Simulation Training for Laparoscopic Surgery Can Improve Minimally Invasive Surgical Techniques for Interns and Probationers

Objective: The clinical clerkship and practice stage plays a pivotal role in the transition of medical students from theoretical knowledge to practical application, bridging the gap between classroom learning and real-life clinical experience. In order to improve the teaching quality of interns and probationers, we try to let them practice the skills of laparoscopic surgery in the early stage, and summed up a set of evaluation methods that can be widely used in medical education. Methods: From September 2019 to December 2019, a total of 54 interns and 72 trainees were selected as research objects. They were assigned to training sessions and their proficiency was assessed before and after the training. The change in proficiency is compared to determine whether the training course is valuable. Results: Before the operation training, the interns scores were BP 17.3 3.1, CC 17.9 3.4, KT 16.4 3.4, LS 16.7 3.3. The results of probationers were BP 16.9 2.7, CC 16.8 2.8, KT 15.2 1.6, and LS 14.8 2.2. After completing the operations training, the results of interns were BP 21.1 1.9, CC 20.6 2.7, KT 19.6 3.0, and LS 20.9 1.4. The probationers scores were BP 19.3 3.2, CC 19.6 3.5, KT 19.6 2.6, and LS 20.0 2.4. After the operation training, the performance of the intern group was better than that before the training (P < 0.05). The same is true of the probationer group. The time-consuming intern examinations were BP 147.9 38.5 s, CC 123.2 28.7 s, KT 82.6 24.1 s and LS 162.5 31.1 s. The examination time of probationers were BP 179.9 46.4 s, CC 132.1 24.3 s, KT 109.3 27.5 s and LS 210.0 58.8 s. Conclusion: Simulation training for laparoscopic surgery can improve minimally invasive surgical techniques for interns and probationers.

Detailed analysis and simulation verification for reconstruction of plasma optical boundary with spectrometric technique on HL-2M tokamak

The plasma optical boundary reconstruction technique based on Hommen's theory is promising for future tokamaks with high parameters. In this work, we conduct detailed analysis and simulation verification to estimate the ‘logic loophole' of this technique. The finite-width effect and unpredictable errors reduce the technique's reliability, which leads to this loophole. Based on imaging theory, the photos of a virtual camera are simulated by integrating the assumed luminous intensity of plasma. Based on Hommen's theory, the plasma optical boundary is reconstructed from the photos. Comparing the reconstructed boundary with the one assumed, the logic loophole and its two effects are quantitatively estimated. The finite-width effect is related to the equivalent thickness of the luminous layer, which is generally about 2-4 cm but sometimes larger. The level of unpredictable errors is around 0.65 cm. The technique based on Hommen's theory is generally reliable, but finite-width effect and unpredictable errors have to be taken into consideration in some scenarios. The parameters of HL-2M are applied in this work.

基于Plant Simulation的化纤自动落丝系统仿真实验分析

基于Plant Simulation软件,构建一种化纤自动落丝系统的3D数字化模型,对系统效率关键输入因子进行参数化设置,将系统各工位三维数字模型导入软件中建立层次化运动机构图形结构,并运用Simltalk语言实现三维动作仿真,通过基础物理参数设置,保证了仿真数字化模型与现实系统更具一致性。通过多级实验设计分析了系统影响因子对于系统效率的影响特性曲线,并进一步通过动态参数化实验方法,计算出双输入因子对系统效能影响的敏感度。该实验结果可为化纤自动落丝系统的建设成本控制与可行性分析提供指导,具有较好的工程应用价值。

基于Simulation X的多轴转向系统功能安全仿真分析

基于ISO 26262《道路车辆功能安全》的标准要求,对特种车的多轴电液转向系统进行分析,以提高系统的安全性和可靠性。运用Simulation X软件建立详细的多轴特种车仿真模型,通过模拟故障模式注入进行仿真试验。对仿真结果和数据进行分析,评估得到故障的严重性、暴露度和可控性,从而确定相应的汽车安全完整性等级。基于故障注入仿真的汽车功能安全分析方法,在系统早期设计阶段可以作为评估架构安全性的重要手段。

