Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Optimum Profiles of Endwall Contouring for Enhanced Net Heat Flux Reduction and Aerodynamic Performance

Successfully utilized non-axisymmetric endwalls to enhance turbine efficiencies(aerodynamic and turbine inlet temperatures)by controlling the characteristics of the secondary flow in a blade passage.This is accomplished by steady-state numerical hydrodynamics and deep knowledge of the field of flow.Because of the interaction between mainstream and purge flow contributing supplementary losses in the stage,non-axisymmetric endwalls are highly susceptible to the inception of purge flow exit compared to the flat and any advantage rapidly vanishes.The conclusions reveal that the supreme endwall pattern could yield a lowering of the gross pressure loss at the design stage and is related to the size of the top-loss location being productively lowered.This has led to diminished global thermal exchange lowered in the passage of the vane alone.The reverse flow adjacent to the suction side corner of the endwall is migrated farther from the vane surface,as the deviated pressure spread on the endwall accelerates the flow and progresses the reverse flow core still downstream.The depleted association between the tornado-like vortex and the corner vortex adjacent to the suction side corner of the endwall is the dominant mechanism of control in the contoured end wall.In this publication,we show that the non-axisymmetric endwall contouring by selective numerical shape change method at most prominent locations is advantageous in lowering the thermal load in turbines to augment the net heat flux reduction as well as the aerodynamic performance using multi-objective optimization.

Loss to Specialized Cardiology Follow-Up in Adults Living with Congenital Heart Disease

Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.

Essential role of postoperative follow-up in the management of clear cell sarcoma

Clear cell sarcoma(CCS)is a rare melanocytic soft tissue sarcoma known for itspropensity to metastasize to the lymph nodes and typically has an unfavorableprognosis.Currently,surgical resection is the primary treatment for localizedCCS,while radiotherapy and chemotherapy are preferred for metastatic cases.The roles of adjuvant chemotherapy,radiotherapy,and lymph node dissection arecontroversial.Although immunotherapy has emerged as a promising avenue inCCS treatment research,there are no established clinical standards for postoperativefollow-up.This editorial discusses a recent article by Liu et al,with afocus on current diagnostic modalities,treatment approaches,and the challengingprognosis associated with CCS.Our aim is to underscore the importance of longtermpatient follow-up in CCS management.

Real-time instance segmentation based on contour learning

Instance segmentation plays an important role in image processing.The Deep Snake algorithm based on contour iteration deforms an initial bounding box to an instance contour end-to-end,which can improve the performance of instance segmentation,but has defects such as slow segmentation speed and sub-optimal initial contour.To solve these problems,a real-time instance segmentation algorithm based on contour learning was proposed.Firstly,ShuffleNet V2 was used as backbone network,and the receptive field of the model was expanded by using a 5×5 convolution kernel.Secondly,a lightweight up-sampling module,multi-stage aggregation(MSA),performs residual fusion of multi-layer features,which not only improves segmentation speed,but also extracts effective features more comprehensively.Thirdly,a contour initialization method for network learning was designed,and a global contour feature aggregation mechanism was used to return a coarse contour,which solves the problem of excessive error between manually initialized contour and real contour.Finally,the Snake deformation module was used to iteratively optimize the coarse contour to obtain the final instance contour.The experimental results showed that the proposed method improved the instance segmentation accuracy on semantic boundaries dataset(SBD),Cityscapes and Kins datasets,and the average precision reached 55.8 on the SBD;Compared with Deep Snake,the model parameters were reduced by 87.2%,calculation amount was reduced by 78.3%,and segmentation speed reached 39.8 frame·s−1 when instance segmentation was performed on an image with a size of 512×512 pixels on a 2080Ti GPU.The proposed method can reduce resource consumption,realize instance segmentation tasks quickly and accurately,and therefore is more suitable for embedded platforms with limited resources.

Long-term assessment of collagenase treatment for Dupuytren’s contracture:A 10-year follow-up study

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.

