The reliable operation of high-speed wire rod finishing mills is crucial in the steel production enterprise.As complex system-level equipment,it is difficult for high-speed wire rod finishing mills to realize fault lo...The reliable operation of high-speed wire rod finishing mills is crucial in the steel production enterprise.As complex system-level equipment,it is difficult for high-speed wire rod finishing mills to realize fault location and real-time monitoring.To solve the above problems,an expert experience and data-driven-based hybrid fault diagnosis method for high-speed wire rod finishing mills is proposed in this paper.First,based on its mechanical structure,time and frequency domain analysis are improved in fault feature extraction.The approach of combining virtual value,peak value with kurtosis value index,is adopted in time domain analysis.Speed adjustment and side frequency analysis are proposed in frequency domain analysis to obtain accurate component characteristic frequency and its corresponding sideband.Then,according to time and frequency domain characteristics,fault location based on expert experience is proposed to get an accurate fault result.Finally,the proposed method is implemented in the equipment intelligent diagnosis system.By taking an equipment fault on site,for example,the effectiveness of the proposed method is illustrated in the system.展开更多
Reducing the control error is vital for high-fidelity digital and analog quantum operations.In superconducting circuits,one disagreeable error arises from the reflection of microwave signals due to impedance mismatch ...Reducing the control error is vital for high-fidelity digital and analog quantum operations.In superconducting circuits,one disagreeable error arises from the reflection of microwave signals due to impedance mismatch in the control chain.Here,we demonstrate a reflection cancelation method when considering that there are two reflection nodes on the control line.We propose to generate the pre-distortion pulse by passing the envelopes of the microwave signal through digital filters,which enables real-time reflection correction when integrated into the field-programmable gate array(FPGA).We achieve a reduction of single-qubit gate infidelity from 0.67%to 0.11%after eliminating microwave reflection.Real-time correction of microwave reflection paves the way for precise control and manipulation of the qubit state and would ultimately enhance the performance of algorithms and simulations executed on quantum processors.展开更多
Acoustic reflection imaging logging technology can detect and evaluate the development of reflection anomalies,such as fractures,caves and faults,within a range of tens of meters from the wellbore,greatly expanding th...Acoustic reflection imaging logging technology can detect and evaluate the development of reflection anomalies,such as fractures,caves and faults,within a range of tens of meters from the wellbore,greatly expanding the application scope of well logging technology.This article reviews the development history of the technology and focuses on introducing key methods,software,and on-site applications of acoustic reflection imaging logging technology.Based on the analyses of major challenges faced by existing technologies,and in conjunction with the practical production requirements of oilfields,the further development directions of acoustic reflection imaging logging are proposed.Following the current approach that utilizes the reflection coefficients,derived from the computation of acoustic slowness and density,to perform seismic inversion constrained by well logging,the next frontier is to directly establish the forward and inverse relationships between the downhole measured reflection waves and the surface seismic reflection waves.It is essential to advance research in imaging of fractures within shale reservoirs,the assessment of hydraulic fracturing effectiveness,the study of geosteering while drilling,and the innovation in instruments of acoustic reflection imaging logging technology.展开更多
During spacecraft re-entry,the challenge of measuring plasma sheath parameters directly contributes to difficulties in addressing communication blackout.In this work,we have discovered a phenomenon of multiple peaks i...During spacecraft re-entry,the challenge of measuring plasma sheath parameters directly contributes to difficulties in addressing communication blackout.In this work,we have discovered a phenomenon of multiple peaks in reflection data caused by the inhomogeneous plasma.Simulation results show that the multi-peak points fade away as the characteristic frequency is approached,resembling a series of gradually decreasing peaks.The positions and quantities of these points are positively correlated with electron density,yet they show no relation to collision frequency.This phenomenon is of significant reference value for future studies on the spatial distribution of plasmas,particularly for using microwave reflection signals in diagnosing the plasma sheath.展开更多
Optical reflection anisotropy microscopy mappings of micropipe defects on the surface of a 4H-SiC single crystal are studied by the scanning anisotropy microscopy(SAM)system.The reflection anisotropy(RA)image with a...Optical reflection anisotropy microscopy mappings of micropipe defects on the surface of a 4H-SiC single crystal are studied by the scanning anisotropy microscopy(SAM)system.The reflection anisotropy(RA)image with a'butterfly pattern'is obtained around the micropipes by SAM.The RA image of the edge dislocations is theoretically simulated based on dislocation theory and the photoelastic principle.By comparing with the Raman spectrum,it is verified that the micropipes consist of edge dislocations.The different patterns of the RA images are due to the different orientations of the Burgers vectors.Besides,the strain distribution of the micropipes is also deduced.One can identify the dislocation type,the direction of the Burgers vector and the optical anisotropy from the RA image by using SAM.Therefore,SAM is an ideal tool to measure the optical anisotropy induced by the strain field around a defect.展开更多
Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related ...Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of HIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned HIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University Hospital Centre (CHUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.2.2.6. Results: One hundred and thirteen HIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with HIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .展开更多
At a time when there is a growing public interest in animal welfare,it is critical to have objective means to assess the way that an animal experiences a situation.Objectivity is critical to ensure appropriate animal ...At a time when there is a growing public interest in animal welfare,it is critical to have objective means to assess the way that an animal experiences a situation.Objectivity is critical to ensure appropriate animal welfare outcomes.Existing behavioural,physiological,and neurobiological indicators that are used to assess animal welfare can verify the absence of extremely negative outcomes.But welfare is more than an absence of negative outcomes and an appropriate indicator should reflect the full spectrum of experience of an animal,from negative to positive.In this review,we draw from the knowledge of human biomedical science to propose a list of candidate biological markers(biomarkers)that should reflect the experiential state of non-human animals.The proposed biomarkers can be classified on their main function as endocrine,oxidative stress,non-coding molecular,and thermobiological markers.We also discuss practical challenges that must be addressed before any of these biomarkers can become useful to assess the experience of an animal in real-life.展开更多
Objective:The objective of this study is to comprehensively understand the psychological experience of primiparous women during breastfeeding while dealing with lactating mastitis and to establish a reliable foundatio...Objective:The objective of this study is to comprehensively understand the psychological experience of primiparous women during breastfeeding while dealing with lactating mastitis and to establish a reliable foundation for tailored support measures.Methods:Twenty primiparous mothers from a tertiary hospital in Beijing between January and March 2023 were chosen using purposive sampling for semi-structured interviews.After conducting 20 interviews,data saturation was achieved.The Colaizzi’s seven-step analytical approach was employed to analyze,summarize,and refine the identified themes.Results:Among primiparous women afflicted by lactating mastitis,the primary themes regarding breastfeeding attitudes included three key aspects:(1)uncertainty during the initial diagnosis phase,(2)intricate emotional journey during treatment,and(3)positive psychological outlook during the recovery stage.Conclusion:Primiparous women undergoing lactating mastitis experience substantial physical and psychological strain.It is crucial for medical personnel,family caregivers,and society at large to be attuned to the emotions of these patients.Tailored support measures should be offered to enhance patients’physical and mental well-being and facilitate disease recovery.展开更多
In this study,we focus on the numerical modelling of the interaction between waves and submerged structures in the presence of a uniform flow current.Both the same and opposite senses of wave propagation are considere...In this study,we focus on the numerical modelling of the interaction between waves and submerged structures in the presence of a uniform flow current.Both the same and opposite senses of wave propagation are considered.The main objective is an understanding of the effect of the current and various geometrical parameters on the reflection coefficient.The wave used in the study is based on potential theory,and the submerged structures consist of two rectangular breakwaters positioned at a fixed distance from each other and attached to the bottom of a wave flume.The numerical modeling approach employed in this work relies on the Boundary Element Method(BEM).The results are compared with experimental data to validate the approach.The findings of the study demonstrate that the double rectangular breakwater configuration exhibits superior wave attenuation abilities if compared to a single rectangular breakwater,particularly at low wavenumbers.Furthermore,the study reveals that wave mitigation is more pronounced when the current and wave propagation are coplanar,whereas it is less effective in the case of opposing current.展开更多
Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affectin...Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mother To Child Transmission-HIV service utilization should be prioritized so as to alleviate stigma and enhancing a positive experience for these mothers thus reducing on the Mother to Child HIV Transmission burden and mortality rates.展开更多
BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and...BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.展开更多
Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry...Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry of Health, community tuberculosis care was introduced with the main goal of reducing tuberculosis-related morbidity and mortality among communities through the expansion of direct observed therapy and community involvement to community settings. The community caregivers were to support tuberculosis patients throughout their treatment period until they were cured or had completed their treatment. Settings: Two major cities of Botswana, Francistown and Gaborone, with more than twenty-two health clinics offering tuberculosis care. Objective: To investigate community caregivers’ experiences and identify programmatic strategies to improve active TB case findings under the community TB care (CTBC) program in Botswana during 2016-2021. Methods: We adopted a descriptive qualitative research design, followed by convenience purposive sampling. We obtained consent and interviewed 40 participants who met the inclusion criteria, 16 out of 73 in Gaborone and 24 out of 38 from Francistown. Results: We interviewed 40 caregivers with a mean age of 43.4 years. Accepting the caregiving role was identified as the main experience by more than two thirds of the caregivers. While at least more than two-fifth felt obligated to care for the patient at home due to personal relations. More than half of the respondents found caregiving difficult or frustrating due to some challenges encountered during the caregiving role. Behavioral modifications were suggested under different subthemes as strategies to improve active case finding. [-rId13-]Conclusion: Acceptance was the major experience in CTBC. Intensification of known programmatic strategies was suggested by caregivers to improve tuberculosis active case finding in CTBC.展开更多
Purpose – The vibration of the rails is a significant source of railway rolling noise, often forming the dominantcomponent of noise in the important frequency region between 400 and 2000 Hz. The purpose of the paper ...Purpose – The vibration of the rails is a significant source of railway rolling noise, often forming the dominantcomponent of noise in the important frequency region between 400 and 2000 Hz. The purpose of the paper is toinvestigate the influence of the ground profile and the presence of the train body on the sound radiation fromthe rail.Design/methodology/approach – Two-dimensional boundary element calculations are used, in which therail vibration is the source. The ground profile and various different shapes of train body are introduced in themodel, and results are observed in terms of sound power and sound pressure. Comparisons are also made withvibro-acoustic measurements performed with and without a train present.Findings – The sound radiated by the rail in the absence of the train body is strongly attenuated by shieldingdue to the ballast shoulder. When the train body is present, the sound from the vertical rail motion is reflectedback down toward the track where it is partly absorbed by the ballast. Nevertheless, the sound pressure at thetrackside is increased by typically 0–5 dB. For the lateral vibration of the rail, the effects are much smaller. Oncethe sound power is known, the sound pressure with the train present can be approximated reasonably well withsimple line source directivities.Originality/value – Numerical models used to predict the sound radiation from railway rails have generallyneglected the influence of the ground profile and reflections from the underside of the train body on the soundpower and directivity of the rail. These effects are studied in a systematic way including comparisons with measurements.展开更多
Cultural ancient roads,known in Chinese as gudao,serve as heritage trails that carry historical exchanges across various regions in China.Due to their extensive preservation,wide geographical distribution,diverse them...Cultural ancient roads,known in Chinese as gudao,serve as heritage trails that carry historical exchanges across various regions in China.Due to their extensive preservation,wide geographical distribution,diverse thematic variations,and considerable tourist appeal,these paths have emerged as representative heritage trails,increasingly transforming into a novel tourism product experience that is highly favored by tourists and recognized by government authorities.However,research on ancient roads for tourism in China currently lacks a systematic theoretical framework,as well as relevant policies,regulations,and standards to guide their practical development.Therefore,there is a pressing need to draw upon international best practices and conduct foundational research to develop an experience element system that aligns with the perceptions,behaviors,and consumption characteristics of Chinese tourists,thereby advancing theoretical exploration in this field.This study focuses on the representative Ancient Shu Road as a case study and employs a mixed-method approach that integrates qualitative and quantitative research.It aims to construct a tourist-centric scale for the experience elements of ancient road tourism while analyzing the interactive relationship between these experience elements and tourist needs.This study addresses a significant gap in the development of indicator systems for domestic studies of ancient road tourism experiences.Ultimately,the study establishes a comprehensive scale that encompasses three core categories—trail resources and environment,facilities and services,and modes of tourism activities—along with eight primary dimensions:core resources,surrounding cultural environment,surrounding natural environment,tourism reception facilities and services,infrastructure and support services,information facilities and information services,and outdoor and recreational activities.This scale consists of thirty-two specific items,providing a robust reference for future research endeavors.Additionally,the study proposes specific development strategies related to key mechanisms,spatial configuration,and facility construction to enhance the overall development of ancient road tourism.展开更多
Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell diseas...Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.展开更多
This study evaluated the state of anxiety, depression, post-traumatic stress disorder, general mental health, and mental well-beingamong citizens after a crowd-crush disaster in Korea. Individuals who experienced the ...This study evaluated the state of anxiety, depression, post-traumatic stress disorder, general mental health, and mental well-beingamong citizens after a crowd-crush disaster in Korea. Individuals who experienced the crowd crush had significantly higheranxiety, depression, and post-traumatic stress disorder (PTSD) scores than those who did not (p < 0.001). Additionally,people who avoided the disaster area had significantly higher depression and PTSD scores than those who did not avoid thearea (p < 0.001). Those who directly witnessed the Seoul Halloween crowd crush had a significant difference in PTSD levels ineither group than those who experienced it indirectly (p = 0.005). There was a significant difference in PTSD scores in cases ofdirect damage or death of an acquaintance (p < 0.001). The Seoul Halloween crowd crush caused psychological damagethrough indiscriminate exposure to the public, and symptoms of PTSD appeared over a long period. It is crucial to provideessential resources for ongoing treatment and case management.展开更多
