Simulation Training for Laparoscopic Surgery Can Improve Minimally Invasive Surgical Techniques for Interns and Probationers

Objective: The clinical clerkship and practice stage plays a pivotal role in the transition of medical students from theoretical knowledge to practical application, bridging the gap between classroom learning and real-life clinical experience. In order to improve the teaching quality of interns and probationers, we try to let them practice the skills of laparoscopic surgery in the early stage, and summed up a set of evaluation methods that can be widely used in medical education. Methods: From September 2019 to December 2019, a total of 54 interns and 72 trainees were selected as research objects. They were assigned to training sessions and their proficiency was assessed before and after the training. The change in proficiency is compared to determine whether the training course is valuable. Results: Before the operation training, the interns scores were BP 17.3 3.1, CC 17.9 3.4, KT 16.4 3.4, LS 16.7 3.3. The results of probationers were BP 16.9 2.7, CC 16.8 2.8, KT 15.2 1.6, and LS 14.8 2.2. After completing the operations training, the results of interns were BP 21.1 1.9, CC 20.6 2.7, KT 19.6 3.0, and LS 20.9 1.4. The probationers scores were BP 19.3 3.2, CC 19.6 3.5, KT 19.6 2.6, and LS 20.0 2.4. After the operation training, the performance of the intern group was better than that before the training (P < 0.05). The same is true of the probationer group. The time-consuming intern examinations were BP 147.9 38.5 s, CC 123.2 28.7 s, KT 82.6 24.1 s and LS 162.5 31.1 s. The examination time of probationers were BP 179.9 46.4 s, CC 132.1 24.3 s, KT 109.3 27.5 s and LS 210.0 58.8 s. Conclusion: Simulation training for laparoscopic surgery can improve minimally invasive surgical techniques for interns and probationers.

激光粉末床熔融成形高性能Al-Mn-Mg-Sc-Zr合金的显微组织演变及力学性能

系统研究时效温度对激光粉末床熔融成形Al-Mn-Mg-Sc-Zr合金显微组织及力学性能的影响。结果表明,成形态合金组织致密且无裂纹,平均晶粒尺寸为3.51μm,屈服强度为(547±3)MPa。经300℃时效后,合金组织中析出大量尺寸为2~3 nm且与基体共格的Al3Sc纳米颗粒。时效样品的屈服强度提升至(616±4)MPa,这得益于合金中的析出强化、固溶强化和晶界强化。当时效温度超过300℃时,部分Mn和Zr从固溶体中析出,形成Al6Mn和Al3(Sc,Zr)相。经500℃时效后,合金中Al6Mn相和Al3(Sc,Zr)相分别粗化至约600和30nm。此,合金的屈服强度下降至(372±3) MPa。

Experimental Proposal on Non-Hermitian Skin Effect by Two-dimensional Quantum Walk with a Single Trapped Ion

Non-Hermitian Hamiltonians are widely used in describing open systems with gain and loss,among which a key phenomenon is the non-Hermitian skin effect.Here we report an experimental scheme to realize a twodimensional(2D)discrete-time quantum walk with non-Hermitian skin effect in a single trapped ion.It is shown that the coin and 2D walker states can be labeled in the spin of the ion and the coherent-state lattice of the ion motion,respectively.We numerically observe a directional bulk flow,whose orientations are controlled by dissipative parameters,showing the emergence of the non-Hermitian skin effect.We then discuss an experimental implementation of our scheme in a laser-controlled trapped Ca^(+)ion.Our experimental proposal may be applicable to research of dissipative quantum walk systems and may be able to generalize to other platforms,such as superconducting circuits and atoms in cavity.

