BACKGROUND The TRIANGLE operation involves the removal of all tissues within the triangle bounded by the portal vein-superior mesenteric vein,celiac axis-common hepatic artery,and superior mesenteric artery to improve...BACKGROUND The TRIANGLE operation involves the removal of all tissues within the triangle bounded by the portal vein-superior mesenteric vein,celiac axis-common hepatic artery,and superior mesenteric artery to improve patient prognosis.Although previously promising in patients with locally advanced pancreatic ductal adenocarcinoma(PDAC),data are limited regarding the long-term oncological outcomes of the TRIANGLE operation among resectable PDAC patients undergoing pancreaticoduodenectomy(PD).AIM To evaluate the safety of the TRIANGLE operation during PD and the prognosis in patients with resectable PDAC.METHODS This retrospective cohort study included patients who underwent PD for pancreatic head cancer between January 2017 and April 2023,with or without the TRIANGLE operation.Patients were divided into the PD_(TRIANGLE)and PD_(non-TRIANGLE)groups.Surgical and survival outcomes were compared between the two groups.Adequate adjuvant chemotherapy was defined as adjuvant chemotherapy≥6 months.RESULTS The PD_(TRIANGLE)and PD_(non-TRIANGLE) groups included 52 and 55 patients,respectively.There were no significant differences in the baseline characteristics or perioperative indexes between the two groups.Furthermore,the recurrence rate was lower in the PD_(TRIANGLE) group than in the PD_(non-TRIANGLE) group(48.1%vs 81.8%,P<0.001),and the local recurrence rate of PDAC decreased from 37.8%to 16.0%.Multivariate Cox regression analysis revealed that PD_(TRIANGLE)(HR=0.424;95%CI:0.256-0.702;P=0.001),adequate adjuvant chemotherapy≥6 months(HR=0.370;95%CI:0.222-0.618;P<0.001)and margin status(HR=2.255;95%CI:1.252-4.064;P=0.007)were found to be independent factors for the recurrence rate.CONCLUSION The TRIANGLE operation is safe for PDAC patients undergoing PD.Moreover,it reduces the local recurrence rate of PDAC and may improve survival in patients who receive adequate adjuvant chemotherapy.展开更多
In current dual porosity/permeability models,there exists a fundamental assumption that the adsorption-induced swelling is distributed uniformly within the representative elementary volume (REV),irrespective of its in...In current dual porosity/permeability models,there exists a fundamental assumption that the adsorption-induced swelling is distributed uniformly within the representative elementary volume (REV),irrespective of its internal structures and transient processes.However,both internal structures and transient processes can lead to the non-uniform swelling.In this study,we hypothesize that the non-uniform swelling is responsible for why coal permeability in experimental measurements is not only controlled by the effective stress but also is affected by the adsorption-induced swelling.We propose a concept of the swelling triangle composed of swelling paths to characterize the evolution of the non-uniform swelling and serve as a core link in coupled multiphysics.A swelling path is determined by a dimensionless volumetric ratio and a dimensionless swelling ratio.Different swelling paths have the same start and end point,and each swelling path represents a unique swelling case.The swelling path as the diagonal of the triangle represents the case of the uniform swelling while that as the two perpendicular boundaries represents the case of the localized swelling.The paths of all intermediate cases populate inside the triangle.The corresponding relations between the swelling path and the response of coal multiphysics are established by a non-uniform swelling coefficient.We define this method as the triangle approach and corresponding models as swelling path-based ones.The proposed concept and models are verified against a long-term experimental measurement of permeability and strains under constant effective stress.Our results demonstrate that during gas injection,coal multiphysics responses have a close dependence on the swelling path,and that in both future experiments and field predictions,this dependence must be considered.展开更多
