Minimum quantity Lubrication(MQL)is a sustainable lubrication system that is famous in many machining systems.It involve the spray of an infinitesimal amount of mist-like lubricants during machining processes.The MQL ...Minimum quantity Lubrication(MQL)is a sustainable lubrication system that is famous in many machining systems.It involve the spray of an infinitesimal amount of mist-like lubricants during machining processes.The MQL system is affirmed to exhibit an excellent machining performance,and it is highly economical.The nanofluids are understood to exhibit excellent lubricity and heat evacuation capability,compared to pure oil-based MQL system.Studies have shown that the surface quality and amount of energy expended in the grinding operations can be reduced considerably due to the positive effect of these nanofluids.This work presents an experimental study on the tribological performance of SiO_(2)nanofluid during grinding of Si_(3)N_(4)ceramic.The effect different grinding modes and lubrication systems during the grinding operation was also analyzed.Different concentrations of the SiO_(2)nanofluid was manufactured using canola,corn and sunflower oils.The quantitative evaluation of the grinding process was done based on the amount of grinding forces,specific grinding energy,frictional coefficient,and surface integrity.It was found that the canola oil exhibits optimal lubrication performance compared to corn oil,sunflower oil,and traditional lubrication systems.Additionally,the introduction of ultrasonic vibrations with the SiO_(2)nanofluid in MQL system was found to reduce the specific grinding energy,normal grinding forces,tangential grinding forces,and surface roughness by 65%,57%,65%,and 18%respectively.Finally,regression analysis was used to obtain an optimum parameter combinations.The observations from this work will aid the smooth transition towards ecofriendly and sustainable machining of engineering ceramics.展开更多
Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear ...Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.展开更多
Fatigue properties are crucial for critical aero-engine components in extreme serviceenvironments,which are significantly affected by surface integrity(SI)indexes(especially surface topography,residual stressσ_(res),...Fatigue properties are crucial for critical aero-engine components in extreme serviceenvironments,which are significantly affected by surface integrity(SI)indexes(especially surface topography,residual stressσ_(res),and microhardness)after machining processes.Normal-direction ultrasonic vibration-assisted face grinding(ND-UVAFG)has advantages in improving the machinability of Inconel 718,but there is a competitive relationship between higher compressiveσ_(res)and higher surface roughness R_(a)in affecting fatigue strength.The lack of a quantitative relationship between multiple SI indexes and fatigue strength makes theindeterminacy of a regulatory strategy for improving fatigue properties.In this work,a model of fatigue strength(σ_f)_(sur)considering multiple SI indexes was developed.Then,high-cycle fatigue tests were carried out on Inconel 718 samples with different SI characteristics,and the influence of ND-UVAFG process parameters on SI was analyzed.Based on SI indexes data,the(σ_f)_(sur)distribution in the grinding surface layer for ND-UVAFG Inconel 718 samples was determined using the developed model,and then the fatigue crack initiation(FCI)sites were furtherpredicted.The predicted FCI sites corresponded well with the experimental results,therebyverifying this model.A strategy for improving the fatigue life was proposed in this work,which was to transfer the fatigue source from the machined surface to the bulk material by controlling the SI indexes.Finally,a critical condition of SI indexes that FCI sites appeared on the surface or in bulk material was given by fitting the predicted results.According to the critical condition,an SI field where FCI sites appeared in the bulk material could be obtained.In this field,thefatigue life of Inconel 718 samples could be improved by approximately 140%.展开更多
Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open...Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open questions related to technological aspects.This work presents a systematic review of upper limb rehabilitation robotics in order to analyze and establish technological challenges and future directions in this area.A bibliometric analysis was performed for the systematic literature review.Literature from the last six years,conducted between August 2020 and May 2021,was reviewed.The methodology for the literature search and a bibliometric analysis of the metadata are presented.After a preliminary search resulted in 820 articles,a total of 66 articles were included.A concurrency network and bibliographic analysis were provided.And an analysis of occurrences,taxonomy,and rehabilitation robotics reported in the literature is presented.This review aims to provide to the scientific community an overview of the state of the art in assistive robotics for upper limb physical rehabilitation.The literature analysis allows access to a gap of unexplored options to define the technological prospects applied to upper limb physical rehabilitation robotics.展开更多
This paper attempts to approach the interface of a robot from the perspective of virtual assistants.Virtual assistants can also be characterized as the mind of a robot,since they manage communication and action with t...This paper attempts to approach the interface of a robot from the perspective of virtual assistants.Virtual assistants can also be characterized as the mind of a robot,since they manage communication and action with the rest of the world they exist in.Therefore,virtual assistants can also be described as the brain of a robot and they include a Natural Language Processing(NLP)module for conducting communication in their human-robot interface.This work is focused on inquiring and enhancing the capabilities of this module.The problem is that nothing much is revealed about the nature of the human-robot interface of commercial virtual assistants.Therefore,any new attempt of developing such a capability has to start from scratch.Accordingly,to include corresponding capabilities to a developing NLP system of a virtual assistant,a method of systemic semantic modelling is proposed and applied.For this purpose,the paper briefly reviews the evolution of virtual assistants from the first assistant,in the form of a game,to the latest assistant that has significantly elevated their standards.Then there is a reference to the evolution of their services and their continued offerings,as well as future expectations.The paper presents their structure and the technologies used,according to the data provided by the development companies to the public,while an attempt is made to classify virtual assistants,based on their characteristics and capabilities.Consequently,a robotic NLP interface is being developed,based on the communicative power of a proposed systemic conceptual model that may enhance the NLP capabilities of virtual assistants,being tested through a small natural language dictionary in Greek.展开更多