Autonomous umanned aerial vehicle(UAV) manipulation is necessary for the defense department to execute tactical missions given by commanders in the future unmanned battlefield. A large amount of research has been devo...Autonomous umanned aerial vehicle(UAV) manipulation is necessary for the defense department to execute tactical missions given by commanders in the future unmanned battlefield. A large amount of research has been devoted to improving the autonomous decision-making ability of UAV in an interactive environment, where finding the optimal maneuvering decisionmaking policy became one of the key issues for enabling the intelligence of UAV. In this paper, we propose a maneuvering decision-making algorithm for autonomous air-delivery based on deep reinforcement learning under the guidance of expert experience. Specifically, we refine the guidance towards area and guidance towards specific point tasks for the air-delivery process based on the traditional air-to-surface fire control methods.Moreover, we construct the UAV maneuvering decision-making model based on Markov decision processes(MDPs). Specifically, we present a reward shaping method for the guidance towards area and guidance towards specific point tasks using potential-based function and expert-guided advice. The proposed algorithm could accelerate the convergence of the maneuvering decision-making policy and increase the stability of the policy in terms of the output during the later stage of training process. The effectiveness of the proposed maneuvering decision-making policy is illustrated by the curves of training parameters and extensive experimental results for testing the trained policy.展开更多
Introduction: Priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. Ho...Introduction: Priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. However, the management is often late because of the delay in consultation, which is characteristic in our context. The purpose of our study is to describe the clinical and therapeutic aspects of patients who presented with priapism at the Yaoundé Central Hospital as well as to propose a present synthesis concerning the management of priapism. Methodology: We conducted a descriptive cross-sectional study with a retrospective recruitment method in the urology department of the YCH. It extended over a period of 6 months from January 2022 to June 2022. We reviewed the files of patients seen within a period spanning 10 years from January 1<sup>st</sup>, 2011 to January 31<sup>st</sup>, December 2021. The study population consisted of patients who had been hospitalized and treated for priapism. We carried out consecutive and non-exhaustive sampling. Results: During the study, we collected data from the medical files of 13 patients. The median age was 25 years, with extremes of 12 and 82 years. Most of the patients were between 20 and 30 years old (38.5%). Most of the patients were single (69.2%). Sickle cell disease was the main comorbidity encountered during the study (76.9%). The median time from onset of symptoms to consultation was 10 [6 - 20.5] hours, with extremes of 1 and 264 hours. All patients presented with painful penile erection (100%). There was concomitant multifocal pain in 38.5% of cases suggestive of vaso-occlusive crises (VOC). The symptoms occurred in a non-traumatic context in the majority of cases (92.3%). The T-shunt was the most used surgical technique (84.6%). The median duration of surgery was 36 [35 - 40] minutes with extremes of 25 and 60 minutes, the majority being operated in less than 45 minutes (84.6%). The frequency of postoperative complications was 46.2%, dominated by weak erections/loss of erections (38.5%). The median duration of hospitalisation was 4 [3 - 5.5] days, with extremes 2 and 20 days of hospitalisation. Resumption of sexual activity was reported in 8 patients (61.5%). The time to recovery was mostly greater than 6 weeks (62.5%). Conclusion: Priapism remains a urological emergency. The prognosis depends on the patients’ promptness in consulting. The T-Shunt is an effective surgical technique in the event of failure of medical treatment.展开更多
In space-oriented design,the guide logo is often combined with the overall visual style and spatial positioning of the space design through the designer’s whims.With the development of digital technology and the appl...In space-oriented design,the guide logo is often combined with the overall visual style and spatial positioning of the space design through the designer’s whims.With the development of digital technology and the application of artificial intelligence,the practice of designers is reflected in the integration of digital information into media content and physical objects.Digital-oriented identity from touch,voice to eye sensing;static and dynamic conversion of multi-dimensional presentation,real to virtual possibilities are expanded,so that people experiencing in space can produce a variety of morphological perception and virtual immersion experience.展开更多
BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is b...BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.展开更多
基金the National Key Research and Development Program of China under Grant 2021YFB3301300the National Natural Science Foundation of China under Grant 62203213+1 种基金the Natural Science Foundation of Jiangsu Province under Grant BK20220332the Open Project Program of Fujian Provincial Key Laboratory of Intelligent Identification and Control of Complex Dynamic System under Grant 2022A0004.