BACKGROUND Radical surgery combined with systemic chemotherapy offers the possibility of long-term survival or even cure for patients with pancreatic ductal adenocar-cinoma(PDAC),although tumor recurrence,especially l...BACKGROUND Radical surgery combined with systemic chemotherapy offers the possibility of long-term survival or even cure for patients with pancreatic ductal adenocar-cinoma(PDAC),although tumor recurrence,especially locally,still inhibits the treatment efficacy.The TRIANGLE technique was introduced as an extended dissection procedure to improve the R0 resection rate of borderline resectable or locally advanced PDAC.However,there was a lack of studies concerning postoperative complications and long-term outcomes of this procedure on patients with resectable PDAC.PDAC.METHODS Patients with resectable PDAC eligible for PD from our hospital between June 2018 and December 2021 were enrolled in this retrospective cohort study.All the patients were divided into PDstandard and PDTRIANGLE groups according to the surgical procedure.Baseline characteristics,surgical data,and postoperative morbidities were recorded.All of the patients were followed up,and the date and location of tumor recurrence,and death were recorded.The Kaplan-Meier method and log-rank test were used for the survival analysis.RESULTS There were 93 patients included in the study and 37 underwent the TRIANGLE technique.Duration of operation was longer in the PDTRIANGLE group compared with the PDstandard group[440(410-480)min vs 320(265-427)min](P=0.001).Intraoperative blood loss[700(500-1200)mL vs 500(300-800)mL](P=0.009)and blood transfusion[975(0-1250)mL vs 400(0-800)mL](P=0.009)were higher in the PDTRIANGLE group.There was a higher incidence of surgical site infection(43.2%vs 12.5%)(P=0.001)and postoperative diarrhea(54.1%vs 12.5%)(P=0.001)in the PDTRIANGLE group.The rates of R0 resection and local recurrence,overall survival,and disease-free survival did not differ significantly between the two groups.CONCLUSION The TRIANGLE technique is safe,with acceptable postoperative morbidities compared with standardized PD,but it does not improve prognosis for patients with resectable PDAC.展开更多
目的研究糖尿病患者采用Triangle分层分级管理结合LEARNS模式干预的护理效果。方法选择2020年10月—2023年10月东南大学附属中大医院收治的40例糖尿病患者为研究对象,以随机抽签法分为A组(20例,行Triangle分层分级管理结合LEARNS模式护...目的研究糖尿病患者采用Triangle分层分级管理结合LEARNS模式干预的护理效果。方法选择2020年10月—2023年10月东南大学附属中大医院收治的40例糖尿病患者为研究对象,以随机抽签法分为A组(20例,行Triangle分层分级管理结合LEARNS模式护理)和B组(20例,施行常规护理干预)。对比两组护理前后血糖水平、糖尿病自我管理行为量表(Summary of Diabetes Self Care Activities,SDSCA)评分及依从性。结果干预后,A组患者血糖水平显著优于B组,差异有统计学意义(P<0.05)。干预前,两组患者SDSCA评分对比,差异无统计学意义(P>0.05);干预后,A组SDSCA评分显著优于B组,差异有统计学意义(P<0.05)。A组患者依从性显著优于B组,差异有统计学意义(P<0.05)。结论给予糖尿病患者Triangle分层分级管理结合LEARNS模式进行干预,与常规护理干预对比,其能够很大程度改善患者血糖情况,提高糖尿病患者自我管理能力及依从性。展开更多
With the development of the Internet of Things(IoT),it requires better performance from wireless sensor networks(WSNs),such as larger coverage,longer lifetime,and lower latency.However,a large amount of data generated...With the development of the Internet of Things(IoT),it requires better performance from wireless sensor networks(WSNs),such as larger coverage,longer lifetime,and lower latency.However,a large amount of data generated from monitoring and long-distance transmission places a heavy burden on sensor nodes with the limited battery power.For this,we investigate an unmanned aerial vehicles assisted mobile wireless sensor network(UAV-assisted WSN)to prolong the network lifetime in this paper.Specifically,we use UAVs to assist the WSN in collecting data.In the current UAV-assisted WSN,the clustering and routing schemes are determined sequentially.However,such a separate consideration might not maximize the lifetime of the whole WSN due to the mutual coupling of clustering and routing.To efficiently prolong the lifetime of the WSN,we propose an integrated clustering and routing scheme that jointly optimizes the clustering and routing together.In the whole network space,it is intractable to efficiently obtain the optimal integrated clustering and routing scheme.Therefore,we propose the Monte-Las search strategy based on Monte Carlo and Las Vegas ideas,which can generate the chain matrix to guide the algorithm to find the solution faster.Unnecessary point-to-point collection leads to long collection paths,so a triangle optimization strategy is then proposed that finds a compromise path to shorten the collection path based on the geometric distribution and energy of sensor nodes.To avoid the coverage hole caused by the death of sensor nodes,the deployment of mobile sensor nodes and the preventive mechanism design are indispensable.An emergency data transmission mechanism is further proposed to reduce the latency of collecting the latency-sensitive data due to the absence of UAVs.Compared with the existing schemes,the proposed scheme can prolong the lifetime of the UAVassisted WSN at least by 360%,and shorten the collection path of UAVs by 56.24%.展开更多