Analysis of GC×GC fingerprints from medicinal materials using a novel contour detection algorithm:A case of Curcuma wenyujin

This study introduces an innovative contour detection algorithm,PeakCET,designed for rapid and efficient analysis of natural product image fingerprints using comprehensive two-dimensional gas chromatogram(GC×GC).This method innovatively combines contour edge tracking with affinity propagation(AP)clustering for peak detection in GC×GC fingerprints,the first in this field.Contour edge tracking signif-icantly reduces false positives caused by“burr”signals,while AP clustering enhances detection accuracy in the face of false negatives.The efficacy of this approach is demonstrated using three medicinal products derived from Curcuma wenyujin.PeakCET not only performs contour detection but also employs inter-group peak matching and peak-volume percentage calculations to assess the compositional similarities and differences among various samples.Furthermore,this algorithm compares the GC×GC fingerprints of Radix/Rhizoma Curcumae Wenyujin with those of products from different botanical origins.The findings reveal that genetic and geographical factors influence the accumulation of secondary metabolites in various plant tissues.Each sample exhibits unique characteristic components alongside common ones,and vari-ations in content may influence their therapeutic effectiveness.This research establishes a foundational data-set for the quality assessment of Curcuma products and paves the way for the application of computer vision techniques in two-dimensional(2D)fingerprint analysis of GC×GC data.

Contour Farming Suitability of the Black Soil Region in Northeast China and Its Spatial Characteristics

Contour farming technology plays a key role in reducing soil erosion,enhancing water use efficiency,and fostering sustain-able agricultural development,Despite being a straightforward yet efficacious farming technique,it has not seen widespread implement-ation in China.Considering the deteriorating quality of arable lands in the Black Soil Region of Northeast China(BSR-NEC),it is ne-cessary to investigate spatial patterns and identify suitable areas for contour farming in this region.To achieve this objective,spatial autocorrelation and grouping analysis methods were employed to classify the land into four categories of suitability for contour farming:highly suitable,moderately suitable,generally suitable,and unsuitable.The results reveal that:1)the contour farming suitable area in BSR-NEC covers 89861.32 km^(2),accounting for 21.59%of arable land as of 2020.Heilongjiang Province owns the largest suitable area of 32853.68 km^(2),and Inner Mongolia has the highest proportion of 28.89%.2)In terms of the spatial distribution,regions with higher suitability for contour farming are concentrated in the Da Hinggan Mountains region,particularly Nenjiang City(Heilongjiang Province),which has the highest area of 2593.07 km^(2).Areas with a high proportion of suitable arable lands for contour farming are mainly found in the Da Hinggan Mountains and Changbai Mountains regions,with Ergun City(Inner Mongolia)having the highest pro-portion at 47.2%.Regions with higher suitability and proportion are concentrated in the Da Hinggan Mountains region,primarily cover-ing the Inner Mongolia and Heilongjiang.3)Regarding spatial clustering,both the area and proportion of suitable contour farming areas exhibit noticeable clustering effects,though not entirely consistent.4)Group analysis results designate 148 counties in BSR-NEC as highly suitable areas,predominantly located in the Changbai Mountains region,Liaodong Peninsula,Hulun Buir Plateau,and the north and south regions of the Da Hinggan Mountains.The zoning of suitable areas for contour farming in BSR-NEC informs the strategic de-velopment of policies and measures,allowing for the implementation of targeted policies in distinct areas suitable for contour farming.This provides a valuable reference for promoting contour farming technology more effectively and efficiently.re effectively and effi-ciently.

Environmental Impact Assessment Follow-Up of Seismic Survey Offshore Activities in Brazil

Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.

Body Contour in the Post-Bariatric Male Patient

Background: Obesity is currently considered a public health problem. Bariatric procedures have become an important part of obesity management and, consequently, the number of male patients seeking post-bariatric reconstructive procedures have increased. Therefore, the clinical approach and understanding of the body contour of this population have become more relevant. The goal of post-bariatric reconstruction is to enhance the male silhouette through removal of skin and adipose tissue excess, and abdominal rectus diastasis repair. Material and Methods: We conducted a retrospective study at the Plastic and Reconstructive Surgery Department of the National Medical Center “20 de Noviembre”. All male patients referred to our department to start a post-bariatric reconstruction protocol from January 2018 to December 2022 were included in this study. Results: In total, 15 patients who underwent corporal contouring procedures were included;median age was 49.2 years with minimum of 33 years, and a maximum of 57 years. Median Body mass index was 28.4 kg/m2 with minimum of 22 kg/m2 and maximum of 38 kg/m2. All patients were treated 18 months after their bariatric surgery. All patients underwent an abdominoplasty as a body contouring procedure. 4 (26.7%) patients presented complications related to the surgery. Conclusion: We described a comprehensive and systematic approach to massive weight loss for male patients, suggesting an abdominal marking based on the patient’s clinical features and the expected results avoiding feminization of the abdominal body contour.

