Effect of body mass index on functional outcome in primary total knee arthroplasty——a single institution analysis of 2180 primary total knee replacements

AIM To evaluate the effect of body mass index(BMI) on short-term functional outcome and complications in primary total knee arthroplasty. METHODS All patients undergoing primary total knee arthroplasty at a single institution between 2007 and 2013 were identified from a prospective arthroplasty database. 2180 patients were included in the study. Age, gender, BMI, pre- and post-operative functional scores [Western Ontario and Mc Master University Arthritis Index(WOMAC) and SF-36], complications and revision rate were recorded. Patients were grouped according to the WHO BMI classification. The functional outcome of the normal weight cohort(BMI < 25) was compared to the overweight and obese(BMI ≥ 25) cohort. A separate sub-group analysis was performed comparing all five WHO BMI groups; Normal weight, overweight, class 1 obese, class 2 obese and class 3 obese.RESULTS With a mean age of 67.89(28-92), 2180 primary total knee replacements were included. 64.36%(1403) were female. The mean BMI was 31.86(18-52). Ninty-three percent of patients were either overweight or obese. Mean follow-up 19.33 mo(6-60 mo). There was no significant difference in pre or post-operative WOMAC score in the normal weight(BMI < 25) cohort compared to patients with a BMI ≥ 25(P > 0.05). Sub-group analysis revealed significantly worse WOMAC scores in class 2 obese 30.80 compared to overweight 25.80(P < 0.01) and class 1 obese 25.50(P < 0.01). Similarly, there were significantly worse SF-36 scores in class 2 obese 58.16 compared to overweight 63.93(P < 0.01) and class 1 obese 63.65(P < 0.01) There were 32(1.47%) superficial infections, 9(0.41%) deep infections and 19(0.87%) revisions overall with no complications or revisions in the normal weight cohort(BMI < 25).CONCLUSION Post-operative functional outcome was not influenced by BMI comparing normal weight individuals with BMI > 25. Patients should not be denied total knee arthroplasty based solely on weight alone.

Body-temperature circadian rhythm in 67 patients after heart valve replacement surgery secondary to valvular heart disease

Purpose:Patient body temperature was monitored after cardiac valve replacement,in order to explore the characteristics of body-temperature circadian rhythm and the factors influencing that rhythm.Methods:A cohort of 67 patients who received cardiac valve replacement in a Fuzhou,Fujian province,China,general hospital underwent temperature measurements and analysis(by cosine curve)of their body-temperature circadian rhythm.A biological rhythm model was established through principal component analysis and evaluation of biological rhythm features.Multiple circadian parameters were included through linear regression analysis.Results:Patients’temperature after cardiac valve replacement exhibited circadian characteristics(p<0.05),among which the scores of temperature mesor,amplitude,and acrophase were respectively(37.61
0.08),(0.10
0.09),and33(e355,e119).Body-temperature rhythms were influenced by both gender and cardiopulmonary bypass time(p<0.05).Conclusion:Although some patients’circadian characteristics disappeared after cardiac valve replacement,circadian rhythms remained intact for most patients.Measures that were found to mitigate body-temperature circadian rhythm disruption included building a natural rhythm of light/darkness and decreasing cardiopulmonary bypass time.

Are Black Holes 4-D Spatial Balls Filled with Black Body Radiation? Generalization of the Stefan-Boltzmann Law and Young-Laplace Relation for Spatial Radiative Transfers

