Nice结在骨科中的应用进展

Nice结是一种新型缝合固定技术,作为近年来国内外学者及临床工作者应用研究的热点,该技术将双缝合线与滑动结相结合,可用于开放性手术和关节镜手术,适用于骨折碎片复位固定、肌腱或韧带的修复固定、皮肤软组织的损伤固定等。Nice结的优点包括强度高、可操作性强、可调节性强、简单易学习、使用中可逐渐拉紧及多功能性等。该技术在近年来被证实在临床实践中的实用性,逐渐取代钢丝等金属线在手术中的固定作用。本文将从Nice结的操作方法、生物力学、临床应用等方面展开综述。

基于子空间的I-nice聚类算法

高维数据的子空间聚类是无监督学习领域的热点研究问题,其难点在于寻找恰当的子空间以及其中的数据簇。大多数现有的子空间聚类算法均存在计算复杂度高和参数选择难的缺陷,这是因为在高维数据中子空间的组合数量很大,算法的执行时间非常长,且不同数据集和应用场景需要不同的参数设定。为此,提出了基于子空间的I-nice(简记为sub-I-nice)聚类算法用于识别高维数据中子空间内数据簇的个数。首先,该算法将原始数据维度随机划分成多个维度组,根据维度组生成子空间样本;接着,使用最新的I-niceMO算法对每个子空间数据进行聚类;最后,采用新设计的球模型对所有子空间的基聚类结果进行集成。在含有噪声的高维仿真数据集上对所提出的sub-I-nice算法进行了详细的性能验证,实验结果表明sub-I-nice算法相比其他3种代表性聚类算法有更好的准确性和鲁棒性,从而证实了其合理性和有效性。

基于NICE分型的结直肠小息肉诊断临床研究

目的探讨基于窄带成像国际结肠内窥镜(Narrow-band Imaging International Colorectal Endoscopic,NICE)分型的结直肠小息肉诊断临床价值。方法选取2019年1月—2020年9月武汉科技大学附属汉阳医院内镜中心200例进行肠镜检查发现小息肉(直径≤10 mm)的患者作为研究对象。入院后,均行窄带成像(Narrow Band Imaging,NBI)放大肠镜检查,观察病灶位置、形态特征。与“金标准”病理检查相比,观察NICE分型标准下病灶分型情况及诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值。结果200例患者镜下共发现248个小息肉样病变,分布于直肠45个(18.15%)、横结肠61个(24.60%)、升结肠58个(23.39%)、乙状结肠40个(16.13%)、降结肠44个(17.74%);隆起型125个(50.40%)、平坦型病灶123个(49.60%)。病理学检查结果显示,248个小息肉样病变中,良性病灶191个(77.02%),恶性病灶57个(22.98%)。与病理检查相比,观察NICE分型标准下检出病灶灵敏度96.49%、特异度98.43%、准确度97.98%、阳性预测值94.83%、阴性预测值98.95%。结论结直肠小息肉样病变诊断中应用NICE分型法效果理想,可鉴别诊断息肉性质,了解息肉具体特征。

UAV-assisted data collection for wireless sensor networks with dynamic working modes

Wireless Sensor Network(WSN)is a cornerstone of Internet of Things(IoT)and has rich application scenarios.In this work,we consider a heterogeneous WSN whose sensor nodes have a diversity in their Residual Energy(RE).In this work,to protect the sensor nodes with low RE,we investigate dynamic working modes for sensor nodes which are determined by their RE and an introduced energy threshold.Besides,we employ an Unmanned Aerial Vehicle(UAV)to collect the stored data from the heterogeneous WSN.We aim to jointly optimize the cluster head selection,energy threshold and sensor nodes’working mode to minimize the weighted sum of energy con-sumption from the WSN and UAV,subject to the data collection rate constraint.To this end,we propose an efficient search method to search for an optimal energy threshold,and develop a penalty-based successive convex approximation algorithm to select the cluster heads.Then we present a low-complexity iterative approach to solve the joint optimization problem and discuss the implementation procedure.Numerical results justify that our proposed approach is able to reduce the energy consumption of the sensor nodes with low RE significantly and also saves energy for the whole WSN.

