Time-Optimal Trajectory Planning and Tracking for Autonomous Vehicles.

This article presents a hierarchical control framework for autonomous vehicle trajectory planning and tracking, addressing the challenge of accurately following high-speed, at-limit maneuvers. The proposed time-optimal trajectory planning and tracking (TOTPT) framework utilizes a hierarchical control structure, with an offline trajectory optimization (TRO) module and an online nonlinear model predictive control (NMPC) module. The TRO layer generates minimum-lap-time trajectories using a direct collocation method, which optimizes the vehicle's path, velocity, and control inputs to achieve the fastest possible lap time, while respecting the vehicle dynamics and track constraints. The NMPC layer is responsible for precisely tracking the reference trajectories generated by the TRO in real time. The NMPC also incorporates a preview algorithm that utilizes the predicted future travel distance to estimate the optimal reference speed and curvature for the next time step, thereby improving the overall tracking performance. Simulation results on the Catalunya circuit demonstrated the framework's capability to accurately follow the time-optimal raceline at an average speed of 116 km/h, with a maximum lateral error of 0.32 m. The NMPC module uses an acados solver with a real-time iteration (RTI) scheme, to achieve a millisecond-level computation time, making it possible to implement it in real time in autonomous vehicles.

Silk fibroin biohydrogel composites for loading and ordered release of multiple active ingredients with enhanced bioactivity.

Bioactive hydrogels are currently receiving significant attention. In this study, silk fibroin tyramine-modified gelatin hydrogels (SF-TG) with varying degrees of tyramine root substitution were explored. The physicochemical property and biocompatibility of low degree of substitution tyramine-modified gelatin hydrogel (SF-LTG) and high degree of substitution tyramine-modified gelatin hydrogel (SF-HTG) were compared. The results showed that SF-LTG possessed better mechanical property and higher biocompatibility. Thus, SF-LTG was selected as a bioactive matrix and loaded with basic fibroblast growth factor (bFGF); subsequently, curcumin-coupled chitosan rods (CCCRs-EGF) enriched with epidermal growth factor (EGF) were added to obtain SF-LTG-bFGF@CCCRs-EGF hydrogels. The results showed that SF-LTG-bFGF@CCCRs-EGF retained the basic structural and mechanical properties of the SF-LTG matrix gel material and underwent multiple loading and orderly release with different activities while displaying antioxidant, anti-inflammatory, antimicrobial, and pro-cellular proliferation activities and orderly regulation of activity during wound healing. Therefore, the SF-LTG-bFGF@CCCRs-EGF hydrogel is of great value in healing complex wounds.

Analysis of the nursing effects of integrated medical and nursing care intervention in correction surgery for children with concealed penis.

OBJECTIVE: This study aimed to analyze and explore the nursing effects of integrated medical and nursing care intervention in correction surgery for children with concealed penis. METHODS: A total of 76 eligible patients with concealed penis were randomly divided into an observation group and a control group. The control group received conventional nursing care, while the observation group received integrated medical and nursing care intervention. Outcomes include pain levels, comfort status, incidence of complications, and nursing satisfaction were collected and analyzed to investigate the nursing effects of the integrated medical and nursing care model. RESULTS: After 2/3 days of nursing intervention, the patients in the observation group had significantly lower pain scores (measured by FPS-R) compared to the control group (P < 0.05). The patients in the observation group also had significantly higher comfort scores (measured by Kolcabal) compared to the control group (P < 0.05). The incidence of complications in the observation group was significantly lower than that in the control group (2.63 vs. 23.68, P < 0.05). Parental satisfaction in the observation group was significantly higher than that in the control group (P < 0.05). CONCLUSION: The integrated medical and nursing care intervention in correction surgery for children with concealed penis demonstrated positive nursing effects. It effectively reduced pain, improved comfort, lowered the risk of complications, and increased parental satisfaction. This approach maximizes the role of nursing care and is recommended for clinical implementation.

Bioinformatics analysis and experimental verification of the cancer-promoting effect of DHODH in clear cell renal cell carcinoma.

