BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints...BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.展开更多
Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid adv...Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid advancement of computer technology has enabled the integration of virtual reality(VR)into medical training,thereby revolutionizing ophthalmic surgical education through VRbased educational methods.VR technology offers a safe,risk-free environment for trainees to practice repeatedly,enhancing surgical skills and accelerating the learning curve without compromising patient safety.This research outlines the application of VR technology in ophthalmic surgical skills training,particularly in cataract and vitreoretinal surgery.Including assessing the effectiveness of intraocular surgery training systems,evaluating skills transfer to the operating room,comparing it with wet lab cataract surgery training,and enhancing non-dominant hand training for cataract surgery,among other aspects.Additionally,this paper will identify the limitations of VR technology in ocular surgical skills training,offer improvement strategies,and detail the advantages and prospects,with the objective of guiding subsequent researchers.展开更多
Safer,smarter,faster...In China,people prefer high-speed trains to flights if the journey time is under five hours.High-speed train travel is set to become even more attractive with the addition of a new member to the...Safer,smarter,faster...In China,people prefer high-speed trains to flights if the journey time is under five hours.High-speed train travel is set to become even more attractive with the addition of a new member to the high-speed train family:the CR450,the world’s fastest electric multiple unit(EMU).展开更多
软测量技术为工业过程中重要变量及难测变量的预测提供了一个有效的解决办法。然而,由于工业过程的复杂化和高昂的数据获取成本,使得标记数据与未标记数据分布不平衡。此时,构建高性能的软测量模型成为一个挑战。针对这一问题,提出了一...软测量技术为工业过程中重要变量及难测变量的预测提供了一个有效的解决办法。然而,由于工业过程的复杂化和高昂的数据获取成本,使得标记数据与未标记数据分布不平衡。此时,构建高性能的软测量模型成为一个挑战。针对这一问题,提出了一种基于时差的多输出tri-training异构软测量方法。通过构建一种新的tri-training框架,采用多输出的高斯过程回归(multi-output Gaussian process regression,MGPR)、相关向量机(multi-output relevance vector machine,MRVM)、最小二乘支持向量机(multi-output least squares support vector machine,MLSSVM)三种模型作为基线监督回归器,使用标记数据进行训练和迭代;同时,引入时间差分(time difference,TD)改进模型的动态特性,并通过卡尔曼滤波(Kalman filtering,KF)优化模型的参数,提高其预测性能;最后通过模拟污水处理平台(benchmark simulation model 1,BSM1)和实际污水处理厂对该模型进行了验证。结果表明,与传统的软测量建模方法相比,该模型能显著提高数据分布不平衡下软测量模型的自适应性和预测性能。展开更多
BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential t...BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.展开更多
Purpose–The study aims to build a high-precision longitudinal dynamics model for heavy-haul trains and validate it with line test data,present an optimization method for multi-stage cyclic brakes based on the model a...Purpose–The study aims to build a high-precision longitudinal dynamics model for heavy-haul trains and validate it with line test data,present an optimization method for multi-stage cyclic brakes based on the model and conduct a multi-objective detailed evaluation of the driver’s manipulation during cyclic braking.Design/methodology/approach–The high-precision longitudinal train dynamics model was established and verified by the cyclic braking test data of the 20,000 t heavy-haul combination train on the long and steep downgrade.Then the genetic algorithm is employed for optimization subsequent to decoupling multiple cyclic braking procedures,with due consideration of driver operation rules.For evaluation,key manipulation assessments in the scenario are prioritized,supplemented by multi-objective evaluation requirements,and the computational model is employed for detailed evaluation analysis.Findings–Based on the model,experimental data reveal that the probability of longitudinal force error being less than 64.6 kN is approximately 68%,95%for less than 129.2 kN and 99.7%for less than 193.8 kN.Upon optimizing manipulations during the cyclic braking,the maximum reduction in coupler force spans from 21%∼23.9%.Andtheevaluation scoresimply that a proper elevationof the releasingspeed favorssafety.A high electric braking force,although beneficial to some extent for energy-saving,is detrimental to reducing coupler force.Originality/value–The results will provide a theoretical basis and practical guidance for further ensuring the safety and energy-efficient operation of heavy haul trains on long downhill sections and improving the operational quality of heavy-haul trains.展开更多
In recent years,railway construction in China has developed vigorously.With continuous improvements in the highspeed railway network,the focus is gradually shifting from large-scale construction to large-scale operati...In recent years,railway construction in China has developed vigorously.With continuous improvements in the highspeed railway network,the focus is gradually shifting from large-scale construction to large-scale operations.However,several challenges have emerged within the high-speed railway dispatching and command system,including the heavy workload faced by dispatchers,the difficulty of quantifying subjective expertise,and the need for effective training of professionals.Amid the growing application of artificial intelligence technologies in railway systems,this study leverages Large Language Model(LLM)technology.LLMs bring enhanced intelligence,predictive capabilities,robust memory,and adaptability to diverse real-world scenarios.This study proposes a human-computer interactive intelligent scheduling auxiliary training system built on LLM technology.The system offers capabilities including natural dialogue,knowledge reasoning,and human feedback learning.With broad applicability,the system is suitable for vocational education,guided inquiry,knowledge-based Q&A,and other training scenarios.Validation results demonstrate its effectiveness in auxiliary training,providing substantial support for educators,students,and dispatching personnel in colleges and professional settings.展开更多
Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesit...Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesity drug alone or combined with exercise training on body weight,body fat,fat-free mass and cardiorespiratory fitness in obese patients were retrieved from Pubmed and EMBASE up to May 2024.Risk of bias assessment was performed with RoB 2.0,and the GRADE approach assessed the certainty of evidence(CoE)of each main outcome.We included four publications summing up 202 patients.Two publications used orlistat as an anti-obesity drug treatment,while the other two adopted GLP-1 receptor agonist(liraglutide or tirzepatide)as a pharmacotherapy for weight management.Orlistat combined with exercise was superior to change body weight(mean difference(MD):−2.27 kg;95%CI:−2.86 to−1.69;CoE:very low),fat mass(MD:−2.89;95%CI:−3.87 to−1.91;CoE:very low),fat-free mass(MD:0.56;95%CI:0.40–0.72;CoE:very low),and VO_(2)Peak(MD:2.64;95%CI:2.52–2.76;CoE:very low).GLP-1 receptor agonist drugs combined with exercise had a great effect on body weight(MD:−3.96 kg;95%CI:−5.07 to−2.85;CoE:low),fat mass(MD:−1.76;95%CI:−2.24 to−1.27;CoE:low),fat-free mass(MD:0.50;95%CI:−0.98 to 1.98;CoE:very low)and VO_(2)Peak(MD:2.47;95%CI:1.31–3.63;CoE:very low).The results reported here suggest that exercise training remains an important approach in weight management when combined with pharmacological treatment.展开更多
This paper introduces the Surrogate-assisted Multi-objective Grey Wolf Optimizer(SMOGWO)as a novel methodology for addressing the complex problem of empty-heavy train allocation,with a focus on line utilization balanc...This paper introduces the Surrogate-assisted Multi-objective Grey Wolf Optimizer(SMOGWO)as a novel methodology for addressing the complex problem of empty-heavy train allocation,with a focus on line utilization balance.By integrating surrogate models to approximate the objective functions,SMOGWO significantly improves the efficiency and accuracy of the optimization process.The effectiveness of this approach is evaluated using the CEC2009 multi-objective test function suite,where SMOGWO achieves a superiority rate of 76.67%compared to other leading multi-objective algorithms.Furthermore,the practical applicability of SMOGWO is demonstrated through a case study on empty and heavy train allocation,which validates its ability to balance line capacity,minimize transportation costs,and optimize the technical combination of heavy trains.The research highlights SMOGWO's potential as a robust solution for optimization challenges in railway transportation,offering valuable contributions toward enhancing operational efficiency and promoting sustainable development in the sector.展开更多
In recent years,train-tail swaying of 160 km/h electric multiple units(EMUs)inside single-line tunnels has been heavily researched,because the issue needs to be solved urgently.In this paper,a co-simulation model of v...In recent years,train-tail swaying of 160 km/h electric multiple units(EMUs)inside single-line tunnels has been heavily researched,because the issue needs to be solved urgently.In this paper,a co-simulation model of vortex-induced vibration(VIV)of the tail car body is established,and the aerodynamics of train-tail swaying is studied.The simulation results were confirmed through a field test of operating EMUs.Furthermore,the influence mechanism of train-tail swaying on the wake flow field is studied in detail through a wind-tunnel experiment and a simulation of a reduced-scaled train model.The results demonstrate that the aerodynamic force frequency(i.e.,vortex-induced frequency)of the train tail increases linearly with train speed.When the train runs at 130 km/h,with a small amplitude of train-tail swaying(within 10 mm),the vortex-induced frequency is 1.7 Hz,which primarily depends on the nose shape of the train tail.After the tail car body nose is extended,the vortex-induced frequency is decreased.As the swaying amplitude of the train tail increases(exceeding 25 mm),the separation point of the high-intensity vortex in the train wake shifts downstream to the nose tip,and the vortex-induced frequency shifts from 1.7 Hz to the nearby car body hunting(i.e.,the primary hunting)frequency of 1.3 Hz,which leads to the frequency-locking phenomenon of VIV,and the resonance intensifies train-tail swaying.For the motor vehicle of the train tail,optimization of the yaw damper to improve its primary hunting stability can effectively alleviate train-tail swaying inside single-line tunnels.Optimization of the tail car body nose shape reduces the amplitude of the vortex-induced force,thereby weakening the aerodynamic effect and solving the problem of train-tail swaying inside the single-line tunnels.展开更多
Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhan...Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms.This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture,electrical stimulation,and biofeedback therapy versus conventional therapy consisting of electroacupuncture,electrical stimulation,and biofeedback alone in women with SUI,and to explore the role of PFPT in improving symptom and functional outcomes.Methods:In this randomized controlled trial,72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital,Central South University,between December 2021 and October 2023.Participants were randomly assigned to an experimental group(n=36)or a control group(n=36).Both groups received health education.The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy,while the experimental group additionally received PFPT 3 times per week for 4 weeks.The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF).Secondary outcomes included pelvic floor muscle strength,bladder neck mobility,and balance ability.The ICIQ-SF was reassessed at 1,3,6,and 12 months post-treatment.Results:Both groups showed statistically significant improvements in all parameters after treatment(all P<0.05).However,there were no statistically significant differences between groups in most measures(all P>0.05).The experimental group demonstrated longer singleleg stance duration with eyes closed than the control group(left leg:P=0.026;right leg:P=0.006),with a significant increase from baseline(P<0.001).At 6 months post-treatment,the cure rate in the experimental group was significantly higher than that in the control group(P=0.037).Conclusion:Conventional therapy effectively improves SUI symptoms,but adding PFPT provides notable additional benefits,including enhanced balance ability and sustained midterm cure rates.These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.展开更多
Purpose–In recent years,the rapid advancement of artificial intelligence(AI)has exerted profound impacts on and provided strong impetus to numerous fields in the industrial sector.Within the railway industry,AI has d...Purpose–In recent years,the rapid advancement of artificial intelligence(AI)has exerted profound impacts on and provided strong impetus to numerous fields in the industrial sector.Within the railway industry,AI has driven continuous upgrading and optimization of intelligent train control technology,thanks to its enhanced computational capabilities derived from advanced algorithms and models,as well as its role in improving safety performance.Integrating AI technology more extensively into train autonomous driving and control has thus become an inevitable trend in the global development of railways.Design/methodology/approach–This paper,therefore,conducts a comprehensive analysis of the development progress and current status of AI technology applications in the field of train driving and control on a global scale.It systematically sorts out and analyzes the advantages of various AI technologies and the positive impacts they bring to the upgrading of train control technology,elucidates the feasibility and future prospects of applying a range of emerging AI technologies from the perspective of technical theory and provides guidance for the intelligent development of this field from a practical perspective.Findings–The application of AI technology in the train driving and control field is still in its infancy.While a large number of AI technologies have been widely adopted,there remains significant room for further optimization and improvement of these technologies.Additionally,a variety of AI technologies that have been applied in other industrial sectors but not yet widely implemented in training autonomous driving and control have demonstrated tremendous development potential.Originality/value–The research findings provide references and guidance for advancing train control technology,promoting the digital transformation of railways,accelerating the overall optimization and upgrading of railway industry technologies,and facilitating the accelerated development of global railways.展开更多
Exercise is a therapeutic approach in cancer treatment,providing several benefits.Moreover,exercise is associated with a reduced risk for developing a range of cancers and for their recurrence,as well as with improvin...Exercise is a therapeutic approach in cancer treatment,providing several benefits.Moreover,exercise is associated with a reduced risk for developing a range of cancers and for their recurrence,as well as with improving survival,even though the underlying mechanisms remain unclear.Preclinical and clinical evidence shows that the acute effects of a single exercise session can suppress the growth of various cancer cell lines in vitro.This suppression is potentially due to altered concentrations of hormones(e.g.,insulin)and cytokines(e.g.,tumor necrosis factor alpha and interleukin 6)after exercise.These factors,known to be involved in tumorigenesis,may explain why exercise is associated with reduced cancer incidence,recurrence,and mortality.However,the effects of short-(<8 weeks)and long-term(≥8 weeks)exercise programs on cancer cells have been reported with mixed results.Although more research is needed,it appears that interventions incorporating both exercise and diet seem to have greater inhibitory effects on cancer cell growth in both apparently healthy subjects as well as in cancer patients.Although speculative,these suppressive effects on cancer cells may be driven by changes in body weight and composition as well as by a reduction in low-grade inflammation often associated with sedentary behavior,low muscle mass,and excess fat mass in cancer patients.Taken together,such interventions could alter the systemic levels of suppressive circulating factors,leading to a less favorable environment for tumorigenesis.While regular exercise and a healthy diet may establish a more cancer-suppressive environment,each acute bout of exercise provides a further“dose”of anticancer medicine.Therefore,integrating regular exercise could potentially play a significant role in cancer management,highlighting the need for future investigations in this promising area of research.展开更多