Clinical Efficacy of GBR Technique Combined with Temporary Bridgework-Guided Gingival Contouring in Treating Upper Anterior Tooth Loss with Labial Bone Defects

Objective:To investigate the clinical effect of the guided bone regeneration(GBR)technique combined with temporary bridgework-guided gingival contouring in treating upper anterior tooth loss with labial bone defects.Methods:From July 2023 to April 2024,80 patients with upper anterior tooth loss and labial bone defects were admitted to the hospital and selected as evaluation samples.They were divided into an observation group(n=40)and a control group(n=40)using a numerical table lottery scheme.The control group received treatment with the GBR technique,while the observation group received treatment with the GBR technique combined with temporary bridges to guide gingival contouring.The two groups were compared in terms of clinical red aesthetic scores(PES),labial alveolar bone density,labial bone wall thickness,gingival papillae,gingival margin levels,and patient satisfaction.Results:The PES scores of patients in the observation group were higher than those in the control group after surgery(P<0.05).The bone density of the labial alveolar bone and the thickness of the labial bone wall in the observation group were higher than those in the control group.The levels of gingival papillae and gingival margins were lower in the observation group after surgery(P<0.05).Additionally,patient satisfaction in the observation group was higher than in the control group(P<0.05).Conclusion:The GBR technique combined with temporary bridge-guided gingival contouring for treating upper anterior tooth loss with labial bone defects can improve the aesthetic effect of gingival soft tissue,increase alveolar bone density and the thickness of the labial bone wall,and enhance patient satisfaction.This approach is suitable for widespread application in healthcare institutions.

凯途(CONTOUR)在低位直肠癌双吻合器技术中的应用

目的:评价CONTOUR在双吻合器技术中的作用。方法:回顾性分析2005年4月至2006年7月在低位直肠癌中应用的90例CONTOUR和219例XF进行双吻合器技术的比较。结果:CONTOUR组保肛率(57.8%)优于XF组(44.7%);吻合口漏、吻合口狭窄和吻合口出血等并发症两组无差异。结论:CONTOUR不增加并发症,能提高保肛率,是双吻合器技术中XF很好的替代产品。

Internal residual stress measurement on linear friction welding of titanium alloy plates with contour method

The internal residual stress within a TC 17 titanium alloy joint welded by linear friction welding （LFW） was measured by the contour method, which is a relatively new and destructive technique to obtain a full map of internal residual stress. The specimen was first cut into two parts; the out-of-plane displacement contour formed by the release of the residual stress was then measured; finally, taking the measured contour of the cut plane as the boundary conditions, a linear elastic finite element analysis was carried out to calculate the corresponding distribution of residual stress normal to the cut plane. The internal stress distribution of the TC 17 titanium alloy LFWjoint was also analyzed. The results show that the tensile residual stress in the TC17 LFW weld is mainly present within a region about 12 mm from the weld centerline; the peak tensile residual stress occurs at the weld centerline and reaches 360 MPa （about one third of the yield strength of TC17 alloy）; within the weld zone of the TC17 LFW weld, the through-thickness stress is not uniform, and the internal stress is larger than that near the top or bottom surface.

CONTOUR EXTRACTION AND FEATURE POINT DETECTION FOR 3-D FRAGMENT REASSEMBLY

An approach to contour extraction and feature point detection in the 3-D fragment reassembly is proposed. A simple and effective technique is used for building the intrinsic topology of the fragment data suitable for contour extraction. For the scanned data in which the topology is difficult to be achieved, the corresponding solutions are given to manage this problem. A robust approach is used for the curvature and torsion calculation of the discrete contour in a 3-D space. Finally, a method is developed for detecting feature points of the fragment contour based on total curvature. Therefore, the contour description combines the simple global information with local feature points. Experiments with real contour curves extracted from 3-D fragments demonstrate that the proposed method is robust and efficient.

