Clinical Study on Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis in Pancreaticoduodenectomy

Objective To study the influence of Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis （SPDJCS） on the incidence of pancreatic fistula after pancreaticoduodenectomy, and to analyze its applicability, safety, and efficacies. Methods A prospective controlled trial was conducted with 165 cases receiving pancreati- coduodenectomy in the Department of Hepatopancreatobiliary Surgery from January 2010 to May 2012. The patients were divided into Group A （end-to-end/end-to-side invaginated anastomosis, n=52）, Group B （end-to-side mucosal anastomosis, n=48）, and Group C （SPDJCS, n=65）. The preoperative data, intra- operative data, and operative outcomes （incidence of pancreatic fistula, operation time, intraoperative blood loss, peritoneal drainage, peritoneal hemorrhage, peritoneal abscess, delayed gastric emptying, pulmonary infection, postoperative infection, blood transfusion, and perioperative mortality） were com- pared among the 3 groups. Results The total incidence of pancreatic fistula was 13.9% （23/165） in all the 165 patients. The inci- dence in Group A and Group B was 23.1% （12/52） and 18.8% （9/48）, both higher than that in Group C [3.1% （2/65）, both P〈0.05]. Group C showed significantly better outcomes than group A and B in terms of the opera- tion time （5.5±1.2 hours vs. 6.1±1.1 hours, 5.5±1.2 hours vs. 6.3±1.5 hours）, volume of blood loss （412.0±205.0 mL vs. 525.0±217.0 mL, 412.0±205.0 mL vs. 514.0±217.0 mL）, and postoperative drainage amount of plasma tubes （175.0±65.0 mE vs. 275.0±80.0 mL, 175.0±65.0 mL vs. 255.0±75.0 mL） （all P〈0.05）, while Group A and Group B displayed no difference in these aspects （P〉0.05）. As complications other than pancreatic fistula were concerned, the three groups were not different from each other （P〉0.05）. Conclusions SPDJCS may have the effect of reducing the incidence of pancreatic fistula after pan- creaticoduodenectomy. It could be safe, practical and convenient technique of anastomosis for pancreaticoje- junostomy.

Thirty-gauge needle-guided purse-string suture pupilloplasty:a new technique

AIM:To observe the clinical outcomes of 30-gauge(G)needle-guided 10-0 prolene suture purse-string pupilloplasty for atonic pupil management.METHODS:Eight patients with atonic pupils who underwent suture purse-string pupilloplasty were retrospectively analyzed.Preoperative data and at least 6mo of postoperative data were collected from all the patients.RESULTS:The corrected distance visual acuity(CDVA)before and after surgery was 0.58±0.22 and 0.20±0.10 logMAR,respectively(P=0.002).The pre-and postoperative pupil size was 7.38±0.88 and 3.09±0.71 mm(P=0.000),respectively.The corneal endothelial cell count was 2841±176/mm^(2) before and 2692±143/mm^(2) after surgery(P=0.000).No intraoperative or postoperative complications were reported.During the follow-up period of at least 6mo,all treated pupils were centered and generally or nearly round.Furthermore,the patients did not exhibit photophobia,glare,or diplopia.CONCLUSION:This technique is a simple and effective method for pupil reduction.

Continuous glucose monitoring metrics in pregnancy with type 1 diabetes mellitus

Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests,the advent of continuous glucose monitoring(CGM)systems has revolutionized the approach.These devices offer a safe and reliable means of tracking glucose levels in real-time,benefiting both women with diabetes during pregnancy and the healthcare providers.Moreover,CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes,especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device.Such a combined approach has been demonstrated to improve overall blood sugar control,lessen the occurrence of preeclampsia and neonatal hypoglycaemia,and minimize the duration of neonatal intensive care unit stays.This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.

Double-nylon purse-string suture in closing postoperative wounds following endoscopic resection of large(≥3 cm)gastric submucosal tumors

BACKGROUND Endoscopic full-thickness resection(EFTR)of gastric submucosal tumors(SMTs)is safe and effective;however,postoperative wound management is equally important.Literature on suturing following EFTR for large(≥3 cm)SMTs is scarce and limited.AIM To evaluate the efficacy and clinical value of double-nylon purse-string suture in closing postoperative wounds following EFTR of large(≥3 cm)SMTs.METHODS We retrospectively analyzed the data of 85 patients with gastric SMTs in the fundus of the stomach or in the lesser curvature of the gastric body whose wounds were treated with double-nylon purse-string sutures after successful tumor resection at the Endoscopy Center of Renmin Hospital of Wuhan University.The operative,postoperative,and follow-up conditions of the patients were evaluated.RESULTS All tumors were completely resected using EFTR.36(42.35%)patients had tumors located in the fundus of the stomach,and 49(57.65%)had tumors located in the body of the stomach.All patients underwent suturing with double-nylon sutures after EFTR without laparoscopic assistance or further surgical treatment.Postoperative fever and stomach pain were reported in 13(15.29%)and 14(16.47%)patients,respectively.No serious adverse events occurred during the intraoperative or postoperative periods.A postoperative review of all patients revealed no residual or recurrent lesions.CONCLUSION Double-nylon purse-string sutures can be used to successfully close wounds that cannot be completely closed with a single nylon suture,especially for large(≥3 cm)EFTR wounds in SMTs.