Flow characteristics and hot workability of a typical low-alloy high-strength steel during multi-pass deformation

Heavy components of low-alloy high-strength(LAHS) steels are generally formed by multi-pass forging. It is necessary to explore the flow characteristics and hot workability of LAHS steels during the multi-pass forging process, which is beneficial to the formulation of actual processing parameters. In the study, the multi-pass hot compression experiments of a typical LAHS steel are carried out at a wide range of deformation temperatures and strain rates. It is found that the work hardening rate of the experimental material depends on deformation parameters and deformation passes, which is ascribed to the impacts of static and dynamic softening behaviors. A new model is established to describe the flow characteristics at various deformation passes. Compared to the classical Arrhenius model and modified Zerilli and Armstrong model, the newly proposed model shows higher prediction accuracy with a confidence level of 0.98565. Furthermore, the connection between power dissipation efficiency(PDE) and deformation parameters is revealed by analyzing the microstructures. The PDE cannot be utilized to reflect the efficiency of energy dissipation for microstructure evolution during the entire deformation process, but only to assess the efficiency of energy dissipation for microstructure evolution in a specific deformation parameter state.As a result, an integrated processing map is proposed to better study the hot workability of the LAHS steel, which considers the effects of instability factor(IF), PDE, and distribution and size of grains. The optimized processing parameters for the multi-pass deformation process are the deformation parameters of 1223–1318 K and 0.01–0.08 s^(-1). Complete dynamic recrystallization occurs within the optimized processing parameters with an average grain size of 18.36–42.3 μm. This study will guide the optimization of the forging process of heavy components.

Use of cognitive-behavioral career coaching to reduce work anxiety and depression in public employees

BACKGROUND Public employees worldwide are increasingly concerned about work anxiety and depression.Cognitive-behavioral career coaching has emerged as a promising strategy for addressing these mental health disorders,which can negatively impact on a person's overall well-being and performance.AIM To examine whether cognitive-behavioral career coaching reduces work anxiety and depression among Nigerian public employees.METHODS A total of 120 public employees(n=60)suffering from severe anxiety and depression were randomly assigned to the treatment or control groups in this study.Cognitive behavioral coaching was provided twice a week to those in the treatment group,whereas no treatment was given to those in the control group.As part of the study,the Hamilton Anxiety Rating Scales and Beck Depression Inventory were used to collect data.RESULTS Analysis of covariance of the data from participants indicates a significant effect of cognitive-behavioral career coaching on work anxiety and depression.CONCLUSION Insights into the underlying mechanisms by which cognitive behavior career coaching exerts its effects have been gained from this study.Also,the study has gathered valuable data that can inform future practice and guide the development of strategies for supporting mental health at work.

NICE《产时管理》指南(2023)解读

妇女儿童健康是人类持续发展的前提和基础,其相关指标反映一个国家卫生健康事业发展水平,也是衡量经济发展水平的重要评价指标。近年来,我国母婴健康水平不断提高,但生育率呈断崖式下降,虽然生育率受到一系列复杂社会经济等因素影响,但在国家三孩政策和积极生育支持措施逐步完善落实的背景下,产科医务人员应着力于持续提高母婴健康服务质量,改善分娩体验,积极营造生育友好氛围。

Formulation of Work-Study Combined and Result-Oriented Integrated Curriculum Standards

According to the Annex Technical Regulations for Integrated Curriculum Development(Trial)in Document No.30 of the General Office of the Ministry of Human Resources and Social Security(2012),this paper studies the formulation of the curriculum standards for the integration of Chinese medicinal materials production.We focus on the formulation ideas of the curriculum standards for the integration of Chinese medicinal materials production,the formulation process of the curriculum standards for the integration of Chinese medicinal materials production,including the description of typical work tasks,the determination of curriculum objectives,the analysis of study content,the description of referential study tasks,teaching implementation suggestions,assessment and evaluation suggestions,which can provide a reference for the development and research of other related integrated courses.