This is the first paper in a two part series on black holes. In this work, we concern ourselves with the event horizon. A second follow-up paper will deal with its internal structure. We hypothesize that black holes are 4-dimensional spatial, steady state, self-contained spheres filled with black-body radiation. As such, the event horizon marks the boundary between two adjacent spaces, 4-D and 3-D, and there, we consider the radiative transfers involving black- body photons. We generalize the Stefan-Boltzmann law assuming that photons can transition between different dimensional spaces, and we can show how for a 3-D/4-D interface, one can only have zero, or net positive, transfer of radiative energy into the black hole. We find that we can predict the temperature just inside the event horizon, on the 4-D side, given the mass, or radius, of the black hole. For an isolated black hole with no radiative heat inflow, we will assume that the temperature, on the outside, is the CMB temperature, T2 = 2.725 K. We take into account the full complement of radiative energy, which for a black body will consist of internal energy density, radiative pressure, and entropy density. It is specifically the entropy density which is responsible for the heat flowing in. We also generalize the Young- Laplace equation for a 4-D/3-D interface. We derive an expression for the surface tension, and prove that it is necessarily positive, and finite, for a 4-D/3-D membrane. This is important as it will lead to an inherently positively curved object, which a black hole is. With this surface tension, we can determine the work needed to expand the black hole. We give two formulations, one involving the surface tension directly, and the other involving the coefficient of surface tension. Because two surfaces are expanding, the 4-D and the 3-D surfaces, there are two radiative contributions to the work done, one positive, which assists expansion. The other is negative, which will resist an increase in volume. The 4-D side promotes expansion whereas the 3-D side hinders it. At the surface itself, we also have gravity, which is the major contribution to the finite surface tension in almost all situations, which we calculate in the second paper. The surface tension depends not only on the size, or mass, of the black hole, but also on the outside surface temperature, quantities which are accessible observationally. Outside surface temperature will also determine inflow. Finally, we develop a “waterfall model” for a black hole, based on what happens at the event horizon. There we find a sharp discontinuity in temperature upon entering the event horizon, from the 3-D side. This is due to the increased surface area in 4-D space, AR(4) = 2π2R3, versus the 3-D surface area, AR(3) = 4πR2. This leads to much reduced radiative pressures, internal energy densities, and total energy densities just inside the event horizon. All quantities are explicitly calculated in terms of the outside surface temperature, and size of a black hole. Any net radiative heat inflow into the black hole, if it is non-zero, is restricted by the condition that, 0cdQ/dt FR(3), where, FR(3), is the 3-D radiative force applied to the event horizon, pushing it in. We argue throughout this paper that a 3-D/3-D interface would not have the same desirable characteristics as a 4-D/3-D interface. This includes allowing for only zero or net positive heat inflow into the black hole, an inherently positive finite radiative surface tension, much reduced temperatures just inside the event horizon, and limits on inflow.

Application of Hypothesis of Replacement at the Analysis of a Slow Flow of a Body by a Viscous Fluid

On the basis of hypothesis of replacement and the vector formula of Newton’s law for a viscous fluid the way of a finding of resistance a slow flow by an incompressible fluid of bodies of the various form is represented. Application of an offered way to calculation of a flow of various bodies is shown: a sphere, a cylinder, a oblong ellipsoid, a flat plate. Comparison with results of other authors is given.

Delayed presentation of a loose body in undisplaced paediatric talar neck fracture

Fractures of the talus are rare in children.A high index of suspicion is needed to avoid missing such an injury,which is not an uncommon occurrence especially with undisplaced fractures.We present an unusual case of an undisplaced talar neck fracture in a five-year-old child leading to a delayed presentation of a symptomatic osteochondral loose body in the ankle joint.To our knowledge there are no reports in the literature of osteochondral loose bodies occurring in conjunction with an associated undisplaced talar neck fracture in either children or adults.The loose body was removed using anterior ankle arthroscopy.The child had an uneventful post operative recovery and regained full range of movement and function of his ankle joint and was discharged at one year follow-up.We aim to highlight the need to have a low threshold to further evaluate symptomatic children after fracture healing of an undisplaced talar neck fracture for a possible associated loose bodyin the ankle joint.

On the Gravitational Two-Body System and an Infinite Set of Laplace-Runge-Lenz Vectors

The current approach of a system of two bodies that interact through a gravitational force goes beyond the familiar expositions [1-3] and derives some interesting features and laws that are overlooked. A new expression for the angular momentum of a system in terms of the angular momenta of its parts is deduced. It is shown that the characteristics of the relative motion depend on the system’s total mass, whereas the characteristics of the individual motions depend on the masses of the two bodies. The reduced energy and angular momentum densities are constants of motion that do not depend on the distribution of the total mass between the two bodies;whereas the energy may vary in absolute value from an infinitesimal to a maximum value which occurs when the two bodies are of equal masses. In correspondence with infinite possible ways to describe the absolute rotational positioning of a two body system, an infinite set of Laplace-Runge-Lenz vectors (LRL) are constructed, all fixing a unique orientation of the orbit relative to the fixed stars. The common expression of LRV vector is an approximation of the actual one. The conditions for nested and intersecting individual orbits of the two bodies are specified. As far as we know, and apart from the law of periods, the laws of equivalent orbits concerning their associated periods, areal velocities, angular velocities, velocities, energies, as well as, the law of total angular momentum, were never considered before.

