Influencing factors of early post-traumatic stress disorder in young and middle-aged individuals with open globe injuries in west China:a cross-sectional study

AIM:To evaluate the prevalence of early post-traumatic stress disorder(PTSD)among young and middle-aged patients who have suffered open globe injuries,and to identify the psychosocial factors influencing PTSD in these patients.METHODS:A total of 280 patients who underwent ocular trauma surgery between January 2023 and January 2024 were selected through convenience sampling.Data were collected using a custom-designed demographic questionnaire,the Connor-Davidson Resilience Scale(CDRISC),the Cognitive Emotion Regulation Questionnaire(C-ERRI),and the PTSD Checklist-Civilian Version(PCL-C).Univariate analysis and stepwise multiple linear regression analysis were performed to determine the factors affecting PTSD in these patients.RESULTS:The average PTSD score for the patients was 33.22±13.48.The scores for individual PTSD dimensions,ranked from highest to lowest,were recurrent traumatic experiences,heightened arousal,avoidance reactions,and social dysfunction.Positive PTSD symptoms were observed in 85 patients(30.36%).Univariate analysis indicated that gender,postoperative vision,marital status,psychological resilience,and rumination were significant factors affecting PTSD symptoms(χ^(2)/t=6.53,17.88,8.83,2.17,and 14.1,respectively;all P<0.05).Pearson correlation analysis showed a positive correlation between rumination and PTSD symptoms(r=0.73,P<0.01)and a negative correlation between psychological resilience and PTSD symptoms(r=-0.14,P<0.05).Stepwise multiple linear regression analysis identified postoperative vision(notably eye removal),rumination levels,and psychological resilience(optimism)as major factors influencing PTSD in these patients(R^(2)=0.57,P<0.001).CONCLUSION:Young and middle-aged patients with open globe injuries have a high incidence of PTSD.Significant risk factors for early PTSD include primary enucleation,high levels of rumination,and low psychological resilience(optimism).Conversely,patients with good postoperative vision recovery,low rumination levels,and high levels of optimism are less likely to develop PTSD.Healthcare providers should pay special attention to patients who undergo primary enucleation,strive to reduce their rumination levels,and enhance their psychological resilience,thereby promoting a positive and optimistic attitude towards their condition and reducing the incidence of PTSD.

Are outcomes for emergency index-admission laparoscopic cholecystectomy performed by hepatopancreatobiliary surgeons better compared to non-hepatopancreatobiliary surgeons?A 10-year audit using 1:1 propensity score matching

Background:Emergency index-admission cholecystectomy(EIC)is recommended for acute cholecystitis in most cases.General surgeons have less exposure in managing“difficult”cholecystectomies.This study aimed to compare the outcomes of EIC between hepatopancreatobiliary(HPB)versus non-HPB surgeons.Methods:This is a 10-year retrospective audit on patients who underwent EIC from December 2011 to March 2022.Patients who underwent open cholecystectomy,had previous cholecystitis,previous endoscopic retrograde cholangiopancreatography or cholecystostomy were excluded.A 1:1 propensity score matching(PSM)was performed to adjust for confounding variables(e.g.age≥75 years,history of abdominal surgery,presence of dense adhesions).Results:There were 1409 patients(684 HPB cases,725 non-HPB cases)in the unmatched cohort.Majority(52.3%)of them were males with a mean age of 59.2±14.9 years.Among 472(33.5%)patients with EIC performed≥72 hours after presentation,40.1%had dense adhesion.The incidence of any morbidity,open conversion,subtotal cholecystectomy and bile duct injury were 12.4%,5.0%,14.6%and 0.1%,respectively.There was one mortality within 30 days from EIC.PSM resulted in 1166 patients(583 per group).Operative time was shorter when EIC was performed by HPB surgeons(115.5 vs.133.4 min,P<0.001).The mean length of hospital stay was comparable.EIC performed by HPB surgeons was independently associated with lower open conversion[odds ratio(OR)=0.24,95%confidence interval(CI):0.12–0.49,P<0.001],lower fundus-first cholecystectomy(OR=0.58,95%CI:0.35–0.95,P=0.032),but higher subtotal cholecystectomy(OR=4.19,95%CI:2.24–7.84,P<0.001).Any morbidity,bile duct injury and mortality were comparable between the two groups.Conclusions:EIC performed by HPB surgeons were associated with shorter operative time and reduced risk of open conversion.However,the incidence of subtotal cholecystectomy was higher.