基于Plant Simulation的压气机叶片型线加工产线分析与优化

运用专业仿真软件Plant Simulation,根据压气机叶片型线机械加工工艺特点和物料运行流程建立生产线仿真模型,从产能、设备利用率及产线瓶颈等多方面进行仿真分析与优化。结果表明:Plant Simulation仿真平台的仿真可以找出规划设计方案中存在的问题并验证方案的合理性。该仿真结果为型线机械加工产线的优化设计提供了可靠依据,达到了节约投资成本和缩短设计周期的目的。

Clinical diagnostic advances in intestinal anastomotic techniques:Hand suturing,stapling,and compression devices

The development of intestinal anastomosis techniques,including hand suturing,stapling,and compression anastomoses,has been a significant advancement in surgical practice.These methods aim to prevent leakage and minimize tissue fibrosis,which can lead to stricture formation.The healing process involves various phases:hemostasis and inflammation,proliferation,and remodeling.Mechanical staplers and sutures can cause inflammation and fibrosis due to the release of profibrotic chemokines.Compression anastomosis devices,including those made of nickel-titanium alloy,offer a minimally invasive option for various surgical challenges and have shown safety and efficacy.However,despite advancements,anastomotic techniques are evaluated based on leakage risk,with complications being a primary concern.Newer devices like Magnamosis use magnetic rings for compression anastomosis,demonstrating greater strength and patency compared to stapling.Magnetic technology is also being explored for other medical treatments.While there are promising results,particularly in animal models,the realworld application in humans is limited,and further research is needed to assess their safety and practicality.

Global hybrid simulations of soft X-ray emissions in the Earth’s magnetosheath

Earth’s magnetopause is a thin boundary separating the shocked solar wind plasma from the magnetospheric plasmas,and it is also the boundary of the solar wind energy transport to the magnetosphere.Soft X-ray imaging allows investigation of the large-scale magnetopause by providing a two-dimensional(2-D)global view from a satellite.By performing 3-D global hybrid-particle-in-cell(hybrid-PIC)simulations,we obtain soft X-ray images of Earth’s magnetopause under different solar wind conditions,such as different plasma densities and directions of the southward interplanetary magnetic field.In all cases,magnetic reconnection occurs at low latitude magnetopause.The soft X-ray images observed by a hypothetical satellite are shown,with all of the following identified:the boundary of the magnetopause,the cusps,and the magnetosheath.Local X-ray emissivity in the magnetosheath is characterized by large amplitude fluctuations(up to 160%);however,the maximum line-of-sight-integrated X-ray intensity matches the tangent directions of the magnetopause well,indicating that these fluctuations have limited impact on identifying the magnetopause boundary in the X-ray images.Moreover,the magnetopause boundary can be identified using multiple viewing geometries.We also find that solar wind conditions have little effect on the magnetopause identification.The Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)mission will provide X-ray images of the magnetopause for the first time,and our global hybrid-PIC simulation results can help better understand the 2-D X-ray images of the magnetopause from a 3-D perspective,with particle kinetic effects considered.

The Probability Density Function Related to Shallow Cumulus Entrainment Rate and Its Influencing Factors in a Large-Eddy Simulation

The process of entrainment-mixing between cumulus clouds and the ambient air is important for the development of cumulus clouds.Accurately obtaining the entrainment rate(λ)is particularly important for its parameterization within the overall cumulus parameterization scheme.In this study,an improved bulk-plume method is proposed by solving the equations of two conserved variables simultaneously to calculateλof cumulus clouds in a large-eddy simulation.The results demonstrate that the improved bulk-plume method is more reliable than the traditional bulk-plume method,becauseλ,as calculated from the improved method,falls within the range ofλvalues obtained from the traditional method using different conserved variables.The probability density functions ofλfor all data,different times,and different heights can be well-fitted by a log-normal distribution,which supports the assumed stochastic entrainment process in previous studies.Further analysis demonstrate that the relationship betweenλand the vertical velocity is better than other thermodynamic/dynamical properties;thus,the vertical velocity is recommended as the primary influencing factor for the parameterization ofλin the future.The results of this study enhance the theoretical understanding ofλand its influencing factors and shed new light on the development ofλparameterization.

