Imaging characteristics and treatment strategies for carotid artery occlusion caused by skull base fracture:Three case reports

BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct management are crucial for saving the lives of such patients and improving their prognosis.This article retrospectively analyzed the imaging and clinical data of three patients,to explore the imaging characteristics and treatment strategies for carotid artery occlusion,combined with severe skull base fractures.CASE SUMMARY This case included three patients,all male,aged 21,63,and 16 years.They underwent plain film skull computed tomography(CT)examination at the onset of their illnesses,which revealed fractures at the bases of their skulls.Ultimately,these cases were definitively diagnosed through CT angiography(CTA)examinations.The first patient did not receive surgical treatment,only anticoagulation therapy,and recovered smoothly with no residual limb dysfunction(Case 1).The other two patients both developed intracranial hypertension and underwent decompressive craniectomy.One of these patients had high intracranial pressure and significant brain swelling postoperatively,leading the family to choose to take him home(Case 2).The other patient also underwent decompressive craniectomy and recovered well postoperatively with only mild limb motor dysfunction(Case 3).We retrieved literature from PubMed on skull base fractures causing ICA occlusion to determine the imaging characteristics and treatment strategies for this type of disease.CONCLUSION For patients with cranial trauma combined with skull base fractures,it is essential to complete a CTA examination as soon as possible,to screen for blunt cerebrovascular injury.

Are case reports valuable?Exploring their role in evidence based medicine and patient care

Case reports,often overlooked in evidence-based medicine(EBM),play a pivotal role in healthcare research.They provide unique insights into rare conditions,novel treatments,and adverse effects,serving as valuable educational tools and generating new hypothesis.Despite their limitations in generalizability,case reports contribute significantly to evidence-based practice by offering detailed clinical information and fostering critical thinking among healthcare professionals.By acknowledging their limitations and adhering to reporting guidelines,case reports can contribute significantly to medical knowledge and patient care within the evolving landscape of EBM.This editorial explores the intrinsic value of case reports in EBM and patient care.

Construction of Teaching Case Base of Anti-Seismic Design of Building Structure

Anti-Seismic Design of Building Structures is an important course in civil engineering majors,and it is also a course that pays equal attention to theory and practice.Therefore,by establishing a case base for Anti-Seismic Design of Building Structures,the obscure theoretical knowledge can be taught to students in the form of examples,and the knowledge becomes intuitive.In this way,the students’understanding of anti-seismic design theory and the efficiency of teaching can be improved,and the students’interest in learning can be stimulated.

Using clinical cases to guide healthcare

Evidence-based practice(EBP)has been the gold standard in healthcare for nearly three centuries and aims to assist physicians in providing the safest and most effective healthcare for their patients.The well-established hierarchy of evidence lists systematic reviews and meta-analyses at the top however these methodologies are not always appropriate or possible and in these instances case-control studies,case series and case reports are utilised to support EBP.Case-control studies allow simultaneous study of multiple risk factors and can be performed rapidly and relatively cheaply.A recent example was during the Coronavirus pandemic where case-control studies were used to assess the efficacy of personal protective equipment for healthcare workers.Case series and case reports also play a role in EBP and are particularly useful to study rare diseases such as inflammatory bowel disease in transgender and gender non-conforming individuals.They are also vital in generating and disseminating early signals and encouraging further research.Whilst these methodologies have weaknesses,particularly with regards to bias and loss of patient confidentiality for rare pathologies,they have an important part to play in EBP and when appropriately utilised can significantly impact upon clinical practice.

VARIABLE MODEL FOR BUILDING CASE BASE AND ITS APPLICATION

The case variable model is put forward by analyzing the system model and the IDEFO model. The component variables of the machining system are classified into four types, I. E uncontrolled variables, process variables, controlled variables and output variables. The process of building the case base is given. The high-speedcutting data base system is developed based on the presented variable model.

A Teaching Case of Subject Clause Based on Implicit Learning

The New English curriculum criteria suggest teaching English grammar based on the students’cognitive characteristics and emotional needs,helping them discover the rules and encouraging them to master the grammar by using it.But due to the limited time in a lesson,many English teachers adopt a simple approach to teach grammar,in which students are required to memorize the rules first and then practice a lot.This approach is effec-

Data Mining and Neural Network Techniques in Case Based System

This paper first puts forward a case based system framework based on data mining techniques. Then the paper examines the possibility of using neural networks as a method of retrieval in such a case based system. In this system we propose data mining algorithms to discover case knowledge and other algorithms.