Machine learning and human‐machine trust in healthcare:A systematic survey

As human‐machine interaction(HMI)in healthcare continues to evolve,the issue of trust in HMI in healthcare has been raised and explored.It is critical for the development and safety of healthcare that humans have proper trust in medical machines.Intelligent machines that have applied machine learning(ML)technologies continue to penetrate deeper into the medical environment,which also places higher demands on intelligent healthcare.In order to make machines play a role in HMI in healthcare more effectively and make human‐machine cooperation more harmonious,the authors need to build good humanmachine trust(HMT)in healthcare.This article provides a systematic overview of the prominent research on ML and HMT in healthcare.In addition,this study explores and analyses ML and three important factors that influence HMT in healthcare,and then proposes a HMT model in healthcare.Finally,general trends are summarised and issues to consider addressing in future research on HMT in healthcare are identified.

Study on Sealing Characteristics of Sliding Seal Assembly of Aircraft Hydraulic Actuator

The hydraulic actuator,known as the"muscle"of military aircraft,is responsible for flight attitude adjustment,trajectory control,braking turn,landing gear retracting and other actions,which directly affect its flight efficiency and safety.However,the sealing assembly often has the situation of over-aberrant aperture fit clearance or critical over-aberrant clearance,which increases the failure probability and degree of movable seal failure,and directly affects the flight efficiency and safety of military aircraft.In this paper,the simulation model of hydraulic actuator seal combination is established by ANSYS software,and the sealing principle is described.The change curve of contact width and contact pressure of combination seal under the action of high-pressure fluid is drawn.The effects of different oil pressure,fit clearance and other parameters on the sealing performance are analyzed.Finally,the accelerated life test of sliding seal components is carried out on the hydraulic actuator accelerated life test rig,and the surface morphology is compared and analyzed.The research shows that the O-ring is the main sealing element and the role of the check ring is to protect and support the O-ring to prevent damage caused by squeezing into the fit clearance,so the check ring bears a large load and is prone to shear failure.Excessive fit clearance is the main factor affecting the damage of the check ring,and the damage parts are mainly concentrated at the edge of the sealing surface.This paper provides a theoretical basis for the design of hydraulic actuator and the improvement of sealing performance.

Erythropoietin inhibits ferroptosis and ameliorates neurological function after spinal cord injury

Ferroptosis is one of the critical pathological events in spinal cord injury.Erythropoietin has been reported to improve the recovery of spinal cord injury.However,whether ferroptosis is involved in the neuroprotective effects of erythropoietin on spinal cord injury has not been examined.In this study,we established rat models of spinal cord injury by modified Allen’s method and intraperitoneally administered 1000 and 5000 IU/kg erythropoietin once a week for 2 successive weeks.Both low and high doses of erythropoietin promoted recovery of hindlimb function,and the high dose of erythropoietin led to better outcome.High dose of erythropoietin exhibited a stronger suppressive effect on ferroptosis relative to the low dose of erythropoietin.The effects of erythropoietin on inhibiting ferroptosis-related protein expression and restoring mitochondrial morphology were similar to those of Fer-1(a ferroptosis suppressor),and the effects of erythropoietin were largely diminished by RSL3(ferroptosis activator).In vitro experiments showed that erythropoietin inhibited RSL3-induced ferroptosis in PC12 cells and increased the expression of xCT and Gpx4.This suggests that xCT and Gpx4 are involved in the neuroprotective effects of erythropoietin on spinal cord injury.Our findings reveal the underlying anti-ferroptosis role of erythropoietin and provide a potential therapeutic strategy for treating spinal cord injury.

