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Introduction: Sleep loss and sleep deprivation (SD) cause deleterious influences on health, cognition, mood and behaviour. Nevertheless, insufficient sleep and SD are prevalent across many industries and occur in various emergencies. The deleterious consequences of SD have yet to be fully elucidated. This study aimed to assess the extensive influences of SD on physiology, vigilance, and plasma biochemical variables. Methods: Seventeen volunteers were recruited to participate in a 32.5-h SD experiment. Multiple physiological and cognitive variables, including tympanic temperature, blood oxygen saturation (SaO2), and vigilance were recorded. Urinal/salivary samples were collected and subjected to cortisol or cortisone analysis, and plasma samples were subjected to transcriptomic analysis of circular RNA (circRNA) expression using microarray. Plasma neurotransmitters were measured by targeted metabolic analysis, and the levels of inflammatory factors were assessed by antibody microarray. Results: The volunteers showed significantly increased sleepiness and decreased vigilance during SD, and the changes in circadian rhythm and plasma biochemistry were observed. The plasma calcium (p = 0.0007) was induced by SD, while ischaemia-modified albumin (IMA, p = 0.0030) and total bile acid (TBA, p = 0.0157) decreased. Differentially expressed circRNAs in plasma were identified, which are involved in multiple signaling pathways including neuronal regulation and immunity. Accordingly, SD induced a decrease in 3-hydroxybutyric acid (3OBH, p = 0.0002) and an increase in thyroxine (T4, p < 0.0001) in plasma. The plasma anti-inflammatory cytokine IL-10 was downregulated while other ten inflammatory factors were upregulated. Conclusion: This study demonstrates that SD influences biochemical, physiological, cognitive variables, and the significantly changed variables may serve as candidates of SD markers. These findings may further our understanding of the detrimental consequence of sleep disturbance at multiple levels.
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Objective: To investigate the medium- and long-term effectiveness of hip revision with SL-PLUS MIA stem in patients with Paprosky typeâ -â ¢ femoral bone defect. Methods: Between June 2012 and December 2018, 44 patients with Paprosky typeâ -â ¢ femoral bone defect received hip revision using SL-PLUS MIA stem. There were 28 males and 16 females, with an average age of 57.7 years (range, 31-76 years). Indications for revision comprised aseptic loosening (27 cases) and periprosthetic joint infection (17 cases). The Harris hip scores were 54 (48, 60) and 43 (37, 52) in patients with aseptic loosening and periprosthetic joint infection, respectively. The preoperative femoral bone defects were identified as Paprosky type â in 32 cases, type â ¡ in 9 cases, type â ¢A in 2 cases, and type â ¢B in 1 case. Operation time and intraoperative blood transfusion volume were recorded. During follow-up after operation, the hip joint function were evaluated by Harris hip score and X-ray films, the femoral stem survival was analyzed, and the surgical related complications were recorded. Results: The operation time of infected patients was 95-215 minutes, with an average of 125.0 minutes. The intraoperative blood transfusion volume was 400-1 800 mL, with an average of 790.0 mL. The operation time of patients with aseptic loosening was 70-200 minutes, with an average of 121.0 minutes. The intraoperative blood transfusion volume was 400-1 400 mL, with an average of 721.7 mL. All patients were followed up 5.3-10.0 years (mean, 7.4 years). At last follow-up, the Harris hip scores were 88 (85, 90) and 85 (80, 88) in patients with aseptic loosening and periprosthetic joint infection, respectively, both of which were significantly higher than those before operation ( P<0.05). Radiological examination results showed that the distal end of the newly implanted femoral stem did not cross the distal end of the original prosthesis in 25 cases, and all femoral stems obtained bone fixation. Two cases experienced femoral stem subsidence and 1 case had a translucent line on the lateral side of the proximal femoral stem. When aseptic loosening was defined as the end event, the 10-year survival rate of the SL-PLUS MIA stem was 100%. When treatment failure due to any reason was defined as the end event, the survival time of the prosthesis was (111.70±3.66) months, and the 7-year survival rate was 95.5%. The 7-year survival rates were 94.1% and 96.3% in patients with aseptic loosening and periprosthetic joint infection, respectively. The incidence of postoperative complications was 9.1% (4/44), among which the prosthesis related complications were 4.5% (2/44), 1 case of dislocation and 1 case of infection recurrence. Conclusion: Hip revision with SL-PLUS MIA stem has the advantages of simple operation and few postoperative complications in the patients with Paprosky type â -â ¢ femoral bone defect, and the medium- and long-term effectiveness is reliable.