Early Triassic Volcanic Rocks in the Western Yarlung Zangbo Suture Zone:Implications for the Opening of the Neo-Tethys Ocean

In this study,zircon U-Pb dating of volcanic rocks from the Zhongba ophiolite of the Yarlung Zangbo Suture Zone(YZSZ)in southern Xizang(Tibet)yielded an age of 247±3 Ma.According to whole rock geochemical and Sr-NdPb isotopic data,the Early Triassic samples could be divided into two groups:Group 1 with P-MORB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70253–0.70602,ε_(Nd)(t)values of 4.2–5.3,(^(206)Pb/^(204)Pb)_(t)ratios of 16.353–18.222,(^(207)Pb/^(204)Pb)_(t)ratios of 15.454–15.564,and(^(208)Pb/^(204)Pb)_(t)ratios of 35.665–38.136;Group 2 with OIB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70249–0.70513,ε_(Nd)(t)values of 4.4–4.9,(^(206)Pb/^(204)Pb)_(t)ratios of 17.140–18.328,(^(207)Pb/^(204)Pb)_(t)ratios of 15.491–15.575,and(^(208)Pb/^(204)Pb)_(t)ratios of 36.051–38.247.Group 2 rocks formed by partial melting of the mantle source enriched by a former plume,and assimilated continental crustal material during melt ascension.The formation of Group 1 rocks corresponds to the mixing of OIB melts,with the same components as Group 2 and N-MORBs.The Zhongba Early Triassic rocks belong to the continental margin type ophiolite and formed in the continental–oceanic transition zone during the initial opening of the Neo-Tethys in southern Xizang(Tibet).

Regulatable Orthotropic 3D Hybrid Continuous Carbon Networks for Efficient Bi-Directional Thermal Conduction

Vertically oriented carbon structures constructed from low-dimen-sional carbon materials are ideal frameworks for high-performance thermal inter-face materials(TIMs).However,improving the interfacial heat-transfer efficiency of vertically oriented carbon structures is a challenging task.Herein,an orthotropic three-dimensional(3D)hybrid carbon network(VSCG)is fabricated by depositing vertically aligned carbon nanotubes(VACNTs)on the surface of a horizontally oriented graphene film(HOGF).The interfacial interaction between the VACNTs and HOGF is then optimized through an annealing strategy.After regulating the orientation structure of the VACNTs and filling the VSCG with polydimethylsi-loxane(PDMS),VSCG/PDMS composites with excellent 3D thermal conductive properties are obtained.The highest in-plane and through-plane thermal conduc-tivities of the composites are 113.61 and 24.37 W m^(-1)K^(-1),respectively.The high contact area of HOGF and good compressibility of VACNTs imbue the VSCG/PDMS composite with low thermal resistance.In addition,the interfacial heat-transfer efficiency of VSCG/PDMS composite in the TIM performance was improved by 71.3%compared to that of a state-of-the-art thermal pad.This new structural design can potentially realize high-performance TIMs that meet the need for high thermal conductivity and low contact thermal resistance in interfacial heat-transfer processes.

Application and management of continuous glucose monitoring in diabetic kidney disease

Diabetic kidney disease(DKD)is a common complication of diabetes mellitus that contributes to the risk of end-stage kidney disease(ESKD).Wide glycemic var-iations,such as hypoglycemia and hyperglycemia,are broadly found in diabetic patients with DKD and especially ESKD,as a result of impaired renal metabolism.It is essential to monitor glycemia for effective management of DKD.Hemoglobin A1c(HbA1c)has long been considered as the gold standard for monitoring glycemia for>3 months.However,assessment of HbA1c has some bias as it is susceptible to factors such as anemia and liver or kidney dysfunction.Continuous glucose monitoring(CGM)has provided new insights on glycemic assessment and management.CGM directly measures glucose level in interstitial fluid,reports real-time or retrospective glucose concentration,and provides multiple glycemic metrics.It avoids the pitfalls of HbA1c in some contexts,and may serve as a precise alternative to estimation of mean glucose and glycemic variability.Emerging studies have demonstrated the merits of CGM for precise monitoring,which allows fine-tuning of glycemic management in diabetic patients.Therefore,CGM technology has the potential for better glycemic monitoring in DKD patients.More research is needed to explore its application and management in different stages of DKD,including hemodialysis,peritoneal dialysis and kidney transplantation.