Artificial Self-Recovery Opens up a New Journey of Autonomous Health of Mechanical Equipments

1.Introduction With the implementation of modern production strategies,such as“Industry 4.0”and“Made in China 2025,”the development of high-end mechanical equipment is gradually reaching a high degree of parameterization,digitalization,networking,and intelligence[1].High-end mechanical equipment no longer consists of traditional single devices,but is closely linked to the overall production process;that is,a variety of devices interact with each other and collectively form a complex system.However,faults can lead to production delays throughout the system and even seriously threaten the safety of workers[2].In addition,equipment operating in unmanned air or space vehicles(including space robots)cannot be repaired by humans if they break down[3].Until recently,the typical method of addressing machine faults was primarily the“fault cure”method,which involves manually shutting down,inspecting,and repairing the equipment to restore normal operation.Accordingly,the maintenance cycle of the traditional“fault cure”method is time-consuming,and the quality of the maintenance depends on the skills of the technician[4].

Atomically Dispersed Ruthenium Catalysts with Open Hollow Structure for Lithium-Oxygen Batteries

Lithium–oxygen battery with ultrahigh theoretical energy density is considered a highly competitive next-generation energy storage device,but its practical application is severely hindered by issues such as difficult decomposition of discharge products at present.Here,we have developed N-doped carbon anchored atomically dispersed Ru sites cathode catalyst with open hollow structure(h-RuNC)for Lithium–oxygen battery.On one hand,the abundance of atomically dispersed Ru sites can effectively catalyze the formation and decomposition of discharge products,thereby greatly enhancing the redox kinetics.On the other hand,the open hollow structure not only enhances the mass activity of atomically dispersed Ru sites but also improves the diffusion efficiency of catalytic molecules.Therefore,the excellent activity from atomically dispersed Ru sites and the enhanced diffusion from open hollow structure respectively improve the redox kinetics and cycling stability,ultimately achieving a high-performance lithium–oxygen battery.

Indications of pro-inflammatory cytokines in laparoscopic and open liver resection for early-stage hepatocellular carcinoma

Background:Our clinical practice of laparoscopic liver resection(LLR)had achieved better short-term and long-term benefits for patients with hepatocellular carcinoma(HCC)over open liver resection(OLR),but the underlying mechanisms are not clear.This study was to find out whether systemic inflammation plays an important role.Methods:A total of 103 patients with early-stage HCC under liver resection were enrolled(LLR group,n=53;OLR group,n=50).The expression of 9 inflammatory cytokines in patients at preoperation,postoperative day 1(POD1)and POD7 was quantified by Luminex Multiplex assay.The relationships of the cytokines and the postoperative outcomes were compared between LLR and OLR.Results:Seven of the circulating cytokines were found to be significantly upregulated on POD1 after LLR or OLR compared to their preoperative levels.Compared to OLR,the POD1 levels of granulocytemacrophage colony-stimulating factor(GM-CSF),interleukin-6(IL-6),IL-8,and monocyte chemoattractant protein-1(MCP-1)in the LLR group were significantly lower.Higher POD1 levels of these cytokines were significantly correlated with longer operative time and higher volume of blood loss during operation.The levels of these cytokines were positively associated with postoperative liver injury,and the length of hospital stay.Importantly,a high level of IL-6 at POD1 was a risk factor for HCC recurrence and poor disease-free survival after liver resection.Conclusions:Significantly lower level of GM-CSF,IL-6,IL-8,and MCP-1 after liver resection represented a milder systemic inflammation which might be an important mechanism to offer better short-term and long-term outcomes in LLR over OLR.