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Artroplastia de Reemplazo de Cadera , Fémur , Prótesis de Cadera , Falla de Prótesis , Reoperación , Humanos , Masculino , Femenino , Persona de Mediana Edad , Artroplastia de Reemplazo de Cadera/métodos , Anciano , Adulto , Estudios Retrospectivos , Fémur/cirugía , Resultado del Tratamiento , Infecciones Relacionadas con Prótesis/cirugía , Infecciones Relacionadas con Prótesis/etiología , Articulación de la Cadera/cirugíaRESUMEN
Copper (Cu)-based catalysts have established their unique capability for yielding wide value-added products from CO2. Herein, we demonstrate that the pathways of the electrocatalytic CO2 reduction reaction (CO2RR) can be rationally altered toward C1 or C2+ products by simply optimizing the coordination of Cu with O-containing organic species (squaric acid (H2C4O4) and cyclohexanehexaone (C6O6)). It is revealed that the strength of Cu-O bonds can significantly affect the morphologies and electronic structures of derived Cu catalysts, resulting in the distinct behaviors during CO2RR. Specifically, the C6O6-Cu catalysts made up from organized nanodomains shows a dominant C1 pathway with a total Faradaic efficiency (FE) of 63.7 % at -0.6â V (versus reversible hydrogen electrode, RHE). In comparison, the C4O4-Cu with an about perfect crystalline structure results in uniformly dispersed Cu-atoms, showing a notable FE of 65.8 % for C2+ products with enhanced capability of C-C coupling. The latter system also shows stable operation over at least 10â h with a high current density of 205.1â mA cm-2 at -1.0â VRHE, i.e., is already at the boarder of practical relevance. This study sheds light on the rational design of Cu-based catalysts for directing the CO2RR reaction pathway.
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Removing free hemoglobin generated during extracorporeal circulation remains a challenge. Currently, there is no adsorbent with specificity and good biosafety for removing hemoglobin. In this study, a new chitosan/sodium alginate/carbon nitride (CS/SA/C3N4) hydrogel adsorbent was prepared by blending SA with C3N4 to drop into CS/CaCl2 solution. The physicochemical properties of CS/SA/C3N4 hydrogel were evaluated using some techniques, including scanning electron microscope, Zeta potential measurement, and thermogravimetric analysis. Hemoglobin adsorption in vitro, stability, hemocompatibility, cell compatibility, inflammatory reaction and blood extracorporeal circulation in vivo were also evaluated. The findings revealed that the CS/SA/C3N4-0.4 % hydrogel exhibited an impressive adsorption capacity of 142.35 mg/g for hemoglobin. The kinetic data of hemoglobin adsorption were well-described by pseudo second-order model, while the isothermal model data conformed to the Langmuir model. The hardness and modulus of CS/SA/C3N4-0.4 % was 11.7 KPa and 94.66 KPa respectively, which indicated robust resistance to breakage. CS/SA/C3N4 demonstrated excellent hemocompatibility, biocompatibility and anti-inflammatory properties. In addition, the results of in vivo rabbit extracorporeal blood circulation experiment demonstrated that CS/SA/C3N4 could adsorb free hemoglobin from blood while maintaining high biosafety standard. Consequently, CS/SA/C3N4 hydrogel emerges as a promising candidate for use as a hemoglobin adsorbent in extracorporeal blood circulation system.
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Alginatos , Quitosano , Hemoglobinas , Hidrogeles , Nitrilos , Quitosano/química , Hemoglobinas/química , Alginatos/química , Adsorción , Hidrogeles/química , Animales , Conejos , Nitrilos/química , Humanos , CinéticaRESUMEN
The development of innovative methods for synthesizing silylcyclopentene compounds is particularly important for enriching and improving the synthetical toolbox of organosilicon compounds. Herein, a facile approach has been developed for the synthesis of silylcyclopentenes promoted by mechanochemically generated organolithium species as silicon nucleophiles under ball milling conditions, avoiding the requirement of large amounts of bulk solvent. This operationally simple method demonstrates good functional group compatibility, which provides a great opportunity for further exploration of the synthetic applications of silylcyclopentenes. Density functional theory calculations indicated that the transient lithiosilole intermediates undergo a stepwise nucleophilic addition process, which governs this mechanic-force-promoted [4+1] cycloaddition reaction.