Context: Advanced heart failure (AHF) poses a global challenge, where heart transplantation is a treatment option but limited by donor scarcity. Proposal: This study aims to enhance the performance of ventricular assi...Context: Advanced heart failure (AHF) poses a global challenge, where heart transplantation is a treatment option but limited by donor scarcity. Proposal: This study aims to enhance the performance of ventricular assist devices (VADs) in the face of adverse events (AEs) using a resilience-based approach. The objective is to develop a method for integrating resilience attributes into VAD control systems, employing dynamic risk analysis and control strategies. Results: The outcomes include a resilient control architecture enabling anticipatory, regenerative, and degenerative actions in response to AEs. A method of applied resilience (MAR) based on dynamic risk management and resilience attribute analysis was proposed. Conclusion: Dynamic integration between medical and technical teams allows continuous adaptation of control systems to meet patient needs over time, improving reliability, safety, and effectiveness of VADs, with potential positive impact on the health of heart failure patients.展开更多
The Advanced Metering Infrastructure(AMI),as a crucial subsystem in the smart grid,is responsible for measuring user electricity consumption and plays a vital role in communication between providers and consumers.Howe...The Advanced Metering Infrastructure(AMI),as a crucial subsystem in the smart grid,is responsible for measuring user electricity consumption and plays a vital role in communication between providers and consumers.However,with the advancement of information and communication technology,new security and privacy challenges have emerged for AMI.To address these challenges and enhance the security and privacy of user data in the smart grid,a Hierarchical Privacy Protection Model in Advanced Metering Infrastructure based on Cloud and Fog Assistance(HPPM-AMICFA)is proposed in this paper.The proposed model integrates cloud and fog computing with hierarchical threshold encryption,offering a flexible and efficient privacy protection solution that significantly enhances data security in the smart grid.The methodology involves setting user protection levels by processing missing data and utilizing fuzzy comprehensive analysis to evaluate user importance,thereby assigning appropriate protection levels.Furthermore,a hierarchical threshold encryption algorithm is developed to provide differentiated protection strategies for fog nodes based on user IDs,ensuring secure aggregation and encryption of user data.Experimental results demonstrate that HPPM-AMICFA effectively resists various attack strategies while minimizing time costs,thereby safeguarding user data in the smart grid.展开更多
Object: To compare the safety, clinical efficacy, and complication rate of “Tianji” robot-assisted surgery with traditional open surgery in the treatment of cervical vertebrae fracture. Methods: 60 patients with upp...Object: To compare the safety, clinical efficacy, and complication rate of “Tianji” robot-assisted surgery with traditional open surgery in the treatment of cervical vertebrae fracture. Methods: 60 patients with upper cervical vertebrae fracture admitted to Baise People’s Hospital between November 2018 and April 2024 were retrospectively analyzed. Among these patients, 29 underwent “Tianji” robot-assisted surgery (Robot group), and 31 underwent traditional C-arm fluoroscopy-assisted open surgery (Open group). Statistical analysis of the data was performed using SPSS 27.0 software to compare general data (gender, age, BMI), preoperative and postoperative visual analogue scale (VAS) scores, neck disability index (NDI), intraoperative blood loss, accuracy of screw placement on imaging, and the number of complications in both groups for comprehensive evaluation. A P value < 0.05 was deemed to have achieved statistical significance. Results: There was no significant difference in preoperative VAS scores between the two groups (Robot group: 8.34 ± 0.61;Open group: 8.26 ± 0.68, P = 0.317). There was also no significant difference in VAS scores at 1 week postoperatively (Robot group: 6.90 ± 0.31;Open group: 6.94 ± 0.36, P = 0.3237). Preoperative NDI scores showed no significant difference between the two groups (Robot group: 43.31 ± 2.67;Open group: 43.84 ± 2.67, P = 0.2227), and the difference in NDI scores at 1 week postoperatively was also not significant (Robot group: 35.69 ± 4.24;Open group: 37.35 ± 3.48, P = 0.0509). Intraoperative blood loss in the Robot group was significantly lower than in the Open group (246.21 ± 209 ml vs 380.65 ± 328.04 ml, P = 0.0308), with a statistically significant difference. The operation time was longer in the Robot group (3.75 ± 0.74 h) compared to the Open group (2.74 ± 0.86 h). In terms of screw placement accuracy, the Robot group had a higher accuracy rate for Class A screws compared to the Open group (102 screws vs 94 screws, P = 0.0487), and the accuracy rate for Class B screws was also higher in the Robot group (13 screws vs 29 screws, P = 0.0333), with both differences being statistically significant. There was no significant difference in the number of complications between the two groups (Robot group: 8 cases;Open group: 10 cases, P = 0.6931). Conclusion: Patients treated with “Tianji” robot-assisted surgery for upper cervical vertebrae fracture had lower intraoperative blood loss and higher screw placement accuracy compared to those undergoing traditional C-arm fluoroscopy-assisted open surgery, indicating that this robot-assisted surgery can effectively reduce intraoperative blood loss and improve screw placement accuracy.展开更多
Intelligent personal assistants play a pivotal role in in-vehicle systems,significantly enhancing life efficiency,driving safety,and decision-making support.In this study,the multi-modal design elements of intelligent...Intelligent personal assistants play a pivotal role in in-vehicle systems,significantly enhancing life efficiency,driving safety,and decision-making support.In this study,the multi-modal design elements of intelligent personal assistants within the context of visual,auditory,and somatosensory interactions with drivers were discussed.Their impact on the driver’s psychological state through various modes such as visual imagery,voice interaction,and gesture interaction were explored.The study also introduced innovative designs for in-vehicle intelligent personal assistants,incorporating design principles such as driver-centricity,prioritizing passenger safety,and utilizing timely feedback as a criterion.Additionally,the study employed design methods like driver behavior research and driving situation analysis to enhance the emotional connection between drivers and their vehicles,ultimately improving driver satisfaction and trust.展开更多