BSEC Method for Unveiling Open Clusters and its Application to Gaia DR3:83 New Clusters

Open clusters(OCs) are common in the Milky Way, but most of them remain undiscovered. There are numerous techniques, including some machine-learning algorithms, available for the exploration of OCs. However, each method has its limitations and therefore, different approaches to discovering OCs hold significant values. We develop a comprehensive approach method to automatically explore the data space and identify potential OC candidates with relatively reliable membership determination. This approach combines the techniques of Hierarchical Density-Based Spatial Clustering of Applications with Noise, Gaussian mixture model, and a novel cluster member identification technique, color excess constraint. The new method exhibits efficiency in detecting OCs while ensuring precise determination of cluster memberships. Because the main feature of this technique is to add an extra constraint(EC) for the members of cluster candidates using the homogeneity of color excess,compared to typical blind search codes, it is called Blind Search-Extra Constraint(BSEC) method. It is successfully applied to the Gaia Data Release 3, and 83 new OCs are found, whose color–magnitude diagrams(CMDs) are fitted well to the isochrones. In addition, this study reports 621 new OC candidates with discernible main sequence or red giant branch. It is shown that BSEC technique can discard some false negatives of previous works, which takes about three percentage of known clusters. It shows that as an EC, the color excess(or twocolor) constraint is useful for removing fake cluster member stars from the clusters that are identified from the positions and proper motions of stars, and getting more precise CMDs, when differential reddening of member stars of a cluster is not large(e.g., ΔE(G_(BP)-G_(RP)) < 0.5 mag). It makes the CMDs of 15% clusters clearer(in particular for the region near turnoff) and therefore is helpful for CMD and stellar population studies. Our result suggests that the color excess constraint is more appropriate for clusters with small differential reddening, such as globular clusters or older OCs, and clusters that the distances of member stars cannot be determined accurately.

Open Winding-permanent Magnet/Magnet Reluctance Hybrid Rotor Double Stator Synchronous Motor SVPWM Control

Coal mine conveyor belt and other low-speed large torque system,the torque density and torque stability of the motor requirements are higher,permanent magnet/magnet reluctance hybrid rotor double stator synchronous motor(PM/MRHRDSSM)is just adapted to this requirement,however,the traditional close winding single inverter vector control system control PM/MRHRDSSM provides large torque ripple,high speed fluctuation and large total harmonic distortion(THD)of the current,difficult to be used in actual production and life,this paper proposes a large torque open winding-permanent magnet/magnet reluctance hybrid rotor double stator synchronous motor(OW-PM/MRHRDSSM)based on SVPWM dual inverter control strategy,and analysis of open winding double inverter structure,and its voltage vector mathematical model,using the existing two-level inverter as a basis,the bilateral inverter separately discussed its role and control method,as well as the decomposition method of synthetic voltage vector and the inverter device in the small sector on-time,the end of this paper through simulation to compare the traditional close winding single inverter vector control system control PM/MRHRDSSM and the large torque OW-PM/MRHRDSSM based on SVPWM dual inverter control strategy to prove the effectiveness of the proposed method in reducing torque ripple,speed fluctuation and THD of current during motor operation.

Pure State Feedback Switching Control Based on the Online Estimated State for Stochastic Open Quantum Systems

For the n-qubit stochastic open quantum systems,based on the Lyapunov stability theorem and LaSalle’s invariant set principle,a pure state switching control based on on-line estimated state feedback(short for OQST-SFC)is proposed to realize the state transition the pure state of the target state including eigenstate and superposition state.The proposed switching control consists of a constant control and a control law designed based on the Lyapunov method,in which the Lyapunov function is the state distance of the system.The constant control is used to drive the system state from an initial state to the convergence domain only containing the target state,and a Lyapunov-based control is used to make the state enter the convergence domain and then continue to converge to the target state.At the same time,the continuous weak measurement of quantum system and the quantum state tomography method based on the on-line alternating direction multiplier(QST-OADM)are used to obtain the system information and estimate the quantum state which is used as the input of the quantum system controller.Then,the pure state feedback switching control method based on the on-line estimated state feedback is realized in an n-qubit stochastic open quantum system.The complete derivation process of n-qubit QST-OADM algorithm is given;Through strict theoretical proof and analysis,the convergence conditions to ensure any initial state of the quantum system to converge the target pure state are given.The proposed control method is applied to a 2-qubit stochastic open quantum system for numerical simulation experiments.Four possible different position cases between the initial estimated state and that of the controlled system are studied and discussed,and the performances of the state transition under the corresponding cases are analyzed.