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BACKGROUND: Although radical surgical resection is the most effective treatment for hepatocellular carcinoma (HCC), the high rate of postoperative recurrence remains a major challenge, especially in patients with alpha-fetoprotein (AFP)-negative HCC who lack effective biomarkers for postoperative recurrence surveillance. Emerging radiomics can reveal subtle structural changes in tumors by analyzing preoperative contrast-enhanced computer tomography (CECT) imaging data and may provide new ways to predict early recurrence (recurrence within 2 years) in AFP-negative HCC. In this study, we propose to develop a radiomics model based on preoperative CECT to predict the risk of early recurrence after surgery in AFP-negative HCC. PATIENTS AND METHODS: Patients with AFP-negative HCC who underwent radical resection were included in this study. A computerized tool was used to extract radiomic features from the tumor region of interest (ROI), select the best radiographic features associated with patient's postoperative recurrence, and use them to construct the radiomics score (RadScore), which was then combined with clinical and follow-up information to comprehensively evaluate the reliability of the model. RESULTS: A total of 148 patients with AFP-negative HCC were enrolled in this study, and 1,977 radiographic features were extracted from CECT, 2 of which were the features most associated with recurrence in AFP-negative HCC. They had good predictive ability in both the training and validation cohorts, with an area under the ROC curve (AUC) of 0.709 and 0.764, respectively. Tumor number, microvascular invasion (MVI), AGPR and radiomic features were independent risk factors for early postoperative recurrence in patients with AFP-negative HCC. The AUCs of the integrated model in the training and validation cohorts were 0.793 and 0.791, respectively. The integrated model possessed the clinical value of predicting early postoperative recurrence in patients with AFP-negative HCC according to decision curve analysis, which allowed the classification of patients into subgroups of high-risk and low-risk for early recurrence. CONCLUSION: The nomogram constructed by combining clinical and imaging features has favorable performance in predicting the probability of early postoperative recurrence in AFP-negative HCC patients, which can help optimize the therapeutic decision-making and prognostic assessment of AFP-negative HCC patients.
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Carcinoma Hepatocelular , Medios de Contraste , Neoplasias Hepáticas , Recurrencia Local de Neoplasia , Tomografía Computarizada por Rayos X , alfa-Fetoproteínas , Humanos , Carcinoma Hepatocelular/cirugía , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/patología , Masculino , Femenino , alfa-Fetoproteínas/metabolismo , alfa-Fetoproteínas/análisis , Recurrencia Local de Neoplasia/diagnóstico por imagen , Persona de Mediana Edad , Tomografía Computarizada por Rayos X/métodos , Anciano , Estudios Retrospectivos , Adulto , Hepatectomía , Pronóstico , RadiómicaRESUMEN
BACKGROUND: The use of long stems for severe femoral bone defects is suggested by many scholars, but it is associated with further bone loss, intraoperative fracture, increased surgical trauma, and complications. With better bone retention, simple and quick surgical procedures, and minimal complications, the short cementless stems with a tapered rectangular shape may be an alternative for femoral revision. This study aimed to evaluate the results of this type of stem in treating selected Paprosky II-IV bone defects. METHODS: This retrospective study included 73 patients (76 hips involved) who underwent conservative femoral revision using the short cementless stems with a tapered rectangular shape between January 2012 and December 2020. The preoperative femoral bone defects were identified as follows: 54 cases of type II, 11 cases of type IIIA, 7 cases of type IIIB, and 4 cases of type IV. Indications for revision included aseptic loosening (76.3%) and prosthetic joint infection (23.7%). Six cementless stems with a tapered rectangular shape from three companies were used in all patients. Among them, SLR-Plus, SL-Plus MIA, and Corail stems were employed in most patients (40.8%, 23.7%, and 17.1%, respectively). The average length of these stems measured 171.7 mm (SD 27 mm; 122-215 mm). Radiographic results, Harris hip scores (HHS), complications, and survivorship were analyzed. The follow-up lasted for 7 years on average (range 3-11 years). RESULTS: The subsidence was observed in three hips (3.9%), and all stems achieved stable bone ingrowth. Proximal femoral bone restoration in the residual osteolytic area was found in 67 hips (88.2%), constant defects in nine hips (11.8%), and increasing defects in 0 cases. There was no evidence of stem fractures and stem loosening in this series. The mean HHS significantly improved from 32 (range 15-50) preoperatively to 82 (range 68-94) at the last follow-up (t = - 36.297, P < 0.001). Five hips developed prosthesis-related complications, including three infection and two dislocation cases. The mean 5- and 10-year revision-free survivorships for any revision or removal of an implant and reoperation for any reason were 94.6% and 93.3%, respectively. Both mean 5- and 10-year revision-free survivorships for aseptic femoral loosening were 100%. CONCLUSION: Conservative femoral revision using short cementless stems with a tapered rectangular shape can provide favorable radiographic outcomes, joint function, and mid-term survivorship with minimal complications. Of note, a sclerotic proximal femoral bone shell with continued and intact structure and enough support strength is the indication for using these stems.