Background Schizophrenia is characterised by pervasive cognitive deficits that significantly impair daily functioning and quality of life.Pharmacological treatments have limited efficacy in addressing these deficits,h...Background Schizophrenia is characterised by pervasive cognitive deficits that significantly impair daily functioning and quality of life.Pharmacological treatments have limited efficacy in addressing these deficits,highlighting the need for adjunctive interventions like computerised cognitive training(CCT).Aims This study aimed to evaluate the effects of a 30-session CCT programme on mental well-being and cognitive performance in individuals with schizophrenia.Additionally,it assessed the usability and acceptability of CCT in this population.Methods A double-blind,randomised clinical trial was conducted with 54 participants assigned to intervention and control groups.Cognitive and mental health outcomes were assessed using validated tools such as the Depression Anxiety Stress Scale 21,the Warwick-Edinburgh Mental Wellbeing Scale and the Cambridge Neuropsychological Test Automated Battery.Usability was measured with the System Usability Scale(SUS).Assessments were conducted at baseline,post-intervention and 3 months post-follow-up.Results The CCT intervention significantly improved mental well-being,reduced stress and enhanced working memory(paired associate learning,spatial working memory and spatial span)compared with controls.However,no significant effects were observed for anxiety,depression or executive function.Usability scores were high(SUS=83.51),and compliance rates were strong(92.7%),indicating favourable participant engagement.Conclusion CCT demonstrated potential as an adjunctive treatment for schizophrenia,with significant improvements in targeted cognitive and mental health domains.The high usability and compliance rates support its feasibility for broader implementation.Further research is needed to optimise protocols and explore long-term benefits.CCT offers a promising approach to addressing mental health and cognitive challenges in schizophrenia,particularly for stress and working memory.Its usability and acceptability suggest it could be seamlessly integrated into clinical practice.展开更多
Standardized residency training programs primarily focus on developing clinical diagnostic and treatment skills,often allocating limited time to research activities.However,enhancing research skills is of paramount im...Standardized residency training programs primarily focus on developing clinical diagnostic and treatment skills,often allocating limited time to research activities.However,enhancing research skills is of paramount importance for residents,as it fosters critical thinking,problem-solving abilities,and a deeper understanding of applying scientific principles to clinical practice.This paper explores the necessity and significance of integrating research training into residency programs,emphasizing its role in cultivating well-rounded physicians capable of advancing medical knowledge.This study proposes a competency-based research training model that encompasses research literacy,study design,biostatistics,and scientific writing.Additionally,online asynchronous training modules,robust mentorship,and balanced time management strategies are recommended to enhance residents’research engagement without compromising clinical training.By implementing these measures,residency programs can improve residents’research capabilities,contributing to both individual professional growth and the broader advancement of medical science.展开更多
High-speed maglev trains(HSMTs)can run at high running speeds due to their unique design.The pressure waves that these trains generate while passing each other are therefore very intense,and can even have safety impli...High-speed maglev trains(HSMTs)can run at high running speeds due to their unique design.The pressure waves that these trains generate while passing each other are therefore very intense,and can even have safety implications.In order to reduce the transient impact of such waves,the standard k-ε turbulence model is used in this work to assess the effect of railway spacing on the aerodynamic loads,pressure and surrounding flow field of 600 km/h maglev trains passing each other in open air.The sliding mesh technique is used to determine the relative motion between the considered trains.The results show that the surface pressure is approximately linearly correlated with the square of the speed while the amplitude of the pressure wave on the train surface,side force,and rolling moment all have negative exponential relationships with the railway spacing.展开更多
Global Navigation Satellite Systems(GNSSs)are vulnerable to both unintentional interference and intentional attacks,making it difficult to meet the stringent safety requirements of railway train control systems.The gr...Global Navigation Satellite Systems(GNSSs)are vulnerable to both unintentional interference and intentional attacks,making it difficult to meet the stringent safety requirements of railway train control systems.The growing threat to information security posed by spoofing attacks has received limited attention.This study investigates the impact of GNSS spoofing attacks on train positioning,emphasizing their detrimental effects on the accuracy and availability of train location report functions for train operation control.To explore the antispoofing performance of typical GNSS-based train positioning schemes,specific approaches,and system architectures are designed under two GNSS-alone and two GNSS-integrated train positioning schemes.Field data are utilized to establish spoofing attack scenarios for GNSS-based train positioning,with which the anti-spoofing capabilities of different train positioning schemes are evaluated.Experimental results indicate that under specific conditions,the GNSS-integrated positioning schemes demonstrate superior GNSS spoofing suppression capabilities.Results of the tests present valuable guidance for designers and manufacturers in developing more advanced and resilient train positioning solutions and equipment for the next generation of train control systems,thereby promoting the applications of GNSS technology in railway systems.展开更多
文摘BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.
