Gross agricultural product is an important indication to measure the agricultural development level of a region. It would be affected by many factors,having the characteristics of non- linearity. For this reason,LM- B...Gross agricultural product is an important indication to measure the agricultural development level of a region. It would be affected by many factors,having the characteristics of non- linearity. For this reason,LM- BP neural network was put forward as the model and method for predicting gross agricultural product. Taking the indications of the sown area of crop,the output of grain,sugarcane,cassava,tea,meat,aquatic products,turpentine and camellia seed,etc. as inputs,during 2000 to 2012 in Guangxi,the gross agricultural product data from the analysis of simulation experiment show that the prediction of LM- BP neural network fits well with actual results.展开更多
The aim of the present study was to compare the effects of colloid and crystalloid preload on cardiac output (CO) and incidence of hypotension in elderly patients under spinal anesthesia (SA). A randomized, double...The aim of the present study was to compare the effects of colloid and crystalloid preload on cardiac output (CO) and incidence of hypotension in elderly patients under spinal anesthesia (SA). A randomized, double-blinded study was conducted including 47 elderly patients undergoing scheduled total hip replacement (THR), who were randomized to three groups: the control group (C group, n = 15), crystalloid (RS group, n =16) and colloid group (HES group, n = 16). An intravenous preload of 8 mL/kg of either lactated Ringer’s solution in the RS group or 6% hydroxyethyl starch in the HES group was infused within 20 min before SA induction, while no intravenous preload was given in the C group. There was a trend of decrease in CO and systolic blood pressure after SA with time in the C group. In the RS and HES groups, CO increased significantly after fluid preloading as compared with baseline (P 0.01). Thereafter, CO remained higher than baseline until 30 min after SA in the HES group. The change of systolic blood pressure was similar to CO, but no significant difference from baseline was observed in each group. Hypotension occurred in 3 patients in the C group and one each in the RS and HES group, respec-tively (P = 0.362). Intravascular volume preload with colloid is more effective than crystalloid solution in main-taining CO, which may be improved the hemodynamic stability in elderly patients during SA.展开更多
Total ionizing dose induced single transistor latchup effects for 130 nm partially depleted silicon-on-insulator (PDSOI) NMOSFETs with the bodies floating were studied in this work. The latchup phenomenon strongly c...Total ionizing dose induced single transistor latchup effects for 130 nm partially depleted silicon-on-insulator (PDSOI) NMOSFETs with the bodies floating were studied in this work. The latchup phenomenon strongly correlates with the bias configuration during irradiation. It is found that the high body doping concentration can make the devices less sensitive to the single transistor latchup effect, and the onset drain voltage at which latchup occurs can degrade as the total dose level rises. The mechanism of band-to-band tunneling (BBT) has been discussed. Two-dimensional simulations were conducted to evaluate the BBT effect. It is demonstrated that BBT combined with the positive trapped charge in the buried oxide (BOX) contributes a lot to the latchup effect.展开更多
Input/output devices for flash memory are exposed to gamma ray irradiation. Total ionizing dose has been shown great influence on characteristic degradation of transistors with different sizes. In this paper, we obser...Input/output devices for flash memory are exposed to gamma ray irradiation. Total ionizing dose has been shown great influence on characteristic degradation of transistors with different sizes. In this paper, we observed a larger increase of off-state leakage in the short channel device than in long one. However, a larger threshold voltage shift is observed for the narrow width device than for the wide one, which is well known as the radiation induced narrow channel effect. The radiation induced charge in the shallow trench isolation oxide influences the electric field of the narrow channel device. Also, the drain bias dependence of the off-state leakage after irradiation is observed, which is called the radiation enhanced drain induced barrier lowing effect. Finally, we found that substrate bias voltage can suppress the off-state leakage, while leading to more obvious hump effect.展开更多
In order to realize the accurate prediction of the total output value of construction industry in the future,the grey prediction model is used to compare the measured value with the predicted value from 2012 to 2021,a...In order to realize the accurate prediction of the total output value of construction industry in the future,the grey prediction model is used to compare the measured value with the predicted value from 2012 to 2021,and based on the existing data,the total output value of construction industry in Jiangxi Province in the next five years is predicted.The results show that the grey prediction model has a good prediction effect,and the error between the predicted value and the measured value is within 14%,which provides a basis for policy adjustment and resource optimization.展开更多
BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications o...BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications of hip approaches remains inconclusive.This study conducted an umbrella review to systematically appraise previous meta-analysis(MAs)including conventional posterior approach(PA),and minimally invasive surgeries as the lateral approach(LA),direct anterior approach(DAA),2-incisions method,mini-lateral approach and the newest technique direct superior approach(DSA)or supercapsular percutaneouslyassisted total hip(SuperPath).AIM To compare the efficacy and complications of hip approaches that have been published in all MAs and randomized controlled trials(RCTs).METHODS MAs were identified from MEDLINE and Scopus from inception until 2023.RCTs were then updated from the latest MA to September 2023.This study included studies which compared hip approaches and reported at least one outcome such as Harris Hip Score(HHS),dislocation,intra-operative fracture,wound compliData were independently selected,extracted and assessed by two reviewers.Network MA and cluster rank and surface under the cumulative ranking curve(SUCRA)were estimated for treatment efficacy and safety.RESULTS Finally,twenty-eight MAs(40 RCTs),and 13 RCTs were retrieved.In total 47 RCTs were included for reanalysis.The results of corrected covered area showed high degree(13.80%).Among 47 RCTs,most of the studies were low risk of bias in part of random process and outcome reporting,while other domains were medium to high risk of bias.DAA significantly provided higher HHS at three months than PA[pooled unstandardized mean difference(USMD):3.49,95%confidence interval(CI):0.98,6.00 with SUCRA:85.9],followed by DSA/SuperPath(USMD:1.57,95%CI:-1.55,4.69 with SUCRA:57.6).All approaches had indifferent dislocation and intraoperative fracture rates.SUCRA comparing early functional outcome and composite complications(dislocation,intra-operative fracture,wound complication,and nerve injury)found DAA was the best approach followed by DSA/SuperPath.CONCLUSION DSA/SuperPath had better earlier functional outcome than PA,but still could not overcome the result of DAA.This technique might be the other preferred option with acceptable complications.展开更多