改良Nice结联合接骨板内固定术对掌指骨斜形骨折患者手指功能恢复情况及并发症的影响

目的探讨改良Nice结联合接骨板内固定术对掌指骨斜形骨折患者手指功能恢复情况及并发症的影响。方法将60例掌指骨斜形骨折患者根据治疗方式不同分为参照组和观察组各30例。参照组采用克氏针内固定术治疗,观察组采用改良Nice结联合接骨板内固定术治疗。比较两组围术期指标、手指功能恢复情况及并发症发生率。结果与参照组相比,观察组手术时间、住院时间较短,术中出血量较少,Dargan功能优良率较高,并发症发生率较低(P<0.05)。结论改良Nice结联合接骨板内固定术治疗掌指骨斜形骨折患者,可明显缩短手术时间及住院时间,减少其术中出血量,促进其手指功能恢复,减少并发症发生。

桥接组合式内固定系统结合Nice结与锁定钢板治疗锁骨中段粉碎性骨折的疗效比较

目的探究在锁骨中段粉碎性骨折治疗中应用桥接组合式内固定系统(OBS)结合Nice结的效果,以及对患者肩关节功能、疼痛的影响。方法选取常熟市第二人民医院2021年2月至2023年2月收治的82例锁骨中段粉碎性骨折患者,按照随机数字表法分为对照组(41例,采用锁定钢板治疗)和观察组(41例,采用OBS结合Nice结治疗)。两组患者均观察至术后4个月。比较两组患者术后4个月的临床疗效,围术期指标,以及术前、术后4个月临床指标评分、肩关节活动度。结果术后4个月,观察组患者临床总优良率高于对照组;观察组患者手术时间、切口长度及骨折愈合时间均短于对照组,术中出血量少于对照组;与术前比,术后4个月两组患者疼痛数字评价量表(NRS)评分均降低,且观察组低于对照组,Constant-Murley评分、Neer肩关节功能评分均升高,且观察组均高于对照组;与术前比,术后4个月两组患者肩关节前屈、后伸、内旋、外旋活动度均增大,且观察组均大于对照组(均P<0.05)。结论相较于锁定钢板治疗,在临床中治疗锁骨中段粉碎性骨折时,应用OBS结合Nice结可缩短手术时间、减少术中出血量,缓解患者疼痛,加快骨折愈合,进而促进肩关节功能恢复。

Design and optimization of fluid lubricated bearings operated with extreme working performances——a comprehensive review

Fluid lubricated bearings have been widely adopted as support components for high-end equipment in metrology,semiconductor devices,aviation,strategic defense,ultraprecision manufacturing,medical treatment,and power generation.In all these applications,the equipment must deliver extreme working performances such as ultraprecise movement,ultrahigh rotation speed,ultraheavy bearing loads,ultrahigh environmental temperatures,strong radiation resistance,and high vacuum operation,which have challenged the design and optimization of reliable fluid lubricated bearings.Breakthrough of any related bottlenecks will promote the development course of high-end equipment.To promote the advancement of high-end equipment,this paper reviews the design and optimization of fluid lubricated bearings operated at typical extreme working performances,targeting the realization of extreme working performances,current challenges and solutions,underlying deficiencies,and promising developmental directions.This paper can guide the selection of suitable fluid lubricated bearings and optimize their structures to meet their required working performances.

Exploring the Factors Associated with 12-Month Non-Return to Work among Motorcyclists Involved in Road Accidents

Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study aimed to determine the prevalence and factors associated with non-return to work among surviving motorcyclists involved in road accidents 12 months after the event. Materials and Methods: It was a cross-sectional study conducted using data from a cohort of motorcyclists involved in accidents and recruited in five hospitals in Benin from July 2019 to January 2020. The dependent variable was non-return to work 12 months after the accident (yes vs no). The independent variables were categorized into two groups: baseline and 12-month follow-up variables. Logistic regression was used to determine the factors associated with non-return to work at 12 months among the participants. Results: Among the 362 participants, 55 (15.19%, 95% CI = 11.84 - 19.29) had not returned to work 12 months after the accident. Risk factors for non-return to work identified were: smoking (aOR = 4.41, 95% CI = 1.44 - 13.56, p = 0.010), hospitalization (aOR = 2.87, 95% CI = 1.14 - 7.24, p Conclusion: The prevalence of non-return to work at 12 months was high among surviving motorcyclists involved in road accidents in Benin. Integrated support for patients based on identified risk factors should effectively improve their return to work.