The Effects of the Geometry of a Current Collector with an Equal Open Ratio on Output Power of a Direct Methanol Fuel Cell

The open ratio of a current collector has a great impact on direct methanol fuel cell(DMFC)performance.Although a number of studies have investigated the influence of the open ratio of DMFC current collectors,far too little attention has been given to how geometry(including the shape and feature size of the flow field)affects a current collector with an equal open ratio.In this paper,perforated and parallel current collectors with an equal open ratio of 50%and different feature sizes are designed,and the corresponding experimental results are shown to explain the geometry effects on the output power of the DMFC.The results indicate that the optimal feature sizes are between 2 and 2.5 mm for both perforated and parallel flow field in the current collectors with an equal open ratio of 50%.This means that for passive methanol fuel cells,to achieve the highest output power,the optimal feature size of the flow field in both anode and cathode current collectors is between 2 and 2.5 mm under the operating mode of this experiment.The effects of rib and channel position are also investigated,and the results indicate that the optimum pattern depends on the feature sizes of the flow field.

Impact of open hepatectomy on postoperative bile leakage in patients with biliary tract cancer

BACKGROUND Bile leakage is a common and serious complication of open hepatectomy for the treatment of biliary tract cancer.AIM To evaluate the incidence,risk factors,and management of bile leakage after open hepatectomy in patients with biliary tract cancer.METHODS We retrospectively analyzed 120 patients who underwent open hepatectomy for biliary tract cancer from February 2018 to February 2023.Bile leak was defined as bile drainage from the surgical site or drain or the presence of a biloma on imaging.The incidence,severity,timing,location,and treatment of the bile leaks were recorded.The risk factors for bile leakage were analyzed using univariate and multivariate logistic regression analyses.RESULTS The incidence of bile leak was 16.7%(20/120),and most cases were grade A(75%,15/20)according to the International Study Group of Liver Surgery classification.The median time of onset was 5 d(range,1-14 d),and the median duration was 7 d(range,2-28 d).The most common location of bile leakage was the cut surface of the liver(70%,14/20),followed by the anastomosis site(25%,5/20)and the cystic duct stump(5%,1/20).Most bile leaks were treated conservatively with drainage,antibiotics,and nutritional support(85%,17/20),whereas some required endoscopic retrograde cholangiopancreatography with stenting(10%,2/20)or percutaneous transhepatic cholangiography with drainage(5%,1/20).Risk factors for bile leakage include male sex,hepatocellular carcinoma,major hepatectomy,blood loss,and blood transfusion.CONCLUSION Bile leakage is a frequent complication of open hepatectomy for biliary tract cancer.However,most cases are mild and can be conservatively managed.Male sex,hepatocellular carcinoma,major hepatectomy,blood loss,and blood transfusion were associated with an increased risk of bile leak.

The Effect of Uterine Artery Occlusion with Tourniquet on Ovarian Reserve during Open Myomectomy at a University Teaching Hospital in Southern Nigeria

Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the procedure is a serious risk that is often mitigated with a uterine tourniquet. Aim and Objectives: To evaluate the effect of uterine artery occlusion with a tourniquet during open myomectomy on ovarian reserve using serial anti-Mullerian hormone (AMH) measurements. Materials and Methods: This was a prospective longitudinal study with a quasi-experimental design and a convenient sampling technique. The study enrolled 47 women who had abdominal myomectomy between September 1, 2021, and March 31, 2022, at the University of Port Harcourt Teaching Hospital. Blood samples were collected before anaesthesia was administered in theatre, on day two, and three months after open abdominal myomectomy for anti-Mullerian hormone assay. The data was collected using a semi-structured proforma, entered into an Excel spreadsheet, and analyzed using SPSS version 25.0 with a 95% confidence interval. Statistical significance level was set at 0.05. Results: The pre-surgery AMH mean value was 1.67 ± 1.44 ng/ml, while the values after using a uterine tourniquet at myomectomy on the second day and three months later were 1.22 ± 1.24 ng/ml and 1.59 ± 1.43 ng/ml, respectively. There was no statistically significant change in AMH levels, and there was no statistically significant relationship between blood loss and tourniquet time and AMH after open abdominal myomectomy. Conclusion: The use of a uterine tourniquet and blood loss during open myomectomy has no effect on ovarian reserve.