The problem of prescribed performance tracking control for unknown time-delay nonlinear systems subject to output constraints is dealt with in this paper. In contrast with related works, only the most fundamental requ...The problem of prescribed performance tracking control for unknown time-delay nonlinear systems subject to output constraints is dealt with in this paper. In contrast with related works, only the most fundamental requirements, i.e., boundedness and the local Lipschitz condition, are assumed for the allowable time delays. Moreover, we focus on the case where the reference is unknown beforehand, which renders the standard prescribed performance control designs under output constraints infeasible. To conquer these challenges, a novel robust prescribed performance control approach is put forward in this paper.Herein, a reverse tuning function is skillfully constructed and automatically generates a performance envelop for the tracking error. In addition, a unified performance analysis framework based on proof by contradiction and the barrier function is established to reveal the inherent robustness of the control system against the time delays. It turns out that the system output tracks the reference with a preassigned settling time and good accuracy,without constraint violations. A comparative simulation on a two-stage chemical reactor is carried out to illustrate the above theoretical findings.展开更多
A frequency servo system-on-chip(FS-SoC)featuring output power stabilization technology is introduced in this study for high-precision and miniaturized cesium(Cs)atomic clocks.The proposed power stabilization loop(PSL...A frequency servo system-on-chip(FS-SoC)featuring output power stabilization technology is introduced in this study for high-precision and miniaturized cesium(Cs)atomic clocks.The proposed power stabilization loop(PSL)technique,incorporating an off-chip power detector(PD),ensures that the output power of the FS-SoC remains stable,mitigating the impact of power fluctuations on the atomic clock's stability.Additionally,a one-pulse-per-second(1PPS)is employed to syn-chronize the clock with GPS.Fabricated using 65 nm CMOS technology,the measured phase noise of the FS-SoC stands at-69.5 dBc/Hz@100 Hz offset and-83.9 dBc/Hz@1 kHz offset,accompanied by a power dissipation of 19.7 mW.The Cs atomic clock employing the proposed FS-SoC and PSL obtains an Allan deviation of 1.7×10^(-11) with 1-s averaging time.展开更多
BACKGROUND Total knee arthroplasty(TKA)is a mature procedure recommended for correcting knee osteoarthritis deformity,relieving pain,and restoring normal biomechanics.Although TKA is a successful and cost-effective pr...BACKGROUND Total knee arthroplasty(TKA)is a mature procedure recommended for correcting knee osteoarthritis deformity,relieving pain,and restoring normal biomechanics.Although TKA is a successful and cost-effective procedure,patient dissatisfaction is as high as 50%.Knee pain after TKA is a significant cause of patient dissatisfaction;the most common location for residual pain is the anterior region.Between 4%and 40%of patients have anterior knee pain(AKP).AIM To investigate the effect of various TKA procedures on postoperative AKP.METHODS We searched PubMed,EMBASE,and Cochrane from January 2000 to September 2022.Randomized controlled trials with one intervention in the experimental group and no corresponding intervention(or other interventions)in the control group were collected.Two researchers independently read the title and abstract of the studies,preliminarily screened the articles,and read the full text in detail according to the selection criteria.Conflicts were resolved by consultation with a third researcher.And relevant data from the included studies were extracted and analyzed using Review Manager 5.4 software.RESULTS There were 25 randomized controlled trials;13 were comparative studies with or without patellar resurfacing.The meta-analysis showed no significant difference between the experimental and control groups(P=0.61).Six studies were comparative studies of circumpatellar denervation vs non-denervation,divided into three subgroups for meta-analysis.The two-subgroup meta-analysis showed no significant difference between the experimental and the control groups(P=0.31,P=0.50).One subgroup meta-analysis showed a significant difference between the experimental and control groups(P=0.001).Two studies compared fixed-bearing TKA and mobile-bearing TKA;the results meta-analysis showed no significant difference between the experimental and control groups(P=0.630).Two studies compared lateral retinacular release vs non-release;the meta-analysis showed a significant difference between the experimental and control groups(P=0.002);two other studies compared other factors.CONCLUSION Patellar resurfacing,mobile-bearing TKA,and fixed-bearing TKA do not reduce the incidence of AKP.Lateral retinacular release can reduce AKP;however,whether circumpatellar denervation can reduce AKP is controversial.展开更多
BACKGROUND There is concern regarding potential long-term cardiotoxicity with systemic distribution of metals in total joint arthroplasty(TJA)patients.AIM To determine the association of commonly used implant metals w...BACKGROUND There is concern regarding potential long-term cardiotoxicity with systemic distribution of metals in total joint arthroplasty(TJA)patients.AIM To determine the association of commonly used implant metals with echocardiographic measures in TJA patients.METHODS The study comprised 110 TJA patients who had a recent history of high chromium,cobalt or titanium concentrations.Patients underwent two-dimensional,three-dimensional,Doppler and speckle-strain transthoracic echocardiography and a blood draw to measure metal concentrations.Age and sex-adjusted linear and logistic regression models were used to examine the association of metal concentrations(exposure)with echocardiographic measures(outcome).RESULTS Higher cobalt concentrations were associated with increased left ventricular end-diastolic volume(estimate 5.09;95%CI:0.02-10.17)as well as left atrial and right ventricular dilation,particularly in men but no changes in cardiac function.Higher titanium concentrations were associated with a reduction in left ventricle global longitudinal strain(estimate 0.38;95%CI:0.70 to 0.06)and cardiac index(estimate 0.08;95%CI,-0.15 to-0.01).CONCLUSION Elevated cobalt and titanium concentrations may be associated with structural and functional cardiac changes in some patients.Longitudinal studies are warranted to better understand the systemic effects of metals in TJA patients.展开更多
Total hip arthroplasty(THA)is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint disease.However,dislocation continues to...Total hip arthroplasty(THA)is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint disease.However,dislocation continues to be a troublesome complication after THA,as it is a leading cause of revision and is associated with substantial social,health,and economic costs.It is a relatively rare,usually early occurrence that depends on both the patients’characteristics and the surgical aspects.The most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility,which is closely related to the incidence of dislocation.Consequently,clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the cup.Lumbar spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after THA.Surgical options for its treatment and prevention include the use of prostheses with large diameter of femoral head size,dual mobility constructs,constrained liners,and modular neck stems.展开更多
In order to address the output feedback issue for linear discrete-time systems, this work suggests a brand-new adaptive dynamic programming(ADP) technique based on the internal model principle(IMP). The proposed metho...In order to address the output feedback issue for linear discrete-time systems, this work suggests a brand-new adaptive dynamic programming(ADP) technique based on the internal model principle(IMP). The proposed method, termed as IMP-ADP, does not require complete state feedback-merely the measurement of input and output data. More specifically, based on the IMP, the output control problem can first be converted into a stabilization problem. We then design an observer to reproduce the full state of the system by measuring the inputs and outputs. Moreover, this technique includes both a policy iteration algorithm and a value iteration algorithm to determine the optimal feedback gain without using a dynamic system model. It is important that with this concept one does not need to solve the regulator equation. Finally, this control method was tested on an inverter system of grid-connected LCLs to demonstrate that the proposed method provides the desired performance in terms of both tracking and disturbance rejection.展开更多