Transcriptomic and cellular decoding of scaffolds-induced suture mesenchyme regeneration

Precise orchestration of cell fate determination underlies the success of scaffold-based skeletal regeneration.Despite extensive studies on mineralized parenchymal tissue rebuilding,regenerating and maintaining undifferentiated mesenchyme within calvarial bone remain very challenging with limited advances yet.Current knowledge has evidenced the indispensability of rebuilding suture mesenchymal stem cell niches to avoid severe brain or even systematic damage.But to date,the absence of promising therapeutic biomaterials/scaffolds remains.The reason lies in the shortage of fundamental knowledge and methodological evidence to understand the cellular fate regulations of scaffolds.To address these issues,in this study,we systematically investigated the cellular fate determinations and transcriptomic mechanisms by distinct types of commonly used calvarial scaffolds.Our data elucidated the natural processes without scaffold transplantation and demonstrated how different scaffolds altered in vivo cellular responses.A feasible scaffold,polylactic acid electrospinning membrane(PLA),was next identified to precisely control mesenchymal ingrowth and self-renewal to rebuild non-osteogenic suture-like tissue at the defect center,meanwhile supporting proper osteointegration with defect bony edges.Especially,transcriptome analysis and cellular mechanisms underlying the well-orchestrated cell fate determination of PLA were deciphered.This study for the first time cellularly decoded the fate regulations of scaffolds in suture-bony composite defect healing,offering clinicians potential choices for regenerating such complicated injuries.

Single self-leading suture technique for iridodialysis repairment

Dear Editor,We described an innovative“single self-leading suture technique”for repairing iridodialysis.Instead of moving the needle forth and back,our method is easier to manipulate in the narrow surgical space between the cornea and lens,which will decrease the unnecessary complications related to iatrogenic injury.We provide an economical friendly and less time-taking method,which improves the suture accuracy.

Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery:a technique note

AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.

Comparative Analysis of Continuous versus Intermittent Proton Pump Inhibitor Therapy in Patients with Upper Gastrointestinal Bleeding Due to Ulcers

Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bleeding ulcers recommend a continuous infusion of proton pump inhibitors (PPI). However, studies comparing intermittent dosing of PPI therapy show that this regimen achieves similar clinical benefits. If the clinical efficacy remains equivalent, intermittent dosing will be more cost-effective for patients and the health care system. Our research study aims to analyze the comparative effectiveness of intermittent versus continuous PPI therapy after endoscopic treatment in patients with UGIB, focusing on such endpoints as rebleeding risk at 3-and 7-day mortality rates. Methods: Resources searched included MEDLINE, EMBASE, PUBMED, and the Cochrane Central Register of Controlled Trials databases from January 2010 through December 2023 with the inclusion of meta-analysis, systematic review, review, or ACG guideline recommendations. Results of the analysis show how recommendations regarding high vs. low PPI regimen changed over time: from no difference in regimen in 2010 to recommending continuous regimen in 2012 to declaring insufficient evidence between choosing one regimen over another in 2013 to determine that both regimens were comparable to each other in 2014-2018 and finally to recommending both regimens in 2021. To conclude, our review shows that in patients with bleeding ulcers and high-risk endoscopic findings, intermittent PPI therapy is non-inferior to continuous PPI infusion for three days, seven days bleeding risk or mortality rates;however, it remains challenging to determine the most optimal intermittent regimen due to heterogeneity of RCTs included in meta-analyses, and further trials will need to be performed.

Outcomes of a non-randomised audit of single pigtail suture stents in urolithiasis management of Asian patients in Singapore

Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symptoms.This study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.Methods:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were analysed.Parameters compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.Results:Both groups had similar median age,distribution in male to female ratio,and stone size.The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at voiding.Both groups had similar ease in insertion with no hospital readmissions.Conclusion:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues.It showed a good safety profile with easy deployment and removal.It promises a new standard in stenting.