CASE-BASED PRODUCT CONFIGURATION AND REUSE IN MASS CUSTOMIZATION

The increasing complexity and size of configuration knowledge bases requres the provisionof advanced methods supporting the development of the actual configuration process and design reuse.A new framework to find a feasible and practical product configuration method is presented in masscustomization. The basic idea of the appoach is to integrate case-based reasoning (CBR) with a con-straint satisfaction problem(CSP). The similarity measure between a crisp and range is also given,which is common in case retrieves. Based on the configuration model, a product platform and customerneeds, case adaptation is carried out with the repair-based algorithm. Lastly, the methodology in theelevator configuration design domain is tested.

Case-based Agile Fixture Design

In order to realize the agility of the fixture design, such as reconfigurability, rescalability and reusability, fixture structure is function unit based decomposed from a fire new point of view. Which makes it easy for agile fixture to be reconfigured and modified. Thereby, the base of case based agile fixture design system info is established.Whole case based agile fixture design model is presented. In which, three modules are added relative to the other models, including case matching of fixture planning module, conflict arbitration module and agile fixture case modify module. The three modules could solve the previous problem that the experience and result are difficult to be reused in the process of design.Two key techniques in the process of the agile fixture design, the evaluation of case similarity, and restriction based conflict arbitration, are listed. And some methods are presented to evaluate the similarity and clear up the conflict.

Case-Based Reasoning for Reducing Software Development Effort

How can we best find project changes that most improve project estimates? Prior solutions to this problem required the use of standard software process models that may not be relevant to some new project. Also, those prior solutions suffered from limited verification (the only way to assess the results of those studies was to run the recommendations back through the standard process models). Combining case-based reasoning and contrast set learning, the W system requires no underlying model. Hence, it is widely applicable (since there is no need for data to conform to some software process models). Also, W’s results can be verified (using holdout sets). For example, in the experiments reported here, W found changes to projects that greatly reduced estimate median and variance by up to 95% and 83% (respectively).

CASE-BASED CONCEPTUAL DESIGN

The current method of case-based design (CBD) can be well practiced forconfiguration design in which design experience knowledge is involved. However, since the designcase is confined to a certain application domain, it is difficult for CBD to be applied toconceptual design process that develops concepts to meet design specifications. Firstly, a functionfactor description space is erected to provide an exhibition room for all functions of design cases.Next, the approach for identifying the space state of function factor in description space isproposed, including the determination of the similarities between function factors of design case.And then a general object-oriented representation for design case is presented by bringing the classof function and in-out flow into the current case representation. Finally, a living example forelectro-pet design that illustrates the implementation of the method for case-based conceptualdesign based on distributed design case repositories is described.

Design System of the Two-step Gear Reducer on Case-based Reasoning

The design of the two-step gear reducer is a tedious and time-consuming process. For the purpose of improving the efficiency and intelligence of design process, case-based reasoning（CBR） technology was applied to the design of the two-step gear reducer. Firstly, the current design method for the two-step gear reducer was analyzed and the principle of CBR was described. Secondly, according to the characteristics of the reducer, three key technologies of CBR were studied and the corresponding methods were provided, which are as follows： （a） an object-oriented knowledge representation method, （b） a retrieval method combining the nearest neighbor with the induction indexing, and （c） a case adaptation algorithm combining the revision based on rule with artificial revision. Also, for the purpose of improving the credibility of case retrieval, a new method for determining the weights of characteristics and a similarity formula were presented, which is a combinatorial weighting method with the analytic hierarchy process（AHP） and roughness set theory. Lastly, according to the above analytic results, a design system of the two-step gear reducer on CBR was developed by VC＋＋, UG and Access 2003. A new method for the design of the two-step gear reducer is provided in this study. If the foregoing developed system is applied to design the two-step gear reducer, design efficiency is improved, which enables the designer to release from the tedious design process of the gear reducer so as to put more efforts on innovative design. The study result fully reflects the feasibility and validity of CBR technology in the process of the design of the mechanical parts.

Endpoint temperature prediction of molten steel in RH using improved case-based reasoning

An improved case-based reasoning （CBR） method was proposed to predict the endpoint temperature of molten steel in Ruhrstahl Heraeus （RH） process. Firstly, production data were analyzed by multiple linear regressions and a pairwise comparison matrix in analytic hierarchy process （AHP） was determined by this linear regression＇s coefficient. The weights of various influencing factors were obtained by AHP. Secondly, the dividable principles of case base including ＂0-1＂ and ＂breakpoint＂ were proposed, and the case base was divided into several homogeneous parts. Finally, the improved CBR was compared with ordinary CBR, which is based on the even weight and the single base. The results show that the improved CBR has a higher hit rate for predicting the endpoint temperature of molten steel in RH.