Parkinson’s disease(PD)is a common neurodegenerative disorder with no cure.Astragalus membranaceus is used in Chinese culture as a food supplement to boost immunity.The present study aimed to explore the neuroprotect...Parkinson’s disease(PD)is a common neurodegenerative disorder with no cure.Astragalus membranaceus is used in Chinese culture as a food supplement to boost immunity.The present study aimed to explore the neuroprotective effects of total flavonoids extracted from A.membranaceus(TFA)and their protective mechanisms.TFA offered neuroprotection against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)in the mouse model of Parkinsonism,by improving behavior performance in the gait analysis and pole test,and inhibiting the decline of tyrosine hydroxylase(TH)positive neurons and TH protein expression in substantia nigra of mice.TFA also prevented 1-methyl-4-phenylpyridinium(MPP+)induced neurotoxicity in SHSY5Y cells,by increasing GSH and GSH/GSSG ratio,and reducing reactive oxygen species.In addition,the neuroprotective effects of TFA were associated with its ability to restore MPTP/MPP+induced downregulation of SLC7A11 and glutathione peroxidase 4(GPX-4).In conclusion,we demonstrated that TFA exerted significant neuroprotection against MPTP/MPP+induced neurodegeneration by inhibiting ferroptosis through the regulation of SLC7A11/GPX-4 axis,suggesting the use of TFA as a possible food supplement in the prevention of PD.展开更多
The high-quality development of the construction industry fundamentally stems from the significant improvement of total factor productivity.Therefore,it is of crucial significance for promoting the development of the ...The high-quality development of the construction industry fundamentally stems from the significant improvement of total factor productivity.Therefore,it is of crucial significance for promoting the development of the construction industry to a higher level by scientifically and accurately measuring the total factor productivity of the construction industry and deeply analyzing the influencing factors behind it.Based on a comprehensive consideration of research methods and influencing factors,this paper systematically reviews the existing relevant literature on total factor productivity in the construction industry,aiming to reveal the current research development trend in this field and point out potential problems.This effort aims to provide a solid theoretical foundation and valuable reference for further in-depth research,and jointly promote the continuous progress and development of total factor productivity research in the construction industry.展开更多
The aim of the present work is to assess the value of Detarium Senegalense by determining the content of total phenols, total flavonoids and total anthocyanins, and by evaluating the free radical scavenging activity o...The aim of the present work is to assess the value of Detarium Senegalense by determining the content of total phenols, total flavonoids and total anthocyanins, and by evaluating the free radical scavenging activity of Detarium Senegalense extracts. For this purpose, sequential extraction using solvents of increasing polarity was essential. The various extracts obtained underwent phytochemical and biochemical analyses. Phytochemical screening revealed the presence of flavonoids, alkaloids, tannins, polyphenols, anthocyanins and steroids/terpenes. Quantitative analysis of total polyphenols, total flavonoids and total anthocyanins yielded the following results: total flavonoids (0.803 ± 0029 mg EQ/100g P for acetone extract of roots and 0.871 ± 0.401 mg EQ/100g P for methanol extract of leaves);total polyphenols (23.298 ± 12.68 mg EAG/100g P for acetone extract of roots and 24.69 ± 0.49 401 mg EAG/100g P for methanol extract of leaves);total monomeric anthocyanins (44.697 ± 0.939 mg EC3G/100g P and 16.699 ± 0.193 mg EC3G/100g P respectively for acetone and methanol extracts of stem bark). DPPH free radical scavenging activity was 1.674 ± 0.023 mg/mL for the acetone extract and 0.934 ± 0.24 mg/mL for the methanol extract of roots. .展开更多
This study aims to provide a quantitative basis for the precision emission reduction of land-based total nitrogen(TN)pollutants in Laizhou Bay(LZB),China.The total maximum allocated load(TMAL)of TN pollutants within j...This study aims to provide a quantitative basis for the precision emission reduction of land-based total nitrogen(TN)pollutants in Laizhou Bay(LZB),China.The total maximum allocated load(TMAL)of TN pollutants within jurisdictions around LZB was calculated using the stepwise simulation-optimization model after the division of source units,simulation of the concentration response matrix,setting of the additional constraint conditions for stepwise source units,and calculation of TMAL.The load reduction allocation system for jurisdictions can be constructed on the basis of the TMAL and the load monitored or statistics.The index system for TN emission reduction included indices for two groups:a fixed index of marine emission reduction rate for jurisdictions,which was 11.93%on average;and threshold indices of pollution prevention rate at sources,the increment rate of pollution removal by municipal sewage treatment systems,and watershed retention of jurisdictions,which were 7.43%,1.58%,and 1.09%on average,respectively.Efficiency of pollutant reduction can be evaluated using a 3D hydrodynamic-water quality model.Simulation results showed that the precise reduction indicators achieved the seawater quality improvement target of LZB 5 years earlier than the equal proportion reduction indicators currently used in LZB Basin.展开更多
The purpose of this study is to investigate the physicochemical properties of some local varieties of onion (Allium cepa L.) and compare them with an imported variety, all collected in May 2021. Proteins, reducing sug...The purpose of this study is to investigate the physicochemical properties of some local varieties of onion (Allium cepa L.) and compare them with an imported variety, all collected in May 2021. Proteins, reducing sugars, lipids, and polyphenol content were estimated according to the AFNOR standardized methods. The determination of calcium, magnesium, iron, sodium, potassium and phosphorus was performed by atomic absorption spectrophotometer coupled with a CCD detector. The results highlighted an average acidity of 0.377% ± 0.002% lower than the value of the imported variety which is 0.520% ± 0.001%. Local varieties have a pH ranging from 6.35 ± 0.003 to 6.42 ± 0.004, while the variety has a pH of 6.36 ± 0.003. The ash and dry matter contents vary respectively from 4.788% ± 0.004% to 8.253% ± 0.003% and 7.945% ± 0.021% to 11.945% ± 0.007% for the local varieties. Moreover, the imported one has ash and dry matter contents of 5.175% ± 0.007% and 10.035% ± 0.021% respectively. The results show that the protein, reducing sugar and lipid contents in the local onion varieties vary respectively from 2.815 ± 0.000 to 15.634 ± 0.001 g·100 g<sup>-1</sup>;4.691 ± 0.001 to 12.596 ± 0.002 g·100 g<sup>-1</sup> and 0.006 ± 0.001 to 0.050 ± 0.057 g·100 g<sup>-1</sup>. Furthermore, the imported variety has a protein, reducing sugar and lipid content of 5.649 ± 0.002;8.565 ± 0.002 g·100 g<sup>-1</sup> and 0.011 ± 0.010 g·100 g<sup>-1</sup> respectively. The maximum levels of total polyphenols are obtained in the imported variety, Bellani and Gandiol, respectively 9.973 ± 0.001, 4.535 ± 0.002, and 3.425 ± 0.006 mg EAG/g of dry matter. The local varieties have a significant calorific intake of between 35.451 ± 0.001 and 112.980 ± 0.003 kcal·100 g<sup>-1</sup> compared to the imported one with an energy value of 56.953 ± 0.001 kcal·100 g<sup>-1</sup> of dry matter. The bulbs of different onion varieties studied have a fairly high content of mineral elements. The potassium content of local varieties is between 502.16 ± 0.06 mg·100 g<sup>-1</sup> and 582.77 ± 0.04 mg·100 g<sup>-1</sup> while the imported variety has a content of 536.62 ± 1.30 mg·100 g<sup>-1</sup>. They note that the local varieties have a better calcium content (249.75 ± 0.07 to 434.20 ± 0.57 mg·100 g<sup>-1</sup>) and magnesium (142.15 ± 0.07 to 162.60 ± 0.42 mg·100 g<sup>-1</sup>) than the imported variety (229.58 ± 0.04 mg·100 g<sup>-1</sup>) except for the varieties White Grano (228.29 ± 0.01 mg·100 g<sup>-1</sup>) and Rouge Amposta (117.00 ± 0.42 mg·100 g<sup>-1</sup>) respectively. These results reveal that Gandiol, Dayo and Orient F1 are nutritionally found better due to their higher antioxidant property, proteins, carbohydrates, and reducing sugar and should be included in diets to supplement our daily allowance needed by the body.展开更多