基金Supported by the Key Special Project of“Cutting-Edge Biotechnology”in the National Key Research and Development Program of China(No.2024YFC3406200)Sanming Project of Medicine in Shenzhen(No.SZSM202411007)Shenzhen Science and Technology Program(No.JCYJ20240813152704006).
文摘Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid advancement of computer technology has enabled the integration of virtual reality(VR)into medical training,thereby revolutionizing ophthalmic surgical education through VRbased educational methods.VR technology offers a safe,risk-free environment for trainees to practice repeatedly,enhancing surgical skills and accelerating the learning curve without compromising patient safety.This research outlines the application of VR technology in ophthalmic surgical skills training,particularly in cataract and vitreoretinal surgery.Including assessing the effectiveness of intraocular surgery training systems,evaluating skills transfer to the operating room,comparing it with wet lab cataract surgery training,and enhancing non-dominant hand training for cataract surgery,among other aspects.Additionally,this paper will identify the limitations of VR technology in ocular surgical skills training,offer improvement strategies,and detail the advantages and prospects,with the objective of guiding subsequent researchers.
文摘Safer,smarter,faster...In China,people prefer high-speed trains to flights if the journey time is under five hours.High-speed train travel is set to become even more attractive with the addition of a new member to the high-speed train family:the CR450,the world’s fastest electric multiple unit(EMU).
文摘软测量技术为工业过程中重要变量及难测变量的预测提供了一个有效的解决办法。然而,由于工业过程的复杂化和高昂的数据获取成本,使得标记数据与未标记数据分布不平衡。此时,构建高性能的软测量模型成为一个挑战。针对这一问题,提出了一种基于时差的多输出tri-training异构软测量方法。通过构建一种新的tri-training框架,采用多输出的高斯过程回归(multi-output Gaussian process regression,MGPR)、相关向量机(multi-output relevance vector machine,MRVM)、最小二乘支持向量机(multi-output least squares support vector machine,MLSSVM)三种模型作为基线监督回归器,使用标记数据进行训练和迭代;同时,引入时间差分(time difference,TD)改进模型的动态特性,并通过卡尔曼滤波(Kalman filtering,KF)优化模型的参数,提高其预测性能;最后通过模拟污水处理平台(benchmark simulation model 1,BSM1)和实际污水处理厂对该模型进行了验证。结果表明,与传统的软测量建模方法相比,该模型能显著提高数据分布不平衡下软测量模型的自适应性和预测性能。
文摘BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.
文摘Purpose–The study aims to build a high-precision longitudinal dynamics model for heavy-haul trains and validate it with line test data,present an optimization method for multi-stage cyclic brakes based on the model and conduct a multi-objective detailed evaluation of the driver’s manipulation during cyclic braking.Design/methodology/approach–The high-precision longitudinal train dynamics model was established and verified by the cyclic braking test data of the 20,000 t heavy-haul combination train on the long and steep downgrade.Then the genetic algorithm is employed for optimization subsequent to decoupling multiple cyclic braking procedures,with due consideration of driver operation rules.For evaluation,key manipulation assessments in the scenario are prioritized,supplemented by multi-objective evaluation requirements,and the computational model is employed for detailed evaluation analysis.Findings–Based on the model,experimental data reveal that the probability of longitudinal force error being less than 64.6 kN is approximately 68%,95%for less than 129.2 kN and 99.7%for less than 193.8 kN.Upon optimizing manipulations during the cyclic braking,the maximum reduction in coupler force spans from 21%∼23.9%.Andtheevaluation scoresimply that a proper elevationof the releasingspeed favorssafety.A high electric braking force,although beneficial to some extent for energy-saving,is detrimental to reducing coupler force.Originality/value–The results will provide a theoretical basis and practical guidance for further ensuring the safety and energy-efficient operation of heavy haul trains on long downhill sections and improving the operational quality of heavy-haul trains.
基金the Talent Fund of Beijing Jiaotong University(Grant No.2024XKRC055).
文摘In recent years,railway construction in China has developed vigorously.With continuous improvements in the highspeed railway network,the focus is gradually shifting from large-scale construction to large-scale operations.However,several challenges have emerged within the high-speed railway dispatching and command system,including the heavy workload faced by dispatchers,the difficulty of quantifying subjective expertise,and the need for effective training of professionals.Amid the growing application of artificial intelligence technologies in railway systems,this study leverages Large Language Model(LLM)technology.LLMs bring enhanced intelligence,predictive capabilities,robust memory,and adaptability to diverse real-world scenarios.This study proposes a human-computer interactive intelligent scheduling auxiliary training system built on LLM technology.The system offers capabilities including natural dialogue,knowledge reasoning,and human feedback learning.With broad applicability,the system is suitable for vocational education,guided inquiry,knowledge-based Q&A,and other training scenarios.Validation results demonstrate its effectiveness in auxiliary training,providing substantial support for educators,students,and dispatching personnel in colleges and professional settings.