Case-based retrieval approach for machining fixture design utilizingontology

In order to develop an intelligent case-based reasoning （CBR） system to reuse fixture de- sign knowledge, ontology technology was integrated in CBR system by semantic annotation of fixture design case. Domain ontology of fixture design was constructed; concepts and relations were de- fined and represented. The 2-level similarity evaluation approach of domain ontology was presented. The concept similarity of cases was calculated as the first grade case retrieval. Numerical measure- ment was the second grade case retrieval, which adopted various methods to calculate different types of attribute values. The problem of similarity measurement of fixture design case was resolved. Pro- totype system based on the proposed method was illustrated and the retrieval approach was proved to be efficient.

Case Based Reasoning Intelligent System for Network Computer Aided Process Planning

Computer aided process planning system played a key role for integrating design and manufacturing or assembly systems properly considering available resources and design constraints.To take advantage of the enterprise resource,the web CAPP framework was established.Case based reasoning and multi agent system were integrated in the system.The multi agent mecha- nism was discussed in the paper.And an instance of case base was introduced.They made the system run independently and contin- uously in the network environment of process planning problems.

Case-Based Reasoning(CBR) Model for Ultra-Fast Cooling in Plate Mill

New generation thermo-mechanical control process（TMCP） based on ultra-fast cooling is being widely adopted in plate mill to product high-performance steel material at low cost. Ultra-fast cooling system is complex because of optimizing the temperature control error generated by heat transfer mathematical model and process parameters. In order to simplify the system and improve the temperature control precision in ultra-fast cooling process, several existing models of case-based reasoning（CBR） model are reviewed. Combining with ultra-fast cooling process, a developed R5 CBR model is proposed, which mainly improves the case representation, similarity relation and retrieval module. Certainty factor is defined in semantics memory unit of plate case which provides not only internal data reliability but also product performance reliability. Similarity relation is improved by defined power index similarity membership function. Retrieval process is simplified and retrieval efficiency is improved apparently by windmill retrieval algorithm. The proposed CBR model is used for predicting the case of cooling strategy and its capability is superior to traditional process model. In order to perform comprehensive investigations on ultra-fast cooling process, different steel plates are considered for the experiment. The validation experiment and industrial production of proposed CBR model are carried out, which demonstrated that finish cooling temperature（FCT） error is controlled within±25℃ and quality rate of product is more than 97%. The proposed CBR model can simplify ultra-fast cooling system and give quality performance for steel product.

HYBRID STRATIFIED ATMS AND ANN FOR CASE-BASED REASONING

Case Based Reasoning (CBR) is a powerful problem solving technique in AI, but the traditional CBR techniques have its limitations. We hybridized stratified ATMS and ANN for CBR which can deal with case representation, case retrieving, case adapting, learning from failure more effectively. The structure of our CBR system and algorithms of case base reasoning in our CBR system were presented.

Case-Based Reasoning for Slope Stability Evaluation and Its Application

Slope is a non-linear and uncertain kinetic system affected by many factors. In view of the incompleteness and uncertainty of the information of slope stability evaluation, a new method of slop stability evaluation by using case-based reasoning is presented. Considering the sensitivity of attribute weights to the environment, the algorithm of attribute weights is set up on the basis of the concept of changeable weights. Calculating the similarity between target case of the slope and base case, the stability of target case is evaluated. It is shown from examples that the method is simple, visual, practical, and convenient for use.

CASE STORAGE BASED ON RELATIONAL DATABASE

This paper focused on the integration of case base and relational database management system (RDBMS). The organizational and commercial impact will be far greater if the case based reasoning (CBR) system is integrated with main stream information system, which is exemplified by RDBMS. The scalability, security and robustness provided by a commercial RDBMS facilitate the CBR system to manage the case base. The virtual table in relational database (RDB) is important for CBR systems to implement the flexibility of case template. It was discussed how to implement a flexible and succinct case template, and a mapping model between case template and RDB was proposed. The key idea is to build the case as the virtual view of underlying data.

A large basal cell adenoma extending to the ipsilateral skull base and mastoid in the right parotid gland: A case report

BACKGROUND Basal cell adenoma (BCA) is a rare benign tumour that has unique histological characteristics and primarily arises in the parotid glands. According to published reports, nearby tissue destruction by BCA seems impossible. CASE SUMMARY We presented a case of a 54-year-old woman with a mass in the deep lobe of the right parotid gland involving the ipsilateral skull base and mastoid. The patient exhibited gradual right facial swelling but no other obvious symptoms. Combined resection of the total right parotid gland and partial skull base excision were performed. The biopsy conducted before the surgery and sections cut from intraoperatively obtained tissues were not definitive for identifying the character of the neoplasm. A final diagnosis of tubular BCA without malignant elements was established based on postoperative pathology results and immunohistochemical analysis. The tumour did not recur during the 12-mo follow-up period. CONCLUSION A diagnosis of BCA can only be established based on a histopathological examination after an excisional biopsy, and tubular BCA should carefully be considered as a destructive type.