Abstract Objective： To evaluate the diagnostic value of two-phase multidetector-row spiral CT threedimensional reconstruction technique in TNM staging of gastric cancer. Methods： In 29 patients with gastric carcinom...Abstract Objective： To evaluate the diagnostic value of two-phase multidetector-row spiral CT threedimensional reconstruction technique in TNM staging of gastric cancer. Methods： In 29 patients with gastric carcinoma pathologically conformed, plan scans were done firstly. Two-phase spiral CT was performed within one breathhold each. Distension of the stomach was achieved by intravenous application of anisodamine and effervescent granules. After bolus injection of contrast medium, scanning was performed in the arterial and venous phase, and the source images were thin reconstructed. The stomach to three-dimension analysis was constructed by volume rendering （VR） multiplanaz volume reconstruction （MPVR）, shaded surface display （SSD） and CT virtual gastroscopy （CTVG） technique. In combination with the sources images, gastric tumour invasion and lymph node metastasis was assessed, and TNM staging was performed. Results： In 29 cases of gastric carcinoma, the sensitivity and specificity of two-phase multidetector-row spiral CT three-dimensional reconstruction technique in T1, T2, T3 and Ta staging, the sensitivity and specificity was 50% and 50%, 87.5% and 77.8%, 83.3% and 76.9% and 100% and 80% respectively. For the N staging, the sensitivity and specificity in No, N1, and N2 N3 was 83.3% and 71.4%, 87.5% and 77.8% and 81.8% and 75% respectively. The sensitivity and the specificity for M1 staging was 100%. Conclusion： The reconstruction technique in combination with 16-slices spiral-CT can perform TNM staging well and effectively guide the choice of the surgical procedures for gastric cancer.展开更多
Weak measurement offers a powerful framework for probing nonclassical features of quantum mechanics,with anomalous weak values serving as operational signatures of contextuality.While the anomalous weak value verifica...Weak measurement offers a powerful framework for probing nonclassical features of quantum mechanics,with anomalous weak values serving as operational signatures of contextuality.While the anomalous weak value verification of quantum contextuality has been predominantly investigated in the single-photon regime and analyzed under approximation condition of infinitesimally small perturbation strength.This study releases the approximation condition and takes into account the impact of perturbation strength on the rigor of the verification.And the investigation on the verification of contextuality is extended to the multi-photon scenarios for observing the influence of the correlation between photons on the verification.Without the limitation of infinitesimally small probability of disturbance,anomalous weak values are identified as necessary for contextuality to emerge,thereby refining the criterion proposed by Pusey[Phys.Rev.Lett.113200401(2014)].In the multi-photon scenarios,the emergence of contextuality also depends strongly on both the photon number and the photon-number distribution state.In particular,contextuality is found to be maximized when the single-photon component dominates and the second-order correlation is lower.These results highlight the critical role of photon statistics in experimental tests of contextuality via anomalous weak values.展开更多
According to the Mindlin plate theory and the first-order piston theory,this work obtains accurate closed-form eigensolutions for the flutter problem of three-dimensional(3D)rectangular laminated panels.The governing ...According to the Mindlin plate theory and the first-order piston theory,this work obtains accurate closed-form eigensolutions for the flutter problem of three-dimensional(3D)rectangular laminated panels.The governing differential equations are derived by the Hamilton's variational principle,and then solved by the iterative Separation-of-Variable(i SOV)method,which are applicable to arbitrary combinations of homogeneous Boundary Conditions(BCs).However,only the simply-support,clamped and cantilever panels are considered in this work for the sake of clarity.With the closed-form eigensolutions,the flutter frequency,flutter mode and flutter boundary are presented,and the effect of shear deformation and aerodynamic damping on flutter frequencies is investigated.Besides,the relation between panel energy and the work of aerodynamic load is discussed.The numerical comparisons reveal the following.(A)The flutter eigenvalues obtained by the present method are accurate,validated by the Finite Element Method(FEM)and the Galerkin method.(B)When the span-chord ratio is larger than 3,simplifying a 3D panel to 2D(two-dimensional)panel is reasonable and the relative differences of the flutter points predicted by the two models are less than one percent.(C)The reciprocal relationship between the mechanical energy of the panel and the work done by aerodynamic load is verified by using the present flutter eigenvalues and modes,further indicating the high accuracy of the present solutions.(D)The coupling of shear deformation and aerodynamic damping prevents frequency coalescing.展开更多
AIM:To evaluate the predictive value of pan-immuneinflammation value(PIV)in the diagnosis of proliferative diabetic retinopathy(PDR)and its association with the stage of PDR.METHODS:This observational case-control stu...AIM:To evaluate the predictive value of pan-immuneinflammation value(PIV)in the diagnosis of proliferative diabetic retinopathy(PDR)and its association with the stage of PDR.METHODS:This observational case-control study included participants who underwent routine complete blood count testing.Inflammation-related indices,including neutrophil-to-lymphocyte ratio,systemic immune-inflammation index(SII),and PIV,were derived and analyzed.Receiver operating characteristic curve(ROC)analysis was applied to assess the diagnostic performance of these indices in distinguishing patients with PDR,with sensitivity,specificity,area under ROC,and optimal threshold values calculated.In addition,binary logistic regression analysis was performed to evaluate the association between inflammatory indices and PDR stage.RESULTS:This study included 205 patients:60 with diabetes without retinopathy(mean age:61.81±10.76y),80 with PDR(mean age:61.63±10.03y)and 65 healthy controls(mean age:59.52±5.88y).The PDR group had significantly higher white blood cell(WBC,P<0.001),monocyte(MONO,P=0.009)and neutrophil(NEU)counts(P<0.001).SII and PIV had the highest sensitivity and area under ROC for predicting patients with PDR(0.822,0.846,respectively).The optimal cut-off values for discriminating patients with PDR were determined to be>527.12 and>299.08 for SII and PIV,respectively.The logistic regression analysis demonstrated that a decrease in lymphocyte(LYM)count and an increase in platelet count(PLT),glycated haemoglobin(HbA1c),SII,and PIV were all significantly associated with the development of high-risk PDR(all P<0.05).PIV was more stable than independent MONO,LYM,PLT and NEU levels in predicting both the diagnosis and stage of PDR.The optimal cut-off value for PIV to discriminate patients with high-risk PDR was found to be>345.87 area under ROC=0.871,with sensitivity of 0.827 and specificity of 0.812.CONCLUSION:PIV is a reliable,valuable,and inexpensive blood index that can be used for early detection and staging of PDR.PIV may therefore be essential to be used for the follow-up of diabetic patients.展开更多