基金supported by Brazilian agencies CAPES(Finance Code 001)CNPq through PQ productivity scholarship.
文摘Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesity drug alone or combined with exercise training on body weight,body fat,fat-free mass and cardiorespiratory fitness in obese patients were retrieved from Pubmed and EMBASE up to May 2024.Risk of bias assessment was performed with RoB 2.0,and the GRADE approach assessed the certainty of evidence(CoE)of each main outcome.We included four publications summing up 202 patients.Two publications used orlistat as an anti-obesity drug treatment,while the other two adopted GLP-1 receptor agonist(liraglutide or tirzepatide)as a pharmacotherapy for weight management.Orlistat combined with exercise was superior to change body weight(mean difference(MD):−2.27 kg;95%CI:−2.86 to−1.69;CoE:very low),fat mass(MD:−2.89;95%CI:−3.87 to−1.91;CoE:very low),fat-free mass(MD:0.56;95%CI:0.40–0.72;CoE:very low),and VO_(2)Peak(MD:2.64;95%CI:2.52–2.76;CoE:very low).GLP-1 receptor agonist drugs combined with exercise had a great effect on body weight(MD:−3.96 kg;95%CI:−5.07 to−2.85;CoE:low),fat mass(MD:−1.76;95%CI:−2.24 to−1.27;CoE:low),fat-free mass(MD:0.50;95%CI:−0.98 to 1.98;CoE:very low)and VO_(2)Peak(MD:2.47;95%CI:1.31–3.63;CoE:very low).The results reported here suggest that exercise training remains an important approach in weight management when combined with pharmacological treatment.
基金supported by the National Natural Science Foundation of China(Project No.5217232152102391)+2 种基金Sichuan Province Science and Technology Innovation Talent Project(2024JDRC0020)China Shenhua Energy Company Limited Technology Project(GJNY-22-7/2300-K1220053)Key science and technology projects in the transportation industry of the Ministry of Transport(2022-ZD7-132).
文摘This paper introduces the Surrogate-assisted Multi-objective Grey Wolf Optimizer(SMOGWO)as a novel methodology for addressing the complex problem of empty-heavy train allocation,with a focus on line utilization balance.By integrating surrogate models to approximate the objective functions,SMOGWO significantly improves the efficiency and accuracy of the optimization process.The effectiveness of this approach is evaluated using the CEC2009 multi-objective test function suite,where SMOGWO achieves a superiority rate of 76.67%compared to other leading multi-objective algorithms.Furthermore,the practical applicability of SMOGWO is demonstrated through a case study on empty and heavy train allocation,which validates its ability to balance line capacity,minimize transportation costs,and optimize the technical combination of heavy trains.The research highlights SMOGWO's potential as a robust solution for optimization challenges in railway transportation,offering valuable contributions toward enhancing operational efficiency and promoting sustainable development in the sector.
基金supported by the National Natural Science Foundation of China(Nos.52372403 and U2268211)the Natural Science Foundation of Sichuan Province(No.2022NSFSC0034),China+1 种基金the National Railway Group Science and Technology Program(No.2023J071)the Traction Power State Key Laboratory of the Independent Research and Development Projects(No.2022TPL-T02),China.
文摘In recent years,train-tail swaying of 160 km/h electric multiple units(EMUs)inside single-line tunnels has been heavily researched,because the issue needs to be solved urgently.In this paper,a co-simulation model of vortex-induced vibration(VIV)of the tail car body is established,and the aerodynamics of train-tail swaying is studied.The simulation results were confirmed through a field test of operating EMUs.Furthermore,the influence mechanism of train-tail swaying on the wake flow field is studied in detail through a wind-tunnel experiment and a simulation of a reduced-scaled train model.The results demonstrate that the aerodynamic force frequency(i.e.,vortex-induced frequency)of the train tail increases linearly with train speed.When the train runs at 130 km/h,with a small amplitude of train-tail swaying(within 10 mm),the vortex-induced frequency is 1.7 Hz,which primarily depends on the nose shape of the train tail.After the tail car body nose is extended,the vortex-induced frequency is decreased.As the swaying amplitude of the train tail increases(exceeding 25 mm),the separation point of the high-intensity vortex in the train wake shifts downstream to the nose tip,and the vortex-induced frequency shifts from 1.7 Hz to the nearby car body hunting(i.e.,the primary hunting)frequency of 1.3 Hz,which leads to the frequency-locking phenomenon of VIV,and the resonance intensifies train-tail swaying.For the motor vehicle of the train tail,optimization of the yaw damper to improve its primary hunting stability can effectively alleviate train-tail swaying inside single-line tunnels.Optimization of the tail car body nose shape reduces the amplitude of the vortex-induced force,thereby weakening the aerodynamic effect and solving the problem of train-tail swaying inside the single-line tunnels.