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Treatment of femoral bone defects continues to be a challenge in revision total hip arthroplasty (THA); therefore, meticulous preoperative evaluation of patients and surgical planning are required. This review provides a concise synopsis of the etiology, classification, treatment strategy, and prosthesis selection in relation to femoral bone loss in revision THA. A search of literature was conducted for identification of research articles related to classification of bone loss, management of femoral revision, and comparison of different types of stems. Findings of a thorough review of the included articles were as follows: (1) the Paprosky classification system is used most often when defining femoral bone loss, (2) a primary-length fully coated monoblock femoral component is recommended for treatment of types I or II bone defects, (3) use of an extensively porouscoated stem and a modular fluted tapered stem is recommended for management of types III or IV bone defects, and (4) use of an impaction grafting technique is another option for improvement of bone stock, and allograft prosthesis composite and proximal femoral replacement can be applied by experienced surgeons, in selected cases, as a final salvage solution. Stems with a tapered design are gradually replacing components with a cylindrical design as the first choice for femoral revision; however, further confirmation regarding the advantages and disadvantages of modular and nonmodular stems will be required through conduct of higher-level comparative studies.
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SCOPE: This study investigates the exosomal microRNA (miRNA) profiles of term and preterm breast milk, including the most abundant and differentially expressed (DE) miRNAs, and their impact on neurodevelopment in infants. METHODS AND RESULTS: Mature milk is collected from the mothers of term and preterm infants. Using high-throughput sequencing and subsequent data analysis, exosomal miRNA profiles of term and preterm human breast milk (HBM) are acquired and it is found that the let-7 and miR-148 families are the most abundant miRNAs. Additionally, 23 upregulated and 15 downregulated miRNAs are identified. MiR-3168 is the most upregulated miRNA in preterm HBM exosome, exhibiting targeting activity toward multiple genes involved in the SMAD and MAPK signaling pathways and playing a crucial role in early neurodevelopment. Additionally, the effects of miR-3168 on neurodevelopment is confirmed and it is determined that it is an essential factor in the differentiation of neural stem cells (NSCs). CONCLUSION: This study demonstrates that miRNA expression in breast milk exosomes can be influenced by preterm delivery, thereby potentially impacting neurodevelopment in preterm infants.