The shift toward specialized and large-scale agricultural production has spurred the emergence of agricultural clusters as key forces of rural vitalization and sustainable development.This paper explored the formation...The shift toward specialized and large-scale agricultural production has spurred the emergence of agricultural clusters as key forces of rural vitalization and sustainable development.This paper explored the formation and evolution of Meizhou pomelo industry cluster in China,focusing on its role in restructuring rural socio-economic systems and integrating the whole value chains.Based on a case study employing qualitative methods such as in-depth interviews and participatory observation,the agricultural cluster evolution of Meizhou pomelo was categorized into three key phases of initial decentralization,self-organized scaling,and reorganized clustering.Geographical proximity and industrial agglomeration constitute the physical foundation,while vertical/horizontal linkages,technologic-al innovation,and policy support enhance competitiveness.Special mechanisms emerge through localized social networks,farmer co-operatives’activation,and cross-regional market expansion.The cluster’s impact is manifested in the shift from extensive to standard-ized and modernized production,diversified and flexible livelihood of farmers,and the integration of agriculture with industry and ser-vices.The development of the whole value chain based on agricultural cluster represents a critical pathway for achieving agricultural modernization,encompassing both internal and external value chain optimization.Through quality assurance systems,product diversi-fication strategies,operational efficiency improvements,and brand enhancement,these clusters amplify product value propositions and market competitiveness.This systemic approach facilitates supply-demand coordination,enables resource synergies,and optimizes eco-nomic returns across the horizontal and vertical value chain.This paper argues that agricultural clusters serve as strategic catalysts for sustainable rural development by reconstructing local production systems,fostering innovation ecosystems,and aligning agricultural modernization.It contributes to debates on rural vitalization by demonstrating how agricultural clustering can reconfigure rural areas as hubs of ecological modernization,rather than mere urban peripheries.展开更多
In the Tianshan region,a complete textile industry chain has been established,covering the entire process from cotton cultivation and chemical fiber production,through spinning,weaving,dyeing,and finishing,and further...In the Tianshan region,a complete textile industry chain has been established,covering the entire process from cotton cultivation and chemical fiber production,through spinning,weaving,dyeing,and finishing,and further extending to apparel,home textiles,and industrial textiles.In November 2025,the first list of five characteristic textile and apparel industry clusters in Xinjiang was officially announced,marking a new stage in the clustering of Xinjiang's textile and apparel industry.Data shows that the total output value of Xinjiang's cotton and textile and apparel industry chain has exceeded 220 billion yuan.With the nation's largest cotton production,a complete industrial chain system,and strong synergistic effects,Xinjiang has become a leading and highly competitive textile industry hub in China.展开更多
The Double Take column looks at a single topic from an African and Chinese perspective.This month,we discuss how to understand the growing emphasis on emotional returns among young people.Emotional value has emerged a...The Double Take column looks at a single topic from an African and Chinese perspective.This month,we discuss how to understand the growing emphasis on emotional returns among young people.Emotional value has emerged as a central force shaping youth decision-making across work,consumption,relationships and lifestyle choices.Unlike traditional economic rationality that prioritises income and material security,emotional value focuses on how choices make individuals feel and how they align with personal meaning.This shift is particularly evident in rapidly transforming societies such as China and Ghana,where economic restructuring,globalisation and social change have reshaped pathways to adulthood.展开更多
Ming-style furniture represents the pinnacle of Chinese traditional furniture,with the four-head official’s cap chair standing out as a representative category due to its classic form and cultural connotations.This p...Ming-style furniture represents the pinnacle of Chinese traditional furniture,with the four-head official’s cap chair standing out as a representative category due to its classic form and cultural connotations.This paper takes a specific rosewood four-head official’s cap chair inscribed by Wang Shixiang as the research subject,employing a tripartite approach of form analysis,material examination,and inscription interpretation.The chair strictly adheres to the classic form of Ming-style four-head official’s cap chairs,embodying the Ming Dynasty design philosophy of“the unity of function and aesthetics”.The scarcity and unique grain pattern of the golden-flecked rosewood(Zitan)endow it with the status of“gold among woods”.Wang Shixiang’s inscription binds the furniture to the cultural essence of“the charm of the Ming Dynasty”,transforming it into“heritable cultural heritage”.This paper provides a new perspective for the case study of Ming-style furniture and offers theoretical reference for the contemporary inheritance of traditional craftsmanship.展开更多
The Nuo mask is the core visual vehicle within China’s Nuo culture and constitutes a complex symbolic system through facial features(icons),patterns(indexes),and colors(symbols).Within the context of intangible cultu...The Nuo mask is the core visual vehicle within China’s Nuo culture and constitutes a complex symbolic system through facial features(icons),patterns(indexes),and colors(symbols).Within the context of intangible cultural heritage(ICH)preservation,its value lies in the continuation and revitalization of its dynamic symbolic functions.Grounded in semiotic theory,this paper elaborates on three core dimensions of symbolic value manifested by Nuo masks in ICH preservation:a ritual symbol for living transmission,a symbol of identity for collective memory,and an aesthetic symbol as a source of creativity.展开更多
Sometimes endometrial polyps,submucosal myomas,and endometrial cancer show similar findings under ultrasonography.The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensi...Sometimes endometrial polyps,submucosal myomas,and endometrial cancer show similar findings under ultrasonography.The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensional(3D)power Doppler ultrasonography angiography(PDA)between endometrial cancer and uterine parenchyma lumps.The data of the blood flow indices in 3D-PDA including the vascularization index(VI),flow index(FI),and vascularization flow index(VFI)in 40 patients with endometrial cancer and 41 patients with uterine parenchyma lumps(endometrial polyps and submucosal myomas)were retrospectively analysed and compared utilizing Virtual Organ Computer-aided AnaLysis(VOCAL)software.The results showed that all the blood flow parameters(VI,FI,VFI)were significantly higher in women with endometrial cancer than in those with uterine parenchyma lumps(P<0.001).The area under the curve of ROC of VI,FI,and VFI was 0.98,0.84,and 0.97,respectively.Thus,the best predictor of endometrial carcinoma was VI with a sensitivity of 97.0% and a specificity of 91.0%.The optimal cutoff value of VI was 4.06%.Our data demonstrated that all of the blood flow signal parameters(including VI,FI,and VFI)in 3D power Doppler ultrasonography had significant antidiastole values between endometrial cancer and uterine parenchyma lumps to assist clinicians in properly diagnosing patients.展开更多