文摘The reliable operation of high-speed wire rod finishing mills is crucial in the steel production enterprise.As complex system-level equipment,it is difficult for high-speed wire rod finishing mills to realize fault location and real-time monitoring.To solve the above problems,an expert experience and data-driven-based hybrid fault diagnosis method for high-speed wire rod finishing mills is proposed in this paper.First,based on its mechanical structure,time and frequency domain analysis are improved in fault feature extraction.The approach of combining virtual value,peak value with kurtosis value index,is adopted in time domain analysis.Speed adjustment and side frequency analysis are proposed in frequency domain analysis to obtain accurate component characteristic frequency and its corresponding sideband.Then,according to time and frequency domain characteristics,fault location based on expert experience is proposed to get an accurate fault result.Finally,the proposed method is implemented in the equipment intelligent diagnosis system.By taking an equipment fault on site,for example,the effectiveness of the proposed method is illustrated in the system.
基金the National Natural Science Foun-dation of China(Grant Nos.12034018 and 11625419).
文摘Reducing the control error is vital for high-fidelity digital and analog quantum operations.In superconducting circuits,one disagreeable error arises from the reflection of microwave signals due to impedance mismatch in the control chain.Here,we demonstrate a reflection cancelation method when considering that there are two reflection nodes on the control line.We propose to generate the pre-distortion pulse by passing the envelopes of the microwave signal through digital filters,which enables real-time reflection correction when integrated into the field-programmable gate array(FPGA).We achieve a reduction of single-qubit gate infidelity from 0.67%to 0.11%after eliminating microwave reflection.Real-time correction of microwave reflection paves the way for precise control and manipulation of the qubit state and would ultimately enhance the performance of algorithms and simulations executed on quantum processors.
基金Supported by the PetroChina Science and Technology Project(2021DJ4002,2022DJ3908)。
文摘Acoustic reflection imaging logging technology can detect and evaluate the development of reflection anomalies,such as fractures,caves and faults,within a range of tens of meters from the wellbore,greatly expanding the application scope of well logging technology.This article reviews the development history of the technology and focuses on introducing key methods,software,and on-site applications of acoustic reflection imaging logging technology.Based on the analyses of major challenges faced by existing technologies,and in conjunction with the practical production requirements of oilfields,the further development directions of acoustic reflection imaging logging are proposed.Following the current approach that utilizes the reflection coefficients,derived from the computation of acoustic slowness and density,to perform seismic inversion constrained by well logging,the next frontier is to directly establish the forward and inverse relationships between the downhole measured reflection waves and the surface seismic reflection waves.It is essential to advance research in imaging of fractures within shale reservoirs,the assessment of hydraulic fracturing effectiveness,the study of geosteering while drilling,and the innovation in instruments of acoustic reflection imaging logging technology.
文摘During spacecraft re-entry,the challenge of measuring plasma sheath parameters directly contributes to difficulties in addressing communication blackout.In this work,we have discovered a phenomenon of multiple peaks in reflection data caused by the inhomogeneous plasma.Simulation results show that the multi-peak points fade away as the characteristic frequency is approached,resembling a series of gradually decreasing peaks.The positions and quantities of these points are positively correlated with electron density,yet they show no relation to collision frequency.This phenomenon is of significant reference value for future studies on the spatial distribution of plasmas,particularly for using microwave reflection signals in diagnosing the plasma sheath.
基金Project supported by the National Key Research and Development Program of China(Grant Nos.2018YFE0204001,2018YFA0209103,2016YFB0400101,and 2016YFB0402303)the National Natural Science Foundation of China(Grant Nos.61627822,61704121,61991430,and 62074036)Postdoctoral Research Program of Jiangsu Province(Grant No.2021K599C).