Soft Electronics for Health Monitoring Assisted by Machine Learning

Due to the development of the novel materials,the past two decades have witnessed the rapid advances of soft electronics.The soft electronics have huge potential in the physical sign monitoring and health care.One of the important advantages of soft electronics is forming good interface with skin,which can increase the user scale and improve the signal quality.Therefore,it is easy to build the specific dataset,which is important to improve the performance of machine learning algorithm.At the same time,with the assistance of machine learning algorithm,the soft electronics have become more and more intelligent to realize real-time analysis and diagnosis.The soft electronics and machining learning algorithms complement each other very well.It is indubitable that the soft electronics will bring us to a healthier and more intelligent world in the near future.Therefore,in this review,we will give a careful introduction about the new soft material,physiological signal detected by soft devices,and the soft devices assisted by machine learning algorithm.Some soft materials will be discussed such as two-dimensional material,carbon nanotube,nanowire,nanomesh,and hydrogel.Then,soft sensors will be discussed according to the physiological signal types(pulse,respiration,human motion,intraocular pressure,phonation,etc.).After that,the soft electronics assisted by various algorithms will be reviewed,including some classical algorithms and powerful neural network algorithms.Especially,the soft device assisted by neural network will be introduced carefully.Finally,the outlook,challenge,and conclusion of soft system powered by machine learning algorithm will be discussed.

Experiment and numerical simulation of distribution law of waterbased corrosion inhibitor in natural gas gathering and transportation pipeline

The transmission medium of natural gas gathering and transportation pipelines usually contains cor-rosive gases,which will cause serious corrosion on the inner wall of the pipelines when they coexist with water.Therefore,it is necessary to add corrosion inhibitor to form a protective film to protect the pipeline.The distribution of corrosion inhibitors in a gathering and transportation pipeline in Moxi gas field was studied by combining experiment and simulation.The Pearson function was used to calculate the experimental and simulation results,and the correlation was more than 80%,indicating a high degree of agreement.The simulation results show that:①The larger the pipe angle,filling speed and gas flow rate,the smaller the particle size,the better the distribution of corrosion inhibitor particles in the pipe.The filling amount will affect the concentration,but the distribution trend is unchanged;②A method to determine the filling mode based on the loss was proposed,and for this pipeline,the loss of corrosion inhibitor was determined to be 5.31×10^(-3) kg/s,and the flling amount was recommended to be adjusted to 2o L/h,which has certain guiding significance for the actual flling strategy of pipeline corrosion inhibitor.

Recent Trends of In-Vehicle Time Sensitive Networking Technologies, Applications and Challenges

With the vigorous development of automobile industry,in-vehicle network is also constantly upgraded to meet data transmission requirements of emerging applications.The main transmission requirements are low latency and certainty especially for autonomous driving.Time sensitive networking(TSN)based on Ethernet gives a possible solution to these requirements.Previous surveys usually investigated TSN from a general perspective,which referred to TSN of various application fields.In this paper,we focus on the application of TSN to the in-vehicle networks.For in-vehicle networks,we discuss all related TSN standards specified by IEEE 802.1 work group up to now.We further overview and analyze recent literature on various aspects of TSN for automotive applications,including synchronization,resource reservation,scheduling,certainty,software and hardware.Application scenarios of TSN for in-vehicle networks are analyzed one by one.Since TSN of in-vehicle network is still at a very initial stage,this paper also gives insights on open issues,future research directions and possible solutions.

Tailoring conductive network Zn@NPC@MWCNTs nanocomposites derived from ZIF-8 as high-performance electromagnetic absorber for the whole X-Band

A porous 3D cross-linked conductive network pierced by multi-wall carbon nanotubes(MWCNTs) was successfully designed from zeolitic imidazolate framework-8(ZIF-8). Zn@NPC@MWCNTs composites were tailored by the facile regulating the mass ratios and thermal annealing treatment. Due to the combination of less eddy current loss and dielectric loss together with multiple reflection attenuation caused by a unique structure. With a 10 wt% filler loading, the Zn@NPC@MWCNTs composites carbonized at 800℃ show two high reflection loss(RL) values with different thicknesses. An RL value is-53.18 dB with 4.09 mm thickness in the C-Band(4-8 GHz), and a minimum RL can reach-74.83 d B(10.8 GHz)with a matching thickness of 2.749 mm. The effective absorption bandwidth is 4 GHz(from 8 to 12 GHz,RL ≤-10 d B), which just covers the full X-band. Low cost and easy preparation can also provide advantages to develop MOF-based materials as effective EMW absorbents.