Fracture surface contour study is one of the important requirements for characterization and evaluation of the microstructure of rocks.Based on the improved cube covering method and the 3D contour digital reconstructi...Fracture surface contour study is one of the important requirements for characterization and evaluation of the microstructure of rocks.Based on the improved cube covering method and the 3D contour digital reconstruction model,this study proposes a quantitative microstructure characterization method combining the roughness evaluation index and the 3D fractal dimension to study the change rule of the fracture surface morphology after blasting.This method was applied and validated in the study of the fracture microstructure of the rock after blasting.The results show that the fracture morphology characteristics of the 3D contour digital reconstruction model have good correlation with the changes of the blasting action.The undulation rate of the three-dimensional surface profile of the rock is more prone to dramatic rise and dramatic fall morphology.In terms of tilting trend,the tilting direction also shows gradual disorder,with the tilting angle increasing correspondingly.All the roughness evaluation indexes of the rock fissure surface after blasting show a linear and gradually increasing trend as the distance to the bursting center increases;the difference between the two-dimensional roughness evaluation indexes and the three-dimensional ones of the same micro-area rock samples also becomes increasingly larger,among which the three-dimensional fissure roughness coefficient JRC and the surface roughness ratio Rs display better correlation.Compared with the linear fitting formula of the power function relationship,the three-dimensional fractal dimension of the postblast fissure surface is fitted with the values of JRC and Rs,which renders higher correlation coefficients,and the degree of linear fitting of JRC to the three-dimensional fractal dimension is higher.The fractal characteristics of the blast-affected region form a unity with the three-dimensional roughness evaluation of the fissure surface.展开更多
Advent in three-dimensional(3D) imaging technology has seen 3D ultrasound establish itself as a useful adjunct complementary to traditional two-dimensional imaging of the female pelvis. This advantage largely arises f...Advent in three-dimensional(3D) imaging technology has seen 3D ultrasound establish itself as a useful adjunct complementary to traditional two-dimensional imaging of the female pelvis. This advantage largely arises from its ability to reconstruct the coronal plane of the uterus, which allows further delineation of many gynecological disorders. 3D imaging of the uterus is now the preferred imaging modality for assessing congenital uterine anomalies and intrauterine device localization. Newer indications include the diagnosis of adenomyosis. It can also add invaluable information to delineate other endometrial and myometrial pathology such as fibroids and endometrial polyps.展开更多
BACKGROUND Numerous variables are linked to the success of vaginal delivery,including the subpubic arch angle(SPAA)during labor,the importance of which has not yet been fully elucidated.AIM To examine the SPAA distrib...BACKGROUND Numerous variables are linked to the success of vaginal delivery,including the subpubic arch angle(SPAA)during labor,the importance of which has not yet been fully elucidated.AIM To examine the SPAA distributional characteristics and to ascertain SPAA’s ability to predict the type and duration of labor.METHODS We determined the SPAA and analyzed the corresponding data.We also evaluated the relationship between the SPAA and the mode of delivery and the duration of labor by regression.The present study comprised a total of 301 pregnant women who had given birth at Beijing Tiantan Hospital of the Capital Medical University between January and December of 2021.RESULTS Our analysis of 301 pregnant women revealed that the SPAA measured using three-dimensional trans-perineal ultrasound had a minimum angle of 81°and a maximum angle of 122.2°.The angle in the normal vaginal delivery group was greater than that in the labor cesarean group(P=0.000).The SPAA was a highly significant positive predictor of normal vaginal delivery(P=0.000)with an area under the curve of 0.782(P=0.000;95%CI:0.717-0.848).We found the length of the second stage of labor to be positively influenced by the SPAA using linear regression analysis(P=0.045).CONCLUSION The SPAA was a highly significant positive predictor of normal vaginal delivery.The length of the second stage of labor and normal vaginal birth were predicted by SPAA.展开更多
Stereoscopic three-dimensional echocardiography（S-3DE） is a novel displaying technol-ogy based on real-time 3-dimensional echocardiography （RT-3DE）. Our study was to evaluate the feasibility and efficiency of S-3D...Stereoscopic three-dimensional echocardiography（S-3DE） is a novel displaying technol-ogy based on real-time 3-dimensional echocardiography （RT-3DE）. Our study was to evaluate the feasibility and efficiency of S-3DE in the diagnosis of atrial septal defect （ASD） and its use in the guidance for transcatheter ASD occlusion. Twelve patients with secundum ASD underwent RT-3DE examination and 9 of the 12 were subjected to transcatheter closure of ASD. Stereoscopic vision was generated with a high-performance volume renderer with red-green stereoscopic glasses. S-3DE was compared with standard RT-3D display for the assessment of the shape, size, and the surrounding tis-sues of ASD and for the guidance of ASD occlusion. The appearance rate of coronary sinus and the mean formation time of the IVC, SVC were compared. Our results showed that S-3DE could measure the diameter of ASD accurately and there was no significant difference in the measurements between S-3DE and standard 3D display （2.89±0.73 cm vs 2.85±0.72 cm, P〉0.05; r=0.96, P〈0.05）. The appearance of coronary sinus for S-3DE was higher as compared with the standard 3D display （93.3% vs 100%）. The mean time of the IVC, SVC for S-3DE monitor was slightly shorter than that of the standard 3D display （11.0±3.8 s vs 10.3±3.6 s, P〉0.05）. The mean completion time of interven-tional procedure was shortened with S-3DE display as compared with standard 3D display （17.3±3.1 min vs 23.0±3.9 min, P〈0.05）. Stereoscopic three-dimensional echocardiography could improve the visualization of three-dimensional echocardiography, facilitate the identification of the adjacent structures, decrease the time required for interventional manipulation. It may be a feasible, safe, and efficient tool for guiding transcatheter septal occlusion or the surgical interventions.展开更多