目的:分析基于Triangle模型的分层分级延续护理在2型糖尿病(T2DM)病人中的应用效果。方法:纳入2021年11月—2022年11月在徐州医科大学附属宿迁医院接受治疗的120例T2DM病人,按随机数字表法分为观察组与对照组,各60例。对照组接受延续性...目的:分析基于Triangle模型的分层分级延续护理在2型糖尿病(T2DM)病人中的应用效果。方法:纳入2021年11月—2022年11月在徐州医科大学附属宿迁医院接受治疗的120例T2DM病人,按随机数字表法分为观察组与对照组,各60例。对照组接受延续性护理,观察组接受基于Triangle模型的分层分级延续性护理。于干预前、干预3个月时、干预6个月时评定病人血糖控制状况、自我管理能力、生活质量;并记录病人干预期间再住院次数。结果:干预3个月、6个月时,两组病人空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平明显低于干预前,糖尿病自我管理行为量表(SDSCA)得分高于干预前,中国糖尿病病人生存质量特异性量表(DSQL)得分低于干预前,且观察组病人各项指标改善优于对照组(P<0.05);但两组病人干预6个月时的各项指标与干预3个月时比较,差异无统计学意义(P>0.05);观察组病人再住院次数少于对照组(P<0.05)。结论:基于Triangle模型的分层分级延续性护理可提高T2DM病人的血糖控制水平、自我管理能力及生活质量,并减少再住院次数。展开更多
Clustering a social network is a process of grouping social actors into clusters where intra-cluster similarities among actors are higher than inter-cluster similarities. Clustering approaches, i.e. , k-medoids or hie...Clustering a social network is a process of grouping social actors into clusters where intra-cluster similarities among actors are higher than inter-cluster similarities. Clustering approaches, i.e. , k-medoids or hierarchical, use the distance function to measure the dissimilarities among actors. These distance functions need to fulfill various properties, including the triangle inequality (TI). However, in some cases, the triangle inequality might be violated, impacting the quality of the resulting clusters. With experiments, this paper explains how TI violates while performing traditional clustering techniques: k-medoids, hierarchical, DENGRAPH, and spectral clustering on social networks and how the violation of TI affects the quality of the resulting clusters.展开更多
基金Supported by Shanghai Science and Technology Commission of Shanghai Municipality,No.20Y11908600Shanghai Municipal Health Commission,No.20194Y0195Medical Engineering Jiont Fund of Fudan University,No.XM03231533.
文摘BACKGROUND The TRIANGLE operation involves the removal of all tissues within the triangle bounded by the portal vein-superior mesenteric vein,celiac axis-common hepatic artery,and superior mesenteric artery to improve patient prognosis.Although previously promising in patients with locally advanced pancreatic ductal adenocarcinoma(PDAC),data are limited regarding the long-term oncological outcomes of the TRIANGLE operation among resectable PDAC patients undergoing pancreaticoduodenectomy(PD).AIM To evaluate the safety of the TRIANGLE operation during PD and the prognosis in patients with resectable PDAC.METHODS This retrospective cohort study included patients who underwent PD for pancreatic head cancer between January 2017 and April 2023,with or without the TRIANGLE operation.Patients were divided into the PD_(TRIANGLE)and PD_(non-TRIANGLE)groups.Surgical and survival outcomes were compared between the two groups.Adequate adjuvant chemotherapy was defined as adjuvant chemotherapy≥6 months.RESULTS The PD_(TRIANGLE)and PD_(non-TRIANGLE) groups included 52 and 55 patients,respectively.There were no significant differences in the baseline characteristics or perioperative indexes between the two groups.Furthermore,the recurrence rate was lower in the PD_(TRIANGLE) group than in the PD_(non-TRIANGLE) group(48.1%vs 81.8%,P<0.001),and the local recurrence rate of PDAC decreased from 37.8%to 16.0%.Multivariate Cox regression analysis revealed that PD_(TRIANGLE)(HR=0.424;95%CI:0.256-0.702;P=0.001),adequate adjuvant chemotherapy≥6 months(HR=0.370;95%CI:0.222-0.618;P<0.001)and margin status(HR=2.255;95%CI:1.252-4.064;P=0.007)were found to be independent factors for the recurrence rate.CONCLUSION The TRIANGLE operation is safe for PDAC patients undergoing PD.Moreover,it reduces the local recurrence rate of PDAC and may improve survival in patients who receive adequate adjuvant chemotherapy.