Clear cell renal cell carcinoma (ccRCC) is a malignant tumor of the urinary system. To explore the potential mechanisms of DHODH in ccRCC, we analyzed its molecular characteristics using public databases. TCGA pan-cancer dataset was used to analyze DHODH expression in different cancer types and TCGA ccRCC dataset was used to assess differential expression, prognosis correlation, immune infiltration, single-gene, and functional enrichment due to DHODH. The GSCALite and CellMiner databases were employed to explore drugs and perform molecular docking analysis with DHODH. Protein-protein interaction networks and ceRNA regulatory networks of DHODH were constructed using multiple databases. The effect of DHODH on ccRCC was confirmed in vitro. DHODH was highly expressed in ccRCC. Immune infiltration analysis revealed that DHODH may be involved in regulating the infiltration of immunosuppressive cells such as Tregs. Notably, DHODH influenced ccRCC progression by forming regulatory networks with molecules, such as hsa-miR-26b-5p and UMPS and significantly enhanced the malignant characteristics of ccRCC cells. Several drugs, such as lapatinib, silmitasertib, itraconazole, and dasatinib, were sensitive to DHODH expression and exhibited strong molecular binding with it. Thus, DHODH may promote ccRCC progression and is a candidate effective therapeutic target for ccRCC.

3 M antimicrobial incise drape combined with MEBO in wound recovery of postoperative hypospadias surgery.

OBJECTIVE: To evaluate the efficacy of different dressing methods in wound healing and the postoperative outcome in children who underwent hypospadias repair. METHODS: Altogether 109 children with distal hypospadias who underwent urethroplasty were recruited from our hospital between January 2021 and March 2023. All patients were randomized in two groups according to the different dressing methods: Group A receiving 3 M antimicrobial incise drape + MEBO (moisture-exposed burn ointment) and Group B receiving absorbent dressing + elastic bandage dressing. The age at surgery, operation time, bleeding during the dressing, postoperative changes in glans color, dressing fell off, comfort of children during the dressing, difficulty in dressing removal, and degree of pain during dressing removal were compared between the two groups. RESULTS: Differences in age at surgery (p = 0.337) and operation time (p = 0.055) were not significant between the two groups. The overall effectiveness of the dressing was better in Group A than that in Group B. Only five cases in Group A had blood leakage after dressing (p = 0.006), and there was no dressing dislocation (p < 0.001) or glans color abnormality (p < 0.001). Moreover, the number of complication cases was less. The overall comfort and pain degree during dressing removal in Group A was better than that in Group B (p < 0.001). CONCLUSION: Postoperative dressing using 3 M antimicrobial incise drape + MEBO can achieve lower incidence rates of bleeding during dressing, postoperative glans darkening, and dressing falling off, a lower pain degree during dressing removal, and a better overall comfort level than those of the control group. This method is cost-effective and clinically safe, which contributes to the postoperative recovery of children with hypospadias and is thus worth promoting and applying.

Fabrication of Mildew-Resistant Wood with Multi-Functional Properties Based on In Situ Growth of Metal-Organic Frameworks.

Wood is easily affected by decay fungi, mildew fungi, insects, water, UV, and other factors when used outdoors. In particular, mildew on the surface of wood negatively affects the appearance and practical use of wood or wood-based engineered products. In recent years, as a class of popular crystalline materials, metal-organic frameworks (MOFs) have been widely applied in electrochemistry, adsorption, anti-mildew efforts, and other areas. In this study, we first grew a Co-based metal-organic framework (Co-MOF) in situ on a wood surface and subsequently converted the Co-MOF in situ into a cobalt-nickel double hydroxide layer, which formed micro- and nanohierarchical composite structures on the wood surface. The low surface energy of the CoNi-DH@wood was further modified via impregnation with sodium laurate to obtain the superhydrophobic wood (CoNi-DH-La@wood). We characterized the microstructure, chemical composition, water contact angle, and anti-mold properties of the CoNi-DH-La@wood using SEM, XRD, XPS, water contact angle tests, and anti-fungal tests. The SEM, XRD, and XPS results confirmed that the metal-organic framework was coated on the wood surface, with the long-chain sodium laurate grafted onto it. The CoNi-DH-La@wood had a water contact angle of 151°, demonstrating excellent self-cleaning ability. In addition, the fabricated superhydrophobic balsa wood exhibited excellent chemical and environment stability. Lastly, the CoNi-DH-La@wood exhibited excellent anti-mildew properties in a 30-day anti-mildew test because the superhydrophobic coating was successfully coated on the wood surface. In summary, this work presents an attractive strategy for obtaining wood with superhydrophobic properties at room temperature, thereby endowing the wood or wood-based engineered products with excellent anti-mildew properties.