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Exosomas , MicroARNs , Leche Humana , Leche Humana/química , Humanos , MicroARNs/genética , MicroARNs/metabolismo , Exosomas/genética , Exosomas/metabolismo , Femenino , Recién Nacido , Recien Nacido Prematuro , Células-Madre Neurales/metabolismo , Nacimiento Prematuro/genéticaRESUMEN
BACKGROUND: The lymph node ratio (LNR) is an emerging prognostic biomarker in multiple malignancies. This study aimed to explore the prognostic role of LNR in patients with non-metastatic cervical cancer undergoing radical hysterectomy. METHODS: Data were extracted from the SEER 17 registry. Univariate and multivariate Cox analyses were performed to identify the prognostic factors associated with cancer-specific survival (CSS). A nomogram was constructed to predict the 5-year and 10-year CSS. Survival analyses stratified by the status of LNR and different adjuvant treatments were performed using the Kaplan-Meier method. RESULTS: A total of 8128 female patients with non-metastatic cervical cancer who underwent radical hysterectomy and regional node examination (≥8) were enrolled. Of these, 1269 (15.6%) were confirmed as lymph node-positive. Cox regression analyses showed that age, race, tumor size, tumor grade, histology, and LNR were significant factors affecting CSS. A nomogram was developed for predicting the 5-year and 10-year CSS, which showed good discrimination and calibration. Patients without lymph node involvement had inferior CSS with adjuvant treatments compared to those who did not receive further treatment. In patients with LNR ≤10%, only those receiving adjuvant radiotherapy had a trend of better CSS. In patients with an LNR between 10% and 30% and more than 30%, concurrent radiochemotherapy (CCRT) proved to be the best treatment. CONCLUSIONS: LNR is an independent prognostic factor in patients with non-metastatic cervical cancer undergoing radical hysterectomy. For patients with negative lymph nodes, no further treatment is recommended. Patients with positive lymph nodes could benefit more from CCRT.
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Neoplasias del Cuello Uterino , Humanos , Femenino , Pronóstico , Neoplasias del Cuello Uterino/cirugía , Neoplasias del Cuello Uterino/patología , Índice Ganglionar , Metástasis Linfática/patología , Ganglios Linfáticos/patología , Histerectomía , Estadificación de NeoplasiasRESUMEN
WHAT IS KNOWN ON THE SUBJECT?: Parenting experiences are a great challenge but also a meaningful achievement for mothers diagnosed with schizophrenia (MDWSs). Most previous studies focused on the parenting experiences of Chinese mothers diagnosed with depression rather than those diagnosed with schizophrenia, who usually experience psychiatric symptoms. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Unlike in Western society, Chinese society is characterised by a family-centred culture. This study insightfully explores MDWSs' parenting and family life experiences addressing their intrapersonal mindsets, interpersonal connections with family members across generations and extrapersonal roles such as traditional social expectations as a mother, wife and daughter-in-law. While Western studies have mainly focused on MDWSs' personal resilience, this study insightfully explored MDWSs' resilient dimensions including their personal, familial and cultural issues within the Chinese society. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study develops a comprehensive and professional understanding of the parenting experiences and family interactions of MDWSs who struggle to achieve their motherly role and re-establish connections with intimate family members. The findings highlight the following important considerations when offering family-based nursing cares: (1) assess power relationships, familial dynamics and cultural influences between MDWSs and their family members; (2) extend family members' involvement, such as parents-in-law, while offering psychoeducation to MDWSs and their family members. ABSTRACT: Introduction In Chinese culture, raising the next generation is recognised as a crucial family matter involving intergenerational participation. Mothers diagnosed with schizophrenia (MDWSs) usually experience high stress due to psychiatric symptoms, different parenting values across generations and traditional expectations associated with motherly roles. MDWSs need urgent professional assistance. Aim To explore MDWSs' parenting experiences and family life in Chinese cultural contexts. Method In-depth interviews were conducted with 20 MDWSs. Data were analysed using interpretative phenomenological analyses. Results The superordinate theme was identified as 'You are not a qualified mother'. Three major themes were elicited: experiencing crises in parenting, family life and self-stability; striving to be a good mother and wife under humiliation; and developing wisdom and courage to move forward. Discussion A dehumanised attitude of family members in a paternalistic culture was found. While Western society focuses on personal resilience and family-based nursing care for nuclear families, Chinese society intensively focuses on MDWSs' relationship with nuclear family members as well as extended family members such as parents-in-law. Implications for Practice The results highlighted the significance of culturally sensitive nursing care for MDWSs and family-centred psychoeducation that clarifies familial dynamics and improves effective communication between MDWSs and their family members.