Analysis of the Effect of Laparoscopic Versus Open Cholecystectomy in Patients with Cholelithiasis and the Effect on CRP and IL-1βLevels

Objective:To evaluate the therapeutic effect of laparoscopic cholecystectomy(LC)and open cholecystectomy(OC)on cholelithiasis.Methods:92 cases of cholelithiasis patients admitted to the hospital in the past 2 years were selected and grouped by random number table;the observation group was treated with LC;the reference group was treated with OC,and the inflammatory factor and other indexes were compared.Results:The total effective rate of the observation group was higher than that of the reference group,and the perioperative indexes were better than that of the reference group(P<0.05).Preoperatively,the C-reactive protein(CRP)and interleukin-1β(IL-1β)levels and immune function indexes of the two groups were compared,and no difference was seen(P>0.05).At 5 days postoperatively,the CRP and IL-1βlevels of the observation group were lower than those of the reference group,and the immune function indicators were higher than those of the reference group(P<0.05).The complication rate of the observation group was lower than that of the reference group(P<0.05).Conclusion:LC can increase the effective rate of cholelithiasis patients,improve their perioperative indexes,reduce the inflammatory response,protect patients’immune function,and ensure higher surgical safety.

CIIE to Promote High-Level Opening Up

The 7th China International Import Expo(CIIE),scheduled to be held in Shanghai from 5 to 10 November,will play a part in promoting highlevel opening up,said Tang Wenhong,China’s assistant minister of commerce,at a press conference on 23 October.The CIIE serves to showcase China’s major opening-up measures and confidence,to share China’s new development opportunities with other countries.

Malawi Opens Tourism Doors No visa’s needed for Chinese tourists and others,as Malawi makes visits more convenient

When Malawian President Lazarus Chakwera delivered a State of the Nation Address at the 50th Parliamentary Session and Budget Meeting in February,tourism was top of mind.

Comparative Analysis of the Efficacy of Transabdominal Pre-Peritoneal Vs Open Tension-Free Hernia Repair in Treating Inguinal Hernia

Objective:To investigate and analyze the clinical outcomes of inguinal hernia patients treated with transabdominal pre-peritoneal repair(TAPP)versus open tension-free hernia repair.Methods:The study was carried out from January 2021 to August 2023,and a total of 50 inguinal hernia patients were selected for this study.The patients were randomly divided into a study group(n=25)and a control group(n=25)by the numerical table method.The patients in the control group were treated with open tension-free hernia repair,whereas the patients in the study group were treated with TAPP.The surgical and postoperative recovery indexes,complication rates,and recurrence rates of the two groups were compared.Results:There was no significant difference in the operative time and intraoperative blood loss between the two groups(P>0.05),and the postoperative feeding time,time out of bed,and hospitalization time of the study group were shorter than those of the control group(P<0.05);the incidence rate of postoperative complications in the study group was lower than that in the control group(P<0.05);and there was no significant difference in the recurrence rate of the two groups after operation(P>0.05).Conclusion:Compared to open tension-free hernia repair,TAPP offers a shorter postoperative recovery duration and hospitalization time,and reduces the incidence of complications.Therefore,this surgical method should be popularized in the treatment of inguinal hernia.