基于Simulation的薄壁桶搬运过程的形变研究

桶料的搬运方式主要有托底式、夹取式和挂取(吊取)式,文中针对薄壁桶的搬运方式进行模拟分析,通过模拟分析的具体数值来进行合理的选择。主要对挂取(吊取)和夹取2种薄壁桶的搬运方式进行模拟分析,基于Soildworks中的Simulation进行计算,并得出具体数值,选取合理的薄壁桶搬运方式。模拟分析表明:在同等桶壁厚的情况下,夹取式桶料搬运形式薄壁桶的变形程度较大,主要体现在薄壁桶的夹持部位,如特定场景需夹持薄壁桶的桶身进行搬运时,还需适当加厚薄壁桶的桶壁来抵抗夹持板的夹持力,使薄壁桶不会产生较大的形变量。

Magnetopause properties at the dusk magnetospheric flank from global magnetohydrodynamic simulations,the kinetic Vlasov equilibrium,and in situ observations--Potential implications for SMILE

We derived the properties of the terrestrial magnetopause(MP)from two modeling approaches,one global–fluid,the other local–kinetic,and compared the results with data collected in situ by the Magnetospheric Multiscale 2(MMS2)spacecraft.We used global magnetohydrodynamic(MHD)simulations of the Earth’s magnetosphere(publicly available from the NASA-CCMC[National Aeronautics and Space Administration–Community Coordinated Modeling Center])and local Vlasov equilibrium models(based on kinetic models for tangential discontinuities)to extract spatial profiles of the plasma and field variables at the Earth’s MP.The global MHD simulations used initial solar wind conditions extracted from the OMNI database at the time epoch when the MMS2 observes the MP.The kinetic Vlasov model used asymptotic boundary conditions derived from the same in situ MMS measurements upstream or downstream of the MP.The global MHD simulations provide a three-dimensional image of the magnetosphere at the time when the MMS2 crosses the MP.The Vlasov model provides a one-dimensional local view of the MP derived from first principles of kinetic theory.The MMS2 experimental data also serve as a reference for comparing and validating the numerical simulations and modeling.We found that the MP transition layer formed in global MHD simulations was generally localized closer to the Earth(roughly by one Earth radius)from the position of the real MP observed by the MMS.We also found that the global MHD simulations overestimated the thickness of the MP transition by one order of magnitude for three analyzed variables:magnetic field,density,and tangential speed.The MP thickness derived from the local Vlasov equilibrium was consistent with observations for all three of these variables.The overestimation of density in the Vlasov equilibrium was reduced compared with the global MHD solutions.We discuss our results in the context of future SMILE(Solar wind Magnetosphere Ionosphere Link Explorer)campaigns for observing the Earth’s MP.

Fractal Fractional Order Operators in Computational Techniques for Mathematical Models in Epidemiology

New fractional operators, the COVID-19 model has been studied in this paper. By using different numericaltechniques and the time fractional parameters, the mechanical characteristics of the fractional order model areidentified. The uniqueness and existence have been established. Themodel’sUlam-Hyers stability analysis has beenfound. In order to justify the theoretical results, numerical simulations are carried out for the presented methodin the range of fractional order to show the implications of fractional and fractal orders.We applied very effectivenumerical techniques to obtain the solutions of themodel and simulations. Also, we present conditions of existencefor a solution to the proposed epidemicmodel and to calculate the reproduction number in certain state conditionsof the analyzed dynamic system. COVID-19 fractional order model for the case of Wuhan, China, is offered foranalysis with simulations in order to determine the possible efficacy of Coronavirus disease transmission in theCommunity. For this reason, we employed the COVID-19 fractal fractional derivative model in the example ofWuhan, China, with the given beginning conditions. In conclusion, again the mathematical models with fractionaloperators can facilitate the improvement of decision-making for measures to be taken in the management of anepidemic situation.