BACKGROUND The development of laparoscopic technology has provided a new choice for surgery of gastric cancer(GC),but the advantages and disadvantages of laparoscopic total gastrectomy(LTG)and laparoscopic-assisted to...BACKGROUND The development of laparoscopic technology has provided a new choice for surgery of gastric cancer(GC),but the advantages and disadvantages of laparoscopic total gastrectomy(LTG)and laparoscopic-assisted total gastrectomy(LATG)in treatment effect and safety are still controversial.The purpose of this study is to compare the efficacy and safety of the two methods in the treatment of GC,and to provide a basis for clinical decision-making.AIM To compare the efficacy of totally LTG(TLTG)and LATG in the context of radical gastrectomy for GC.Additionally,we investigated the safety and feasibility of the total laparoscopic esophagojejunostomy technique.METHODS Literature on comparative studies of the above two surgical methods for GC(TLTG group and LATG group)published before September 2022 were searched in the PubMed,Web of Science,Wanfang Database,CNKI,and other Chinese and English databases.In addition,the following search keywords were used:Gastric cancer,total gastrectomy,total laparoscopy,laparoscopy-assisted,esophagojejunal anastomosis,gastric/stomach cancer,total gastrectomy,totally/completely laparoscopic,laparoscopic assisted/laparoscopy assisted/laparoscopically assisted,and esophagojejunostomy/esophagojejunal anastomosis.Review Manager 5.3 software was used for the meta-analysis after two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included studies.RESULTS After layer-by-layer screening,258 pieces of literature were recovered,and 11 of those pieces were eventually included.This resulted in a sample size of 2421 instances,with 1115 cases falling into the TLTG group and 1306 cases into the LATG group.Age or sex differences between the two groups were not statistically significant,according to the meta-analysis,however the average body mass index of the TLTG group was considerably higher than that of the LATG group(P=0.01).Compared with those in the LATG group,the incision length in the TLTG group was significantly shorter(P<0.001),the amount of intraoperative blood loss was significantly lower(P=0.003),the number of lymph nodes removed was significantly greater(P=0.04),and the time of first postoperative feeding and postoperative hospitalization were also significantly shorter(P=0.03 and 0.02,respectively).There were no significant differences in tumor size,length of proximal incisal margin,total operation time,anastomotic time,postoperative pain score,postoperative anal exhaust time,postoperative anastomosis-related complications(including anastomotic fistula,anastomotic stenosis,and anastomotic hemorrhage),or overall postoperative complication rate(P>0.05).CONCLUSION TLTG and esophagojejunostomy are safe and feasible.Compared with LATG,TLTG has the advantages of less trauma,less bleeding,easier access to lymph nodes,and faster postoperative recovery,and TLTG is also suitable for obese patients.展开更多
This study highlights the changing priorities of China’s paired assistance throughout the past decades,as well as its theoretical implications and economic growth effects for recipient regions.Using panel data from 3...This study highlights the changing priorities of China’s paired assistance throughout the past decades,as well as its theoretical implications and economic growth effects for recipient regions.Using panel data from 32 prefecture-level cities from 1990 to 2020,this study uses the multiperiod difference-in-differences approach to examine how paired assistance has contributed to economic growth in Xizang Autonomous Region and Xinjiang Uygur Autonomous Region.The findings indicate that,first,the implementation of the paired assistance policy has boosted economic growth in Xizang and Xinjiang.Second,paired assistance has stimulated economic growth in recipient communities by improving infrastructure.Third,paired assistance has contributed to economic growth in recipient communities by providing improved public services such as education and healthcare.Improvements to public services have a relatively smaller indirect effect in short term than infrastructure development on economic growth.Yet both education and healthcare are crucial to people’s quality of life in recipient communities.This paper has refined and broadened research on the effects of paired assistance,providing preference for future policymaking.展开更多
GHz burst-mode femtosecond(fs)laser,which emits a series of pulse trains with extremely short intervals of several hundred picoseconds,provides distinct characteristics in materials processing as compared with the con...GHz burst-mode femtosecond(fs)laser,which emits a series of pulse trains with extremely short intervals of several hundred picoseconds,provides distinct characteristics in materials processing as compared with the conventional irradiation scheme of fs laser(single-pulse mode).In this paper,we take advantage of the moderate pulse interval of 205 ps(4.88 GHz)in the burst pulse for high-quality and high-efficiency micromachining of single crystalline sapphire by laser induced plasma assisted ablation(LIPAA).Specifically,the preceding pulses in the burst generate plasma by ablation of copper placed behind the sapphire substrate,which interacts with the subsequent pulses to induce ablation at the rear surface of sapphire substrates.As a result,not only the ablation quality but also the ablation efficiency and the fabrication resolution are greatly improved compared to the other schemes including single-pulse mode fs laser direct ablation,single-pulse mode fs-LIPAA,and nanosecond-LIPAA.展开更多
In the new era,there is an urgent need to further promote pairing assistance to Tibet,promote the simultaneous construction of a strong agriculture in Tibet and the China's Mainland,and compose a Chinese-style mod...In the new era,there is an urgent need to further promote pairing assistance to Tibet,promote the simultaneous construction of a strong agriculture in Tibet and the China's Mainland,and compose a Chinese-style modernization.Southern Tibet,located in the southeastern part of the Tibet Autonomous Region,includes Shannan City and Nyingchi City,is a region assisted by four provincial partners including Hubei Province.This paper introduces the agricultural environment in southern Tibet,studies its agricultural characteristics,and analyzes the main issues of its pairing assistance.Taking forging the strong consciousness of the Chinese national community as the main line,the paper explores strategies for promoting agricultural high-quality development in southern Tibet through pairing assistance to Tibet from the perspective of agricultural power,and proposes some strategies,such as inheriting agricultural cultural heritage,promoting the upgrading of modern seed industry,enhancing the characteristic advantages of highland barley(naked barley)and animal husbandry industries,and developing edible fungi and cold water fish industries.展开更多
BACKGROUND Esophagopericardial fistula(EPF)is a rare,life-threatening condition with limited scientific literature and no established management guidelines.This case report highlights a successful multidisciplinary ap...BACKGROUND Esophagopericardial fistula(EPF)is a rare,life-threatening condition with limited scientific literature and no established management guidelines.This case report highlights a successful multidisciplinary approach and the innovative use of endoscopic vacuum assisted closure(endoVAC)therapy in treating this complex condition.CASE SUMMARY A 16-year-old male with a history of esophageal atresia and colon interposition presented with progressive chest pain,fever,and dyspnea.Imaging revealed an EPF with associated pleural and pericardial effusions.Initial management with an esophageal stent failed,prompting the use of an endoVAC system.The patient underwent multiple endoVAC device changes and received broad-spectrum antibiotics and nutritional support.The fistula successfully closed,and the patient recovered,demonstrating no new symptoms at a 6-month follow-up.CONCLUSION EndoVAC therapy can effectively manage EPF,providing a minimally invasive treatment option.展开更多
