored through a numerical approach.The numerical simulation consisted of hypervelocity impact by a 2 mm diameter,stainless steel projectile,launched at speeds of 3 e9 km/s with a normal impact trajectory towards the Whipple shield.The front and rear bumpers,made of AA6061-T6,were each 1 mm thick.A space of 10 mm was taken between the plates(occupied by fluid).The key metrics analyzed were the perforation characteristics,stages of the debris cloud generation and propagation,energy variations(internal,kinetic and plastic work),temperature variations,and the fragmentation summary.From the computational analysis,employing water-core in Whipple shields could prevent the rear bumper perforation till 6 km/s,lower the peak temperatures at the front bumper perforation zones and debris tip,and generate fewer,larger fragments.
基金supported by National Natural Science Foundation of China(Grant No.12432018,12372346)the Innovative Research Groups of the National Natural Science Foundation of China(Grant No.12221002).
文摘A typical Whipple shield consists of double-layered plates with a certain gap.The space debris impacts the outer plate and is broken into a debris cloud(shattered,molten,vaporized)with dispersed energy and momentum,which reduces the risk of penetrating the bulkhead.In the realm of hypervelocity impact,strain rate(>10^(5)s^(-1))effects are negligible,and fluid dynamics is employed to describe the impact process.Efficient numerical tools for precisely predicting the damage degree can greatly accelerate the design and optimization of advanced protective structures.Current hypervelocity impact research primarily focuses on the interaction between projectile and front plate and the movement of debris cloud.However,the damage mechanism of debris cloud impacts on rear plates-the critical threat component-remains underexplored owing to complex multi-physics processes and prohibitive computational costs.Existing approaches,ranging from semi-empirical equations to a machine learningbased ballistic limit prediction method,are constrained to binary penetration classification.Alternatively,the uneven data from experiments and simulations caused these methods to be ineffective when the projectile has irregular shapes and complicate flight attitude.Therefore,it is urgent to develop a new damage prediction method for predicting the rear plate damage,which can help to gain a deeper understanding of the damage mechanism.In this study,a machine learning(ML)method is developed to predict the damage distribution in the rear plate.Based on the unit velocity space,the discretized information of debris cloud and rear plate damage from rare simulation cases is used as input data for training the ML models,while the generalization ability for damage distribution prediction is tested by other simulation cases with different attack angles.The results demonstrate that the training and prediction accuracies using the Random Forest(RF)algorithm significantly surpass those using Artificial Neural Networks(ANNs)and Support Vector Machine(SVM).The RF-based model effectively identifies damage features in sparsely distributed debris cloud and cumulative effect.This study establishes an expandable new dataset that accommodates additional parameters to improve the prediction accuracy.Results demonstrate the model's ability to overcome data imbalance limitations through debris cloud features,enabling rapid and accurate rear plate damage prediction across wider scenarios with minimal data requirements.
文摘Background: Endoscopic treatment of biliopancreatic pathology is challenging due to surgically altered anatomy after Whipple's pancreaticoduodenectomy. This study aimed to evaluate the feasibility and safety of single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography(SBE-ERCP) to treat biliopancreatic pathology in patients with Whipple's pancreaticoduodenectomy surgical variants. Methods: We retrospectively analyzed 106 SBE-ERCP procedures in 46 patients with Whipple's variants. Technical and clinical success rates and adverse events were evaluated. Results: Biliary SBE-ERCP was performed in 34 patients and pancreatic SBE-ERCP in 17, including 5 with both indications. From a total of 106 SBE-ERCP procedures, 76 were biliary indication with technical success rate of 68/76(90%) procedures and clinical success rate of 30/34(88%) patients. Mild adverse event rate was 8/76(11%), without serious adverse events. From a total of 106 SBE-ERCP procedures, 30 were pancreatic indication with technical success rate of 24/30(80%) procedures( P = 0.194 vs. biliary SBEERCP) and clinical success rate of 11/17(65%) patients( P = 0.016 vs. biliary SBE-ERCP). Mild adverse event rate was 6/30(20%)( P = 0.194 vs. biliary SBE-ERCP), without serious adverse events. After SBE-ERCP failure, endoscopic ultrasound-guided drainage, percutaneous drainage and redo surgery were alternative therapeutic options. Conclusions: Biliopancreatic pathology after Whipple's pancreaticoduodenectomy variants can be treated using SBE-ERCP without serious adverse events. Technical and clinical success rates are high for biliary indications, whereas clinical success rate of pancreatic indications is significantly lower. SBE-ERCP can be considered as first-line treatment option in this patient group with surgically altered anatomy.
文摘To the Editor:Biliary stricture formation at the bilioenteric anastomosis is an infrequent complication(2%-3%)after pancreaticoduodenectomy;the average presentation is within 13-14 months(range from 1 month to 9 years)after surgery[1,2].While the etiology is unknown,development of biliary stricture has shown to be more likely if a bile leak occurs in the postoperative period[3,4]and with younger patients[5].
文摘BACKGROUND Currently,perioperative complications of classic Whipple surgery occur at a rate of approximately 40%.Common complications include delayed gastric emptying,pancreatic fistula,and bile leakage,whereas gastrojejunostomy(GJ)leakage is rare.CASE SUMMARY This case report will assess the management of a GJ leak in a 71-year-old male patient following the Whipple procedure.After surgery,the patient was trans-ferred to the clinic after four days of intensive care,where vacuum therapy was used to handle a developing subcutaneous collection.The patient,who had bile in the drains and incision during follow-up,underwent endoscopic examination on the 21st day after the operation.An opening of approximately 4 mm was observed in the GJ anastomosis during endoscopy.Five titanium clips were used to close the openings.The drainage of bile decreased to less than 50 mL on the first day after the procedure,and the patient's oral intake was opened.CONCLUSION Current literature reports a GJ leakage rate of 0.54%following Whipple surgery,with clinical findings lasting on average between 4-34 days.Surgery was the main form of therapy for this case,with a success rate of 84%,and percutaneous drai-nage was also utilized as a treatment option.This case report is the first to docu-ment endoscopic treatment of GJ leaks following the classic Whipple procedure.
文摘BACKGROUND Whipple’s disease is a rare systemic infection caused by Tropheryma whipplei.Most patients present with nonspecific symptoms,and routine laboratory and imaging examination results also lack specificity.The diagnosis often relies on invasive manipulation,pathological examination,and molecular techniques.These difficulties in diagnosing Whipple’s disease often result in misdiagnosis and inappropriate treatments.CASE SUMMARY This paper reports on the case of a 58-year-old male patient who complained of fatigue and decreased exercise capacity.The results of routine blood tests indicated hypochromic microcytic anemia.Results of gastroscopy and capsule endoscopy showed multiple polypoid bulges distributed in the duodenal and proximal jejunum.A diagnosis of small intestinal adenomatosis was initially considered;hence,the Whipple procedure,a pylorus-preserving pancreaticoduodenectomy,was performed.Pathological manifestations showed many periodic acid-Schiff-positive macrophages aggregated in the intestinal mucosa of the duodenum,upper jejunum,and surrounding lymph nodes.Based on comprehensive analysis of symptoms,laboratory findings,and pathological manifestations,the patient was finally diagnosed with Whipple’s disease.After receiving 1 mo of antibiotic treatment,the fatigue and anemia were significantly improved.CONCLUSION This case presented with atypical gastrointestinal manifestations and small intestinal polypoid bulges,which provided new insight on the diagnosis of Whipple’s disease.