An investigation using high-precision CCD laser displacement sensor to measure body surface motion induced by heartbeat

The aim of this study was to measure the motion of the body surface induced by heartbeat by using a high-precision laser sensor in order to provide a reference for other research on medical remote sensing techniques that are unconstrained and non-contact. Body surface motions at some points on the chest and on the dorsal region were measured for eight men with a laser displacement sensor. For comparison, an electrocardiograph was also used to monitor the heartbeat. As a result, we confirmed cyclic motion of about 0.1 mm in amplitude everywhere on the body surface, not only from the front of the body but also from the back and the neck. In contrast, which part on the body was most suitable for measurement had to be taken into account because a difference in motion amplitudes was observed in different parts on the body. The amplitude of the motions also depended on the conditions of the body surface as well as underneath the skin. These results show the possibility of acquiring information about heartbeats from anywhere on the body by using an unconscious sensing technique, and the potential for the technique to monitor the condition of the body and personal physical characteristics.

Linguistic landscape and its impacts on place-making in mountain destination:A case of Mogan Mountain Town of Huzhou City,China

The place and placeness are believed to be a crucial perspective for comprehending the transformative dynamics of tourist destinations in the context of globalization and the rapid development of the tourism industry.As the material carrier of language,linguistic landscape is an intermediary for people to endow emotions and personalities into the place,becoming an effective path for exploring the place-making in a certain area.Mogan Mountain is a famous national tourist resort,which is located in Mogan Mountain Town,Deqing County,Huzhou City,China.This is a good case area for studying the relationship between linguistic landscape and placemaking in tourist destinations.There are two theories that form the theoretical foundation of the study,namely the place and the geosemiotics.Firstly,the results showed the overall style of the linguistic landscape.Multilingual labelling(52.7%),official signs(55.3%),and standardized Chinese characters predominantly shaped the linguistic landscape,with English and other languages being complementary.Secondly,from the perspective of three dimensions of the geosemiotics framework,such as inscription,language preference,and placement position,we conduct a comprehensive semiotic analysis of the linguistic landscape,which encompasses diverse facets such as fonts,materials,shifts in state,text vectors,and symmetrical arrangements.Finally,we explore the influence of linguistic landscapes on the place-making of Mogan Mountain through the dimensions of location,locale,and sense of place.The information on linguistic landscapes indicates the geographical location.These linguistic landscapes play an important role in constructing the language order,nostalgic atmosphere,exotic atmosphere,and elegant and tasteful lifestyle of the public space in Mogan Mountain.Readers of linguistic landscapes,including tourists and residents,generate and identify with the unique sense of place in Mogan Mountain.These linguistic landscapes construct the destination placeness of Mogan Mountain that combines both foreign and nostalgic styles,and the integration of Chinese and Western cultures.It will help promote the image positioning of tourism destinations and have practical guiding significance for the tourism planning,landscape-making,language management,and other aspects of tourism destinations.

交互式数字叙事:加拿大Writing New Body Worlds阅读治疗新探索

文章基于相关研究文献与语料,对加拿大WNB阅读治疗实践进行梳理与归纳。WNB首次使用交互式数字叙事技术,构建面向公众的阅读治疗平台,以其交互式特征,融合了阅读和治疗引导两个过程,提供可访问的非临床方式,可面向大规模人群实现预防性健康干预。基于数据与计算的精准化阅读治疗是数字人文视角下的新变革,更具推广应用价值;以在线阅读平台建设为依托,推进实施平台化的阅读和治疗应成为未来发展方向之一;基于阅读形态与体验因技术赋能而改变的现状,图书馆应发挥引领作用,积极收集、创建或协助创建数字故事,推进阅读推广、服务与治疗的融合性发展,成为社区建设促进者、历史欣赏者和社区参与倡导者,也使阅读借助交互式数字叙事这一新载体,更好地发挥变革的力量,促进健康与幸福。