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Madres , Responsabilidad Parental , Esquizofrenia , Humanos , Esquizofrenia/etnología , Femenino , Responsabilidad Parental/etnología , Responsabilidad Parental/psicología , Adulto , Madres/psicología , China/etnología , Relaciones Familiares/etnología , Relaciones Familiares/psicología , Persona de Mediana Edad , Investigación Cualitativa , Masculino , Pueblos del Este de AsiaRESUMEN
The differentiated characteristics of the silver (elderly) group from other groups means that the previous interaction mechanism in short-form video (SFV) e-commerce is no longer applicable. Drawing on sociotechnical systems theory and the ERG theory, this study is motivated to explore the purchase intention of silver consumers in SFV platforms. We categorize the characteristics of SFV platforms into social and technical aspects, and analyze silver consumers' purchasing decisions in terms of existence, relatedness, and growth needs. The empirical results of 284 samples show that social belonging, perceived trust, and product relevance are positive factors that promote purchase. Information diversity and social interaction have significant positive effects on social belonging and perceived trust. Recommendation affordance is significantly positively associated with perceived trust and product relevance, while platform ease of use did not have a significant effect on perceived trust. The findings provide management insights into SFV platforms to better understand the digital divide faced by silver consumers and to facilitate increased consumption.
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The performance of environmental perception is critical for the safe driving of intelligent connected vehicles (ICVs). Currently, the most prevalent technical solutions are based on multimodal data fusion to achieve a comprehensive perception of the surrounding environment. However, existing fusion perception methods suffer from issues such as low sensor data utilization and unreasonable fusion strategies, which severely limit their performance in adverse weather conditions. To address these issues, this article proposes a novel multimodal data fusion framework called MixedFusion. In this framework, we introduce two innovative fusion strategies for the data characteristics of each sensor: high-level semantic guidance (HLSG) and multipriority matching (MPM). It not only realizes the efficient utilization of the multimodal data but also further realizes the complementary fusion between the multimodal data. We perform extensive experiments on the nuScenes and K-radar datasets. The experimental results demonstrate that the fusion framework proposed in this article significantly improves the performance of 3-D object detection and tracking in severe weather conditions.
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As a fundamental computer vision task, instance segmentation is widely used in the field of autonomous driving because it can perform both instance-level distinction and pixel-level segmentation. We propose CompleteInst based on QueryInst as a solution to the problems of missed detection with a network structure designed from the feature level and the instance level. At the feature level, we propose Global Pyramid Networks (GPN) to collect global information of missed instances. Then, we introduce the semantic branch to complete the semantic features of the missed instances. At the instance level, we implement the query-based optimal transport assignment (OTA-Query) sample allocation strategy which enhances the quality of positive samples of missed instances. Both the semantic branch and OTA-Query are parallel, meaning that there is no interference between stages, and they are compatible with the parallel supervision mechanism of QueryInst. We also compare their performance to that of non-parallel structures, highlighting the superiority of the proposed parallel structure. Experiments were conducted on the Cityscapes and COCO dataset, and the recall of CompleteInst reached 56.7% and 54.2%, a 3.5% and 3.2% improvement over the baseline, outperforming other methods.
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Objective: To investigate the accuracy, safety, and short-term effectiveness of a domestic robot-assisted system in total knee arthroplasty (TKA) by a multicenter randomized controlled trial. Methods: Between December 2021 and February 2023, 138 patients with knee osteoarthritis who received TKA in 5 clinical centers were prospectively collected, and 134 patients met the inclusion criteria were randomly assigned to either a trial group ( n=68) or a control group ( n=66). Seven patients had lost follow-up and missing data, so they were excluded and the remaining 127 patients were included for analysis, including 66 patients in the trial group and 61 patients in the control group. There was no significant difference ( P>0.05) in gender, age, body mass index, side, duration of osteoarthritis, Kellgren-Lawrence grading, preoperative Knee Society Score (KSS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score between the two groups. The trial group completed the TKA by domestic robot-assisted osteotomy according to the preoperative CT-based surgical planning. The control group was performed by traditional osteotomy plate combined with soft tissue release. Total operation time, osteotomy time of femoral/tibial side, intraoperative blood loss, and postoperative complications were recorded and compared between the two groups. The radiographs were taken at 5 and 90 days after operation, and hip-knee-ankle angle (HKA), lateral distal angle of femur (LDFA), and posterior tibial slope (PTS) were measured. The difference between the measured values of the above indexes at two time points after operation and the preoperative planning target values was calculated, and the absolute value (absolute error) was taken for