It is interesting yet nontrivial to achieve given control precision within user-assignable time for uncertain nonlinear systems.The underlying problem becomes even more challenging if the transient behavior also needs...It is interesting yet nontrivial to achieve given control precision within user-assignable time for uncertain nonlinear systems.The underlying problem becomes even more challenging if the transient behavior also needs to be accommodated and only system output is available for feedback.Several key design innovations are proposed to circumvent the aforementioned technical difficulties,including the employment of state estimation filters with event-triggered mechanism,the construction of a novel performance scaling function and an error transformation.In contrast to most existing performance based works where the stability is contingent on initial conditions and the maximum allowable steady-state tracking precision can only be guaranteed at some unknown(theoretically infinite)time,in this work the output of the system is ensured to synchronize with the desired trajectory with arbitrarily pre-assignable convergence rate and arbitrarily pre-specified precision within prescribed time,using output only with lower cost of sensing and communication.In addition,all the closed-loop signals are ensured to be globally uniformly bounded under the proposed control method.The merits of the designed control scheme are confirmed by numerical simulation on a ship model.展开更多
BACKGROUND With the increasing incidence of total joint arthroplasty(TJA),there is a desire to reduce peri-operative complications and resource utilization.As degenerative conditions progress in multiple joints,many p...BACKGROUND With the increasing incidence of total joint arthroplasty(TJA),there is a desire to reduce peri-operative complications and resource utilization.As degenerative conditions progress in multiple joints,many patients undergo multiple proce-dures.AIM To determine if both physicians and patients learn from the patient’s initial arth-roplasty,resulting in improved outcomes following the second procedure.METHODS The institutional database was retrospectively queried for primary total hip arth-roplasty(THA)and total knee arthroplasty(TKA).Patients with only unilateral THA or TKA,and patients undergoing same-day bilateral TJA,were excluded.Patient demographics,comorbidities,and implant sizes were collected at the time of each procedure and patients were stratified by first vs second surgery.Outcome metrics evaluated included operative time,length of stay(LOS),disposition,90-d readmissions and emergency department(ED)visits.RESULTS A total of 642 patients,including 364 undergoing staged bilateral TKA and 278 undergoing bilateral THA,were analyzed.There was no significant difference in demographics or comorbidities between the first and second procedure,which were separated by a mean of 285 d.For THA and TKA,LOS was significantly less for the second surgery,with 66%of patients having a shorter hospitalization(P<0.001).THA patients had significantly decreased operative time only when the same sized implant was utilized(P=0.025).The vast majority(93.3%)of patients were discharged to the same type of location following their second surgery.However,when a change in disposition was present from the first surgery,patients were significantly more likely to be discharged to home after the second procedure(P=0.033).There was no difference between procedures for post-operative readmissions(P=0.438)or ED visits(P=0.915).CONCLUSION After gaining valuable experience recovering from the initial surgery,a patient’s perioperative outcomes are improved for their second TJA.This may be the result of increased confidence and decreased anxiety,and it supports the theory that enhanced patient education pre-operatively may improve outcomes.For the surgical team,the second procedure of a staged THA is more efficient,although this finding did not hold for TKA.展开更多
BACKGROUND The totally preperitoneal(TPP)approach is a new concept that was recently introduced.Although the TPP approach combined with single-incision laparoscopic hernia repair has its own advantages,there is little...BACKGROUND The totally preperitoneal(TPP)approach is a new concept that was recently introduced.Although the TPP approach combined with single-incision laparoscopic hernia repair has its own advantages,there is little evidence reflecting the characteristics and feasibility of either approach.AIM To analyze the potential applications of single-incision laparoscopic TPP(SILTPP)inguinal hernia hernioplasty for the treatment of inguinal hernias.METHODS A total of 152 SIL-TPP surgeries were performed at the First Affiliated Hospital of Ningbo University from February 2019 to November 2022.A single-port,named Iconport,and standard laparoscopic instruments were used during the operation.Demographic data,intraoperative parameters and short-term postoperative outcomes were collected and retrospectively analyzed.RESULTS The demographic data of 152 patients underwent SIL-TPP were shown in Table 1.The average age was 49.5 years(range from 21 to 81 years).The average body mass index was 27.7 kg/m^(2)(range from 17.7 kg/m^(2) to 35.6 kg/m^(2)).SIL-TPP were conducted successfully in 147 patients.Three patients were converted to the SILtransabdominal preperitoneal laparoscopic herniorrhaphy at the initial stage of the study due to a lack of experience.In 2 patients with incisional hernias,an auxiliary operation hole was added during the SIL-TPP procedure,as required for surgery.The mean operative time was 64.5 minutes(range:36.0-110.0 minutes)for unilateral direct and femoral hernias and 81.6 minutes for indirect hernias(range:40.0-150.0 minutes).The mean postoperative hospital stay was 3.4 days.CONCLUSION SIL-TPP is feasible and has advantages for inguinal hernia repair.SIL-TPP has potential benefits for patients with various abdominal wall hernias.Consequently,doctors should be encouraged to actively apply the TPP approach combined with a single incision in their daily work.展开更多
基金Supported by Science and Technology Research Project of Guangxi University(2013LX143)
文摘Gross agricultural product is an important indication to measure the agricultural development level of a region. It would be affected by many factors,having the characteristics of non- linearity. For this reason,LM- BP neural network was put forward as the model and method for predicting gross agricultural product. Taking the indications of the sown area of crop,the output of grain,sugarcane,cassava,tea,meat,aquatic products,turpentine and camellia seed,etc. as inputs,during 2000 to 2012 in Guangxi,the gross agricultural product data from the analysis of simulation experiment show that the prediction of LM- BP neural network fits well with actual results.