基金supported by the Australian Research Council(Grant No.DP200101293)supported by the UWA-China Joint Scholarships(201906430030).
文摘In current dual porosity/permeability models,there exists a fundamental assumption that the adsorption-induced swelling is distributed uniformly within the representative elementary volume (REV),irrespective of its internal structures and transient processes.However,both internal structures and transient processes can lead to the non-uniform swelling.In this study,we hypothesize that the non-uniform swelling is responsible for why coal permeability in experimental measurements is not only controlled by the effective stress but also is affected by the adsorption-induced swelling.We propose a concept of the swelling triangle composed of swelling paths to characterize the evolution of the non-uniform swelling and serve as a core link in coupled multiphysics.A swelling path is determined by a dimensionless volumetric ratio and a dimensionless swelling ratio.Different swelling paths have the same start and end point,and each swelling path represents a unique swelling case.The swelling path as the diagonal of the triangle represents the case of the uniform swelling while that as the two perpendicular boundaries represents the case of the localized swelling.The paths of all intermediate cases populate inside the triangle.The corresponding relations between the swelling path and the response of coal multiphysics are established by a non-uniform swelling coefficient.We define this method as the triangle approach and corresponding models as swelling path-based ones.The proposed concept and models are verified against a long-term experimental measurement of permeability and strains under constant effective stress.Our results demonstrate that during gas injection,coal multiphysics responses have a close dependence on the swelling path,and that in both future experiments and field predictions,this dependence must be considered.
基金Supported by the National Natural Science Foundation of China,No.31971518.
文摘BACKGROUND Radical surgery combined with systemic chemotherapy offers the possibility of long-term survival or even cure for patients with pancreatic ductal adenocar-cinoma(PDAC),although tumor recurrence,especially locally,still inhibits the treatment efficacy.The TRIANGLE technique was introduced as an extended dissection procedure to improve the R0 resection rate of borderline resectable or locally advanced PDAC.However,there was a lack of studies concerning postoperative complications and long-term outcomes of this procedure on patients with resectable PDAC.PDAC.METHODS Patients with resectable PDAC eligible for PD from our hospital between June 2018 and December 2021 were enrolled in this retrospective cohort study.All the patients were divided into PDstandard and PDTRIANGLE groups according to the surgical procedure.Baseline characteristics,surgical data,and postoperative morbidities were recorded.All of the patients were followed up,and the date and location of tumor recurrence,and death were recorded.The Kaplan-Meier method and log-rank test were used for the survival analysis.RESULTS There were 93 patients included in the study and 37 underwent the TRIANGLE technique.Duration of operation was longer in the PDTRIANGLE group compared with the PDstandard group[440(410-480)min vs 320(265-427)min](P=0.001).Intraoperative blood loss[700(500-1200)mL vs 500(300-800)mL](P=0.009)and blood transfusion[975(0-1250)mL vs 400(0-800)mL](P=0.009)were higher in the PDTRIANGLE group.There was a higher incidence of surgical site infection(43.2%vs 12.5%)(P=0.001)and postoperative diarrhea(54.1%vs 12.5%)(P=0.001)in the PDTRIANGLE group.The rates of R0 resection and local recurrence,overall survival,and disease-free survival did not differ significantly between the two groups.CONCLUSION The TRIANGLE technique is safe,with acceptable postoperative morbidities compared with standardized PD,but it does not improve prognosis for patients with resectable PDAC.