comparison between the two groups. The postoperative recovery of lower limb alignment was judged and the accuracy was calculated. KSS score and WOMAC score were used to evaluate the knee joint function of patients before operation and at 90 days after operation. The improvement rates of KSS score and WOMAC score were calculated. The function, stability, and convenience of the robot-assisted system were evaluated by the surgeons. Results: The total operation time and femoral osteotomy time of the trial group were significantly longer than those of the control group ( P<0.05). There was no significant difference in the tibial osteotomy time and the amount of intraoperative blood loss between the two groups ( P>0.05). The incisions of both groups healed by first intention after operation, and there was no infection around the prosthesis. Nine patients in the trial group and 8 in the control group developed lower extremity vascular thrombosis, all of which were calf intermuscular venous thrombosis, and there was no significant difference in the incidence of complications ( P>0.05). All patients were followed up 90 days. There was no significant difference in KSS score and WOMAC score between the two groups at 90 days after operation ( P>0.05). There was significant difference in the improvement rate of KSS score between the two groups ( P<0.05), while there was no significant difference in the improvement rate of WOMAC score between the two groups ( P>0.05). Radiological results showed that the absolute errors of HKA and LDFA in the trial group were significantly smaller than those in the control group at 5 and 90 days after operation ( P<0.05), and the recovery accuracy of lower limb alignment was significantly higher than that in control group ( P<0.05). The absolute error of PTS in the trial group was significantly smaller than that in the control group at 5 days after operation ( P<0.05), but there was no significant difference at 90 days between the two groups ( P>0.05). The functional satisfaction rate of the robot-assisted system was 98.5% (65/66), and the satisfaction rates of stability and convenience were 100% (66/66). Conclusion: Domestic robot-assisted TKA is a safe and effective surgical treatment for knee osteoarthritis, which can achieve favorable lower limb alignment reconstruction, precise implant of prosthesis, and satisfactory functional recovery.
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Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla , Osteoartritis de la Rodilla , Robótica , Humanos , Artroplastia de Reemplazo de Rodilla/métodos , Osteoartritis de la Rodilla/cirugía , Pérdida de Sangre Quirúrgica , Articulación de la Rodilla/cirugía , Estudios RetrospectivosRESUMEN
Background: The Discharge Planning Curriculum (DPC) is a 4-hour course for penultimate-year medical students at a tertiary teaching hospital in Taiwan. The course begins with a 30-minute introduction, followed by the students shadowing discharge planning case managers as they visit patients on the wards. After patient visits, the students engaged in a 1-hour case discussion. Our research assessed the effectiveness of the DPC for medical students. Methods: This mixed methods study recruited medical students participating in family medicine rotations between October 2017 and May 2018. To determine the impact of the DPC, we quantitatively analyzed questionnaire responses to measure changes in self-efficacy, attitude toward discharge planning, and course satisfaction before and after completing the DPC. Additionally, we conducted qualitative focus group interviews to gain insight into the students' learning experiences and applied thematic analysis to the interview data. Results: Our study found two quantitative results: 1) The DPC significantly improved self-efficacy and attitude toward discharge planning (p < 0.001). 2) The medical students acquired knowledge about home care, assistive device application, long-term care facility referral, home rehabilitation, and home care services, and more than 95% of the students reported being satisfied with the course. In addition, the focus group interviews revealed that medical students learned several aspects of discharge planning through the curriculum, including an understanding of various aspects of discharge planning through the curriculum, the importance of early discharge planning, the roles of doctors and case managers, and the challenges faced in the process. Conclusion: The DPC helped medical students understand different team members' roles in discharge planning and appreciate the challenges that case managers face in this process. The DPC improved medical students' attitudes toward discharge planning. The curriculum can be a valuable tool in training future healthcare providers in effective transitional care.
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Metamaterials, thoughtfully designed, have demonstrated remarkable success in the manipulation of electromagnetic waves. More recently, deep learning can advance the performance in the field of metamaterial inverse design. However, existing inverse design methods based on deep learning often overlook potential trade-offs of optimal design and outcome diversity. To address this issue, in this work we introduce contrastive learning to implement a simple but effective global ranking inverse design framework. Viewing inverse design as spectrum-guided ranking of the candidate structures, our method creates a resemblance relationship of the optical response and metamaterials, enabling the prediction of diverse structures of metamaterials based on the global ranking. Furthermore, we have combined transfer learning to enrich our framework, not limited in prediction of single metamaterial representation. Our work can offer inverse design evaluation and diverse outcomes. The proposed method may shrink the gap between flexibility and accuracy of on-demand design.