文摘The aim of the present study was to compare the effects of colloid and crystalloid preload on cardiac output (CO) and incidence of hypotension in elderly patients under spinal anesthesia (SA). A randomized, double-blinded study was conducted including 47 elderly patients undergoing scheduled total hip replacement (THR), who were randomized to three groups: the control group (C group, n = 15), crystalloid (RS group, n =16) and colloid group (HES group, n = 16). An intravenous preload of 8 mL/kg of either lactated Ringer’s solution in the RS group or 6% hydroxyethyl starch in the HES group was infused within 20 min before SA induction, while no intravenous preload was given in the C group. There was a trend of decrease in CO and systolic blood pressure after SA with time in the C group. In the RS and HES groups, CO increased significantly after fluid preloading as compared with baseline (P 0.01). Thereafter, CO remained higher than baseline until 30 min after SA in the HES group. The change of systolic blood pressure was similar to CO, but no significant difference from baseline was observed in each group. Hypotension occurred in 3 patients in the C group and one each in the RS and HES group, respec-tively (P = 0.362). Intravascular volume preload with colloid is more effective than crystalloid solution in main-taining CO, which may be improved the hemodynamic stability in elderly patients during SA.
基金Project supported by Shanghai Municipal Natural Science Foundation,China(Grant No.15ZR1447100)
文摘Total ionizing dose induced single transistor latchup effects for 130 nm partially depleted silicon-on-insulator (PDSOI) NMOSFETs with the bodies floating were studied in this work. The latchup phenomenon strongly correlates with the bias configuration during irradiation. It is found that the high body doping concentration can make the devices less sensitive to the single transistor latchup effect, and the onset drain voltage at which latchup occurs can degrade as the total dose level rises. The mechanism of band-to-band tunneling (BBT) has been discussed. Two-dimensional simulations were conducted to evaluate the BBT effect. It is demonstrated that BBT combined with the positive trapped charge in the buried oxide (BOX) contributes a lot to the latchup effect.
文摘Input/output devices for flash memory are exposed to gamma ray irradiation. Total ionizing dose has been shown great influence on characteristic degradation of transistors with different sizes. In this paper, we observed a larger increase of off-state leakage in the short channel device than in long one. However, a larger threshold voltage shift is observed for the narrow width device than for the wide one, which is well known as the radiation induced narrow channel effect. The radiation induced charge in the shallow trench isolation oxide influences the electric field of the narrow channel device. Also, the drain bias dependence of the off-state leakage after irradiation is observed, which is called the radiation enhanced drain induced barrier lowing effect. Finally, we found that substrate bias voltage can suppress the off-state leakage, while leading to more obvious hump effect.
文摘In order to realize the accurate prediction of the total output value of construction industry in the future,the grey prediction model is used to compare the measured value with the predicted value from 2012 to 2021,and based on the existing data,the total output value of construction industry in Jiangxi Province in the next five years is predicted.The results show that the grey prediction model has a good prediction effect,and the error between the predicted value and the measured value is within 14%,which provides a basis for policy adjustment and resource optimization.
文摘BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications of hip approaches remains inconclusive.This study conducted an umbrella review to systematically appraise previous meta-analysis(MAs)including conventional posterior approach(PA),and minimally invasive surgeries as the lateral approach(LA),direct anterior approach(DAA),2-incisions method,mini-lateral approach and the newest technique direct superior approach(DSA)or supercapsular percutaneouslyassisted total hip(SuperPath).AIM To compare the efficacy and complications of hip approaches that have been published in all MAs and randomized controlled trials(RCTs).METHODS MAs were identified from MEDLINE and Scopus from inception until 2023.RCTs were then updated from the latest MA to September 2023.This study included studies which compared hip approaches and reported at least one outcome such as Harris Hip Score(HHS),dislocation,intra-operative fracture,wound compliData were independently selected,extracted and assessed by two reviewers.Network MA and cluster rank and surface under the cumulative ranking curve(SUCRA)were estimated for treatment efficacy and safety.RESULTS Finally,twenty-eight MAs(40 RCTs),and 13 RCTs were retrieved.In total 47 RCTs were included for reanalysis.The results of corrected covered area showed high degree(13.80%).Among 47 RCTs,most of the studies were low risk of bias in part of random process and outcome reporting,while other domains were medium to high risk of bias.DAA significantly provided higher HHS at three months than PA[pooled unstandardized mean difference(USMD):3.49,95%confidence interval(CI):0.98,6.00 with SUCRA:85.9],followed by DSA/SuperPath(USMD:1.57,95%CI:-1.55,4.69 with SUCRA:57.6).All approaches had indifferent dislocation and intraoperative fracture rates.SUCRA comparing early functional outcome and composite complications(dislocation,intra-operative fracture,wound complication,and nerve injury)found DAA was the best approach followed by DSA/SuperPath.CONCLUSION DSA/SuperPath had better earlier functional outcome than PA,but still could not overcome the result of DAA.This technique might be the other preferred option with acceptable complications.