BACKGROUND Endocardial fibroelastosis(EFE)is a rare heart disease characterized by thickening of the endocardium caused by massive proliferation of collagenous and elastic tissue,usually leading to impaired cardiac fu...BACKGROUND Endocardial fibroelastosis(EFE)is a rare heart disease characterized by thickening of the endocardium caused by massive proliferation of collagenous and elastic tissue,usually leading to impaired cardiac function.Multimodality cardiovascular imaging for the evaluation of EFE with thrombi is even rarer.CASE SUMMARY We report a rare case of EFE associated with multiple cardiovascular thrombi.Three-dimensional(3D)and contrast echocardiography(CE)were used to assess ventricular thrombi.Anticoagulant therapy was administered to eliminate the thrombi.The peripheral contrast-enhanced thrombi with the highest risk were dissolved with anticoagulant therapy at the time of reexamination,which was consistent with the presumption of fresh loose thrombi.CONCLUSION This new echocardiography technique has a great advantage in the diagnosis and treatment of EFE.On the basis of conventional echocardiography,3D echocardiography is used to display the position,shape,and narrow base of the thrombus.CE does not only help to confirm the diagnosis of thrombus,but also determines its risk.展开更多
Objective To evaluate the clinical value of three dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage. Methods 616 cases were diagnosed as suspected in...Objective To evaluate the clinical value of three dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage. Methods 616 cases were diagnosed as suspected intracranial aneurysms in 3D CTA system. Computed tomographic scans and CTA studies were展开更多
The software for oil-gas transport and accumulation is to describe the history of oil-gas transport and accumulation in basin evolution. It is of great value in rational evaluation of prospecting and exploiting oil-ga...The software for oil-gas transport and accumulation is to describe the history of oil-gas transport and accumulation in basin evolution. It is of great value in rational evaluation of prospecting and exploiting oil-gas resources. The mathematical model can be discribed as a coupled system of nonlinear partial differential equations with moving boundary value problem. For a generic case of the three-demensional bounded region, bi this thesis, the effects of gravitation、buoyancy and capillary pressure are considered, we put forward a kind of characteristic finite difference schemes and make use thick and thin grids to form a complete set, and of calculus of vaviations, the change of variable, the theory of prior estimates and techniques, Optimal order estimates in l^2 norm are derived for the error in approximate assumption, Thus we have completely solved the well-known theoretical problem proposed by J. Douglas, Jr.展开更多
Background Sinus venosus atrial septal defect（SVASD） is a rare atrial septal defect. The right-sided pulmonary veins may drain into the right atrium directly or via vena cava. Two-dimensional transthoracic echocardi...Background Sinus venosus atrial septal defect（SVASD） is a rare atrial septal defect. The right-sided pulmonary veins may drain into the right atrium directly or via vena cava. Two-dimensional transthoracic echocardiography（2D-TTE） is certainly the initial choice of evaluation of SVASD but is unable to show its spatial relation to the surrounding structures and the configuration of the veins accurately. The purpose of this study was to evaluate the diagnostic accuracy of real-time three-dimensional transesophageal echocardiography（RT3D-TEE） for detecting SVASD and partial anomalous pulmonary venous connection（PAPVC）. Methods2D-TTE and RT3D-TEE were performed in 25 patients with the SVASD before surgical repair. Records of these patients were compared with surgical assessments. Results Twenty-three of the 25 patients with SVASD were detected by 2D-TTE. All the 23 patents were associated with PAPVC. Two of the 25 patients with SVASD were misdiagnosed as the secundum atrial septal defect by 2D-TTE. SVASD was demonstrated in all the 25 cases by RT3D-TEE, and 25 patents were associated with PAPVC. Conclusions RT3D-TEE is highly accurate, scientific method for displaying the location, size, shape of the defect and its spatial relation to the surrounding structures, and provides additional value to the surgeon and physicians for better understanding of spatial intracardiac morphology and making more accurate diagnosis and treatment.展开更多
Objective:To investigate the value of two-dimensional ultrasound speckle tracking(2D-STI)and three-dimensional ultrasound speckle tracking(3D-STI)in evaluating myocardial function in children with Kawasaki disease.Met...Objective:To investigate the value of two-dimensional ultrasound speckle tracking(2D-STI)and three-dimensional ultrasound speckle tracking(3D-STI)in evaluating myocardial function in children with Kawasaki disease.Methods 92 children with Kawasaki disease admitted to our hospital from February 2017 to February 2019 were retrospectively analyzed.50 children who underwent 3D-STI examination were taken as observation group and 42 children who underwent 2D-STI examination were taken as control group.The left ventricular systolic function index,storage time and analysis time of the image,the diameter of coronary artery,the strain difference of left ventricular basal segment,middle segment,apical segment and whole segment were observed.Results The levels of left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular myocardial mass(LVMI)in the observation group were higher than those in the control group(P<0.05),but there was no statistical difference in left ventricular ejection fraction(LVEF)between the two groups(P>0.05).The storage time and analysis time of the image in the observation group were significantly lower than those in the control group(P<0.05).The left coronary artery(LCA)and right coronary artery(RCA)in the observation group were higher than those in the control group(P<0.05).There was no statistical difference between left anterior descending(LAD)in the two groups(P>0.05).The longitudinal peak systolic strain(LS),circumferential peak systolic strain(CS)and radial peak systolic strain(RS)in the observation group were higher than those in the control group(P<0.05).The global longitudinal peak strain(GLS),global circumferential peak strain(GCS)and global radial peak strain(GRS)in the observation group were higher than those in the control group(P<0.05).LS and CS in the middle segment of the observation group were higher than those in the control group(P<0.05).Conclusions Compared with 2D-STI,3D-STI can objectively and accurately reflect the myocardial function of children with Kawasaki disease.展开更多
Objective: To study the evaluation value of three-dimensional finite element model analysis for bone mineral density (BMD) and bone metabolism activity in patients with osteoporosis. Methods: A total of 218 patients w...Objective: To study the evaluation value of three-dimensional finite element model analysis for bone mineral density (BMD) and bone metabolism activity in patients with osteoporosis. Methods: A total of 218 patients who were diagnosed with osteoporosis in the hospital between February 2014 and January 2017 were collected as observation group, and 100 healthy volunteers who received physical examination in the hospital during the same period were selected as normal control group. The femoral head of the two groups was analyzed by three-dimensional finite element model, and the femoral head BMD levels and serum bone metabolism index contents were measured. Pearson test was used to evaluate the evaluation value of femoral head three-dimensional finite element model for osteoporosis. Results: The cancellous bone and cortical bone Von Mises stress value of observation group were lower than those of normal control group, and femoral neck BMD value of observation group was lower than that of normal control group;serum bone metabolism index BGP content was lower than that of normal control group while NBAP, TRACP-5b and CTX-1 contents were higher than those of normal control group. Pearson test showed that the cancellous bone and cortical bone Von Mises stress value of patients with osteoporosis were directly correlated with BMD value and bone metabolism index contents. Conclusion: The three-dimensional finite element model analysis resultsof patients with osteoporosis can objectively reflect the femoral headBMD value and bone metabolism activity, and is a reliable way to evaluate the risk of long-term fractures.展开更多