文摘Optical reflection anisotropy microscopy mappings of micropipe defects on the surface of a 4H-SiC single crystal are studied by the scanning anisotropy microscopy(SAM)system.The reflection anisotropy(RA)image with a'butterfly pattern'is obtained around the micropipes by SAM.The RA image of the edge dislocations is theoretically simulated based on dislocation theory and the photoelastic principle.By comparing with the Raman spectrum,it is verified that the micropipes consist of edge dislocations.The different patterns of the RA images are due to the different orientations of the Burgers vectors.Besides,the strain distribution of the micropipes is also deduced.One can identify the dislocation type,the direction of the Burgers vector and the optical anisotropy from the RA image by using SAM.Therefore,SAM is an ideal tool to measure the optical anisotropy induced by the strain field around a defect.
文摘Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of HIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned HIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University Hospital Centre (CHUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.2.2.6. Results: One hundred and thirteen HIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with HIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .
基金This research was supported by Meat and Livestock Australia grant P.PSH.1232,the Australasian Pork Research Institute Ltd grant 5A-113,The University of Queensland and The University of Western Australia.
文摘At a time when there is a growing public interest in animal welfare,it is critical to have objective means to assess the way that an animal experiences a situation.Objectivity is critical to ensure appropriate animal welfare outcomes.Existing behavioural,physiological,and neurobiological indicators that are used to assess animal welfare can verify the absence of extremely negative outcomes.But welfare is more than an absence of negative outcomes and an appropriate indicator should reflect the full spectrum of experience of an animal,from negative to positive.In this review,we draw from the knowledge of human biomedical science to propose a list of candidate biological markers(biomarkers)that should reflect the experiential state of non-human animals.The proposed biomarkers can be classified on their main function as endocrine,oxidative stress,non-coding molecular,and thermobiological markers.We also discuss practical challenges that must be addressed before any of these biomarkers can become useful to assess the experience of an animal in real-life.
基金supported by the 2022 Capital’s Funds for Health Improvement and Research(CFH)(2022-2-4202).
文摘Objective:The objective of this study is to comprehensively understand the psychological experience of primiparous women during breastfeeding while dealing with lactating mastitis and to establish a reliable foundation for tailored support measures.Methods:Twenty primiparous mothers from a tertiary hospital in Beijing between January and March 2023 were chosen using purposive sampling for semi-structured interviews.After conducting 20 interviews,data saturation was achieved.The Colaizzi’s seven-step analytical approach was employed to analyze,summarize,and refine the identified themes.Results:Among primiparous women afflicted by lactating mastitis,the primary themes regarding breastfeeding attitudes included three key aspects:(1)uncertainty during the initial diagnosis phase,(2)intricate emotional journey during treatment,and(3)positive psychological outlook during the recovery stage.Conclusion:Primiparous women undergoing lactating mastitis experience substantial physical and psychological strain.It is crucial for medical personnel,family caregivers,and society at large to be attuned to the emotions of these patients.Tailored support measures should be offered to enhance patients’physical and mental well-being and facilitate disease recovery.
文摘In this study,we focus on the numerical modelling of the interaction between waves and submerged structures in the presence of a uniform flow current.Both the same and opposite senses of wave propagation are considered.The main objective is an understanding of the effect of the current and various geometrical parameters on the reflection coefficient.The wave used in the study is based on potential theory,and the submerged structures consist of two rectangular breakwaters positioned at a fixed distance from each other and attached to the bottom of a wave flume.The numerical modeling approach employed in this work relies on the Boundary Element Method(BEM).The results are compared with experimental data to validate the approach.The findings of the study demonstrate that the double rectangular breakwater configuration exhibits superior wave attenuation abilities if compared to a single rectangular breakwater,particularly at low wavenumbers.Furthermore,the study reveals that wave mitigation is more pronounced when the current and wave propagation are coplanar,whereas it is less effective in the case of opposing current.
文摘Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mother To Child Transmission-HIV service utilization should be prioritized so as to alleviate stigma and enhancing a positive experience for these mothers thus reducing on the Mother to Child HIV Transmission burden and mortality rates.
基金The study was reviewed and approved by the Science and Research Office of Tong Ren Hospital(Shanghai), No. AF/SC-08/04.0.
文摘BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.