基金supported in part by the National Natural Science Foundation of China (62103093)the National Key Research and Development Program of China (2022YFB3305905)+6 种基金the Xingliao Talent Program of Liaoning Province of China (XLYC2203130)the Fundamental Research Funds for the Central Universities of China (N2108003)the Natural Science Foundation of Liaoning Province (2023-MS-087)the BNU Talent Seed Fund,UIC Start-Up Fund (R72021115)the Guangdong Key Laboratory of AI and MM Data Processing (2020KSYS007)the Guangdong Provincial Key Laboratory IRADS for Data Science (2022B1212010006)the Guangdong Higher Education Upgrading Plan 2021–2025 of “Rushing to the Top,Making Up Shortcomings and Strengthening Special Features” with UIC Research,China (R0400001-22,R0400025-21)。
文摘The problem of prescribed performance tracking control for unknown time-delay nonlinear systems subject to output constraints is dealt with in this paper. In contrast with related works, only the most fundamental requirements, i.e., boundedness and the local Lipschitz condition, are assumed for the allowable time delays. Moreover, we focus on the case where the reference is unknown beforehand, which renders the standard prescribed performance control designs under output constraints infeasible. To conquer these challenges, a novel robust prescribed performance control approach is put forward in this paper.Herein, a reverse tuning function is skillfully constructed and automatically generates a performance envelop for the tracking error. In addition, a unified performance analysis framework based on proof by contradiction and the barrier function is established to reveal the inherent robustness of the control system against the time delays. It turns out that the system output tracks the reference with a preassigned settling time and good accuracy,without constraint violations. A comparative simulation on a two-stage chemical reactor is carried out to illustrate the above theoretical findings.
基金supported by the National Natural Science Foundation of China under Grant 62034002 and 62374026.
文摘A frequency servo system-on-chip(FS-SoC)featuring output power stabilization technology is introduced in this study for high-precision and miniaturized cesium(Cs)atomic clocks.The proposed power stabilization loop(PSL)technique,incorporating an off-chip power detector(PD),ensures that the output power of the FS-SoC remains stable,mitigating the impact of power fluctuations on the atomic clock's stability.Additionally,a one-pulse-per-second(1PPS)is employed to syn-chronize the clock with GPS.Fabricated using 65 nm CMOS technology,the measured phase noise of the FS-SoC stands at-69.5 dBc/Hz@100 Hz offset and-83.9 dBc/Hz@1 kHz offset,accompanied by a power dissipation of 19.7 mW.The Cs atomic clock employing the proposed FS-SoC and PSL obtains an Allan deviation of 1.7×10^(-11) with 1-s averaging time.
基金Supported by the Capital Fund Project for Clinical Diagnosis and Treatment Technology Research and Translational Application,No.Z201100005520091and Beijing Traditional Chinese Medicine Science and Technology Development Fund Project,No.JJ-2020-67.
文摘BACKGROUND Total knee arthroplasty(TKA)is a mature procedure recommended for correcting knee osteoarthritis deformity,relieving pain,and restoring normal biomechanics.Although TKA is a successful and cost-effective procedure,patient dissatisfaction is as high as 50%.Knee pain after TKA is a significant cause of patient dissatisfaction;the most common location for residual pain is the anterior region.Between 4%and 40%of patients have anterior knee pain(AKP).AIM To investigate the effect of various TKA procedures on postoperative AKP.METHODS We searched PubMed,EMBASE,and Cochrane from January 2000 to September 2022.Randomized controlled trials with one intervention in the experimental group and no corresponding intervention(or other interventions)in the control group were collected.Two researchers independently read the title and abstract of the studies,preliminarily screened the articles,and read the full text in detail according to the selection criteria.Conflicts were resolved by consultation with a third researcher.And relevant data from the included studies were extracted and analyzed using Review Manager 5.4 software.RESULTS There were 25 randomized controlled trials;13 were comparative studies with or without patellar resurfacing.The meta-analysis showed no significant difference between the experimental and control groups(P=0.61).Six studies were comparative studies of circumpatellar denervation vs non-denervation,divided into three subgroups for meta-analysis.The two-subgroup meta-analysis showed no significant difference between the experimental and the control groups(P=0.31,P=0.50).One subgroup meta-analysis showed a significant difference between the experimental and control groups(P=0.001).Two studies compared fixed-bearing TKA and mobile-bearing TKA;the results meta-analysis showed no significant difference between the experimental and control groups(P=0.630).Two studies compared lateral retinacular release vs non-release;the meta-analysis showed a significant difference between the experimental and control groups(P=0.002);two other studies compared other factors.CONCLUSION Patellar resurfacing,mobile-bearing TKA,and fixed-bearing TKA do not reduce the incidence of AKP.Lateral retinacular release can reduce AKP;however,whether circumpatellar denervation can reduce AKP is controversial.
基金Supported by The National Institutes of Health,No.R01HL147155 and No.R01AG060920.
文摘BACKGROUND There is concern regarding potential long-term cardiotoxicity with systemic distribution of metals in total joint arthroplasty(TJA)patients.AIM To determine the association of commonly used implant metals with echocardiographic measures in TJA patients.METHODS The study comprised 110 TJA patients who had a recent history of high chromium,cobalt or titanium concentrations.Patients underwent two-dimensional,three-dimensional,Doppler and speckle-strain transthoracic echocardiography and a blood draw to measure metal concentrations.Age and sex-adjusted linear and logistic regression models were used to examine the association of metal concentrations(exposure)with echocardiographic measures(outcome).RESULTS Higher cobalt concentrations were associated with increased left ventricular end-diastolic volume(estimate 5.09;95%CI:0.02-10.17)as well as left atrial and right ventricular dilation,particularly in men but no changes in cardiac function.Higher titanium concentrations were associated with a reduction in left ventricle global longitudinal strain(estimate 0.38;95%CI:0.70 to 0.06)and cardiac index(estimate 0.08;95%CI,-0.15 to-0.01).CONCLUSION Elevated cobalt and titanium concentrations may be associated with structural and functional cardiac changes in some patients.Longitudinal studies are warranted to better understand the systemic effects of metals in TJA patients.
文摘Total hip arthroplasty(THA)is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint disease.However,dislocation continues to be a troublesome complication after THA,as it is a leading cause of revision and is associated with substantial social,health,and economic costs.It is a relatively rare,usually early occurrence that depends on both the patients’characteristics and the surgical aspects.The most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility,which is closely related to the incidence of dislocation.Consequently,clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the cup.Lumbar spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after THA.Surgical options for its treatment and prevention include the use of prostheses with large diameter of femoral head size,dual mobility constructs,constrained liners,and modular neck stems.