Hybrid-Vlasov simulation of soft X-ray emissions at the Earth’s dayside magnetospheric boundaries

Solar wind charge exchange produces emissions in the soft X-ray energy range which can enable the study of near-Earth space regions such as the magnetopause,the magnetosheath and the polar cusps by remote sensing techniques.The Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)and Lunar Environment heliospheric X-ray Imager(LEXI)missions aim to obtain soft Xray images of near-Earth space thanks to their Soft X-ray Imager(SXI)instruments.While earlier modeling works have already simulated soft X-ray images as might be obtained by SMILE SXI during its mission,the numerical models used so far are all based on the magnetohydrodynamics description of the space plasma.To investigate the possible signatures of ion-kinetic-scale processes in soft Xray images,we use for the first time a global hybrid-Vlasov simulation of the geospace from the Vlasiator model.The simulation is driven by fast and tenuous solar wind conditions and purely southward interplanetary magnetic field.We first produce global X-ray images of the dayside near-Earth space by placing a virtual imaging satellite at two different locations,providing meridional and equatorial views.We then analyze regional features present in the images and show that they correspond to signatures in soft X-ray emissions of mirrormode wave structures in the magnetosheath and flux transfer events(FTEs)at the magnetopause.Our results suggest that,although the time scales associated with the motion of those transient phenomena will likely be significantly smaller than the integration time of the SMILE and LEXI imagers,mirror-mode structures and FTEs can cumulatively produce detectable signatures in the soft X-ray images.For instance,a local increase by 30%in the proton density at the dayside magnetopause resulting from the transit of multiple FTEs leads to a 12%enhancement in the line-of-sight-and time-integrated soft X-ray emissivity originating from this region.Likewise,a proton density increase by 14%in the magnetosheath associated with mirror-mode structures can result in an enhancement in the soft X-ray signal by 4%.These are likely conservative estimates,given that the solar wind conditions used in the Vlasiator run can be expected to generate weaker soft X-ray emissions than the more common denser solar wind.These results will contribute to the preparatory work for the SMILE and LEXI missions by providing the community with quantitative estimates of the effects of small-scale,transient phenomena occurring on the dayside.

Relative Impacts of Sea Ice Loss and Atmospheric Internal Variability on the Winter Arctic to East Asian Surface Air Temperature Based on Large-Ensemble Simulations with NorESM2

To quantify the relative contributions of Arctic sea ice and unforced atmospheric internal variability to the “warm Arctic, cold East Asia”(WACE) teleconnection, this study analyses three sets of large-ensemble simulations carried out by the Norwegian Earth System Model with a coupled atmosphere–land surface model, forced by seasonal sea ice conditions from preindustrial, present-day, and future periods. Each ensemble member within the same set uses the same forcing but with small perturbations to the atmospheric initial state. Hence, the difference between the present-day(or future) ensemble mean and the preindustrial ensemble mean provides the ice-loss-induced response, while the difference of the individual members within the present-day(or future) set is the effect of atmospheric internal variability. Results indicate that both present-day and future sea ice loss can force a negative phase of the Arctic Oscillation with a WACE pattern in winter. The magnitude of ice-induced Arctic warming is over four(ten) times larger than the ice-induced East Asian cooling in the present-day(future) experiment;the latter having a magnitude that is about 30% of the observed cooling. Sea ice loss contributes about 60%(80%) to the Arctic winter warming in the present-day(future) experiment. Atmospheric internal variability can also induce a WACE pattern with comparable magnitudes between the Arctic and East Asia. Ice-lossinduced East Asian cooling can easily be masked by atmospheric internal variability effects because random atmospheric internal variability may induce a larger magnitude warming. The observed WACE pattern occurs as a result of both Arctic sea ice loss and atmospheric internal variability, with the former dominating Arctic warming and the latter dominating East Asian cooling.