文摘Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry of Health, community tuberculosis care was introduced with the main goal of reducing tuberculosis-related morbidity and mortality among communities through the expansion of direct observed therapy and community involvement to community settings. The community caregivers were to support tuberculosis patients throughout their treatment period until they were cured or had completed their treatment. Settings: Two major cities of Botswana, Francistown and Gaborone, with more than twenty-two health clinics offering tuberculosis care. Objective: To investigate community caregivers’ experiences and identify programmatic strategies to improve active TB case findings under the community TB care (CTBC) program in Botswana during 2016-2021. Methods: We adopted a descriptive qualitative research design, followed by convenience purposive sampling. We obtained consent and interviewed 40 participants who met the inclusion criteria, 16 out of 73 in Gaborone and 24 out of 38 from Francistown. Results: We interviewed 40 caregivers with a mean age of 43.4 years. Accepting the caregiving role was identified as the main experience by more than two thirds of the caregivers. While at least more than two-fifth felt obligated to care for the patient at home due to personal relations. More than half of the respondents found caregiving difficult or frustrating due to some challenges encountered during the caregiving role. Behavioral modifications were suggested under different subthemes as strategies to improve active case finding. [-rId13-]Conclusion: Acceptance was the major experience in CTBC. Intensification of known programmatic strategies was suggested by caregivers to improve tuberculosis active case finding in CTBC.
基金supported by the TRANSIT project(funded by EU Horizon 2020 and the Europe’s Rail Joint Undertaking under Grant Agreement 881771).
文摘Purpose – The vibration of the rails is a significant source of railway rolling noise, often forming the dominantcomponent of noise in the important frequency region between 400 and 2000 Hz. The purpose of the paper is toinvestigate the influence of the ground profile and the presence of the train body on the sound radiation fromthe rail.Design/methodology/approach – Two-dimensional boundary element calculations are used, in which therail vibration is the source. The ground profile and various different shapes of train body are introduced in themodel, and results are observed in terms of sound power and sound pressure. Comparisons are also made withvibro-acoustic measurements performed with and without a train present.Findings – The sound radiated by the rail in the absence of the train body is strongly attenuated by shieldingdue to the ballast shoulder. When the train body is present, the sound from the vertical rail motion is reflectedback down toward the track where it is partly absorbed by the ballast. Nevertheless, the sound pressure at thetrackside is increased by typically 0–5 dB. For the lateral vibration of the rail, the effects are much smaller. Oncethe sound power is known, the sound pressure with the train present can be approximated reasonably well withsimple line source directivities.Originality/value – Numerical models used to predict the sound radiation from railway rails have generallyneglected the influence of the ground profile and reflections from the underside of the train body on the soundpower and directivity of the rail. These effects are studied in a systematic way including comparisons with measurements.
文摘Cultural ancient roads,known in Chinese as gudao,serve as heritage trails that carry historical exchanges across various regions in China.Due to their extensive preservation,wide geographical distribution,diverse thematic variations,and considerable tourist appeal,these paths have emerged as representative heritage trails,increasingly transforming into a novel tourism product experience that is highly favored by tourists and recognized by government authorities.However,research on ancient roads for tourism in China currently lacks a systematic theoretical framework,as well as relevant policies,regulations,and standards to guide their practical development.Therefore,there is a pressing need to draw upon international best practices and conduct foundational research to develop an experience element system that aligns with the perceptions,behaviors,and consumption characteristics of Chinese tourists,thereby advancing theoretical exploration in this field.This study focuses on the representative Ancient Shu Road as a case study and employs a mixed-method approach that integrates qualitative and quantitative research.It aims to construct a tourist-centric scale for the experience elements of ancient road tourism while analyzing the interactive relationship between these experience elements and tourist needs.This study addresses a significant gap in the development of indicator systems for domestic studies of ancient road tourism experiences.Ultimately,the study establishes a comprehensive scale that encompasses three core categories—trail resources and environment,facilities and services,and modes of tourism activities—along with eight primary dimensions:core resources,surrounding cultural environment,surrounding natural environment,tourism reception facilities and services,infrastructure and support services,information facilities and information services,and outdoor and recreational activities.This scale consists of thirty-two specific items,providing a robust reference for future research endeavors.Additionally,the study proposes specific development strategies related to key mechanisms,spatial configuration,and facility construction to enhance the overall development of ancient road tourism.
文摘Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.
基金the National Research Foundation of Korea(NRF)Grant funded by the Korean government(NRF-2023R1A2C2003043)the Chung-Ang University Research Scholarship Grants in 2023.