Longitudinal changes in body weight of breastfeeding mothers in the first year after delivery and its relationship with human milk composition:a combined longitudinal and cross-sectional cohort study

Objective:Postpartum weight retention(PPWR)is a common problem among women after childbirth.The main objectives of this study are to understand the changes in body weight of breastfeeding mothers during long-term follow-up and preliminarily explore the relationship between maternal body weight and human milk composition,including macronutrients,leptin,and adiponectin.Methods:The study included a longitudinal cohort(122 mothers),and a cross-sectional cohort(37 mothers).The human milk,maternal weight,and dietary surveys were collected in the longitudinal cohort at different follow-up time points(1-14 days postpartum,2-4 months postpartum,5-7 months postpartum,and 12-17 months postpartum).The maternal body weight was analyzed using the responses in the survey questionnaires.A milk analyzer based on the mid-infrared spectroscopy(MIRS)was used to determine milk composition,and nutrition analysis software evaluated dietary intakes.In the cross-sectional cohort,participating mothers were asked to provide blood and human milk samples and pertinent information related to maternal body composition.Maternal body composition was measured by bioelectrical impedance analysis(BIA),while ELISA analyzed leptin and adiponectin in milk and serum.Results:At 5-7 months postpartum,the PPWR of breastfeeding mothers was(2.46±3.59)kg.At 12-17 months postpartum,the PPWR was(0.98±4.06)kg.PPWR was found to be negatively correlated with milk fat content within 14 days postpartum and positively correlated at 2-4 months postpartum.In addition,the maternal weight and body muscle mass were positively correlated with leptin and adiponectin in milk.Plasma leptin was positively correlated with the mother’s body weight,body mass index(BMI),FAT percentage,and body fat mass,while plasma adiponectin did not correlate with any parameter.The results also indicate that the PPWR did not correlate with leptin and adiponectin in plasma or milk.Conclusions:Breastfeeding mothers may retain considerable weight gain one year after delivery.Human milk composition may be related to changes in maternal body weight.Leptin and adiponectin in breast milk and leptin in plasma are associated with the maternal body composition.This study supports the notion that maternal nutritional status may affect offspring health through lactation,and future research should focus on exploring weight management of postpartum mothers.

Ecological Remediation Technology of Urban Landscape Water Body

Urban landscape water body is not only an important part of urban landscape construction,but also an important way to maintain landscape diversity and biodiversity,carrying the beautiful yearning of urban residents for natural life.A good state of urban landscape water body is crucial to the ecological environment of the city.However,due to the poor kinetic energy of urban landscape water body and the influence of various human factors,the quality of urban landscape water body often declines,and urban population is threatened by water security problems.Through the study of several water body ecological remediation technologies,relevant suggestions are put forward,in order to provide a reference for water pollution restoration and treatment in urban human settlement environment.

Flexible bronchoscopy for foreign body aspiration in children:A single-centre experience

BACKGROUND The technological evolution of bronchoscopy has led to the widespread adoption of flexible techniques and their use for both diagnostic and therapeutic purposes.Currently,there is an active debate regarding the comparative efficacy and safety of rigid vs flexible bronchoscopy in the treatment of foreign body aspiration.AIM To evaluate our experience with tracheobronchial foreign body extraction using flexible bronchoscopy and provide a literature overview.METHODS This was a single-centre retrospective study.Twenty-four patients were enrolled between January 2017 and January 2023.Medical records of patients aged below 18 years who were admitted to authors’affiliated institution with a suspected diagnosis of foreign body aspiration were collected from hospital’s database to Microsoft Excel 2019.Data were analysed using MedCalc Statistical Software.RESULTS Patient ages varied from 9 months to 11 years.The median age was 23.5 months,95%confidence interval(CI)19.49-44.77.We observed age clustering in children with foreign body aspiration at our institution with three age subgroups:(1)0-25 months;(2)40-60 months;and(3)120-140 months.We expectancy of an organic tracheobronchial foreign body was significantly higher in 0-25 months subgroup than that in older ones when subgroups 40-60 and 120-140 months were combined together(odds ratio=10.0,95%CI:1.44-29.26,P=0.0197).Successful foreign body extraction was performed in all cases.Conversion to a rigid bronchoscope was not required in any of the cases.No major complications(massive bleeding,tracheobronchial tree perforation,or asphyxia)were observed.CONCLUSION Flexible bronchoscopy is an effective and safe method for tracheobronchial foreign body extraction in children.