Relationship between physical activity and specific working memory indicators of depressive symptoms in university students

BACKGROUND The detection rate of depression among university students has been increasing in recent years,becoming one of the main psychological diseases that endangers their physical and mental health.According to statistics,self-harm and suicide,for which there is no effective intervention,are the second leading causes of death.AIM To explore the relationship between different elements and levels of physical activity and college students’depression-symptom-specific working memory indicators.METHODS Of 143 college students were analyzed using the Beck Depression Self-Rating Scale,the Physical Activity Rating Scale,and the Working Memory Task.RESULTS There was a significant difference between college students with depressive symptoms and healthy college students in completing verbal and spatial working memory(SWM)tasks correctly(all P<0.01).Physical Activity Scale-3 scores were significantly and positively correlated with the correct rate of the verbal working memory task(r=0.166)and the correct rate of the SWM task(r=0.210)(all P<0.05).There were significant differences in the correct rates of verbal and SWM tasks according to different exercise intensities(all P<0.05)and different exercise durations(all P<0.05),and no significant differences in the correct rates of verbal and SWM tasks by exercise frequency(all P>0.05).CONCLUSION An increase in physical exercise among college students,particularly medium-and high-intensity exercise and exercise of 30 min or more,can improve the correct rate of completing working memory tasks.

A Review on Technologies for the Use of CO2 as a Working Fluid in Refrigeration and Power Cycles

The use of carbon dioxide as a working fluid has been the subject of extensive studies in recent years, particularly in the field of refrigeration where it is at the heart of research to replace CFC and HCFC. Its thermodynamic properties make it a fluid of choice in the efficient use of energy at low and medium temperatures in engine cycles. However, the performance of transcritical CO2 cycles weakens under high temperature and pressure conditions, especially in refrigeration systems;On the other hand, this disadvantage becomes rather interesting in engine cycles where CO2 can be used as an alternative to the organic working fluid in small and medium-sized electrical systems for low quality or waste heat sources. In order to improve the performance of systems operating with CO2 in the field of refrigeration and electricity production, research has made it possible to develop several concepts, of which this article deals with a review of the state of the art, followed by analyzes in-depth and critical of the various developments to the most recent modifications in these fields. Detailed discussions on the performance and technical characteristics of the different evolutions are also highlighted as well as the factors affecting the overall performance of the systems studied. Finally, perspectives on the future development of the use of CO2 in these different cycles are presented.

Working condition recognition of sucker rod pumping system based on 4-segment time-frequency signature matrix and deep learning

High-precision and real-time diagnosis of sucker rod pumping system(SRPS)is important for quickly mastering oil well operations.Deep learning-based method for classifying the dynamometer card(DC)of oil wells is an efficient diagnosis method.However,the input of the DC as a two-dimensional image into the deep learning framework suffers from low feature utilization and high computational effort.Additionally,different SRPSs in an oil field have various system parameters,and the same SRPS generates different DCs at different moments.Thus,there is heterogeneity in field data,which can dramatically impair the diagnostic accuracy.To solve the above problems,a working condition recognition method based on 4-segment time-frequency signature matrix(4S-TFSM)and deep learning is presented in this paper.First,the 4-segment time-frequency signature(4S-TFS)method that can reduce the computing power requirements is proposed for feature extraction of DC data.Subsequently,the 4S-TFSM is constructed by relative normalization and matrix calculation to synthesize the features of multiple data and solve the problem of data heterogeneity.Finally,a convolutional neural network(CNN),one of the deep learning frameworks,is used to determine the functioning conditions based on the 4S-TFSM.Experiments on field data verify that the proposed diagnostic method based on 4S-TFSM and CNN(4S-TFSM-CNN)can significantly improve the accuracy of working condition recognition with lower computational cost.To the best of our knowledge,this is the first work to discuss the effect of data heterogeneity on the working condition recognition performance of SRPS.

Nice结缝线内固定治疗青少年髂前上棘撕脱性骨折的临床疗效

目的探讨Nice结不可吸收高强度缝线内固定治疗青少年髂前上棘撕脱性骨折的疗效。方法回顾性分析2019年6月至2021年12月我院骨科收治的6例髂前上棘撕脱性骨折病人资料,均为男性,年龄12~16岁,平均13.83岁;均为运动损伤,短跑比赛5例,篮球比赛1例;骨折移位≥1 cm;均采用Nice结不可吸收高强度缝线切开复位内固定治疗。收集病人手术时间、疼痛视觉模拟量表(visual ana⁃logue scale,VAS)评分及并发症,末次随访采用Harris评分评价疗效。结果6例病人手术时间25~62 min,平均36 min;均得到随访,随访时间6~12个月,平均9.2个月。病人术后4周VAS评分为(1.00±0.63)分,与术前[(3.00±0.63)分]比较,差异具有统计学意义(t=7.746,P=0.001);术后8周VAS评分为(0.17±0.41)分,与术后4周比较差异具有统计学意义(t=2.712,P=0.042)。无术后感染、股外侧皮神经损伤、骨折再移位、内固定失效、骨折不愈合等并发症发生。术后2周均能返回学校,末次随访骨折均愈合并恢复正常生活和运动,Harris评分均为100分。结论采用Nice结不可吸收高强度缝线切开复位内固定治疗青少年髂前上棘撕脱性骨折操作简单,疗效确切,康复快,无需二次手术取出内固定。