文摘This study evaluated the state of anxiety, depression, post-traumatic stress disorder, general mental health, and mental well-beingamong citizens after a crowd-crush disaster in Korea. Individuals who experienced the crowd crush had significantly higheranxiety, depression, and post-traumatic stress disorder (PTSD) scores than those who did not (p < 0.001). Additionally,people who avoided the disaster area had significantly higher depression and PTSD scores than those who did not avoid thearea (p < 0.001). Those who directly witnessed the Seoul Halloween crowd crush had a significant difference in PTSD levels ineither group than those who experienced it indirectly (p = 0.005). There was a significant difference in PTSD scores in cases ofdirect damage or death of an acquaintance (p < 0.001). The Seoul Halloween crowd crush caused psychological damagethrough indiscriminate exposure to the public, and symptoms of PTSD appeared over a long period. It is crucial to provideessential resources for ongoing treatment and case management.
基金supported by the Key Research and Development Program of Shaanxi (2022GXLH-02-09)the Aeronautical Science Foundation of China (20200051053001)the Natural Science Basic Research Program of Shaanxi (2020JM-147)。
文摘Autonomous umanned aerial vehicle(UAV) manipulation is necessary for the defense department to execute tactical missions given by commanders in the future unmanned battlefield. A large amount of research has been devoted to improving the autonomous decision-making ability of UAV in an interactive environment, where finding the optimal maneuvering decisionmaking policy became one of the key issues for enabling the intelligence of UAV. In this paper, we propose a maneuvering decision-making algorithm for autonomous air-delivery based on deep reinforcement learning under the guidance of expert experience. Specifically, we refine the guidance towards area and guidance towards specific point tasks for the air-delivery process based on the traditional air-to-surface fire control methods.Moreover, we construct the UAV maneuvering decision-making model based on Markov decision processes(MDPs). Specifically, we present a reward shaping method for the guidance towards area and guidance towards specific point tasks using potential-based function and expert-guided advice. The proposed algorithm could accelerate the convergence of the maneuvering decision-making policy and increase the stability of the policy in terms of the output during the later stage of training process. The effectiveness of the proposed maneuvering decision-making policy is illustrated by the curves of training parameters and extensive experimental results for testing the trained policy.
文摘Introduction: Priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. However, the management is often late because of the delay in consultation, which is characteristic in our context. The purpose of our study is to describe the clinical and therapeutic aspects of patients who presented with priapism at the Yaoundé Central Hospital as well as to propose a present synthesis concerning the management of priapism. Methodology: We conducted a descriptive cross-sectional study with a retrospective recruitment method in the urology department of the YCH. It extended over a period of 6 months from January 2022 to June 2022. We reviewed the files of patients seen within a period spanning 10 years from January 1<sup>st</sup>, 2011 to January 31<sup>st</sup>, December 2021. The study population consisted of patients who had been hospitalized and treated for priapism. We carried out consecutive and non-exhaustive sampling. Results: During the study, we collected data from the medical files of 13 patients. The median age was 25 years, with extremes of 12 and 82 years. Most of the patients were between 20 and 30 years old (38.5%). Most of the patients were single (69.2%). Sickle cell disease was the main comorbidity encountered during the study (76.9%). The median time from onset of symptoms to consultation was 10 [6 - 20.5] hours, with extremes of 1 and 264 hours. All patients presented with painful penile erection (100%). There was concomitant multifocal pain in 38.5% of cases suggestive of vaso-occlusive crises (VOC). The symptoms occurred in a non-traumatic context in the majority of cases (92.3%). The T-shunt was the most used surgical technique (84.6%). The median duration of surgery was 36 [35 - 40] minutes with extremes of 25 and 60 minutes, the majority being operated in less than 45 minutes (84.6%). The frequency of postoperative complications was 46.2%, dominated by weak erections/loss of erections (38.5%). The median duration of hospitalisation was 4 [3 - 5.5] days, with extremes 2 and 20 days of hospitalisation. Resumption of sexual activity was reported in 8 patients (61.5%). The time to recovery was mostly greater than 6 weeks (62.5%). Conclusion: Priapism remains a urological emergency. The prognosis depends on the patients’ promptness in consulting. The T-Shunt is an effective surgical technique in the event of failure of medical treatment.
文摘In space-oriented design,the guide logo is often combined with the overall visual style and spatial positioning of the space design through the designer’s whims.With the development of digital technology and the application of artificial intelligence,the practice of designers is reflected in the integration of digital information into media content and physical objects.Digital-oriented identity from touch,voice to eye sensing;static and dynamic conversion of multi-dimensional presentation,real to virtual possibilities are expanded,so that people experiencing in space can produce a variety of morphological perception and virtual immersion experience.
文摘BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.