The Reissner-Nordström black hole surrounded by quintessence may not be destroyed

In the study of weak cosmic censorship conjectures(WCCC),some research finds that the Reissner-Nordström black hole might be destroyed by a test particle with particular mass and charge under some conditions,which means that the naked singularity of the black hole could be observed.This is not allowed in WCCC.We have never observed such naked singularities which should not exist in theory,so we need to find a proper way to protect the black hole from being destroyed by such particles.In this paper,we study a Reissner-Nordström black hole that is surrounded by quintessence(RN-Q)and find that the black hole would be stable and safe because of the effective potential barrier induced by the quintessence term.This result may also show in a sense that the quintessence might have more potential value.

Advancing the precision management of inflammatory bowel disease in the era of omics approaches and new technology

There is great heterogeneity among inflammatory bowel disease(IBD)patients in terms of pathogenesis,clinical manifestation,response to treatment,and prognosis,which requires the individualized and precision management of patients.Many studies have focused on prediction biomarkers and models for assessing IBD disease type,activity,severity,and prognosis.During the era of biologics,how to predict the response and side effects of patients to different treatments and how to quickly recognize the loss of response have also become important topics.Multiomics is a promising area for investigating the complex network of IBD pathogenesis.Integrating numerous amounts of data requires the use of artificial intelligence.

Diagnostic and classification value of immune-related lncRNAs in dilated cardiomyopathy

Background:Various physiological mechanisms are linked to dilated cardiomyopathy(DCM)development,including oxidative stress,immune irregularities,inflammation,fibrosis,and genetic changes.However,precise molecular drivers of DCM,especially regarding abnormal immune responses,remain unclear.This study investigates immune-related long non-coding RNAs(lncRNAs)in DCM’s diagnostic and therapeutic potential.Methods:GSE141910,GSE135055,and GSE165303 datasets were acquired from the GEO database.LASSO,SVM-RFE,and random forest algorithms identified DCM-associated immune-related lncRNAs.Diagnostic capabilities were assessed by Nomogram and receiver operating characteristic(ROC)curves.Multivariate linear regression explored lncRNA correlations with ejection fraction.Single-sample gene set enrichment analysis(ssGSEA)gauged immune cell infiltration/functions.Functional enrichment analyses were performed using Gene set variation analysis(GSVA),gene ontology(GO),and the Kyoto Encyclopedia of Genes and Genomes(KEGG).Consensus clustering categorized DCM cases.Results:Ten immune-related lncRNAs emerged:C10orf71-AS1,FHAD1-AS1,SCIRT,FNDC1-AS1,MELTFAS1,LOC101928834,GDNF-AS1,DCXR-DT,C3orf36,and LOC107985323.These lncRNAs,tied to immunomodulation,showed promising DCM diagnostic accuracy.Adjusted for confounders,they independently correlated with ejection fraction.Using lncRNA expression,DCM patients were grouped into subtypes.Subtype C1 displayed a higher level of immune cell infiltration and immune checkpoint expression compared to subtype C2,emphasizing the variations in the immune microenvironment.Conclusion:This study identifies ten immune-related lncRNAs for further exploration in DCM diagnosis and subtyping.Based on expression patterns,we propose two potential DCM subtypes.Notably,findings are preliminary and hypothesis-generating,demanding validation and further investigation.This research provides insights into DCM diagnosis and classification.

On‐device audio‐visual multi‐person wake word spotting

Audio‐visual wake word spotting is a challenging multi‐modal task that exploits visual information of lip motion patterns to supplement acoustic speech to improve overall detection performance.However,most audio‐visual wake word spotting models are only suitable for simple single‐speaker scenarios and require high computational complexity.Further development is hindered by complex multi‐person scenarios and computational limitations in mobile environments.In this paper,a novel audio‐visual model is proposed for on‐device multi‐person wake word spotting.Firstly,an attention‐based audio‐visual voice activity detection module is presented,which generates an attention score matrix of audio and visual representations to derive active speaker representation.Secondly,the knowledge distillation method is introduced to transfer knowledge from the large model to the on‐device model to control the size of our model.Moreover,a new audio‐visual dataset,PKU‐KWS,is collected for sentence‐level multi‐person wake word spotting.Experimental results on the PKU‐KWS dataset show that this approach outperforms the previous state‐of‐the‐art methods.