Clinical Pathway for Enhanced Recovery in the Management of Non-Variceal Upper Gastrointestinal Bleeding: A Randomized Controlled Trial.

Purpose: To explore the effects of the clinical pathway on the outcomes of patients with non-variceal upper gastrointestinal bleeding. Materials and Methods: Randomized controlled trial. The study was conducted in two medical centers in China from 1 June 2022 to 31 December 2022. Patients with a diagnosis of non-variceal upper gastrointestinal bleeding who provided written informed consent were consecutively assigned to the intervention group. The patients in the intervention group were treated using the clinical pathway, while the control group received routine care and follow-up. Time, cost, complications, and prognostic indicators were analyzed. Intentional-to-treat analysis and per-protocol analysis were used for data analysis. Results: A total of 114 eligible patients with non-variceal upper gastrointestinal bleeding were randomly divided into two groups and included in the intention-to-treat analysis. In addition, 106 patients were included in the per-protocol analysis. The median age of the 106 patients was 57 years (range, 18-92 years) and 83.0% were male. There were no significant differences between groups regarding the baseline characteristics. The intervention group demonstrated a statistically significantly shorter length of stay, lower hospital cost (ie, cost during hospitalization, cost in the emergency room, and cost in the ward), significantly fewer cases of complications, and a higher level of patient satisfaction when compared with the control group. There was no significant difference between the two groups in the rates of transfusion, repeat endoscopy, rebleeding readmission, and mortality. Conclusion: The implementation of the clinical pathway for patients with non-variceal upper gastrointestinal bleeding may help improve patient outcomes and satisfaction. Trial Registration Number: ChiCTR2200060316. Registration Link: https://www.chictr.org.cn/.

The incidence and risk factors of unplanned reoperation in endoscopic endonasal surgeries: a single center study.

The incidence of unplanned reoperation after surgery during the same hospitalization is considered one of most important evaluation indicators for health care quality. The purpose of this study was to determine the incidence and risk factors related to unplanned reoperation after an endoscopic endonasal approach (EEA). All patients who underwent elective endoscopic endonasal surgery from January 2016 to December 2021 in the Department of Neurosurgery, Tangdu Hospital, Air Force Military Medical University, were included. We identified the patients who underwent an unplanned reoperation and those who did not and divided them into two groups. The demographic data and risk factors were compared between the groups by univariate and multivariate logistic regression analyses. Of the 1783 patients undergoing EEA for various lesions of the skull base, the incidence of unplanned reoperation was 2.3%. The most common unplanned reoperations were repair of cerebrospinal fluid (CSF) leakage (39%), sellar hematoma evacuation (34.1%), hemostasis of epistaxis (14.6%) and external ventricular drainage for obstructive hydrocephalus (9.8%). The maximum diameter of tumor ≥ 3 cm (OR 2.654, CI 1.236-5.698; p = 0.012), meningioma (OR 4.198, CI 1.169-15.072; p = 0.028), craniopharyngioma (OR 5.020, CI 2.020-12.476; p = 0.001) and other sellar lesions (OR 4.336, CI 1.390-13.527; p = 0.012) and an operation time ≥ 240 min (OR 2.299, CI 1.170-4.518; p = 0.016) were the independent risk factors for unplanned reoperations in multivariate regression analysis. Of the 41 patients undergoing unplanned reoperation, 16 patients died, twenty-one patients had panhypopituitarism, 13 patients had transient and 6 had permanent diabetes insipidus, and 11 patients presented with intracranial infection and 6 of these patients were cured. By reviewing our department's data, we stated the incidence and risk factors for unplanned reoperation. It is important for the hospital administration and neurosurgeons to place more emphasis on these indicators. Furthermore, we suggest some effective quality improvement initiatives to reduce the incidence of unplanned reoperation.

[Medical Institution's Multiple Role in the Collaborative Innovation Transformation Mode of "Industry-University-Research-Medicine" on Domestic Surgical Robots].