Theory of Flexural Shear, Bending and Torsion for a Thin-Walled Beam of Open Section

Aspects of the general Vlasov theory are examined separately as applied to a thin-walled channel section cantilever beam under free-end end loading. In particular, the flexural bending and shear that arise under transverse shear and axial torsional loading are each considered theoretically. These analyses involve the location of the shear centre at which transverse shear forces when applied do not produce torsion. This centre, when taken to be coincident with the centre of twist implies an equivalent reciprocal behaviour. That is, an axial torsion applied concentric with the shear centre will twist but not bend the beam. The respective bending and shear stress conversions are derived for each action applied to three aluminium alloy extruded channel sections mounted as cantilevers with a horizontal principal axis of symmetry. Bending and shear are considered more generally for other thin-walled sections when the transverse loading axes at the shear centre are not parallel to the section = s centroidal axes of principal second moments of area. The fixing at one end of the cantilever modifies the St Venant free angular twist and the free warping displacement. It is shown from the Wagner-Kappus torsion theory how the end constrained warping generates an axial stress distribution that varies with the length and across the cross-section for an axial torsion applied to the shear centre. It should be mentioned here for wider applications and validation of the Vlasov theory that attendant papers are to consider in detail bending and torsional loadings applied to other axes through each of the centroid and the web centre. Therein, both bending and twisting arise from transverse shear and axial torsion applied to each position being displaced from the shear centre. Here, the influence of the axis position upon the net axial and shear stress distributions is to be established. That is, the net axial stress from axial torsional loading is identified with the sum of axial stress due to bending and axial stress arising from constrained warping displacements at the fixing. The net shear stress distribution overlays the distributions from axial torsion and that from flexural shear under transverse loading. Both arise when transverse forces are displaced from the shear centre.

Evaluation of the Degree of Opening to the Outside World in Guizhou Province

The goal of economic opening to the outside world is an important basis for formulating and implementing the policy of opening. Different economic development strategies have different requirements for the degree of economic opening to the outside world. Guizhou should implement the open economy and adopt the export-oriented development strategy, which objectively requires Guizhou to gradually improve the degree of opening to the outside world.

TPFTZ(Tianjin Port Free Trade Zone)——A New Pattern of China's Openning to the Outside World

Under the guidance of Deng Xiao-ping’s strategic think-ing of openning to the outside world, the structure of om-nibearing openness has basically taken shape in China. Follow-

The development of an open economy in China——A retrospective analysis of 30 years of opening to the outside world

China’s three decades of opening to the outside world are a historical process of establishing and developing an open economy. This process can be divided into four stages:1) reducing regulation,rejuvenating the trade regulatory regime and delegating management rights to foreign-trade operators;2) developing foreign trade firms into de facto market entities; 3)pursuing trade liberalization and establishing an open economic system in conformity with international rules;4) furthering improvement and innovation in infrastructure. At the initial stage of establishing an open economy,China restructured its foreign trade system and learned valuable lessons about liberalization through system transition.China experimented with bold breakthrough initiatives in special economic zones and open coastal cities,and correctly selected an export-oriented development strategy. Two core policies underlying China’s open economy are the strengthening of bilateral and multilateral trade relationships,and realigning the institutional environment to comport with international rules.China’s open economy occupies an important position in the national economy. Moreover,it has become an important part of state’s macro-economic regulation and is exerting growing influence on the world economy.

Improved super-elastic Ti-Ni alloy wire for the angle class III patient with anterior open bite:A case report

BACKGROUND Orthodontic treatment for open bite and crossbite cases is always challenging.In this paper,we demonstrate a skeletal class III patient with anterior open bite and crossbite whose problem was successfully corrected with improved super-elastic Ti-Ni alloy wire(ISW).CASE SUMMARY A 19 years old male came to our clinic with a chief complaint of anterior open bite and crossbite and not able to chew food well.Clinical examination revealed an angle class III malocclusion with anterior open bite,crossbite and spaced arch.Ra-diographic and clinical examination showed a skeletal class III pattern.We used ISW to level the upper and lower arch and to correct the anterior open bite and crossbite.Intermaxillary elastics were also used to achieve a better interdigitation.Finally,adequate overbite,overjet and a desirable occlusion were achieved.The active treatment time took 2 years and 2 months.CONCLUSION In a case of class III angular malocclusion with open bite and crossbite in the ante-rior teeth,ideal results were achieved using the ISW technique and the patient was satisfied with the outcome.