Experiencing the Abject Female Body and Writing the Female Self:Body Narrative of In the Heart of the Country

In the Heart of the Country,the second novel by J.M.Coetzee,has been traditionally read as a disembodied writing that focuses on the problem of writing per se instead of the reality.This paper contends that the work is actually a body narrative that explores the visceral pain suffered by Magda whose infertile body impedes her being a qualified subject.As the heroine in a postcolonial novel,Magda is not just a body that is restricted and constructed by the politics of the body,but also a thinking and writing body that consciously questions and resists the gendered bodily norms under whose yardstick her subjecthood is barred.Written in the metafictional manner,Magda’s narrative of the body is not just a record of her corporeal experience,but also a self-conscious negotiation with,and challenge of,the bodily norms under whose yardstick her body has been debased or,in terms of Judith Butler,abjected.Taking her female bodily experience as the starting point,Magda writes a feminine text that values passion,fluidity and non-linearity to disrupt the patriarchal discourse underpinned with logical reasoning.The feminine body narrative endeavors to achieve a new way of communication through which a reciprocal cross race/gender relationship might be established.

3D body解剖软件联合PACS系统在骨科临床实践教学中的应用

目的探讨3D body解剖软件结合医学影像存档与通信系统(PACS)在骨科临床实践教学中的应用效果。方法选择2023年1月至2023年12月在浙江大学医学院附属邵逸夫医院骨科轮转的60名实习生,按照随机数字表法分成实验组和对照组,每组30名。对照组采用传统线上结合线下的混合式教学方法,实验组采用3D body解剖软件联合PACS系统带教模式。在实习期结束时,对两组实习生进行闭卷理论考试与临床实践操作考核,并采用问卷调查方式评估实习生对课程的满意度。结果实验组实习生的理论考试与临床实践操作成绩均高于对照组,差异均有统计学意义(t分别=6.59、4.22,P均<0.05)。实验组实习生在学习兴趣、教学难度、专业能力以及医患沟通能力提升方面的满意度均高于对照组,差异均有统计学意义(χ^(2)分别=9.93、3.77、6.94、8.52,P均<0.05)。结论3D body解剖软件联合PACS系统带教模式运用到骨科实习生的临床教学中,能帮助实习生提高学习兴趣以及医患沟通能力,加强对骨科知识的掌握,降低知识的理解难度,对于提升临床医学教学质量具有重要意义。

Association of daily sitting time and leisure-time physical activity with body fat among U.S.adults

Background:Prolonged sitting and reduced physical activity lead to low energy expenditures.However,little is known about the joint impact of daily sitting time and physical activity on body fat distribution.We investigated the independent and joint associations of daily sitting time and physical activity with body fat among adults.Methods:This was a cross-sectional analysis of U.S.nationally representative data from the National Health and Nutrition Examination Survey2011-2018 among adults aged 20 years or older.Daily sitting time and leisure-time physical activity(LTPA)were self-reported using the Global Physical Activity Questionnaire.Body fat(total and trunk fat percentage)was determined via dual X-ray absorptiometry.Results:Among 10,808 adults,about 54.6%spent 6 h/day or more sitting;more than one-half reported no LTPA(inactive)or less than 150 min/week LTPA(insufficiently active)with only 43.3%reported 150 min/week or more LTPA(active)in the past week.After fully adjusting for sociodemographic data,lifestyle behaviors,and chronic conditions,prolonged sitting time and low levels of LTPA were associated with higher total and trunk fat percentages in both sexes.When stratifying by LTPA,the association between daily sitting time and body fat appeared to be stronger in those who were inactive/insuufficiently active.In the joint analyses,inactive/insuufficiently active adults who reported sitting more than 8 h/day had the highest total(female:3.99%(95%confidence interval(95%CI):3.09%-4.88%);male:3.79%(95%CI:2.75%-4.82%))and trunk body fat percentages(female:4.21%(95%CI:3.09%-5.32%);male:4.07%(95%CI:2.95%-5.19%))when compared with those who were active and sitting less than 4 h/day.Conclusion:Prolonged daily sitting time was associated with increased body fat among U.S.adults.The higher body fat associated with 6 h/day sitting may not be offset by achieving recommended levels of physical activity.