In recent years, with the rapid development of Chinese domestic surgical robot technology and the expansion of the application market, the "industry-university-research-medicine" collaborative innovation transformation mode has gradually developed and formed. Medical institutions play an important role in multi-party cooperation with enterprises, universities, and research institutes, as well as in product planning, technology research and development, achievement transformation, and personnel training. On the basis of reviewing the current situation of the development of the "industry-university-research-medicine" collaborative innovation transformation mode of domestic surgical robots, this study explores the multiple roles played by medical institutions in this mode and challenges, further putting forward corresponding recommendations.

A pregnant woman with a giant bilateral parietal hemangiopericytoma underwent multiple surgeries and radiotherapy: a case report and literature review.

Intracranial hemangiopericytoma is a rare invasive tumor originating from mesenchymal fibroblasts and is prone to local recurrence and distant metastasis. This study reports a case of a 27-year-old woman who presented with severe headache, nausea and vomiting for two weeks at thirty-three weeks of gestation. Cranial magnetic resonance imaging (MRI) demonstrated a giant lesion in the bilateral parietal lobe with a size of 5.12x9.19x6.03 cm and severe edema in the surrounding brain tissue. The patient underwent four operations and 3 gamma knife radiosurgery procedures and is recovering well now. The histopathology findings showed hemangiopericytoma and STAT6 and CD34 positivity after the first and second surgeries. Because of tumor progression, the patient received gamma knife radiosurgery at 1, 3, and 4 years after the first operation. Total tumor resection was achieved in the fourth surgery. Nevertheless, the patient showed malignant transformation to from low-grade to high-grade hemangiopericytoma.

Clinical outcomes and safety of large or giant vestibular schwannoma in older patients undergoing microsurgery: a matched cohort study.

OBJECTIVE: To compare the clinical outcomes of large or giant vestibular schwannomas (VSs) between older patients and younger patients who underwent microsurgery and to explore whether the incidence of postoperative complications increased and whether the postoperative hospital stay was prolonged. METHODS: We conducted a retrospective matched cohort study based on the surgical approach, maximum tumor diameter and extent of resection. Older patients (≥ 60 years) and a matched group (<60 years) who had undergone microsurgery for VSs between January 2015 and December 2021 were included. Clinical data, surgical outcomes and postoperative complications were analyzed statistically. RESULTS: Forty-two older patients (≥ 60 years, 66.0 ± 3.8 years) were identified and matched to younger patients (<60 years, 43.9 ± 11.2 years), and they all underwent microsurgery through a retrosigmoid approach. There were twenty-nine patients with 3-4 cm VSs and thirteen patients with > 4 cm VSs in both groups. The older patients had a higher proportion of imbalance (P = 0.016) and lower American Society of Anesthesiology scores (P = 0.003) before surgery than the younger patients. There was no significant difference in facial nerve function one week (p = 0.851) and one year (p = 0.756) after surgery and no difference in the postoperative complication incidence (40.5% vs. 23.8%, p = 0.102) between the older patients and controls. Furthermore, the older patients had longer postoperative hospital stays than the younger patients (p = 0.043). In the older group, six patients with near total resection and five with subtotal resection were administered stereotactic radiotherapy, and one had recurrence three years after surgery and received conservative treatment. The postoperative follow-up time ranged from 1 to 83 months, with an average of 33.5 ± 21.1 months. CONCLUSIONS: For older patients (≥ 60 years) with symptomatic, large or giant -VSs, microsurgery is the only effective method to prolong lifespan, alleviate clinical symptoms and cure the tumor. However, radical resection of VSs may result in a decreased preservation rate of facial-acoustic nerve function and an increased postoperative complication incidence. Therefore, subtotal resection followed by stereotactic radiotherapy should be recommended.

Regenerated cellulose/chitosan composite aerogel with highly efficient adsorption for anionic dyes.