In times of digitalisation, visual assistance systems in assembly are increasingly important. The design of these assembly systems needs to be highly complex to meet the requirements. Due to the increasing number of v...In times of digitalisation, visual assistance systems in assembly are increasingly important. The design of these assembly systems needs to be highly complex to meet the requirements. Due to the increasing number of variants in production processes, as well as shorter innovation and product life cycles, assistance systems should improve quality and reduce complexity of assembly processes. However, many large kitchen manufacturers still assemble kitchen cabinets manually, due to the high variety of components, such as rails and fittings. This paper focuses on the analysis and evaluation of virtual assistance systems to improve quality and usability in individualised kitchen cabinet assembly processes at a large German manufacturer. A solution is identified and detailed.展开更多
Objective:To investigate the influence of season on live birth and clinical pregnancy rates,as well as assisted reproductive technology(ART)outcomes,in the Hainan region.Methods:Patients were categorized into four gro...Objective:To investigate the influence of season on live birth and clinical pregnancy rates,as well as assisted reproductive technology(ART)outcomes,in the Hainan region.Methods:Patients were categorized into four groups based on the dates of artificial insemination and transplantation:spring,summer,autumn,or winter.The main outcome measures were clinical pregnancy rates and live birth rates.Secondary outcomes included body mass index(BMI),oocyte number,two pronuclei(2PN)cleavage rate,total gonadotropin(Gn)dosage and days,age,2PN fertilization rate,sperm concentration,sperm PR rate,anti-Müllerian hormone(AMH),and endometrial thickness.Outpatient semen quality indicators included sperm PR rate,total sperm count,sperm concentration,and total sperm motility.Results:This retrospective cohort study analyzed 2,016 artificial insemination cycles and 1,783 ovarian retrieval cycles from January 2017 to October 2022,and assessed the semen quality of 6,651 outpatients from May 2017 to October 2022.In artificial insemination cycles,sperm PR rate and clinical pregnancy rate were highest in winter,with a statistically significant difference between groups(P<0.05).Clinical pregnancy rate was influenced by both age and sperm PR rate(P<0.05).In ovarian retrieval cycles,the winter group had significantly higher clinical pregnancy,2PN fertilization,and 2PN cleavage rates than the other groups.The autumn group had higher live birth rates,though not significantly different.Additionally,winter months showed higher total sperm concentration and total sperm number compared to other seasons.Conclusion:Seasonality affected clinical pregnancy and live birth rates in artificial insemination cycles but not in ovarian retrieval cycles in the Hainan region.These findings suggest that while there is no need to choose a specific season for ovarian retrieval cycles,artificial insemination in winter may be preferable for patients.展开更多
This paper describes mass-based energy phase-space projection of microwave-assisted synthesis of transition metals (zinc oxide, palladium, silver, platinum, and gold) nanostructures. The projection uses process energy...This paper describes mass-based energy phase-space projection of microwave-assisted synthesis of transition metals (zinc oxide, palladium, silver, platinum, and gold) nanostructures. The projection uses process energy budget (measured in kJ) on the horizontal axes and process density (measured in kJg−1) on the vertical axes. These two axes allow both mass usage efficiency (Environmental-Factor) and energy efficiency to be evaluated for a range of microwave applicator and metal synthesis. The metrics are allied to the: second, sixth and eleventh principle of the twelve principle of Green Chemistry. This analytical approach to microwave synthesis (widely considered as a useful Green Chemistry energy source) allows a quantified dynamic environmental quotient to be given to renewable plant-based biomass associated with the reduction of the metal precursors. Thus allowing a degree of quantification of claimed “eco-friendly” and “sustainable” synthesis with regard to waste production and energy usage.展开更多
Aim: This study evaluates the impact of Enhanced Recovery After Surgery (ERAS) nursing on postoperative complications and quality of life in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE)....Aim: This study evaluates the impact of Enhanced Recovery After Surgery (ERAS) nursing on postoperative complications and quality of life in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE). Methods: A total of 150 patients who underwent RAMIE from January 2020 to January 2022 at our hospital were randomly assigned to either the observation group or the control group, with 75 patients in each. The control group received standard perioperative management and nursing care, while the observation group was treated with ERAS nursing strategies. Interventions continued until discharge, and outcomes such as postoperative complications, quality of life, and nutritional status were compared between the groups. Results: The observation group exhibited a significantly lower incidence of postoperative adverse reactions compared to the control group (P ionally, all dimension scores of the Short-Form 36 Health Survey (SF-36), including the total score, were higher in the observation group (P < 0.05). Furthermore, the Nutritional Risk Screening (NRS) scores for impaired nutritional status and disease severity, along with the total NRS score, were significantly lower in the observation group compared to the control group (P Conclusion: Implementing ERAS nursing in the perioperative care of patients undergoing RAMIE is associated with reduced postoperative complications and enhanced postoperative quality of life and nutritional status. .展开更多
Introduction: Acromioclavicular (AC) joint dislocation is a common shoulder injury, comprising 9% - 12% of shoulder girdle injuries. Optimal management remains challenging, with treatment decisions guided by the Rockw...Introduction: Acromioclavicular (AC) joint dislocation is a common shoulder injury, comprising 9% - 12% of shoulder girdle injuries. Optimal management remains challenging, with treatment decisions guided by the Rockwood classification system. Controversies surround grade III injuries, necessitating further classification. Non-operative treatment has shown favorable outcomes, while surgical interventions vary. Anatomical coracoclavicular reconstruction (ACCR) has demonstrated biomechanical advantages over traditional methods. Arthroscopic techniques offer advantages, minimizing deltoid detachment and allowing concurrent pathology identification. This study evaluates the outcomes of arthroscopic-assisted ACCR in chronic AC joint dislocation. Surgical Technique: Arthroscopic-assisted ACCR involves meticulous portal placement, tendon graft harvesting, diagnostic arthroscopy, and coracoid exposure. The clavicle tunnels were made to mimic the conoid and trapezoid ligament positions, using FibreTape#2 loop and Dog Bone Button for correct placement against the coracoid base, and passing the semitendinosus graft through to reconstruct the conoid ligament, reduction done and graft follow through for anatomical reconstruction. Methods: A retrospective cohort study at Hospital Kuala Lumpur analyzed 35 patients undergoing arthroscopic-assisted ACCR for Rockwood grade III - V AC joint dislocations. Inclusion criteria encompassed trauma ≥ 3 weeks prior, no prior shoulder injuries, and ≥12-month follow-up. Functional and radiological assessments utilized ASES scores and coracoclavicular distances, respectively. Statistical analysis employed descriptive statistics and logistic regression. Results: The mean age was 38.9 years (SD 11.26), and 34 of 35 patients were male. Grade IV injuries were predominant (37.1%). Waiting time for surgery averaged 234.9 days. Functional improvement was substantial postoperatively (ASES: 55.5 to 88.9). Radiological outcomes demonstrated reduced coracoclavicular distances and maintained reduction. No significant correlation was observed between injury grade and outcomes. Conclusion: Arthroscopic-assisted ACCR for chronic AC joint dislocation yields significant functional and radiological improvement, irrespective of injury grade. Waiting time for surgery exhibits minor impact on outcomes, emphasizing the procedure’s efficacy. Concomitant injuries do not impede success, highlighting the versatility of this approach in managing shoulder instability. The study contributes valuable insights into the nuanced management of chronic AC joint dislocations and supports the adoption of arthroscopic-assisted ACCR as a viable treatment option.展开更多