Winding Function Theory Based Thrust Calculation on Nested-loop Secondary Linear Machine Adapted to Linear Metro

With advantages of strong drive capability,nested-loop secondary linear machine(NLS-LM)has great potentiality in linear metro.For its secondary structure with multiple loops,it is difficult to calculate the electromagnetic thrust of NLS-LM reasonably.Hence,in this paper,one thrust calculation method is proposed considering variable loop inductance and transient loop current.Firstly,to establish the secondary winding function,the modeling domain is confined to a limited range,and the equivalent loop span is employed by analyzing the coupling relationship between primary and secondary.Then,in order to obtain the secondary flux density,the transient secondary current is solved based on the loop impedance and induced voltage.Finally,the electromagnetic thrust can be calculated reasonably by the given primary current sheet and the calculated secondary flux density.Comprehensive simulations and experiments have demonstrated the effectiveness of the proposed method.

Research on Test Methods for AI Industrial Application Capabilities of Smart Mobile Terminals

A test method and system for AI industrial application capabilities of smart terminals. The method includes the following steps: According to the temperature change values of different AI industrial applications executed by standard smart terminal equipment under different equipment parameters, the equipment parameters and temperature changes of standard smart terminal equipment are constructed. Correlation model;obtain the device parameters of the smart terminal device to be tested, and obtain the predicted value of the temperature change of the smart terminal device to be tested based on the correlation model between the device parameters of the standard smart terminal device and the temperature change;Measure the actual value of the temperature change of the intelligent terminal device executing different AI industrial applications;obtain the test result of the intelligent terminal device to be tested according to the predicted value of the temperature change and the actual value of the temperature change.

Ag(111)表面Ag配位结构的分等级组装

表面辅助的金属有机纳米结构因其结构稳定性和潜在应用受到广泛关注。在金属有机纳米结构中,金属原子来源于外部沉积的金属或金属表面原子。外部沉积的金属原子种类多样,取决于目标纳米结构。然而,金属表面原子受限于表面科学常用的金、银和铜单晶金属表面。金属有机纳米结构大多包括Au配位或是Cu配位结构,而只有少量的用表面Ag原子构成。分子金属相互作用的进一步研究有助于预期纳米结构的精确控制形成。至于构建基元,有机分子通过M―C、M―N和M―O键与表面金属原子配位。末端炔反应或者乌尔曼耦合能够实现C―M―C节点的形成。Cu和Au原子能够与含有末端氰基或吡啶基官能团的分子配位形成N―M―N键。另外,表面Ag增原子能够通过Ag―N配位键与酞菁分子配位。然而,M―O配位键的相关研究较少。因此,我们计划使用末端羟基分子与Ag增原子配位形成金属有机配位纳米结构去研究O―Ag节点。我们通过扫描隧道显微镜利用4,4’-二羟基-1,1’:3’,1’’-三联苯分子(4,4’-dihydroxy-1,1’:3’,1’’-terphenyl,H3PH)和Ag增原子成功构筑了一系列二维有序纳米结构。在室温下,蒸镀的H3PH分子自组装形成由环氢键连接的密堆积结构。当退火温度提升到330K,一种新的纳米结构出现了,该结构由O―Ag配位键和氢键共同作用形成。进一步地提升退火温度至420K,蜂巢结构和共存的二重配位链出现,这两种结构中仅由O―Ag―O键构成。为分析金属分子反应路径和O―Ag―O键的能量势垒,我们对该体系进行密度泛函理论计算。计算结果显示,O―Ag键形成的能量势垒是1.41 eV,小于O―Ag―O节点1.85 e V的能量势垒。这也解释了分等级金属-有机纳米结构形成的原因。我们的实验结果提供了一种利用有机小分子和金属增原子来设计和构筑分等级二维纳米结构的有效方法。