基金This project was supported by a grant from the Natural Science Foundation of Hubei Province (No. 2002AB130)
文摘Abstract Objective： To evaluate the diagnostic value of two-phase multidetector-row spiral CT threedimensional reconstruction technique in TNM staging of gastric cancer. Methods： In 29 patients with gastric carcinoma pathologically conformed, plan scans were done firstly. Two-phase spiral CT was performed within one breathhold each. Distension of the stomach was achieved by intravenous application of anisodamine and effervescent granules. After bolus injection of contrast medium, scanning was performed in the arterial and venous phase, and the source images were thin reconstructed. The stomach to three-dimension analysis was constructed by volume rendering （VR） multiplanaz volume reconstruction （MPVR）, shaded surface display （SSD） and CT virtual gastroscopy （CTVG） technique. In combination with the sources images, gastric tumour invasion and lymph node metastasis was assessed, and TNM staging was performed. Results： In 29 cases of gastric carcinoma, the sensitivity and specificity of two-phase multidetector-row spiral CT three-dimensional reconstruction technique in T1, T2, T3 and Ta staging, the sensitivity and specificity was 50% and 50%, 87.5% and 77.8%, 83.3% and 76.9% and 100% and 80% respectively. For the N staging, the sensitivity and specificity in No, N1, and N2 N3 was 83.3% and 71.4%, 87.5% and 77.8% and 81.8% and 75% respectively. The sensitivity and the specificity for M1 staging was 100%. Conclusion： The reconstruction technique in combination with 16-slices spiral-CT can perform TNM staging well and effectively guide the choice of the surgical procedures for gastric cancer.
基金Project supported by the National Natural Science Foun-dation of China(Grant Nos.62371199 and 62071186)the Natural Science Foundation of Guangdong Province,China(Grant No.2024A1515012427)+1 种基金the Quantum Science Strate-gic Initiative Project of Guangdong Province,China(Grant No.GDZX2305001)the Key Laboratory Project of Guangdong Province,China(Grant No.2020B1212060066).
文摘Weak measurement offers a powerful framework for probing nonclassical features of quantum mechanics,with anomalous weak values serving as operational signatures of contextuality.While the anomalous weak value verification of quantum contextuality has been predominantly investigated in the single-photon regime and analyzed under approximation condition of infinitesimally small perturbation strength.This study releases the approximation condition and takes into account the impact of perturbation strength on the rigor of the verification.And the investigation on the verification of contextuality is extended to the multi-photon scenarios for observing the influence of the correlation between photons on the verification.Without the limitation of infinitesimally small probability of disturbance,anomalous weak values are identified as necessary for contextuality to emerge,thereby refining the criterion proposed by Pusey[Phys.Rev.Lett.113200401(2014)].In the multi-photon scenarios,the emergence of contextuality also depends strongly on both the photon number and the photon-number distribution state.In particular,contextuality is found to be maximized when the single-photon component dominates and the second-order correlation is lower.These results highlight the critical role of photon statistics in experimental tests of contextuality via anomalous weak values.
基金support of the National Natural Science Foundation of China(No.12172023)。
文摘According to the Mindlin plate theory and the first-order piston theory,this work obtains accurate closed-form eigensolutions for the flutter problem of three-dimensional(3D)rectangular laminated panels.The governing differential equations are derived by the Hamilton's variational principle,and then solved by the iterative Separation-of-Variable(i SOV)method,which are applicable to arbitrary combinations of homogeneous Boundary Conditions(BCs).However,only the simply-support,clamped and cantilever panels are considered in this work for the sake of clarity.With the closed-form eigensolutions,the flutter frequency,flutter mode and flutter boundary are presented,and the effect of shear deformation and aerodynamic damping on flutter frequencies is investigated.Besides,the relation between panel energy and the work of aerodynamic load is discussed.The numerical comparisons reveal the following.(A)The flutter eigenvalues obtained by the present method are accurate,validated by the Finite Element Method(FEM)and the Galerkin method.(B)When the span-chord ratio is larger than 3,simplifying a 3D panel to 2D(two-dimensional)panel is reasonable and the relative differences of the flutter points predicted by the two models are less than one percent.(C)The reciprocal relationship between the mechanical energy of the panel and the work done by aerodynamic load is verified by using the present flutter eigenvalues and modes,further indicating the high accuracy of the present solutions.(D)The coupling of shear deformation and aerodynamic damping prevents frequency coalescing.
文摘AIM:To evaluate the predictive value of pan-immuneinflammation value(PIV)in the diagnosis of proliferative diabetic retinopathy(PDR)and its association with the stage of PDR.METHODS:This observational case-control study included participants who underwent routine complete blood count testing.Inflammation-related indices,including neutrophil-to-lymphocyte ratio,systemic immune-inflammation index(SII),and PIV,were derived and analyzed.Receiver operating characteristic curve(ROC)analysis was applied to assess the diagnostic performance of these indices in distinguishing patients with PDR,with sensitivity,specificity,area under ROC,and optimal threshold values calculated.In addition,binary logistic regression analysis was performed to evaluate the association between inflammatory indices and PDR stage.RESULTS:This study included 205 patients:60 with diabetes without retinopathy(mean age:61.81±10.76y),80 with PDR(mean age:61.63±10.03y)and 65 healthy controls(mean age:59.52±5.88y).The PDR group had significantly higher white blood cell(WBC,P<0.001),monocyte(MONO,P=0.009)and neutrophil(NEU)counts(P<0.001).SII and PIV had the highest sensitivity and area under ROC for predicting patients with PDR(0.822,0.846,respectively).The optimal cut-off values for discriminating patients with PDR were determined to be>527.12 and>299.08 for SII and PIV,respectively.The logistic regression analysis demonstrated that a decrease in lymphocyte(LYM)count and an increase in platelet count(PLT),glycated haemoglobin(HbA1c),SII,and PIV were all significantly associated with the development of high-risk PDR(all P<0.05).PIV was more stable than independent MONO,LYM,PLT and NEU levels in predicting both the diagnosis and stage of PDR.The optimal cut-off value for PIV to discriminate patients with high-risk PDR was found to be>345.87 area under ROC=0.871,with sensitivity of 0.827 and specificity of 0.812.CONCLUSION:PIV is a reliable,valuable,and inexpensive blood index that can be used for early detection and staging of PDR.PIV may therefore be essential to be used for the follow-up of diabetic patients.