Arthroscopic M-shaped suture fixation for tibia avulsion fracture of posterior cruciate ligament:A modified technique and case series

BACKGROUND Tibial avulsion fractures of the posterior cruciate ligament(PCL)are challenging to treat and compromise knee stability and function.Traditional open surgery often requires extensive soft tissue dissection,which may increase the risk of morbidity.In response to these concerns,arthroscopic techniques have been evolving.The aim of this study was to introduce a modified arthroscopic tech-nique utilizing an M-shaped suture fixation method for the treatment of tibial avulsion fractures of the PCL and to evaluate its outcomes through a case series.AIM To evaluate the effects of arthroscopic M-shaped suture fixation on treating tibia avulsion fractures of the PCL.METHODS We developed a modified arthroscopic M-shaped suture fixation technique for tibia avulsion fractures of the PCL.This case series included 18 patients who underwent the procedure between January 2021 and December 2022.The patients were assessed for range of motion(ROM),Lysholm score and International knee documentation committee(IKDC)score.Postoperative complications were also recorded.RESULTS The patients were followed for a mean of 13.83±2.33 months.All patients showed radiographic union.At the final follow-up,all patients had full ROM and a negative posterior drawer test.The mean Lysholm score significantly improved from 45.28±8.92 preoperatively to 91.83±4.18 at the final follow-up(P<0.001),and the mean IKDC score improved from 41.98±6.06 preoperatively to 90.89±5.32 at the final follow-up(P<0.001).CONCLUSION The modified arthroscopic M-shaped suture fixation technique is a reliable and effective treatment for tibia avulsion fractures of the PCL,with excellent fracture healing and functional recovery.

NCCMF:Non-Collaborative Continuous Monitoring Framework for Container-Based Cloud Runtime Status

The security performance of cloud services is a key factor influencing users’selection of Cloud Service Providers(CSPs).Continuous monitoring of the security status of cloud services is critical.However,existing research lacks a practical framework for such ongoing monitoring.To address this gap,this paper proposes the first NonCollaborative Container-Based Cloud Service Operation State Continuous Monitoring Framework(NCCMF),based on relevant standards.NCCMF operates without the CSP’s collaboration by:1)establishing a scalable supervisory index system through the identification of security responsibilities for each role,and 2)designing a Continuous Metrics Supervision Protocol(CMA)to automate the negotiation of supervisory metrics.The framework also outlines the supervision process for cloud services across different deployment models.Experimental results demonstrate that NCCMF effectively monitors the operational state of two real-world IoT(Internet of Things)cloud services,with an average supervision error of less than 15%.

Model-based risk assessment on dynamic control of twin-column continuous capture under feedstock variations

Dynamic control is essential to guarantee the stable performance of continuous chromatography.AutoMAb dynamic control strategy has been developed to ensure a consistent protein load in twincolumn CaptureSMB continuous capture by integrating the UV signal of breakthrough.In this study,the process risk of CaptureSMB continuous capture under AutoMAb control towards the feedstock variations was assessed by a mechanistic model developed by us.The effects of target protein and impurities under the variation range of±10 mAU$min1 on load amount,protein loss,process productivity,and resin capacity utilization were investigated.The results showed that the CaptureSMB process could be successfully controlled by AutoMAb towards increased or slightly decreased concentration of feedstock.However,the load process would be out of control with drastically decreased target protein or impurities,and the decreased impurities would lead to protein loss.It was found that AutoMAb control would cause 44.7%non-operational areas and 18.3%protein loss areas in the variation range of±10 mAU·min^(-1).To improve the stability of the CaptureSMB process,a modified AutoMAb control that would stop the load procedure when the absolute value of the integral area reached the preset value,was proposed to reduce the risk of protein loss and the non-operational area.

Strengthening effect of prefabrication(10-12)tensile twinning on AZ80+0.4%Ce magnesium alloy and inhibition mechanism of discontinuous precipitation

This paper provided an effective method to further improve the mechanical properties of the AZ80+0.4%Ce magnesium alloy wheel spoke.The effect of high strength and ductility was obtained with a yield strength of 295.36 MPa,an elongation of 10%,by the combination of pre-deformation(7%deformation)and two-stage aging treatment(120℃/9 h+175℃/24 h).The evolution of the microstructure and properties of the alloy was explored under the coupling conditions of different pre-deformation degrees and multi-stage aging.The results show that,pre-deformation introduced a large number of(1012)tensile twinning and dislocations,which greatly promoted the probability of continuous precipitates(CPs)appearing.On the contrary,the discontinuous precipitates(DPs)were limited by the vertical and horizontal twin structure.As a result,the pre-nucleation method of two-stage aging increased the proportion of CPs by 34%-38%.Owing to the DPs was effectively suppressed,the alloy's yield strength has been greatly improved.Besides,under multi-stage aging,the twin boundaries induce protruding nucleation to form static recrystallization by hindering the migration of dislocations,and the matrix swallows the twins,then the texture gradually tilts from the two poles to the basal plane.As an important supplement,the grain refinement and oblique texture promoted the improvement of the yield strength of the component.