Improvement of pain and recuperation of spinal dysfunction by replacement with adjustable hollow artificial vertebral body in patients with metastasis of spine

Objective To observe the results of the metasta sis of spinal vertebra treated by rep lacedment with the adjustable hollo w artificial vertebral body.Method An adjustable hollow artificial vertebral body made from medial used titanium.12pat ients with the metastasis of vertebral body were treated by this technique.The relief of the pain of function of s pinal cord were moinitored.The stability of the operated segments was observed.Results The patients were followed up from 6t o 34months.The neurological functi ons were improved markedly,esp.for the pain re-lieving.The implants were stalbe and the reconstruction of the segment h ighness was observed on the X-ray fil ms.Conclusion The height of anterior column and the stability of the operated segments can be reconstructed by implanting the adjustable hollow artificial vertebral body.T his technique may be an alternative meth od for the management of the metastasis in spinal vertebral body.

Stereotactic body radiotherapy in pancreatic adenocarcinoma

Background:Stereotactic body radiotherapy(SBRT)in pancreatic cancer allows high delivery of radiation doses on tumors without affecting surrounding tissue.This review aimed at the SBRT application in the treatment of pancreatic cancer.Data sources:We retrieved articles published in MEDLINE/PubMed from January 2017 to December 2022.Keywords used in the search included:“pancreatic adenocarcinoma”OR“pancreatic cancer”AND“stereotactic ablative radiotherapy(SABR)”OR“stereotactic body radiotherapy(SBRT)”OR“chemoradiotherapy(CRT)”.English language articles with information on technical characteristics,doses and fractionation,indications,recurrence patterns,local control and toxicities of SBRT in pancreatic tumors were included.All articles were assessed for validity and relevant content.Results:Optimal doses and fractionation have not yet been defined.However,SBRT could be the standard treatment in patients with pancreatic adenocarcinoma in addition to CRT.Furthermore,the combination of SBRT with chemotherapy may have additive or synergic effect on pancreatic adenocarcinoma.Conclusions:SBRT is an effective modality for patients with pancreatic cancer,supported by clinical practice guidelines as it has demonstrated good tolerance and good disease control.SBRT opens a possibility of improving outcomes for these patients,both in neoadjuvant treatment and with radical intent.

Body composition and metabolic syndrome in patients with type 1 diabetes

BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).Visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both P<0.001).Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(P<0.001,OR=0.488)and skeletal muscle mass(P=0.003,OR=1.111).Significant factors for dyslipidemia included trunk fat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.

3D Body解剖软件结合CBL教学法在骨科实习生临床带教中的应用

目的:探讨3D body解剖软件结合CBL教学法在骨科实习生临床带教中的应用效果。方法:随机选取2022年1月~2023年12月在我科室实习的36名骨科实习生为研究对象,随机分为观察组和对照组,对照组采用CBL教学模式,观察组在对照组的教学模式上运用3D body解剖软件。教学结束后,比较两组学生的理论知识考试成绩,PPT汇报成绩以及教学满意度。结果:观察组学生理论知识考核成绩、PPT汇报成绩、教学满意度明显高于对照组,差异具有显著性(P < 0.05)。结论:3D body解剖软件结合CBL教学法应用于骨科实习生临床带教,可以有效提高学生成绩,调动学生积极性及自主学习能力,提升教学满意度。

Soft,body conformable electronics for thermoregulation enabled by kirigami

The application of thermoelectric devices(TEDs)for personalized thermoregulation is attractive for saving energy while balancing the quality of life.TEDs that directly attach to human skin remarkably minimized the energy wasted for cooling the entire environment.However,facing the extreme dynamic geometry change and strain of human skin,conventional TEDs cannot align with the contour of our bodies for the best thermoregulation effect.Hence,we designed a kirigami-based wearable TED with excellent water vapor permeability,flexibility,and conformability.Numerical analysis and experimental results reveal that our product can withstand various types of large mechanical deformation without circuit rupture.The stated outcome and proposed facile approach not only reinforce the development of wearable TEDs but also offer an innovative opportunity for different electronics that require high conformability.