A novel reusable, high-compressible cotton regenerated cellulose/chitosan composite aerogel (RC/CSCA) was prepared using N-methylmorpholine-N-oxide (NMMO) as the green cellulose solvent, and glutaraldehyde (GA) as the crosslinking agent. The regenerated cellulose obtained from cotton pulp could chemically crosslink with chitosan and GA, to form a stable 3D porous structure. The GA played an essential role in preventing shrinkage and preserving the deformation recovery ability of RC/CSCA. Due to the ultralow density (13.92 mg/cm3), thermal stability (above 300 °C), and high porosity (97.36 %), the positively charged RC/CSCA can be used as a novel biocomposite adsorbent for effective and selective removal of toxic anionic dyes from wastewater, showing an excellent adsorption capacity, environmental adaptability, and recyclability. The maximal adsorption capacity and removal efficiency of RC/CSCA for methyl orange (MO) was 742.68 mg/g and 95.83 %.

Natural microfibrils/regenerated cellulose-based carbon aerogel for highly efficient oil/water separation.

Cellulose-based carbon aerogels as biodegradable and renewable biomass materials have presented potential applications in oil/water separation. Herein, a novel carbon aerogel composed of natural microfibrils/regenerated cellulose (NM/RCA) was directly prepared by economical hardwood pulp as raw material using a novel co-solvent composed of deep eutectic solvent (DES) and N-methyl morpholine-N-oxide monohydrate (NMMO·H2O). In addition, the morphology and structure of the filiform natural microfibers could be remained after carbonized at 400 â„ƒ, which resulted in a low density (8-10 mg cm-3), high specific surface area (768.89 m2 g-1) and high sorption capability. In addition, the aerogel exhibited high compressibility, outstanding elasticity, excellent fatigue resistance, and recyclability (80.5% height recovery after repeating 100 cycles at the strain of 80%). Due to the morphology and composition of the carbonized microfiber surface, the superhydrophobic materials with a water contact angle of 151.5°, could sorb various oils and organic solvents with 65-133 times its own weight and maintain 91.9% sorption capacity after 25 cycles. In addition, the aerogels could achieve the continuous separation of carbon tetrachloride (CCl4) from water with a high flux rate of 11,718.8 L m-2 h-1. Therefore, our prepared NM/RCA aerogels are anticipated to have broad potential applications in oil purification and contaminant remediation.

Fertility and prognosis assessment between bleomycin/etoposide/cisplatin and paclitaxel/carboplatin chemotherapy regimens in the conservative treatment of malignant ovarian germ cell tumors: a multicenter and retrospective study.

OBJECTIVE: To evaluate the impact of bleomycin/etoposide/cisplatin (BEP) and paclitaxel/carboplatin (PC) chemotherapy regimens on the fertility and prognostic outcomes in malignant ovarian germ cell tumor (MOGCT) patients who underwent fertility-sparing surgery (FSS). METHODS: A propensity score matching algorithm was performed between the BEP and PC groups. The χ² test and the Kaplan-Meier method were used to compare the fertility outcome, disease-free survival (DFS) and overall survival (OS). The Cox proportional hazards regression analysis was used to identify risk factor of DFS. RESULTS: We included 213 patients, 185 (86.9%) underwent BEP chemotherapy, and 28 (13.1%) underwent PC chemotherapy. The median age was 22 years (range, 8-44 years), and the median follow-up period was 63 months (range, 2-191 months). Fifty-one (29.3%) patients had a pregnancy plan, and 35 (85.4%) delivered successfully. In the before and after propensity score matching cohorts, there were no significant differences in spontaneous abortion, selective termination of pregnancy, during-pregnancy status, and live birth between the BEP and PC groups (p>0.05). Fourteen (6.6%) patients experienced recurrence, including 11 (5.9%) in the BEP group and 3 (10.7%) in the PC group. Four (1.9%) patients in the BEP group died. Kaplan-Meier analysis revealed no significant differences in DFS (p=0.328) and OS (p=0.446) between the BEP and PC groups, and the same survival results were observed in the after matching cohort. CONCLUSION: The PC regimen is as safe as the BEP regimen for MOGCT patients with fertility preservation treatment, and no differences were observed in fertility and clinical prognosis.

Primary pulmonary hyalinizing clear cell carcinoma with pseudopapillary structures and abundant cysts filled with mucus.