Positive Effect of Transcranial Direct Current Stimulation on Visual Verbal Working Memory in Patients with Attention-Deficit/Hyperactivity Disorder

Background: Working memory is an executive function that plays an important role in many aspects of daily life, and its impairment in patients with attention-deficit/hyperactivity disorder (ADHD) affects quality of life. The dorsolateral prefrontal cortex (DLPFC) has been a good target site for transcranial direct current stimulation (tDCS) due to its intense involvement in working memory. In our 2018 study, tDCS improved visual-verbal working memory in healthy subjects. Objective: This study examines the effects of tDCS on ADHD patients, particularly on verbal working memory. Methods: We conducted an experiment involving verbal working memory of two modalities, visual and auditory, and a sustained attention task that could affect working memory in 9 ADHD patients. Active or sham tDCS was applied to the left DLPFC in a single-blind crossover design. Results: tDCS significantly improved the accuracy of visual-verbal working memory. In contrast, tDCS did not affect auditory-verbal working memory and sustained attention. Conclusion: tDCS to the left DLPFC improved visual-verbal working memory in ADHD patients, with important implications for potential ADHD treatments.

The action mechanism of the work done by the electric field force on moving charges to stimulate the emergence of carrier generation/recombination in a PN junction

It is discovered that the product of the current and the electric field in a PN junction should be regarded as the rate of work(power)done by the electric field force on moving charges(hole current and electron current),which was previously misinterpreted as solely a Joule heating effect.We clarify that it is exactly the work done by the electric field force on the moving charges to stimulate the emergence of non-equilibrium carriers,which triggers the novel physical phenomena.As regards to Joule heat,we point out that it should be calculated from Ohm’s law,rather than simply from the product of the current and the electric field.Based on this understanding,we conduct thorough discussion on the role of the electric field force in the process of carrier recombination and carrier generation.The thermal effects of carrier recombination and carrier generation followed are incorporated into the thermal equation of energy.The present study shows that the exothermic effect of carrier recombination leads to a temperature rise at the PN interface,while the endothermic effect of carrier generation causes a temperature reduction at the interface.These two opposite effects cause opposite heat flow directions in the PN junction under forward and backward bias voltages,highlighting the significance of managing device heating phenomena in design considerations.Therefore,this study possesses referential significance for the design and tuning on the performance of piezotronic devices.

Determinants of Satisfaction at Work and Its Reflections on Performance

This study examines the relationship between job satisfaction and performance,investigating personality traits and satisfaction aspects among employees of a Federal Higher Education Institution.A questionnaire was administered to 658 participants,using structural equation modeling for analysis.Results highlighted that challenging work,neuroticism,and self-esteem significantly influenced overall workplace satisfaction,while general satisfaction,self-efficacy,and lack of attention were key determinants of work performance.This emphasizes the importance for managers to prioritize factors enhancing employee satisfaction,as it positively correlates with job performance.

The Impact of the Digital Economy on Rural Residents’Working Hours:Mechanisms and Empirical Evidence

The rapid development of the digital economy has provided a new impetus for rural residents to extend their working hours.Based on the data collected by the China Labor-force Dynamics Survey(CLDS)in 2014,2016,and 2018,this paper measured the development level of the digital economy in China from the perspectives of internet development and digital financial inclusion,and tested the mechanisms of how the digital economy affected rural residents’working hours.The results showed that the digital economy extended rural residents’working hours by expanding information channels and enhancing human capital,and this mechanism was affected by heterogeneity in rural residents’educational background,age,and social capital.Building on these findings,this paper holds that to increase rural residents’income by extending their working hours and achieving common prosperity for all,it is necessary to expand the opportunities for rural residents to participate in skills training and promote their accumulation of human capital.