Enhanced measurement precision with continuous interrogation during dynamical decoupling

Dynamical decoupling(DD)is normally ineffective when applied to DC measurement.In its straightforward implementation,DD nulls out DC signal as well while suppressing noise.This work proposes a phase relay method that is capable of continuously interrogating the DC signal over many DD cycles.We illustrate its efficacy when applied to the measurement of a weak DC magnetic field with an atomic spinor Bose-Einstein condensate.Sensitivities approaching standard quantum limit or Heisenberg limit are potentially realizable for a coherent spin state or a squeezed spin state of 10000 atoms,respectively,while ambient laboratory level noise is suppressed by DD.Our work offers a practical approach to mitigate the limitations of DD to DC measurement and would find other applications for resorting coherence in quantum sensing and quantum information processing research.

Improvement and security analysis of multi-ring discrete modulation continuous variable quantum secret sharing scheme

In order to avoid the complexity of Gaussian modulation and the problem that the traditional point-to-point communication DM-CVQKD protocol cannot meet the demand for multi-user key sharing at the same time, we propose a multi-ring discrete modulation continuous variable quantum key sharing scheme(MR-DM-CVQSS). In this paper, we primarily compare single-ring and multi-ring M-symbol amplitude and phase-shift keying modulations. We analyze their asymptotic key rates against collective attacks and consider the security key rates under finite-size effects. Leveraging the characteristics of discrete modulation, we improve the quantum secret sharing scheme. Non-dealer participants only require simple phase shifters to complete quantum secret sharing. We also provide the general design of the MR-DM-CVQSS protocol.We conduct a comprehensive analysis of the improved protocol's performance, confirming that the enhancement through multi-ring M-PSK allows for longer-distance quantum key distribution. Additionally, it reduces the deployment complexity of the system, thereby increasing the practical value.

Effect of continuous nursing on rehabilitation of older patients with joint replacement after discharge

BACKGROUND Joint replacement is a common treatment for older patients with high incidences of hip joint diseases.However,postoperative recovery is slow and complications are common,which reduces surgical effectiveness.Therefore,patients require long-term,high-quality,and effective nursing interventions to promote rehabilitation.Continuity of care has been used successfully in other diseases;however,little research has been conducted on older patients who have undergone hip replacement.AIM To explore the clinical effect of continuous nursing on rehabilitation after discharge of older individuals who have undergone joint replacement.METHODS A retrospective analysis was performed on the clinical data of 113 elderly patients.Patients receiving routine nursing were included in the convention group(n=60),and those receiving continuous nursing,according to various methods,were included in the continuation group(n=53).Harris score,short form 36(SF-36)score,complication rate,and readmission rate were compared between the convention and continuation groups.RESULTS After discharge,Harris and SF-36 scores of the continuation group were higher than those of the convention group.The Harris and SF-36 scores of the two groups showed an increasing trend with time,and there was an interaction effect between group and time(Harris score:F_(intergroup effect)=376.500,F_(time effect)=20.090,Finteraction effect=4.824;SF-36 score:F_(intergroup effect)=236.200,Ftime effect=16.710,Finteraction effect=5.584;all P<0.05).Furthermore,the total complication and readmission rates in the continuation group were lower(P<0.05).CONCLUSION Continuous nursing could significantly improve hip function and quality of life in older patients after joint replacement and reduce the incidence of complications and readmission rates.

Irregular initial solidification by mold thermal monitoring in the continuous casting of steels:A review

Occasional irregular initial solidification phenomena,including stickers,deep oscillation marks,depressions,and surface cracks of strand shells in continuous casting molds,are important limitations for developing the high-efficiency continuous casting of steels.The application of mold thermal monitoring(MTM) systems,which use thermocouples to detect and respond to temperature variations in molds,has become an effective method to address irregular initial solidification phenomena.Such systems are widely applied in numerous steel companies for sticker breakout prediction.However,monitoring the surface defects of strands remains immature.Hence,indepth research is necessary to utilize the potential advantages and comprehensive monitoring of MTM systems.This paper summarizes what is included in the irregular initial solidification phenomena and systematically reviews the current state of research on these phenomena by the MTM systems.Furthermore,the influences of mold slag behavior on monitoring these phenomena are analyzed.Finally,the remaining problems of the formation mechanisms and investigations of irregular initial solidification phenomena are discussed,and future research directions are proposed.