文摘Minimum quantity Lubrication(MQL)is a sustainable lubrication system that is famous in many machining systems.It involve the spray of an infinitesimal amount of mist-like lubricants during machining processes.The MQL system is affirmed to exhibit an excellent machining performance,and it is highly economical.The nanofluids are understood to exhibit excellent lubricity and heat evacuation capability,compared to pure oil-based MQL system.Studies have shown that the surface quality and amount of energy expended in the grinding operations can be reduced considerably due to the positive effect of these nanofluids.This work presents an experimental study on the tribological performance of SiO_(2)nanofluid during grinding of Si_(3)N_(4)ceramic.The effect different grinding modes and lubrication systems during the grinding operation was also analyzed.Different concentrations of the SiO_(2)nanofluid was manufactured using canola,corn and sunflower oils.The quantitative evaluation of the grinding process was done based on the amount of grinding forces,specific grinding energy,frictional coefficient,and surface integrity.It was found that the canola oil exhibits optimal lubrication performance compared to corn oil,sunflower oil,and traditional lubrication systems.Additionally,the introduction of ultrasonic vibrations with the SiO_(2)nanofluid in MQL system was found to reduce the specific grinding energy,normal grinding forces,tangential grinding forces,and surface roughness by 65%,57%,65%,and 18%respectively.Finally,regression analysis was used to obtain an optimum parameter combinations.The observations from this work will aid the smooth transition towards ecofriendly and sustainable machining of engineering ceramics.
文摘Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.
基金support from the National Science Fund of China(52325506)the National Science and Technology Major Project(2017-VII-0002-0095)Fundamental Research Funds for the Central Universities(DUT22LAB501)。
文摘Fatigue properties are crucial for critical aero-engine components in extreme serviceenvironments,which are significantly affected by surface integrity(SI)indexes(especially surface topography,residual stressσ_(res),and microhardness)after machining processes.Normal-direction ultrasonic vibration-assisted face grinding(ND-UVAFG)has advantages in improving the machinability of Inconel 718,but there is a competitive relationship between higher compressiveσ_(res)and higher surface roughness R_(a)in affecting fatigue strength.The lack of a quantitative relationship between multiple SI indexes and fatigue strength makes theindeterminacy of a regulatory strategy for improving fatigue properties.In this work,a model of fatigue strength(σ_f)_(sur)considering multiple SI indexes was developed.Then,high-cycle fatigue tests were carried out on Inconel 718 samples with different SI characteristics,and the influence of ND-UVAFG process parameters on SI was analyzed.Based on SI indexes data,the(σ_f)_(sur)distribution in the grinding surface layer for ND-UVAFG Inconel 718 samples was determined using the developed model,and then the fatigue crack initiation(FCI)sites were furtherpredicted.The predicted FCI sites corresponded well with the experimental results,therebyverifying this model.A strategy for improving the fatigue life was proposed in this work,which was to transfer the fatigue source from the machined surface to the bulk material by controlling the SI indexes.Finally,a critical condition of SI indexes that FCI sites appeared on the surface or in bulk material was given by fitting the predicted results.According to the critical condition,an SI field where FCI sites appeared in the bulk material could be obtained.In this field,thefatigue life of Inconel 718 samples could be improved by approximately 140%.
基金Supported by Militar Nueva Granada University of Colombia (Grant No.IMP-ING-3127)。
文摘Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open questions related to technological aspects.This work presents a systematic review of upper limb rehabilitation robotics in order to analyze and establish technological challenges and future directions in this area.A bibliometric analysis was performed for the systematic literature review.Literature from the last six years,conducted between August 2020 and May 2021,was reviewed.The methodology for the literature search and a bibliometric analysis of the metadata are presented.After a preliminary search resulted in 820 articles,a total of 66 articles were included.A concurrency network and bibliographic analysis were provided.And an analysis of occurrences,taxonomy,and rehabilitation robotics reported in the literature is presented.This review aims to provide to the scientific community an overview of the state of the art in assistive robotics for upper limb physical rehabilitation.The literature analysis allows access to a gap of unexplored options to define the technological prospects applied to upper limb physical rehabilitation robotics.
文摘This paper attempts to approach the interface of a robot from the perspective of virtual assistants.Virtual assistants can also be characterized as the mind of a robot,since they manage communication and action with the rest of the world they exist in.Therefore,virtual assistants can also be described as the brain of a robot and they include a Natural Language Processing(NLP)module for conducting communication in their human-robot interface.This work is focused on inquiring and enhancing the capabilities of this module.The problem is that nothing much is revealed about the nature of the human-robot interface of commercial virtual assistants.Therefore,any new attempt of developing such a capability has to start from scratch.Accordingly,to include corresponding capabilities to a developing NLP system of a virtual assistant,a method of systemic semantic modelling is proposed and applied.For this purpose,the paper briefly reviews the evolution of virtual assistants from the first assistant,in the form of a game,to the latest assistant that has significantly elevated their standards.Then there is a reference to the evolution of their services and their continued offerings,as well as future expectations.The paper presents their structure and the technologies used,according to the data provided by the development companies to the public,while an attempt is made to classify virtual assistants,based on their characteristics and capabilities.Consequently,a robotic NLP interface is being developed,based on the communicative power of a proposed systemic conceptual model that may enhance the NLP capabilities of virtual assistants,being tested through a small natural language dictionary in Greek.