基金supported by the Natural Science Foundation of Hunan Province(2024JJ8121,2024JJ6626)the Hunan Provincial Key Research and Development Program(2023SK2038),China.
文摘Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms.This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture,electrical stimulation,and biofeedback therapy versus conventional therapy consisting of electroacupuncture,electrical stimulation,and biofeedback alone in women with SUI,and to explore the role of PFPT in improving symptom and functional outcomes.Methods:In this randomized controlled trial,72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital,Central South University,between December 2021 and October 2023.Participants were randomly assigned to an experimental group(n=36)or a control group(n=36).Both groups received health education.The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy,while the experimental group additionally received PFPT 3 times per week for 4 weeks.The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF).Secondary outcomes included pelvic floor muscle strength,bladder neck mobility,and balance ability.The ICIQ-SF was reassessed at 1,3,6,and 12 months post-treatment.Results:Both groups showed statistically significant improvements in all parameters after treatment(all P<0.05).However,there were no statistically significant differences between groups in most measures(all P>0.05).The experimental group demonstrated longer singleleg stance duration with eyes closed than the control group(left leg:P=0.026;right leg:P=0.006),with a significant increase from baseline(P<0.001).At 6 months post-treatment,the cure rate in the experimental group was significantly higher than that in the control group(P=0.037).Conclusion:Conventional therapy effectively improves SUI symptoms,but adding PFPT provides notable additional benefits,including enhanced balance ability and sustained midterm cure rates.These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.
文摘Purpose–In recent years,the rapid advancement of artificial intelligence(AI)has exerted profound impacts on and provided strong impetus to numerous fields in the industrial sector.Within the railway industry,AI has driven continuous upgrading and optimization of intelligent train control technology,thanks to its enhanced computational capabilities derived from advanced algorithms and models,as well as its role in improving safety performance.Integrating AI technology more extensively into train autonomous driving and control has thus become an inevitable trend in the global development of railways.Design/methodology/approach–This paper,therefore,conducts a comprehensive analysis of the development progress and current status of AI technology applications in the field of train driving and control on a global scale.It systematically sorts out and analyzes the advantages of various AI technologies and the positive impacts they bring to the upgrading of train control technology,elucidates the feasibility and future prospects of applying a range of emerging AI technologies from the perspective of technical theory and provides guidance for the intelligent development of this field from a practical perspective.Findings–The application of AI technology in the train driving and control field is still in its infancy.While a large number of AI technologies have been widely adopted,there remains significant room for further optimization and improvement of these technologies.Additionally,a variety of AI technologies that have been applied in other industrial sectors but not yet widely implemented in training autonomous driving and control have demonstrated tremendous development potential.Originality/value–The research findings provide references and guidance for advancing train control technology,promoting the digital transformation of railways,accelerating the overall optimization and upgrading of railway industry technologies,and facilitating the accelerated development of global railways.
文摘Exercise is a therapeutic approach in cancer treatment,providing several benefits.Moreover,exercise is associated with a reduced risk for developing a range of cancers and for their recurrence,as well as with improving survival,even though the underlying mechanisms remain unclear.Preclinical and clinical evidence shows that the acute effects of a single exercise session can suppress the growth of various cancer cell lines in vitro.This suppression is potentially due to altered concentrations of hormones(e.g.,insulin)and cytokines(e.g.,tumor necrosis factor alpha and interleukin 6)after exercise.These factors,known to be involved in tumorigenesis,may explain why exercise is associated with reduced cancer incidence,recurrence,and mortality.However,the effects of short-(<8 weeks)and long-term(≥8 weeks)exercise programs on cancer cells have been reported with mixed results.Although more research is needed,it appears that interventions incorporating both exercise and diet seem to have greater inhibitory effects on cancer cell growth in both apparently healthy subjects as well as in cancer patients.Although speculative,these suppressive effects on cancer cells may be driven by changes in body weight and composition as well as by a reduction in low-grade inflammation often associated with sedentary behavior,low muscle mass,and excess fat mass in cancer patients.Taken together,such interventions could alter the systemic levels of suppressive circulating factors,leading to a less favorable environment for tumorigenesis.While regular exercise and a healthy diet may establish a more cancer-suppressive environment,each acute bout of exercise provides a further“dose”of anticancer medicine.Therefore,integrating regular exercise could potentially play a significant role in cancer management,highlighting the need for future investigations in this promising area of research.
基金supported by a grant from University of Social Welfare and Rehabilitation Sciences for the research expenses.