基金supported by the National Science Fund for Distinguished Young Scholars (62225303)the Fundamental Research Funds for the Central Universities (buctrc202201)+1 种基金China Scholarship Council,and High Performance Computing PlatformCollege of Information Science and Technology,Beijing University of Chemical Technology。
文摘In order to address the output feedback issue for linear discrete-time systems, this work suggests a brand-new adaptive dynamic programming(ADP) technique based on the internal model principle(IMP). The proposed method, termed as IMP-ADP, does not require complete state feedback-merely the measurement of input and output data. More specifically, based on the IMP, the output control problem can first be converted into a stabilization problem. We then design an observer to reproduce the full state of the system by measuring the inputs and outputs. Moreover, this technique includes both a policy iteration algorithm and a value iteration algorithm to determine the optimal feedback gain without using a dynamic system model. It is important that with this concept one does not need to solve the regulator equation. Finally, this control method was tested on an inverter system of grid-connected LCLs to demonstrate that the proposed method provides the desired performance in terms of both tracking and disturbance rejection.
文摘Parkinson’s disease(PD)is a common neurodegenerative disorder with no cure.Astragalus membranaceus is used in Chinese culture as a food supplement to boost immunity.The present study aimed to explore the neuroprotective effects of total flavonoids extracted from A.membranaceus(TFA)and their protective mechanisms.TFA offered neuroprotection against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)in the mouse model of Parkinsonism,by improving behavior performance in the gait analysis and pole test,and inhibiting the decline of tyrosine hydroxylase(TH)positive neurons and TH protein expression in substantia nigra of mice.TFA also prevented 1-methyl-4-phenylpyridinium(MPP+)induced neurotoxicity in SHSY5Y cells,by increasing GSH and GSH/GSSG ratio,and reducing reactive oxygen species.In addition,the neuroprotective effects of TFA were associated with its ability to restore MPTP/MPP+induced downregulation of SLC7A11 and glutathione peroxidase 4(GPX-4).In conclusion,we demonstrated that TFA exerted significant neuroprotection against MPTP/MPP+induced neurodegeneration by inhibiting ferroptosis through the regulation of SLC7A11/GPX-4 axis,suggesting the use of TFA as a possible food supplement in the prevention of PD.
基金Supported by School-level Natural Science Project of Jiangxi University of Technology(232ZRYB02).
文摘The high-quality development of the construction industry fundamentally stems from the significant improvement of total factor productivity.Therefore,it is of crucial significance for promoting the development of the construction industry to a higher level by scientifically and accurately measuring the total factor productivity of the construction industry and deeply analyzing the influencing factors behind it.Based on a comprehensive consideration of research methods and influencing factors,this paper systematically reviews the existing relevant literature on total factor productivity in the construction industry,aiming to reveal the current research development trend in this field and point out potential problems.This effort aims to provide a solid theoretical foundation and valuable reference for further in-depth research,and jointly promote the continuous progress and development of total factor productivity research in the construction industry.
文摘The aim of the present work is to assess the value of Detarium Senegalense by determining the content of total phenols, total flavonoids and total anthocyanins, and by evaluating the free radical scavenging activity of Detarium Senegalense extracts. For this purpose, sequential extraction using solvents of increasing polarity was essential. The various extracts obtained underwent phytochemical and biochemical analyses. Phytochemical screening revealed the presence of flavonoids, alkaloids, tannins, polyphenols, anthocyanins and steroids/terpenes. Quantitative analysis of total polyphenols, total flavonoids and total anthocyanins yielded the following results: total flavonoids (0.803 ± 0029 mg EQ/100g P for acetone extract of roots and 0.871 ± 0.401 mg EQ/100g P for methanol extract of leaves);total polyphenols (23.298 ± 12.68 mg EAG/100g P for acetone extract of roots and 24.69 ± 0.49 401 mg EAG/100g P for methanol extract of leaves);total monomeric anthocyanins (44.697 ± 0.939 mg EC3G/100g P and 16.699 ± 0.193 mg EC3G/100g P respectively for acetone and methanol extracts of stem bark). DPPH free radical scavenging activity was 1.674 ± 0.023 mg/mL for the acetone extract and 0.934 ± 0.24 mg/mL for the methanol extract of roots. .
基金the fund provided by the Basic Scientific Research Funds of Dalian University of Technology(No.DUT21RC(3)035)the Open Funds of Key Laboratory of Estuarine and Coastal Environment(No.HKHA2022001)。
文摘This study aims to provide a quantitative basis for the precision emission reduction of land-based total nitrogen(TN)pollutants in Laizhou Bay(LZB),China.The total maximum allocated load(TMAL)of TN pollutants within jurisdictions around LZB was calculated using the stepwise simulation-optimization model after the division of source units,simulation of the concentration response matrix,setting of the additional constraint conditions for stepwise source units,and calculation of TMAL.The load reduction allocation system for jurisdictions can be constructed on the basis of the TMAL and the load monitored or statistics.The index system for TN emission reduction included indices for two groups:a fixed index of marine emission reduction rate for jurisdictions,which was 11.93%on average;and threshold indices of pollution prevention rate at sources,the increment rate of pollution removal by municipal sewage treatment systems,and watershed retention of jurisdictions,which were 7.43%,1.58%,and 1.09%on average,respectively.Efficiency of pollutant reduction can be evaluated using a 3D hydrodynamic-water quality model.Simulation results showed that the precise reduction indicators achieved the seawater quality improvement target of LZB 5 years earlier than the equal proportion reduction indicators currently used in LZB Basin.