活动轮廓模型和Contourlet多分辨率分析分割血管内超声图像

针对传统图像分割方法中初始化和鲁棒性两个问题,研究了基于活动轮廓模型和Contourlet多分辨率分析分割血管内超声斑块图像的新方法。该方法运用Contourlet变换将原图像分解为多分辨率低通分量和多分辨率带通分量方向性子带。对低通分量进行模板匹配,确定血管内腔边界和中-外膜边界的初始轮廓;对带通分量方向性子带进行扩散滤波,抑制噪声的同时尽可能保留有用边缘,并结合边界矢量场使轮廓演化得到最终分割结果,从而提高了分割算法的鲁棒性。对100幅仿真图像和120幅实际图像的分割结果表明,相对于传统活动轮廓模型,该方法分割实际图像的平均距离误差提高了3.04 pixel,面积差异百分比提高了6.30%。表明该方法能自动、精确地提取血管的两条边界。

CONTOUR0.5T磁共振射频系统故障的排除

CONTOUR 0．5T磁共振成像系统在国内装机量较大．目前该产品逐渐进入了故障多发期。现介绍1例CONTOUR 0．5TMR射频系统故障排除过程，供参考。

AccuContour和DeepViewer两款软件自动勾画胰腺癌患者肾脏结构的比较

目的分析比较AccuContour和DeepViewer两款国产软件自动勾画胰腺癌患者肾脏结构的准确性。方法选择20例胰腺癌患者的定位CT图像进行回顾性研究。分别使用MANTEIA公司的AccuContour和慧软公司的DeepViewer两款软件,在定位CT图像中自动勾画肾脏结构,所得结果与手工勾画的肾脏结构进行比较。通过对体积差异(ΔV%)、质心偏差(Deviation of Centroid,DC)和Dice相似性指数(Dice Similarity Coefficient,DSC)的分析,比较两款软件在体积、位置和形状方面自动勾画的效果和差异。结果AccuContour和DeepViewer两款软件自动勾画胰腺癌患者的肾脏结构,ΔV%分别为左肾0.13%±4.60%和0.83%±7.14%,右肾0.40%±5.24%和1.49%±5.06%;DC分别为左肾(0.87±0.95)mm和(0.76±0.90)mm,右肾(0.67±0.72)mm和(0.90±1.08)mm;DSC分别为左肾0.930±0.020和0.934±0.023,右肾0.934±0.022和0.930±0.030。对两款软件的ΔV%、DC和DSC三种参数进行配对t检验,结果均没有统计学差异(P>0.05)。结论两款软件自动勾画胰腺癌患者的肾脏结构,都能够达到满意的结果;AccuContour软件在体积差异、位置差异和形状相似性方面,与DeepViewer软件相比没有差异。

基于非采样Contourlet特征的水印算法

提出一种利用非采样Contourlet边缘方向信息实现对RST攻击校正的水印方案。该方案利用非采样Contourlet变换提取载体图像多尺度多方向上的变换系数,对显著方向子带系数进行二值并细化,获得载体图像轮廓方向信息。水印检测时,利用轮廓方向的特征点集估计测试图像受到RST攻击的参数,从而使测试图像恢复到原来的大小和位置,即恢复已丢失的同步信息。实验结果表明,该方法对RST攻击具有较好的鲁棒性。

一种由内向外的Active Contour模型图像分割算法

针对主动轮廓模型图像分割,提出一种改进算法。该算法首先选取边界内部点为轮廓初始点,再根据能量与面积的关系,将传统算法中初始点向边界点收缩改进为由初始点向边界点膨胀。算法的实现采用原始模型和改进模型相互交替的贪婪算法,保证了模型的稳定性特点。实验结果表明:这种由内向外的分割算法比传统模型分割效果好及适用范围广;避免了传统模型对凹陷区域分割效果不理想及边界外部复杂环境对分割效果的影响。

Nucleus 24 Contour人工耳蜗植入术初步体会

目的 报道16例Nucleus24Contour人工耳蜗的手术方法和初步效果。方法 介绍Nucleus24Contour人工耳蜗手术方法、注意事项和结果,与Nucleus24M人工耳蜗植入后的编程调试结果(T-Level,C-Level)进行比较。结果 16例病人术后4～5次编程调试后,声场测听达到20～35dB(HL),平均24.4±5.8dB,C-level。T-Level和C-Level均比Nucleuse24M要小,动态范围比Nucleus24M大。结论 初步结果显示,Nucleus24Contour人工耳蜗性能比Nucleus24M型人工耳蜗有某些提高,但手术时应注意操作特点。