文摘Context: Advanced heart failure (AHF) poses a global challenge, where heart transplantation is a treatment option but limited by donor scarcity. Proposal: This study aims to enhance the performance of ventricular assist devices (VADs) in the face of adverse events (AEs) using a resilience-based approach. The objective is to develop a method for integrating resilience attributes into VAD control systems, employing dynamic risk analysis and control strategies. Results: The outcomes include a resilient control architecture enabling anticipatory, regenerative, and degenerative actions in response to AEs. A method of applied resilience (MAR) based on dynamic risk management and resilience attribute analysis was proposed. Conclusion: Dynamic integration between medical and technical teams allows continuous adaptation of control systems to meet patient needs over time, improving reliability, safety, and effectiveness of VADs, with potential positive impact on the health of heart failure patients.
基金This research was funded by the National Natural Science Foundation of China(Grant Number 61902069)Natural Science Foundation of Fujian Province of China(Grant Number 2021J011068)+1 种基金Research Initiation Fund Program of Fujian University of Technology(GY-S24002,GY-Z21048)Fujian Provincial Department of Science and Technology Industrial Guidance Project(Grant Number 2022H0025).
文摘The Advanced Metering Infrastructure(AMI),as a crucial subsystem in the smart grid,is responsible for measuring user electricity consumption and plays a vital role in communication between providers and consumers.However,with the advancement of information and communication technology,new security and privacy challenges have emerged for AMI.To address these challenges and enhance the security and privacy of user data in the smart grid,a Hierarchical Privacy Protection Model in Advanced Metering Infrastructure based on Cloud and Fog Assistance(HPPM-AMICFA)is proposed in this paper.The proposed model integrates cloud and fog computing with hierarchical threshold encryption,offering a flexible and efficient privacy protection solution that significantly enhances data security in the smart grid.The methodology involves setting user protection levels by processing missing data and utilizing fuzzy comprehensive analysis to evaluate user importance,thereby assigning appropriate protection levels.Furthermore,a hierarchical threshold encryption algorithm is developed to provide differentiated protection strategies for fog nodes based on user IDs,ensuring secure aggregation and encryption of user data.Experimental results demonstrate that HPPM-AMICFA effectively resists various attack strategies while minimizing time costs,thereby safeguarding user data in the smart grid.
文摘Object: To compare the safety, clinical efficacy, and complication rate of “Tianji” robot-assisted surgery with traditional open surgery in the treatment of cervical vertebrae fracture. Methods: 60 patients with upper cervical vertebrae fracture admitted to Baise People’s Hospital between November 2018 and April 2024 were retrospectively analyzed. Among these patients, 29 underwent “Tianji” robot-assisted surgery (Robot group), and 31 underwent traditional C-arm fluoroscopy-assisted open surgery (Open group). Statistical analysis of the data was performed using SPSS 27.0 software to compare general data (gender, age, BMI), preoperative and postoperative visual analogue scale (VAS) scores, neck disability index (NDI), intraoperative blood loss, accuracy of screw placement on imaging, and the number of complications in both groups for comprehensive evaluation. A P value < 0.05 was deemed to have achieved statistical significance. Results: There was no significant difference in preoperative VAS scores between the two groups (Robot group: 8.34 ± 0.61;Open group: 8.26 ± 0.68, P = 0.317). There was also no significant difference in VAS scores at 1 week postoperatively (Robot group: 6.90 ± 0.31;Open group: 6.94 ± 0.36, P = 0.3237). Preoperative NDI scores showed no significant difference between the two groups (Robot group: 43.31 ± 2.67;Open group: 43.84 ± 2.67, P = 0.2227), and the difference in NDI scores at 1 week postoperatively was also not significant (Robot group: 35.69 ± 4.24;Open group: 37.35 ± 3.48, P = 0.0509). Intraoperative blood loss in the Robot group was significantly lower than in the Open group (246.21 ± 209 ml vs 380.65 ± 328.04 ml, P = 0.0308), with a statistically significant difference. The operation time was longer in the Robot group (3.75 ± 0.74 h) compared to the Open group (2.74 ± 0.86 h). In terms of screw placement accuracy, the Robot group had a higher accuracy rate for Class A screws compared to the Open group (102 screws vs 94 screws, P = 0.0487), and the accuracy rate for Class B screws was also higher in the Robot group (13 screws vs 29 screws, P = 0.0333), with both differences being statistically significant. There was no significant difference in the number of complications between the two groups (Robot group: 8 cases;Open group: 10 cases, P = 0.6931). Conclusion: Patients treated with “Tianji” robot-assisted surgery for upper cervical vertebrae fracture had lower intraoperative blood loss and higher screw placement accuracy compared to those undergoing traditional C-arm fluoroscopy-assisted open surgery, indicating that this robot-assisted surgery can effectively reduce intraoperative blood loss and improve screw placement accuracy.
文摘Intelligent personal assistants play a pivotal role in in-vehicle systems,significantly enhancing life efficiency,driving safety,and decision-making support.In this study,the multi-modal design elements of intelligent personal assistants within the context of visual,auditory,and somatosensory interactions with drivers were discussed.Their impact on the driver’s psychological state through various modes such as visual imagery,voice interaction,and gesture interaction were explored.The study also introduced innovative designs for in-vehicle intelligent personal assistants,incorporating design principles such as driver-centricity,prioritizing passenger safety,and utilizing timely feedback as a criterion.Additionally,the study employed design methods like driver behavior research and driving situation analysis to enhance the emotional connection between drivers and their vehicles,ultimately improving driver satisfaction and trust.