文摘The purpose of this study is to investigate the physicochemical properties of some local varieties of onion (Allium cepa L.) and compare them with an imported variety, all collected in May 2021. Proteins, reducing sugars, lipids, and polyphenol content were estimated according to the AFNOR standardized methods. The determination of calcium, magnesium, iron, sodium, potassium and phosphorus was performed by atomic absorption spectrophotometer coupled with a CCD detector. The results highlighted an average acidity of 0.377% ± 0.002% lower than the value of the imported variety which is 0.520% ± 0.001%. Local varieties have a pH ranging from 6.35 ± 0.003 to 6.42 ± 0.004, while the variety has a pH of 6.36 ± 0.003. The ash and dry matter contents vary respectively from 4.788% ± 0.004% to 8.253% ± 0.003% and 7.945% ± 0.021% to 11.945% ± 0.007% for the local varieties. Moreover, the imported one has ash and dry matter contents of 5.175% ± 0.007% and 10.035% ± 0.021% respectively. The results show that the protein, reducing sugar and lipid contents in the local onion varieties vary respectively from 2.815 ± 0.000 to 15.634 ± 0.001 g·100 g<sup>-1</sup>;4.691 ± 0.001 to 12.596 ± 0.002 g·100 g<sup>-1</sup> and 0.006 ± 0.001 to 0.050 ± 0.057 g·100 g<sup>-1</sup>. Furthermore, the imported variety has a protein, reducing sugar and lipid content of 5.649 ± 0.002;8.565 ± 0.002 g·100 g<sup>-1</sup> and 0.011 ± 0.010 g·100 g<sup>-1</sup> respectively. The maximum levels of total polyphenols are obtained in the imported variety, Bellani and Gandiol, respectively 9.973 ± 0.001, 4.535 ± 0.002, and 3.425 ± 0.006 mg EAG/g of dry matter. The local varieties have a significant calorific intake of between 35.451 ± 0.001 and 112.980 ± 0.003 kcal·100 g<sup>-1</sup> compared to the imported one with an energy value of 56.953 ± 0.001 kcal·100 g<sup>-1</sup> of dry matter. The bulbs of different onion varieties studied have a fairly high content of mineral elements. The potassium content of local varieties is between 502.16 ± 0.06 mg·100 g<sup>-1</sup> and 582.77 ± 0.04 mg·100 g<sup>-1</sup> while the imported variety has a content of 536.62 ± 1.30 mg·100 g<sup>-1</sup>. They note that the local varieties have a better calcium content (249.75 ± 0.07 to 434.20 ± 0.57 mg·100 g<sup>-1</sup>) and magnesium (142.15 ± 0.07 to 162.60 ± 0.42 mg·100 g<sup>-1</sup>) than the imported variety (229.58 ± 0.04 mg·100 g<sup>-1</sup>) except for the varieties White Grano (228.29 ± 0.01 mg·100 g<sup>-1</sup>) and Rouge Amposta (117.00 ± 0.42 mg·100 g<sup>-1</sup>) respectively. These results reveal that Gandiol, Dayo and Orient F1 are nutritionally found better due to their higher antioxidant property, proteins, carbohydrates, and reducing sugar and should be included in diets to supplement our daily allowance needed by the body.
基金supported in part by the National Natural Science Foundation of China(61933012,62273064,61991400,61991403,62250710167,61860206008,62203078)the National Key Research and Development Program of China(2023YFA1011803)+2 种基金the Natural Science Foundation of Chongqing(CSTB2023NSCQ-MSX0588)the Innovation Support Program for Inter national Students Returning to China(cx2022016)the Central University Project(2022CDJKYJH019).
文摘It is interesting yet nontrivial to achieve given control precision within user-assignable time for uncertain nonlinear systems.The underlying problem becomes even more challenging if the transient behavior also needs to be accommodated and only system output is available for feedback.Several key design innovations are proposed to circumvent the aforementioned technical difficulties,including the employment of state estimation filters with event-triggered mechanism,the construction of a novel performance scaling function and an error transformation.In contrast to most existing performance based works where the stability is contingent on initial conditions and the maximum allowable steady-state tracking precision can only be guaranteed at some unknown(theoretically infinite)time,in this work the output of the system is ensured to synchronize with the desired trajectory with arbitrarily pre-assignable convergence rate and arbitrarily pre-specified precision within prescribed time,using output only with lower cost of sensing and communication.In addition,all the closed-loop signals are ensured to be globally uniformly bounded under the proposed control method.The merits of the designed control scheme are confirmed by numerical simulation on a ship model.
文摘BACKGROUND With the increasing incidence of total joint arthroplasty(TJA),there is a desire to reduce peri-operative complications and resource utilization.As degenerative conditions progress in multiple joints,many patients undergo multiple proce-dures.AIM To determine if both physicians and patients learn from the patient’s initial arth-roplasty,resulting in improved outcomes following the second procedure.METHODS The institutional database was retrospectively queried for primary total hip arth-roplasty(THA)and total knee arthroplasty(TKA).Patients with only unilateral THA or TKA,and patients undergoing same-day bilateral TJA,were excluded.Patient demographics,comorbidities,and implant sizes were collected at the time of each procedure and patients were stratified by first vs second surgery.Outcome metrics evaluated included operative time,length of stay(LOS),disposition,90-d readmissions and emergency department(ED)visits.RESULTS A total of 642 patients,including 364 undergoing staged bilateral TKA and 278 undergoing bilateral THA,were analyzed.There was no significant difference in demographics or comorbidities between the first and second procedure,which were separated by a mean of 285 d.For THA and TKA,LOS was significantly less for the second surgery,with 66%of patients having a shorter hospitalization(P<0.001).THA patients had significantly decreased operative time only when the same sized implant was utilized(P=0.025).The vast majority(93.3%)of patients were discharged to the same type of location following their second surgery.However,when a change in disposition was present from the first surgery,patients were significantly more likely to be discharged to home after the second procedure(P=0.033).There was no difference between procedures for post-operative readmissions(P=0.438)or ED visits(P=0.915).CONCLUSION After gaining valuable experience recovering from the initial surgery,a patient’s perioperative outcomes are improved for their second TJA.This may be the result of increased confidence and decreased anxiety,and it supports the theory that enhanced patient education pre-operatively may improve outcomes.For the surgical team,the second procedure of a staged THA is more efficient,although this finding did not hold for TKA.
文摘BACKGROUND The totally preperitoneal(TPP)approach is a new concept that was recently introduced.Although the TPP approach combined with single-incision laparoscopic hernia repair has its own advantages,there is little evidence reflecting the characteristics and feasibility of either approach.AIM To analyze the potential applications of single-incision laparoscopic TPP(SILTPP)inguinal hernia hernioplasty for the treatment of inguinal hernias.METHODS A total of 152 SIL-TPP surgeries were performed at the First Affiliated Hospital of Ningbo University from February 2019 to November 2022.A single-port,named Iconport,and standard laparoscopic instruments were used during the operation.Demographic data,intraoperative parameters and short-term postoperative outcomes were collected and retrospectively analyzed.RESULTS The demographic data of 152 patients underwent SIL-TPP were shown in Table 1.The average age was 49.5 years(range from 21 to 81 years).The average body mass index was 27.7 kg/m^(2)(range from 17.7 kg/m^(2) to 35.6 kg/m^(2)).SIL-TPP were conducted successfully in 147 patients.Three patients were converted to the SILtransabdominal preperitoneal laparoscopic herniorrhaphy at the initial stage of the study due to a lack of experience.In 2 patients with incisional hernias,an auxiliary operation hole was added during the SIL-TPP procedure,as required for surgery.The mean operative time was 64.5 minutes(range:36.0-110.0 minutes)for unilateral direct and femoral hernias and 81.6 minutes for indirect hernias(range:40.0-150.0 minutes).The mean postoperative hospital stay was 3.4 days.CONCLUSION SIL-TPP is feasible and has advantages for inguinal hernia repair.SIL-TPP has potential benefits for patients with various abdominal wall hernias.Consequently,doctors should be encouraged to actively apply the TPP approach combined with a single incision in their daily work.