The Impact of Simulation Education on Self-Efficacy in Pre-Registration Nursing Students

This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-efficacy of undergraduate pre-registration nursing students. The second aim of this study is to explore additional outcome variables that were examined in the previous studies. Five electronic databases were searched systematically. These databases were MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO. The PICO model was employed to identify the search terms, with a thesaurus being used to provide synonyms. Reference lists of relevant articles were examined and hand searches of journals were also undertaken. The quality of each study was assessed using the Simulation Research Rubric (SRR). A total of 11 studies were included. All studies explored the impact of simulation education on undergraduate pre-registration nursing. Six studies explored nursing students’ competence and performance and two papers examined their critical thinking. Problem solving, learning motivation, communication skills and knowledge acquisition were examined once. The majority of studies indicated that simulation training has a positive impact on pre-registration nursing students’ self-efficacy and other outcome variables. Furthermore, the study results indicate that simulation training is more dependable than traditional training, and students were extremely satisfied with the simulation training. However, most of the studies included in this review had several gaps, including study design, sample size and dissimilarities between the scales used. Further research with large samples, reliable and valid instruments, and outcomes measures (such as critical thinking and transferability of skills) is required to provide better insight into the effectiveness of simulation in undergraduate nursing education. .

Machine learning-enhanced Monte Carlo and subset simulations for advanced risk assessment in transportation infrastructure

The maintenance of safety and dependability in rail and road embankments is of utmost importance in order to facilitate the smooth operation of transportation networks.This study introduces a comprehensive methodology for soil slope stability evaluation,employing Monte Carlo Simulation(MCS)and Subset Simulation(SS)with the"UPSS 3.0 Add-in"in MS-Excel.Focused on an 11.693-meter embankment with a soil slope(inclination ratio of 2H:1V),the investigation considers earthquake coefficients(kh)and pore water pressure ratios(ru)following Indian zoning requirements.The chance of slope failure showed a considerable increase as the Coefficient of Variation(COV),seismic coefficients(kh),and pore water pressure ratios(ru)experienced an escalation.The SS approach showed exceptional efficacy in calculating odds of failure that are notably low.Within computational modeling,the study optimized the worst-case scenario using ANFIS-GA,ANFIS-GWO,ANFIS-PSO,and ANFIS-BBO models.The ANFIS-PSO model exhibits exceptional accuracy(training R2=0.9011,RMSE=0.0549;testing R2=0.8968,RMSE=0.0615),emerging as the most promising.This study highlights the significance of conducting thorough risk assessments and offers practical insights into evaluating and improving the stability of soil slopes in transportation infrastructure.These findings contribute to the enhancement of safety and reliability in real-world situations.

The Application of Analytical Techniques to Alpha-Synuclein in Parkinson’s Disease

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as tremors, rigidity, and bradykinesia, as well as non-motor symptoms including cognitive impairment and mood disorders. A hallmark of PD is the accumulation of alpha-synuclein, a presynaptic neuronal protein that aggregates to form Lewy bodies, leading to neuronal dysfunction and cell death. The study of alpha-synuclein and its pathological forms is crucial for understanding the etiology of PD and developing effective diagnostic and therapeutic strategies. Analytical techniques play a pivotal role in elucidating the structure, function, and aggregation mechanisms of alpha-synuclein. Biochemical methods such as Western blotting and enzyme-linked immunosorbent assay (ELISA) are employed to detect and quantify alpha-synuclein in biological samples, offering insights into its expression levels and post-translational modifications. Imaging techniques like immunohistochemistry and positron emission tomography (PET) allow for the visualization of alpha-synuclein aggregates in tissue samples and in vivo, respectively, facilitating the study of its spatial distribution and progression in PD Spectroscopic methods, including nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry, provide detailed structural information on alpha-synuclein and its isoforms, aiding in the identification of conformational changes associated with aggregation. Emerging techniques such as cryo-electron microscopy (Cryo-EM) and single-molecule fluorescence enable high-resolution structural analysis and real-time monitoring of alpha-synuclein aggregation dynamics, respectively. The application of these analytical techniques has significantly advanced our understanding of the pathophysiological role of alpha-synuclein in PD. They have contributed to the identification of potential biomarkers for early diagnosis and the evaluation of therapeutic interventions targeting alpha-synuclein aggregation. Despite technical limitations and challenges in clinical translation, ongoing advancements in analytical methodologies hold promise for improving the diagnosis, monitoring, and treatment of Parkinson’s disease through a deeper understanding of alpha-synuclein pathology.