文摘BACKGROUND The development of laparoscopic technology has provided a new choice for surgery of gastric cancer(GC),but the advantages and disadvantages of laparoscopic total gastrectomy(LTG)and laparoscopic-assisted total gastrectomy(LATG)in treatment effect and safety are still controversial.The purpose of this study is to compare the efficacy and safety of the two methods in the treatment of GC,and to provide a basis for clinical decision-making.AIM To compare the efficacy of totally LTG(TLTG)and LATG in the context of radical gastrectomy for GC.Additionally,we investigated the safety and feasibility of the total laparoscopic esophagojejunostomy technique.METHODS Literature on comparative studies of the above two surgical methods for GC(TLTG group and LATG group)published before September 2022 were searched in the PubMed,Web of Science,Wanfang Database,CNKI,and other Chinese and English databases.In addition,the following search keywords were used:Gastric cancer,total gastrectomy,total laparoscopy,laparoscopy-assisted,esophagojejunal anastomosis,gastric/stomach cancer,total gastrectomy,totally/completely laparoscopic,laparoscopic assisted/laparoscopy assisted/laparoscopically assisted,and esophagojejunostomy/esophagojejunal anastomosis.Review Manager 5.3 software was used for the meta-analysis after two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included studies.RESULTS After layer-by-layer screening,258 pieces of literature were recovered,and 11 of those pieces were eventually included.This resulted in a sample size of 2421 instances,with 1115 cases falling into the TLTG group and 1306 cases into the LATG group.Age or sex differences between the two groups were not statistically significant,according to the meta-analysis,however the average body mass index of the TLTG group was considerably higher than that of the LATG group(P=0.01).Compared with those in the LATG group,the incision length in the TLTG group was significantly shorter(P<0.001),the amount of intraoperative blood loss was significantly lower(P=0.003),the number of lymph nodes removed was significantly greater(P=0.04),and the time of first postoperative feeding and postoperative hospitalization were also significantly shorter(P=0.03 and 0.02,respectively).There were no significant differences in tumor size,length of proximal incisal margin,total operation time,anastomotic time,postoperative pain score,postoperative anal exhaust time,postoperative anastomosis-related complications(including anastomotic fistula,anastomotic stenosis,and anastomotic hemorrhage),or overall postoperative complication rate(P>0.05).CONCLUSION TLTG and esophagojejunostomy are safe and feasible.Compared with LATG,TLTG has the advantages of less trauma,less bleeding,easier access to lymph nodes,and faster postoperative recovery,and TLTG is also suitable for obese patients.
基金supported by the Major Project of the National Social Science Fund of China (NSSFC)“Economic Development for Ethnic Minorities under Socialism with Chinese Characteristics and International Comparison”(Grant No. 19ZDA173)the NSSFC Project “Study on the Implementation and Development of Educational Assistance to Xizang and Xinjiang under the Horizon of the Community of the Chinese Nation”(Grant No. CMA220323)the Elite Innovation Team of Pu’er University “Innovation Team for the Prosperity of Border Regions and Common Modernization of Ethnic Minority Regions”(Grant No. 2023PEXYCXTD002)
文摘This study highlights the changing priorities of China’s paired assistance throughout the past decades,as well as its theoretical implications and economic growth effects for recipient regions.Using panel data from 32 prefecture-level cities from 1990 to 2020,this study uses the multiperiod difference-in-differences approach to examine how paired assistance has contributed to economic growth in Xizang Autonomous Region and Xinjiang Uygur Autonomous Region.The findings indicate that,first,the implementation of the paired assistance policy has boosted economic growth in Xizang and Xinjiang.Second,paired assistance has stimulated economic growth in recipient communities by improving infrastructure.Third,paired assistance has contributed to economic growth in recipient communities by providing improved public services such as education and healthcare.Improvements to public services have a relatively smaller indirect effect in short term than infrastructure development on economic growth.Yet both education and healthcare are crucial to people’s quality of life in recipient communities.This paper has refined and broadened research on the effects of paired assistance,providing preference for future policymaking.
基金supported by MEXT Quantum Leap Flagship Program(MEXT Q-LEAP)Grant Number JPMXS0118067246.
文摘GHz burst-mode femtosecond(fs)laser,which emits a series of pulse trains with extremely short intervals of several hundred picoseconds,provides distinct characteristics in materials processing as compared with the conventional irradiation scheme of fs laser(single-pulse mode).In this paper,we take advantage of the moderate pulse interval of 205 ps(4.88 GHz)in the burst pulse for high-quality and high-efficiency micromachining of single crystalline sapphire by laser induced plasma assisted ablation(LIPAA).Specifically,the preceding pulses in the burst generate plasma by ablation of copper placed behind the sapphire substrate,which interacts with the subsequent pulses to induce ablation at the rear surface of sapphire substrates.As a result,not only the ablation quality but also the ablation efficiency and the fabrication resolution are greatly improved compared to the other schemes including single-pulse mode fs laser direct ablation,single-pulse mode fs-LIPAA,and nanosecond-LIPAA.
基金Supported by the Project of National Social Science Foundation of China(22CMZ015).
文摘In the new era,there is an urgent need to further promote pairing assistance to Tibet,promote the simultaneous construction of a strong agriculture in Tibet and the China's Mainland,and compose a Chinese-style modernization.Southern Tibet,located in the southeastern part of the Tibet Autonomous Region,includes Shannan City and Nyingchi City,is a region assisted by four provincial partners including Hubei Province.This paper introduces the agricultural environment in southern Tibet,studies its agricultural characteristics,and analyzes the main issues of its pairing assistance.Taking forging the strong consciousness of the Chinese national community as the main line,the paper explores strategies for promoting agricultural high-quality development in southern Tibet through pairing assistance to Tibet from the perspective of agricultural power,and proposes some strategies,such as inheriting agricultural cultural heritage,promoting the upgrading of modern seed industry,enhancing the characteristic advantages of highland barley(naked barley)and animal husbandry industries,and developing edible fungi and cold water fish industries.
文摘BACKGROUND Esophagopericardial fistula(EPF)is a rare,life-threatening condition with limited scientific literature and no established management guidelines.This case report highlights a successful multidisciplinary approach and the innovative use of endoscopic vacuum assisted closure(endoVAC)therapy in treating this complex condition.CASE SUMMARY A 16-year-old male with a history of esophageal atresia and colon interposition presented with progressive chest pain,fever,and dyspnea.Imaging revealed an EPF with associated pleural and pericardial effusions.Initial management with an esophageal stent failed,prompting the use of an endoVAC system.The patient underwent multiple endoVAC device changes and received broad-spectrum antibiotics and nutritional support.The fistula successfully closed,and the patient recovered,demonstrating no new symptoms at a 6-month follow-up.CONCLUSION EndoVAC therapy can effectively manage EPF,providing a minimally invasive treatment option.
文摘In times of digitalisation, visual assistance systems in assembly are increasingly important. The design of these assembly systems needs to be highly complex to meet the requirements. Due to the increasing number of variants in production processes, as well as shorter innovation and product life cycles, assistance systems should improve quality and reduce complexity of assembly processes. However, many large kitchen manufacturers still assemble kitchen cabinets manually, due to the high variety of components, such as rails and fittings. This paper focuses on the analysis and evaluation of virtual assistance systems to improve quality and usability in individualised kitchen cabinet assembly processes at a large German manufacturer. A solution is identified and detailed.