Pulmonary hyalinizing clear cell carcinoma (HCCC) is a new and rare form of lung salivary gland tumor. Only twenty-two cases have been reported in the literature to date. Furthermore, their clinicopathological features have not been fully characterized. In this paper, we describe the clinicopathological characteristics, immunohistochemical features, and molecular genetic changes in two HCCC cases. We also simultaneously reviewed related literature on similar cases reported. Of the two cases, one was of a 58-year-old man with a 4.3 cm lung tumor, which was the largest among all previously reported cases. The tumor showed an infiltrative growth pattern and perineural and vascular invasion microscopically. Moreover, nuclear grooves, high mitotic figures, and comedo necrosis were observed in addition to classic morphological features. More importantly, rare pseudopapillary structures were observed. The second case was of a 60-year-old woman in whom the tumor was mainly composed of multiple cysts filled with mucus. The remaining focal solid areas of the tumor comprised clear and acidophilic cells embedded in the hyalinizing stroma. Immunohistochemical analysis revealed that the tumor cells of both cases were positive for CK5/6, p40, and p63 expression, but negative for napsin A, TTF-1, and SOX10 expression. The HCCC diagnosis in both cases was validated by fluorescence in-situ hybridization (FISH) examination, which showed Ewing sarcoma breakpoint region 1-activating transcription factor 1 (EWSR1-ATF1) gene fusion. Primary pulmonary HCCC is a rare lung tumor originating from the bronchial mucosa, and its histological features may vary, such as rare pseudopapillary structures and abundant cysts. Thus, the diagnosis should be a combined analysis of histopathological characteristics with immunophenotype and molecular examination, including EWSR1-ATF1 gene fusion detection.

Research on the Early-Age Cracking of Concrete Added with Magnesium Oxide under a Temperature Stress Test Machine.

Concrete cracking is a significant issue in the global construction industry, and the restraint stress of concrete is a crucial contributing factor to early concrete cracking. The addition of magnesium oxide additive (MEA) to concrete is a method to enhance its crack resistance. In this paper, concrete specimens with four different contents of MEA were tested with a temperature stress testing machine. The deformation characteristics and mechanical properties of concrete with varying contents of MEA were investigated using both free deformation tests and fully constrained deformation tests. The prediction model for the early restrained stress of concrete was developed by integrating the stress relaxation phenomenon of concrete with models for autogenous shrinkage, temperature deformation, and elastic modulus. According to the results, (1) the thermal expansion coefficient exhibits a pattern of initially increasing and subsequently decreasing with the increasing ratio of MEA; (2) the addition of 3% and 8% MEA can offset 23% and 35.1% of the concrete's self-shrinkage, respectively. Nevertheless, when the added MEA content is 5%, the self-shrinkage of concrete increases by 6%; (3) the addition of 3-8% MEA can result in a 0.5-1.67 times increase in the maximum expansion stress of concrete, as well as a 0.5-0.95 times increase in cracking stress; (4) as the MEA content continues to increase, the stress relaxation level of concrete also increases. In comparison to concrete mixed without MEA, the maximum increase in the stress relaxation level of concrete is 65.5%, thereby enhancing the concrete's anti-cracking ability. However, when the MEA dosage reaches a certain threshold, the stress relaxation enhancement brought about by the addition of MEA will no longer be significant; (5) when compared to the experimental data, the established model of early-age constraint stress accurately predicts the tensile constraint stress of concrete.

Endoscopic endonasal resection of two rare cases of hemangiopericytomas invading the cavernous sinus and literature review.

Hemangiopericytomas (HPCs) invading the cavernous sinus (CS) are extremely rare invasive tumors that have a great propensity for local recurrence. To date, only eight cases have been reported in the literature. Owing to the abundant vascular supply of HPCs, intracavernous bleeding and important blood vessels and nerves passing through the CS, it is very difficult and challenging for neurosurgeons to completely resect HPCs. Here, we report two cases of HPCs invading the CS and introduce their clinical manifestations, imaging findings, surgical approaches and histopathological features in detail. We have implemented the surgery by the endoscopic transpterygoid transcavernous approach (ETPTCa) for the two patients, and one patient has undergone gross total resection (GTR) and another has undergone subtotal resection (STR) and postoperative stereotactic radiosurgery (SRS). The ETPTCa may serve as a viable option to facilitate HPCs resection. Radiotherapy is helpful in prolonging progression-free survival (PFS) following STR of the tumor.