Two Monte Carlo-based simulators for imaging-system modeling and projection simulation of flat-panel X-ray source

The advantages of a flat-panel X-ray source(FPXS)make it a promising candidate for imaging applications.Accurate imaging-system modeling and projection simulation are critical for analyzing imaging performance and resolving overlapping projection issues in FPXS.The conventional analytical ray-tracing approach is limited by the number of patterns and is not applicable to FPXS-projection calculations.However,the computation time of Monte Carlo(MC)simulation is independent of the size of the patterned arrays in FPXS.This study proposes two high-efficiency MC projection simulators for FPXS:a graphics processing unit(GPU)-based phase-space sampling MC(gPSMC)simulator and GPU-based fluence sampling MC(gFSMC)simulator.The two simulators comprise three components:imaging-system modeling,photon initialization,and physical-interaction simulations in the phantom.Imaging-system modeling was performed by modeling the FPXS,imaging geometry,and detector.The gPSMC simulator samples the initial photons from the phase space,whereas the gFSMC simulator performs photon initialization from the calculated energy spectrum and fluence map.The entire process of photon interaction with the geometry and arrival at the detector was simulated in parallel using multiple GPU kernels,and projections based on the two simulators were calculated.The accuracies of the two simulators were evaluated by comparing them with the conventional analytical ray-tracing approach and acquired projections,and the efficiencies were evaluated by comparing the computation time.The results of simulated and realistic experiments illustrate the accuracy and efficiency of the proposed gPSMC and gFSMC simulators in the projection calculation of various phantoms.

Simulation Analysis of Deformation Control for Magnetic Soft Medical Robots

Dear Editor,This letter presents a biocompatible cross-shaped magnetic soft robot and investigates its deformation mode control strategy through COMSOL modeling and simulation.Magnetic soft robots offer novel avenues for precise treatment within intricate regions of the human body.

Mathematical modeling and simulations of stress mitigation by coating polycrystalline particles in lithium-ion batteries

A chemo-mechanical model is developed to investigate the effects on the stress development of the coating of polycrystalline Ni-rich LiNixMnyCo_(z)O_(2)(x≥0.8)(NMC)particles with poly(3,4-ethylenedioxythiophene)(PEDOT).The simulation results show that the coating of primary NMC particles significantly reduces the stress generation by efficiently accommodating the volume change associated with the lithium diffusion,and the coating layer plays roles both as a cushion against the volume change and a channel for the lithium transport,promoting the lithium distribution across the secondary particles more homogeneously.Besides,the lower stiffness,higher ionic conductivity,and larger thickness of the coating layer improve the stress mitigation.This paper provides a mathematical framework for calculating the chemo-mechanical responses of anisotropic electrode materials and fundamental insights into how the coating of NMC active particles mitigates stress levels.

Epileptic brain network mechanisms and neuroimaging techniques for the brain network

Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal discharges.Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice.An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tra ctography,diffusion kurtosis imaging-based fiber tractography,fiber ball imagingbased tra ctography,electroencephalography,functional magnetic resonance imaging,magnetoencephalography,positron emission tomography,molecular imaging,and functional ultrasound imaging have been extensively used to delineate epileptic networks.In this review,we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy,and extensively analyze the imaging mechanisms,advantages,limitations,and clinical application ranges of each technique.A greater focus on emerging advanced technologies,new data analysis software,a combination of multiple techniques,and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.