文摘Background Schizophrenia is characterised by pervasive cognitive deficits that significantly impair daily functioning and quality of life.Pharmacological treatments have limited efficacy in addressing these deficits,highlighting the need for adjunctive interventions like computerised cognitive training(CCT).Aims This study aimed to evaluate the effects of a 30-session CCT programme on mental well-being and cognitive performance in individuals with schizophrenia.Additionally,it assessed the usability and acceptability of CCT in this population.Methods A double-blind,randomised clinical trial was conducted with 54 participants assigned to intervention and control groups.Cognitive and mental health outcomes were assessed using validated tools such as the Depression Anxiety Stress Scale 21,the Warwick-Edinburgh Mental Wellbeing Scale and the Cambridge Neuropsychological Test Automated Battery.Usability was measured with the System Usability Scale(SUS).Assessments were conducted at baseline,post-intervention and 3 months post-follow-up.Results The CCT intervention significantly improved mental well-being,reduced stress and enhanced working memory(paired associate learning,spatial working memory and spatial span)compared with controls.However,no significant effects were observed for anxiety,depression or executive function.Usability scores were high(SUS=83.51),and compliance rates were strong(92.7%),indicating favourable participant engagement.Conclusion CCT demonstrated potential as an adjunctive treatment for schizophrenia,with significant improvements in targeted cognitive and mental health domains.The high usability and compliance rates support its feasibility for broader implementation.Further research is needed to optimise protocols and explore long-term benefits.CCT offers a promising approach to addressing mental health and cognitive challenges in schizophrenia,particularly for stress and working memory.Its usability and acceptability suggest it could be seamlessly integrated into clinical practice.
基金Research on the Construction of a Course Ideological and Political Education System and Evaluation Framework for the“Traditional Chinese Medicine Internal Medicine”Course(Project No.:2025J0459)Open Research Fund Program of Yunnan Key Laboratory of Integrated Traditional Chinese(Project No.:CWCD2023-002,CWCD2023-003&CWCD2023-009)+2 种基金Western Medicine for Chronic Disease in Prevention and TreatmentYunnan 047 Key Laboratory of Yi Dai Medicine and Yi Medicine(Project No.:2024SS24047)Yunnan 025 Key Laboratory of Yi Dai Medicine and Yi Medicine(Project No.:2024SS24025)。
文摘Standardized residency training programs primarily focus on developing clinical diagnostic and treatment skills,often allocating limited time to research activities.However,enhancing research skills is of paramount importance for residents,as it fosters critical thinking,problem-solving abilities,and a deeper understanding of applying scientific principles to clinical practice.This paper explores the necessity and significance of integrating research training into residency programs,emphasizing its role in cultivating well-rounded physicians capable of advancing medical knowledge.This study proposes a competency-based research training model that encompasses research literacy,study design,biostatistics,and scientific writing.Additionally,online asynchronous training modules,robust mentorship,and balanced time management strategies are recommended to enhance residents’research engagement without compromising clinical training.By implementing these measures,residency programs can improve residents’research capabilities,contributing to both individual professional growth and the broader advancement of medical science.
基金supported by the National Natural Science Foundation of China(12372049)Fundamental Research Funds for the Central Universities(2682023ZTPY036)Research and Development Project of JDD For HTS Maglev Transportation System(JDDKYCF2024002).
文摘High-speed maglev trains(HSMTs)can run at high running speeds due to their unique design.The pressure waves that these trains generate while passing each other are therefore very intense,and can even have safety implications.In order to reduce the transient impact of such waves,the standard k-ε turbulence model is used in this work to assess the effect of railway spacing on the aerodynamic loads,pressure and surrounding flow field of 600 km/h maglev trains passing each other in open air.The sliding mesh technique is used to determine the relative motion between the considered trains.The results show that the surface pressure is approximately linearly correlated with the square of the speed while the amplitude of the pressure wave on the train surface,side force,and rolling moment all have negative exponential relationships with the railway spacing.
基金the National Key Research and Development Program of China(2023YFB3907300)the National Natural Science Foundation of China(U2268206,T2222015)the Beijing Natural Science Foundation(4232031).
文摘Global Navigation Satellite Systems(GNSSs)are vulnerable to both unintentional interference and intentional attacks,making it difficult to meet the stringent safety requirements of railway train control systems.The growing threat to information security posed by spoofing attacks has received limited attention.This study investigates the impact of GNSS spoofing attacks on train positioning,emphasizing their detrimental effects on the accuracy and availability of train location report functions for train operation control.To explore the antispoofing performance of typical GNSS-based train positioning schemes,specific approaches,and system architectures are designed under two GNSS-alone and two GNSS-integrated train positioning schemes.Field data are utilized to establish spoofing attack scenarios for GNSS-based train positioning,with which the anti-spoofing capabilities of different train positioning schemes are evaluated.Experimental results indicate that under specific conditions,the GNSS-integrated positioning schemes demonstrate superior GNSS spoofing suppression capabilities.Results of the tests present valuable guidance for designers and manufacturers in developing more advanced and resilient train positioning solutions and equipment for the next generation of train control systems,thereby promoting the applications of GNSS technology in railway systems.