文摘目的研究糖尿病患者采用Triangle分层分级管理结合LEARNS模式干预的护理效果。方法选择2020年10月—2023年10月东南大学附属中大医院收治的40例糖尿病患者为研究对象,以随机抽签法分为A组(20例,行Triangle分层分级管理结合LEARNS模式护理)和B组(20例,施行常规护理干预)。对比两组护理前后血糖水平、糖尿病自我管理行为量表(Summary of Diabetes Self Care Activities,SDSCA)评分及依从性。结果干预后,A组患者血糖水平显著优于B组,差异有统计学意义(P<0.05)。干预前,两组患者SDSCA评分对比,差异无统计学意义(P>0.05);干预后,A组SDSCA评分显著优于B组,差异有统计学意义(P<0.05)。A组患者依从性显著优于B组,差异有统计学意义(P<0.05)。结论给予糖尿病患者Triangle分层分级管理结合LEARNS模式进行干预,与常规护理干预对比,其能够很大程度改善患者血糖情况,提高糖尿病患者自我管理能力及依从性。
基金supported in part by National Natural Science Foundation of China under Grants 62122069, 62071431, 62072490 and 62301490in part by Science and Technology Development Fund of Macao SAR, China under Grant 0158/2022/A+2 种基金in part by the Guangdong Basic and Applied Basic Research Foundation (2022A1515011287)in part by MYRG202000107-IOTSCin part by FDCT SKL-IOTSC (UM)-2021-2023
文摘With the development of the Internet of Things(IoT),it requires better performance from wireless sensor networks(WSNs),such as larger coverage,longer lifetime,and lower latency.However,a large amount of data generated from monitoring and long-distance transmission places a heavy burden on sensor nodes with the limited battery power.For this,we investigate an unmanned aerial vehicles assisted mobile wireless sensor network(UAV-assisted WSN)to prolong the network lifetime in this paper.Specifically,we use UAVs to assist the WSN in collecting data.In the current UAV-assisted WSN,the clustering and routing schemes are determined sequentially.However,such a separate consideration might not maximize the lifetime of the whole WSN due to the mutual coupling of clustering and routing.To efficiently prolong the lifetime of the WSN,we propose an integrated clustering and routing scheme that jointly optimizes the clustering and routing together.In the whole network space,it is intractable to efficiently obtain the optimal integrated clustering and routing scheme.Therefore,we propose the Monte-Las search strategy based on Monte Carlo and Las Vegas ideas,which can generate the chain matrix to guide the algorithm to find the solution faster.Unnecessary point-to-point collection leads to long collection paths,so a triangle optimization strategy is then proposed that finds a compromise path to shorten the collection path based on the geometric distribution and energy of sensor nodes.To avoid the coverage hole caused by the death of sensor nodes,the deployment of mobile sensor nodes and the preventive mechanism design are indispensable.An emergency data transmission mechanism is further proposed to reduce the latency of collecting the latency-sensitive data due to the absence of UAVs.Compared with the existing schemes,the proposed scheme can prolong the lifetime of the UAVassisted WSN at least by 360%,and shorten the collection path of UAVs by 56.24%.
文摘目的:分析基于Triangle模型的分层分级延续护理在2型糖尿病(T2DM)病人中的应用效果。方法:纳入2021年11月—2022年11月在徐州医科大学附属宿迁医院接受治疗的120例T2DM病人,按随机数字表法分为观察组与对照组,各60例。对照组接受延续性护理,观察组接受基于Triangle模型的分层分级延续性护理。于干预前、干预3个月时、干预6个月时评定病人血糖控制状况、自我管理能力、生活质量;并记录病人干预期间再住院次数。结果:干预3个月、6个月时,两组病人空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平明显低于干预前,糖尿病自我管理行为量表(SDSCA)得分高于干预前,中国糖尿病病人生存质量特异性量表(DSQL)得分低于干预前,且观察组病人各项指标改善优于对照组(P<0.05);但两组病人干预6个月时的各项指标与干预3个月时比较,差异无统计学意义(P>0.05);观察组病人再住院次数少于对照组(P<0.05)。结论:基于Triangle模型的分层分级延续性护理可提高T2DM病人的血糖控制水平、自我管理能力及生活质量,并减少再住院次数。
文摘Clustering a social network is a process of grouping social actors into clusters where intra-cluster similarities among actors are higher than inter-cluster similarities. Clustering approaches, i.e. , k-medoids or hierarchical, use the distance function to measure the dissimilarities among actors. These distance functions need to fulfill various properties, including the triangle inequality (TI). However, in some cases, the triangle inequality might be violated, impacting the quality of the resulting clusters. With experiments, this paper explains how TI violates while performing traditional clustering techniques: k-medoids, hierarchical, DENGRAPH, and spectral clustering on social networks and how the violation of TI affects the quality of the resulting clusters.