文摘Objective:To investigate the influence of season on live birth and clinical pregnancy rates,as well as assisted reproductive technology(ART)outcomes,in the Hainan region.Methods:Patients were categorized into four groups based on the dates of artificial insemination and transplantation:spring,summer,autumn,or winter.The main outcome measures were clinical pregnancy rates and live birth rates.Secondary outcomes included body mass index(BMI),oocyte number,two pronuclei(2PN)cleavage rate,total gonadotropin(Gn)dosage and days,age,2PN fertilization rate,sperm concentration,sperm PR rate,anti-Müllerian hormone(AMH),and endometrial thickness.Outpatient semen quality indicators included sperm PR rate,total sperm count,sperm concentration,and total sperm motility.Results:This retrospective cohort study analyzed 2,016 artificial insemination cycles and 1,783 ovarian retrieval cycles from January 2017 to October 2022,and assessed the semen quality of 6,651 outpatients from May 2017 to October 2022.In artificial insemination cycles,sperm PR rate and clinical pregnancy rate were highest in winter,with a statistically significant difference between groups(P<0.05).Clinical pregnancy rate was influenced by both age and sperm PR rate(P<0.05).In ovarian retrieval cycles,the winter group had significantly higher clinical pregnancy,2PN fertilization,and 2PN cleavage rates than the other groups.The autumn group had higher live birth rates,though not significantly different.Additionally,winter months showed higher total sperm concentration and total sperm number compared to other seasons.Conclusion:Seasonality affected clinical pregnancy and live birth rates in artificial insemination cycles but not in ovarian retrieval cycles in the Hainan region.These findings suggest that while there is no need to choose a specific season for ovarian retrieval cycles,artificial insemination in winter may be preferable for patients.
文摘This paper describes mass-based energy phase-space projection of microwave-assisted synthesis of transition metals (zinc oxide, palladium, silver, platinum, and gold) nanostructures. The projection uses process energy budget (measured in kJ) on the horizontal axes and process density (measured in kJg−1) on the vertical axes. These two axes allow both mass usage efficiency (Environmental-Factor) and energy efficiency to be evaluated for a range of microwave applicator and metal synthesis. The metrics are allied to the: second, sixth and eleventh principle of the twelve principle of Green Chemistry. This analytical approach to microwave synthesis (widely considered as a useful Green Chemistry energy source) allows a quantified dynamic environmental quotient to be given to renewable plant-based biomass associated with the reduction of the metal precursors. Thus allowing a degree of quantification of claimed “eco-friendly” and “sustainable” synthesis with regard to waste production and energy usage.
文摘Aim: This study evaluates the impact of Enhanced Recovery After Surgery (ERAS) nursing on postoperative complications and quality of life in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE). Methods: A total of 150 patients who underwent RAMIE from January 2020 to January 2022 at our hospital were randomly assigned to either the observation group or the control group, with 75 patients in each. The control group received standard perioperative management and nursing care, while the observation group was treated with ERAS nursing strategies. Interventions continued until discharge, and outcomes such as postoperative complications, quality of life, and nutritional status were compared between the groups. Results: The observation group exhibited a significantly lower incidence of postoperative adverse reactions compared to the control group (P ionally, all dimension scores of the Short-Form 36 Health Survey (SF-36), including the total score, were higher in the observation group (P < 0.05). Furthermore, the Nutritional Risk Screening (NRS) scores for impaired nutritional status and disease severity, along with the total NRS score, were significantly lower in the observation group compared to the control group (P Conclusion: Implementing ERAS nursing in the perioperative care of patients undergoing RAMIE is associated with reduced postoperative complications and enhanced postoperative quality of life and nutritional status. .
文摘Introduction: Acromioclavicular (AC) joint dislocation is a common shoulder injury, comprising 9% - 12% of shoulder girdle injuries. Optimal management remains challenging, with treatment decisions guided by the Rockwood classification system. Controversies surround grade III injuries, necessitating further classification. Non-operative treatment has shown favorable outcomes, while surgical interventions vary. Anatomical coracoclavicular reconstruction (ACCR) has demonstrated biomechanical advantages over traditional methods. Arthroscopic techniques offer advantages, minimizing deltoid detachment and allowing concurrent pathology identification. This study evaluates the outcomes of arthroscopic-assisted ACCR in chronic AC joint dislocation. Surgical Technique: Arthroscopic-assisted ACCR involves meticulous portal placement, tendon graft harvesting, diagnostic arthroscopy, and coracoid exposure. The clavicle tunnels were made to mimic the conoid and trapezoid ligament positions, using FibreTape#2 loop and Dog Bone Button for correct placement against the coracoid base, and passing the semitendinosus graft through to reconstruct the conoid ligament, reduction done and graft follow through for anatomical reconstruction. Methods: A retrospective cohort study at Hospital Kuala Lumpur analyzed 35 patients undergoing arthroscopic-assisted ACCR for Rockwood grade III - V AC joint dislocations. Inclusion criteria encompassed trauma ≥ 3 weeks prior, no prior shoulder injuries, and ≥12-month follow-up. Functional and radiological assessments utilized ASES scores and coracoclavicular distances, respectively. Statistical analysis employed descriptive statistics and logistic regression. Results: The mean age was 38.9 years (SD 11.26), and 34 of 35 patients were male. Grade IV injuries were predominant (37.1%). Waiting time for surgery averaged 234.9 days. Functional improvement was substantial postoperatively (ASES: 55.5 to 88.9). Radiological outcomes demonstrated reduced coracoclavicular distances and maintained reduction. No significant correlation was observed between injury grade and outcomes. Conclusion: Arthroscopic-assisted ACCR for chronic AC joint dislocation yields significant functional and radiological improvement, irrespective of injury grade. Waiting time for surgery exhibits minor impact on outcomes, emphasizing the procedure’s efficacy. Concomitant injuries do not impede success, highlighting the versatility of this approach in managing shoulder instability. The study contributes valuable insights into the nuanced management of chronic AC joint dislocations and supports the adoption of arthroscopic-assisted ACCR as a viable treatment option.