基金Under the auspices of the Key Projects of Philosophy and Social Sciences Research,Ministry of Education of China(No.23JZD008)National Natural Science Foundation of China(No.42171193)+2 种基金Key Project of Guangdong Provincial Philosophy and Social Sciences Planning(No.GD24ES013,GD25ZX04)2025 Guangzhou Basic and Applied Basic Research Special Project(No.2025A04J7127)Fundamental Research Funds for the Central Universities,Sun Yat-sen University(No.24wkjc11)。
文摘The shift toward specialized and large-scale agricultural production has spurred the emergence of agricultural clusters as key forces of rural vitalization and sustainable development.This paper explored the formation and evolution of Meizhou pomelo industry cluster in China,focusing on its role in restructuring rural socio-economic systems and integrating the whole value chains.Based on a case study employing qualitative methods such as in-depth interviews and participatory observation,the agricultural cluster evolution of Meizhou pomelo was categorized into three key phases of initial decentralization,self-organized scaling,and reorganized clustering.Geographical proximity and industrial agglomeration constitute the physical foundation,while vertical/horizontal linkages,technologic-al innovation,and policy support enhance competitiveness.Special mechanisms emerge through localized social networks,farmer co-operatives’activation,and cross-regional market expansion.The cluster’s impact is manifested in the shift from extensive to standard-ized and modernized production,diversified and flexible livelihood of farmers,and the integration of agriculture with industry and ser-vices.The development of the whole value chain based on agricultural cluster represents a critical pathway for achieving agricultural modernization,encompassing both internal and external value chain optimization.Through quality assurance systems,product diversi-fication strategies,operational efficiency improvements,and brand enhancement,these clusters amplify product value propositions and market competitiveness.This systemic approach facilitates supply-demand coordination,enables resource synergies,and optimizes eco-nomic returns across the horizontal and vertical value chain.This paper argues that agricultural clusters serve as strategic catalysts for sustainable rural development by reconstructing local production systems,fostering innovation ecosystems,and aligning agricultural modernization.It contributes to debates on rural vitalization by demonstrating how agricultural clustering can reconfigure rural areas as hubs of ecological modernization,rather than mere urban peripheries.
文摘In the Tianshan region,a complete textile industry chain has been established,covering the entire process from cotton cultivation and chemical fiber production,through spinning,weaving,dyeing,and finishing,and further extending to apparel,home textiles,and industrial textiles.In November 2025,the first list of five characteristic textile and apparel industry clusters in Xinjiang was officially announced,marking a new stage in the clustering of Xinjiang's textile and apparel industry.Data shows that the total output value of Xinjiang's cotton and textile and apparel industry chain has exceeded 220 billion yuan.With the nation's largest cotton production,a complete industrial chain system,and strong synergistic effects,Xinjiang has become a leading and highly competitive textile industry hub in China.
文摘The Double Take column looks at a single topic from an African and Chinese perspective.This month,we discuss how to understand the growing emphasis on emotional returns among young people.Emotional value has emerged as a central force shaping youth decision-making across work,consumption,relationships and lifestyle choices.Unlike traditional economic rationality that prioritises income and material security,emotional value focuses on how choices make individuals feel and how they align with personal meaning.This shift is particularly evident in rapidly transforming societies such as China and Ghana,where economic restructuring,globalisation and social change have reshaped pathways to adulthood.
文摘Ming-style furniture represents the pinnacle of Chinese traditional furniture,with the four-head official’s cap chair standing out as a representative category due to its classic form and cultural connotations.This paper takes a specific rosewood four-head official’s cap chair inscribed by Wang Shixiang as the research subject,employing a tripartite approach of form analysis,material examination,and inscription interpretation.The chair strictly adheres to the classic form of Ming-style four-head official’s cap chairs,embodying the Ming Dynasty design philosophy of“the unity of function and aesthetics”.The scarcity and unique grain pattern of the golden-flecked rosewood(Zitan)endow it with the status of“gold among woods”.Wang Shixiang’s inscription binds the furniture to the cultural essence of“the charm of the Ming Dynasty”,transforming it into“heritable cultural heritage”.This paper provides a new perspective for the case study of Ming-style furniture and offers theoretical reference for the contemporary inheritance of traditional craftsmanship.
基金National Social Science Fund project“Research on the Narrative of the Sense of Community for the Chinese Nation in Southwest Nuo Opera”(24XMZ063).
文摘The Nuo mask is the core visual vehicle within China’s Nuo culture and constitutes a complex symbolic system through facial features(icons),patterns(indexes),and colors(symbols).Within the context of intangible cultural heritage(ICH)preservation,its value lies in the continuation and revitalization of its dynamic symbolic functions.Grounded in semiotic theory,this paper elaborates on three core dimensions of symbolic value manifested by Nuo masks in ICH preservation:a ritual symbol for living transmission,a symbol of identity for collective memory,and an aesthetic symbol as a source of creativity.
基金This research was supported by grants from the National Natural Science Foundation of China(No.81501530)Hubei Province Health and Family Planning Scientific Research Project(No.WJ2019M130).