Efficacy and safety of transcutaneous auricular vagus nerve stimulation combined with conventional rehabilitation training in acute stroke patients: a randomized controlled trial conducted for 1 year involving 60 patients

Transcutaneous auricular vagus nerve stimulation(ta-VNS)is a novel noninvasive treat-ment for stroke that directly stimulates the peripheral auricular branch of the vagus nerve.There have been recent reports that ta-VNS combined with conventional rehabilitation training promotes the recovery of neurological function of patients with acute stroke.However,these were small-sample-sized studies on the recovery of neurological function in patients after percutaneous vagus nerve stimulation in the subacute and chronic phases after stroke.This double-blinded randomized controlled trial involved 60 acute ischemic or hemorrhagic stroke patients aged 18-80 years who received treatment in the Second Affiliated Hospital of Chongqing Medical University.The subjects were randomly assigned to receive ta-VNS or sham ta-VNS combined with conventional rehabilitation training.The follow-up results over 1 year revealed that ta-VNS combined with conventional rehabilitation training greatly improved the recovery of motor and sensory functions and emotional responses compared with sham ta-VNS combined with conventional rehabilitation training.There were no obvious side effects.These findings suggest that ta-VNS combined with conventional rehabilitation training for the treatment of acute ischemic or hemorrhagic stroke patients is safe and effective.

The expression of oxidative stress genes related to myocardial ischemia reperfusion injury in patients with ST-elevation myocardial infarction

BACKGROUND:We aimed to investigate the gene expression of myocardial ischemia/reperfusion injury(MIRI)in patients with acute ST-elevation myocardial infarction(STEMI)using stress and toxicity pathway gene chip technology and try to determine the underlying mechanism.METHODS:The mononuclear cells were separated by ficoll centrifugation,and plasma total antioxidant capacity(T-AOC)was determined by the ferric reducing ability of plasma(FRAP)assay.The expression of toxic oxidative stress genes was determined and verified by oligo gene chip and quantitative real-time polymerase chain reaction(qRT-PCR).Additionally,gene ontology(GO)enrichment analysis was performed on DAVID website to analyze the potential mechanism further.RESULTS:The total numbers of white blood cells(WBC)and neutrophils(N)in the peripheral blood of STEMI patients(the AMI group)were significantly higher than those in the control group(WBC:11.67±4.85×10^(9)/L vs.6.41±0.72×10^(9)/L,P<0.05;N:9.27±4.75×10^(9)/L vs.3.89±0.81×10^(9)/L,P<0.05),and WBCs were significantly associated with creatine kinase-myocardial band(CK-MB)on the first day(Y=8.945+0.018X,P<0.05).In addition,the T-AOC was significantly lower in the AMI group comparing to the control group(12.80±1.79 U/mL vs.20.48±2.55 U/mL,P<0.05).According to the gene analysis,eight up-regulated differentially expressed genes(DEGs)included GADD45A,PRDX2,HSPD1,DNAJB1,DNAJB2,RAD50,TNFSF6,and TRADD.Four down-regulated DEGs contained CCNG1,CAT,CYP1A1,and ATM.TNFSF6 and CYP1A1 were detected by polymerase chain reaction(PCR)to verify the expression at different time points,and the results showed that TNFSF6 was up-regulated and CYP1A1 was down-regulated as the total expression.GO and kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis suggested that the oxidative stress genes mediate MIRI via various ways such as unfolded protein response(UPR)and apoptosis.CONCLUSIONS:WBCs,especially neutrophils,were the critical cells that mediating reperfusion injury.MIRI was regulated by various genes,including oxidative metabolic stress,heat shock,DNA damage and repair,and apoptosis-related genes.The underlying pathway may be associated with UPR and apoptosis,which may be the novel therapeutic target.