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Electrochemical carbon dioxide reduction reaction (CO2 RR) to produce valuable chemicals is a promising pathway to alleviate the energy crisis and global warming issues. However, simultaneously achieving high Faradaic efficiency (FE) and current densities of CO2 RR in a wide potential range remains as a huge challenge for practical implements. Herein, we demonstrate that incorporating bismuth-based (BH) catalysts with L-histidine, a common amino acid molecule of proteins, is an effective strategy to overcome the inherent trade-off between the activity and selectivity. Benefiting from the significantly enhanced CO2 adsorption capability and promoted electron-rich nature by L-histidine integrity, the BH catalyst exhibits excellent FEformate in the unprecedented wide potential windows (>90 % within -0.1--1.8â V and >95 % within -0.2--1.6â V versus reversible hydrogen electrode, RHE). Excellent CO2 RR performance can still be achieved under the low-concentration CO2 feeding (e.g., 20â vol.%). Besides, an extremely low onset potential of -0.05â VRHE (close to the theoretical thermodynamic potential of -0.02â VRHE ) was detected by in situ ultraviolet-visible (UV-Vis) measurements, together with stable operation over 50â h with preserved FEformate of ≈95 % and high partial current density of 326.2â mA cm-2 at -1.0â VRHE .
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The objective of vehicle search is to locate and identify vehicles in uncropped, real-world images, which is the combination of two tasks: vehicle detection and re-identification (Re-ID). As an emerging research topic, vehicle search plays a significant role in the perception of cooperative autonomous vehicles and road driving in the distant future and has become a trend in the future development of intelligent driving. However, there is no suitable dataset for this study. The Tsinghua University DAIR-V2X dataset is utilized to create the first cross-camera vehicle search dataset, DAIR-V2XSearch, which combines the cameras at both ends of the vehicle and the road in real-world scenes. The primary purpose of the current search network is to address the pedestrian issue. Due to varying task scenarios, it is necessary to re-establish the network in order to resolve the problem of vast differences in different perspectives caused by vehicle searches. A phased feature extraction network (PFE-Net) is proposed as a solution to the cross-camera vehicle search problem. Initially, the anchor-free YOLOX framework is selected as the backbone network, which not only improves the network's performance but also eliminates the fuzzy situation in which multiple anchor boxes correspond to a single vehicle ID in the Re-ID branch. Second, for the vehicle Re-ID branch, a camera grouping module is proposed to effectively address issues such as sudden changes in perspective and disparities in shooting under different cameras. Finally, a cross-level feature fusion module is designed to enhance the model's ability to extract subtle vehicle features and the Re-ID's precision. Experiments demonstrate that our proposed PFE-Net achieves the highest precision in the DAIR-V2XSearch dataset.
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Rapeseed is a significant oil crop, and the size and length of its pods affect its productivity. However, manually counting the number of rapeseed pods and measuring the length, width, and area of the pod takes time and effort, especially when there are hundreds of rapeseed resources to be assessed. This work created two state-of-the-art deep learning-based methods to identify rapeseed pods and related pod attributes, which are then implemented in rapeseed pots to improve the accuracy of the rapeseed yield estimate. One of these methods is YOLO v8, and the other is the two-stage model Mask R-CNN based on the framework Detectron2. The YOLO v8n model and the Mask R-CNN model with a Resnet101 backbone in Detectron2 both achieve precision rates exceeding 90%. The recognition results demonstrated that both models perform well when graphic images of rapeseed pods are segmented. In light of this, we developed a coin-based approach for estimating the size of rapeseed pods and tested it on a test dataset made up of nine different species of Brassica napus and one of Brassica campestris L. The correlation coefficients between manual measurement and machine vision measurement of length and width were calculated using statistical methods. The length regression coefficient of both methods was 0.991, and the width regression coefficient was 0.989. In conclusion, for the first time, we utilized deep learning techniques to identify the characteristics of rapeseed pods while concurrently establishing a dataset for rapeseed pods. Our suggested approaches were successful in segmenting and counting rapeseed pods precisely. Our approach offers breeders an effective strategy for digitally analyzing phenotypes and automating the identification and screening process, not only in rapeseed germplasm resources but also in leguminous plants, like soybeans that possess pods.