文摘Sometimes endometrial polyps,submucosal myomas,and endometrial cancer show similar findings under ultrasonography.The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensional(3D)power Doppler ultrasonography angiography(PDA)between endometrial cancer and uterine parenchyma lumps.The data of the blood flow indices in 3D-PDA including the vascularization index(VI),flow index(FI),and vascularization flow index(VFI)in 40 patients with endometrial cancer and 41 patients with uterine parenchyma lumps(endometrial polyps and submucosal myomas)were retrospectively analysed and compared utilizing Virtual Organ Computer-aided AnaLysis(VOCAL)software.The results showed that all the blood flow parameters(VI,FI,VFI)were significantly higher in women with endometrial cancer than in those with uterine parenchyma lumps(P<0.001).The area under the curve of ROC of VI,FI,and VFI was 0.98,0.84,and 0.97,respectively.Thus,the best predictor of endometrial carcinoma was VI with a sensitivity of 97.0% and a specificity of 91.0%.The optimal cutoff value of VI was 4.06%.Our data demonstrated that all of the blood flow signal parameters(including VI,FI,and VFI)in 3D power Doppler ultrasonography had significant antidiastole values between endometrial cancer and uterine parenchyma lumps to assist clinicians in properly diagnosing patients.
基金National Key Research and Development Program of China,Grant/Award Number:2021YFC2902103National Natural Science Foundation of China,Grant/Award Number:51934001Fundamental Research Funds for the Central Universities,Grant/Award Number:2023JCCXLJ02。
文摘Fracture surface contour study is one of the important requirements for characterization and evaluation of the microstructure of rocks.Based on the improved cube covering method and the 3D contour digital reconstruction model,this study proposes a quantitative microstructure characterization method combining the roughness evaluation index and the 3D fractal dimension to study the change rule of the fracture surface morphology after blasting.This method was applied and validated in the study of the fracture microstructure of the rock after blasting.The results show that the fracture morphology characteristics of the 3D contour digital reconstruction model have good correlation with the changes of the blasting action.The undulation rate of the three-dimensional surface profile of the rock is more prone to dramatic rise and dramatic fall morphology.In terms of tilting trend,the tilting direction also shows gradual disorder,with the tilting angle increasing correspondingly.All the roughness evaluation indexes of the rock fissure surface after blasting show a linear and gradually increasing trend as the distance to the bursting center increases;the difference between the two-dimensional roughness evaluation indexes and the three-dimensional ones of the same micro-area rock samples also becomes increasingly larger,among which the three-dimensional fissure roughness coefficient JRC and the surface roughness ratio Rs display better correlation.Compared with the linear fitting formula of the power function relationship,the three-dimensional fractal dimension of the postblast fissure surface is fitted with the values of JRC and Rs,which renders higher correlation coefficients,and the degree of linear fitting of JRC to the three-dimensional fractal dimension is higher.The fractal characteristics of the blast-affected region form a unity with the three-dimensional roughness evaluation of the fissure surface.
文摘Advent in three-dimensional(3D) imaging technology has seen 3D ultrasound establish itself as a useful adjunct complementary to traditional two-dimensional imaging of the female pelvis. This advantage largely arises from its ability to reconstruct the coronal plane of the uterus, which allows further delineation of many gynecological disorders. 3D imaging of the uterus is now the preferred imaging modality for assessing congenital uterine anomalies and intrauterine device localization. Newer indications include the diagnosis of adenomyosis. It can also add invaluable information to delineate other endometrial and myometrial pathology such as fibroids and endometrial polyps.
文摘BACKGROUND Numerous variables are linked to the success of vaginal delivery,including the subpubic arch angle(SPAA)during labor,the importance of which has not yet been fully elucidated.AIM To examine the SPAA distributional characteristics and to ascertain SPAA’s ability to predict the type and duration of labor.METHODS We determined the SPAA and analyzed the corresponding data.We also evaluated the relationship between the SPAA and the mode of delivery and the duration of labor by regression.The present study comprised a total of 301 pregnant women who had given birth at Beijing Tiantan Hospital of the Capital Medical University between January and December of 2021.RESULTS Our analysis of 301 pregnant women revealed that the SPAA measured using three-dimensional trans-perineal ultrasound had a minimum angle of 81°and a maximum angle of 122.2°.The angle in the normal vaginal delivery group was greater than that in the labor cesarean group(P=0.000).The SPAA was a highly significant positive predictor of normal vaginal delivery(P=0.000)with an area under the curve of 0.782(P=0.000;95%CI:0.717-0.848).We found the length of the second stage of labor to be positively influenced by the SPAA using linear regression analysis(P=0.045).CONCLUSION The SPAA was a highly significant positive predictor of normal vaginal delivery.The length of the second stage of labor and normal vaginal birth were predicted by SPAA.
文摘Stereoscopic three-dimensional echocardiography（S-3DE） is a novel displaying technol-ogy based on real-time 3-dimensional echocardiography （RT-3DE）. Our study was to evaluate the feasibility and efficiency of S-3DE in the diagnosis of atrial septal defect （ASD） and its use in the guidance for transcatheter ASD occlusion. Twelve patients with secundum ASD underwent RT-3DE examination and 9 of the 12 were subjected to transcatheter closure of ASD. Stereoscopic vision was generated with a high-performance volume renderer with red-green stereoscopic glasses. S-3DE was compared with standard RT-3D display for the assessment of the shape, size, and the surrounding tis-sues of ASD and for the guidance of ASD occlusion. The appearance rate of coronary sinus and the mean formation time of the IVC, SVC were compared. Our results showed that S-3DE could measure the diameter of ASD accurately and there was no significant difference in the measurements between S-3DE and standard 3D display （2.89±0.73 cm vs 2.85±0.72 cm, P〉0.05; r=0.96, P〈0.05）. The appearance of coronary sinus for S-3DE was higher as compared with the standard 3D display （93.3% vs 100%）. The mean time of the IVC, SVC for S-3DE monitor was slightly shorter than that of the standard 3D display （11.0±3.8 s vs 10.3±3.6 s, P〉0.05）. The mean completion time of interven-tional procedure was shortened with S-3DE display as compared with standard 3D display （17.3±3.1 min vs 23.0±3.9 min, P〈0.05）. Stereoscopic three-dimensional echocardiography could improve the visualization of three-dimensional echocardiography, facilitate the identification of the adjacent structures, decrease the time required for interventional manipulation. It may be a feasible, safe, and efficient tool for guiding transcatheter septal occlusion or the surgical interventions.
基金Supported by National Natural Science Foundation of China,No.81571686.
文摘BACKGROUND Endocardial fibroelastosis(EFE)is a rare heart disease characterized by thickening of the endocardium caused by massive proliferation of collagenous and elastic tissue,usually leading to impaired cardiac function.Multimodality cardiovascular imaging for the evaluation of EFE with thrombi is even rarer.CASE SUMMARY We report a rare case of EFE associated with multiple cardiovascular thrombi.Three-dimensional(3D)and contrast echocardiography(CE)were used to assess ventricular thrombi.Anticoagulant therapy was administered to eliminate the thrombi.The peripheral contrast-enhanced thrombi with the highest risk were dissolved with anticoagulant therapy at the time of reexamination,which was consistent with the presumption of fresh loose thrombi.CONCLUSION This new echocardiography technique has a great advantage in the diagnosis and treatment of EFE.On the basis of conventional echocardiography,3D echocardiography is used to display the position,shape,and narrow base of the thrombus.CE does not only help to confirm the diagnosis of thrombus,but also determines its risk.
文摘Objective To evaluate the clinical value of three dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage. Methods 616 cases were diagnosed as suspected intracranial aneurysms in 3D CTA system. Computed tomographic scans and CTA studies were
基金Project supported by the National Scaling Program,the National Eighth-Five-Year Tackling Key Problem Programthe Doctoral Program Foundation of the National Education Commission
文摘The software for oil-gas transport and accumulation is to describe the history of oil-gas transport and accumulation in basin evolution. It is of great value in rational evaluation of prospecting and exploiting oil-gas resources. The mathematical model can be discribed as a coupled system of nonlinear partial differential equations with moving boundary value problem. For a generic case of the three-demensional bounded region, bi this thesis, the effects of gravitation、buoyancy and capillary pressure are considered, we put forward a kind of characteristic finite difference schemes and make use thick and thin grids to form a complete set, and of calculus of vaviations, the change of variable, the theory of prior estimates and techniques, Optimal order estimates in l^2 norm are derived for the error in approximate assumption, Thus we have completely solved the well-known theoretical problem proposed by J. Douglas, Jr.
文摘Background Sinus venosus atrial septal defect（SVASD） is a rare atrial septal defect. The right-sided pulmonary veins may drain into the right atrium directly or via vena cava. Two-dimensional transthoracic echocardiography（2D-TTE） is certainly the initial choice of evaluation of SVASD but is unable to show its spatial relation to the surrounding structures and the configuration of the veins accurately. The purpose of this study was to evaluate the diagnostic accuracy of real-time three-dimensional transesophageal echocardiography（RT3D-TEE） for detecting SVASD and partial anomalous pulmonary venous connection（PAPVC）. Methods2D-TTE and RT3D-TEE were performed in 25 patients with the SVASD before surgical repair. Records of these patients were compared with surgical assessments. Results Twenty-three of the 25 patients with SVASD were detected by 2D-TTE. All the 23 patents were associated with PAPVC. Two of the 25 patients with SVASD were misdiagnosed as the secundum atrial septal defect by 2D-TTE. SVASD was demonstrated in all the 25 cases by RT3D-TEE, and 25 patents were associated with PAPVC. Conclusions RT3D-TEE is highly accurate, scientific method for displaying the location, size, shape of the defect and its spatial relation to the surrounding structures, and provides additional value to the surgeon and physicians for better understanding of spatial intracardiac morphology and making more accurate diagnosis and treatment.
基金Shaanxi key research and development plan(No.2019SF-211).
文摘Objective:To investigate the value of two-dimensional ultrasound speckle tracking(2D-STI)and three-dimensional ultrasound speckle tracking(3D-STI)in evaluating myocardial function in children with Kawasaki disease.Methods 92 children with Kawasaki disease admitted to our hospital from February 2017 to February 2019 were retrospectively analyzed.50 children who underwent 3D-STI examination were taken as observation group and 42 children who underwent 2D-STI examination were taken as control group.The left ventricular systolic function index,storage time and analysis time of the image,the diameter of coronary artery,the strain difference of left ventricular basal segment,middle segment,apical segment and whole segment were observed.Results The levels of left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular myocardial mass(LVMI)in the observation group were higher than those in the control group(P<0.05),but there was no statistical difference in left ventricular ejection fraction(LVEF)between the two groups(P>0.05).The storage time and analysis time of the image in the observation group were significantly lower than those in the control group(P<0.05).The left coronary artery(LCA)and right coronary artery(RCA)in the observation group were higher than those in the control group(P<0.05).There was no statistical difference between left anterior descending(LAD)in the two groups(P>0.05).The longitudinal peak systolic strain(LS),circumferential peak systolic strain(CS)and radial peak systolic strain(RS)in the observation group were higher than those in the control group(P<0.05).The global longitudinal peak strain(GLS),global circumferential peak strain(GCS)and global radial peak strain(GRS)in the observation group were higher than those in the control group(P<0.05).LS and CS in the middle segment of the observation group were higher than those in the control group(P<0.05).Conclusions Compared with 2D-STI,3D-STI can objectively and accurately reflect the myocardial function of children with Kawasaki disease.
基金National Science Foundation of China No:81301292.
文摘Objective: To study the evaluation value of three-dimensional finite element model analysis for bone mineral density (BMD) and bone metabolism activity in patients with osteoporosis. Methods: A total of 218 patients who were diagnosed with osteoporosis in the hospital between February 2014 and January 2017 were collected as observation group, and 100 healthy volunteers who received physical examination in the hospital during the same period were selected as normal control group. The femoral head of the two groups was analyzed by three-dimensional finite element model, and the femoral head BMD levels and serum bone metabolism index contents were measured. Pearson test was used to evaluate the evaluation value of femoral head three-dimensional finite element model for osteoporosis. Results: The cancellous bone and cortical bone Von Mises stress value of observation group were lower than those of normal control group, and femoral neck BMD value of observation group was lower than that of normal control group;serum bone metabolism index BGP content was lower than that of normal control group while NBAP, TRACP-5b and CTX-1 contents were higher than those of normal control group. Pearson test showed that the cancellous bone and cortical bone Von Mises stress value of patients with osteoporosis were directly correlated with BMD value and bone metabolism index contents. Conclusion: The three-dimensional finite element model analysis resultsof patients with osteoporosis can objectively reflect the femoral headBMD value and bone metabolism activity, and is a reliable way to evaluate the risk of long-term fractures.
