The reliable operation of high-speed wire rod finishing mills is crucial in the steel production enterprise.As complex system-level equipment,it is difficult for high-speed wire rod finishing mills to realize fault lo...The reliable operation of high-speed wire rod finishing mills is crucial in the steel production enterprise.As complex system-level equipment,it is difficult for high-speed wire rod finishing mills to realize fault location and real-time monitoring.To solve the above problems,an expert experience and data-driven-based hybrid fault diagnosis method for high-speed wire rod finishing mills is proposed in this paper.First,based on its mechanical structure,time and frequency domain analysis are improved in fault feature extraction.The approach of combining virtual value,peak value with kurtosis value index,is adopted in time domain analysis.Speed adjustment and side frequency analysis are proposed in frequency domain analysis to obtain accurate component characteristic frequency and its corresponding sideband.Then,according to time and frequency domain characteristics,fault location based on expert experience is proposed to get an accurate fault result.Finally,the proposed method is implemented in the equipment intelligent diagnosis system.By taking an equipment fault on site,for example,the effectiveness of the proposed method is illustrated in the system.展开更多
Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related ...Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of HIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned HIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University Hospital Centre (CHUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.2.2.6. Results: One hundred and thirteen HIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with HIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .展开更多
At a time when there is a growing public interest in animal welfare,it is critical to have objective means to assess the way that an animal experiences a situation.Objectivity is critical to ensure appropriate animal ...At a time when there is a growing public interest in animal welfare,it is critical to have objective means to assess the way that an animal experiences a situation.Objectivity is critical to ensure appropriate animal welfare outcomes.Existing behavioural,physiological,and neurobiological indicators that are used to assess animal welfare can verify the absence of extremely negative outcomes.But welfare is more than an absence of negative outcomes and an appropriate indicator should reflect the full spectrum of experience of an animal,from negative to positive.In this review,we draw from the knowledge of human biomedical science to propose a list of candidate biological markers(biomarkers)that should reflect the experiential state of non-human animals.The proposed biomarkers can be classified on their main function as endocrine,oxidative stress,non-coding molecular,and thermobiological markers.We also discuss practical challenges that must be addressed before any of these biomarkers can become useful to assess the experience of an animal in real-life.展开更多
BACKGROUND The incidence of colorectal cancer(CRC)has increased in recent decades,and ranks fourth among males and third among females in China.Surgical resection remains the most important treatment modality for cura...BACKGROUND The incidence of colorectal cancer(CRC)has increased in recent decades,and ranks fourth among males and third among females in China.Surgical resection remains the most important treatment modality for curative intent in CRC.Several studies found that surgeon volumes and specialization appeared to be associated with improved overall survival(OS).Moreover,numerous reports have suggested that specialization and minimally invasive surgery have gained increased popularity in CRC surgery.However,few studies have specifically examined the role and long-term survival of all stage CRC in a real-world study.AIM To evaluate the effect of surgeon specialization on survival changes and minimally invasive surgery utilization in a real world study.METHODS A retrospective analysis on the association between surgeon specialization and OS between 2008 and 2013 in Zhongshan Hospital CRC database was performed.Standard demographic,clinicopathologic,surgical and follow-up data were obtained from the CRC database.Surgeon specialty was categorized as colorectal surgeon(CS)and general surgeon(GS).CRC patients who underwent primary surgical resection were enrolled.RESULTS A total of 5141 CRC patients who underwent primary surgical resection between 2008 and 2013 were evaluated,1748(34.0%)of these by CS.The percentage of minimally invasive procedures in the CS group showed an increasing trend.There was no benefit associated with surgeon specialization for stage I,II and IV patients.Surgeon specialization exhibited a significant association with OS solely among stage III patients,with 5-year OS rates of 76%and 67%for the CS and GSgroups,respectively(P<0.01).Further analyses found that surgeon specialization was significantly associated with survival only in stage III rectal patients,and the 5-year OS rate in the CS group and GS group was 80%and 67%,respectively(P<0.01).CONCLUSION Surgeon specialization is associated with improved OS after primary surgery in stage III rectal patients.An appropriate surgical technique,perioperative program and adjuvant therapy may contribute to survival benefit in these patients.展开更多
Objective:The objective of this study is to comprehensively understand the psychological experience of primiparous women during breastfeeding while dealing with lactating mastitis and to establish a reliable foundatio...Objective:The objective of this study is to comprehensively understand the psychological experience of primiparous women during breastfeeding while dealing with lactating mastitis and to establish a reliable foundation for tailored support measures.Methods:Twenty primiparous mothers from a tertiary hospital in Beijing between January and March 2023 were chosen using purposive sampling for semi-structured interviews.After conducting 20 interviews,data saturation was achieved.The Colaizzi’s seven-step analytical approach was employed to analyze,summarize,and refine the identified themes.Results:Among primiparous women afflicted by lactating mastitis,the primary themes regarding breastfeeding attitudes included three key aspects:(1)uncertainty during the initial diagnosis phase,(2)intricate emotional journey during treatment,and(3)positive psychological outlook during the recovery stage.Conclusion:Primiparous women undergoing lactating mastitis experience substantial physical and psychological strain.It is crucial for medical personnel,family caregivers,and society at large to be attuned to the emotions of these patients.Tailored support measures should be offered to enhance patients’physical and mental well-being and facilitate disease recovery.展开更多
Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affectin...Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mother To Child Transmission-HIV service utilization should be prioritized so as to alleviate stigma and enhancing a positive experience for these mothers thus reducing on the Mother to Child HIV Transmission burden and mortality rates.展开更多
BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and...BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.展开更多
Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry...Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry of Health, community tuberculosis care was introduced with the main goal of reducing tuberculosis-related morbidity and mortality among communities through the expansion of direct observed therapy and community involvement to community settings. The community caregivers were to support tuberculosis patients throughout their treatment period until they were cured or had completed their treatment. Settings: Two major cities of Botswana, Francistown and Gaborone, with more than twenty-two health clinics offering tuberculosis care. Objective: To investigate community caregivers’ experiences and identify programmatic strategies to improve active TB case findings under the community TB care (CTBC) program in Botswana during 2016-2021. Methods: We adopted a descriptive qualitative research design, followed by convenience purposive sampling. We obtained consent and interviewed 40 participants who met the inclusion criteria, 16 out of 73 in Gaborone and 24 out of 38 from Francistown. Results: We interviewed 40 caregivers with a mean age of 43.4 years. Accepting the caregiving role was identified as the main experience by more than two thirds of the caregivers. While at least more than two-fifth felt obligated to care for the patient at home due to personal relations. More than half of the respondents found caregiving difficult or frustrating due to some challenges encountered during the caregiving role. Behavioral modifications were suggested under different subthemes as strategies to improve active case finding. [-rId13-]Conclusion: Acceptance was the major experience in CTBC. Intensification of known programmatic strategies was suggested by caregivers to improve tuberculosis active case finding in CTBC.展开更多
Cultural ancient roads,known in Chinese as gudao,serve as heritage trails that carry historical exchanges across various regions in China.Due to their extensive preservation,wide geographical distribution,diverse them...Cultural ancient roads,known in Chinese as gudao,serve as heritage trails that carry historical exchanges across various regions in China.Due to their extensive preservation,wide geographical distribution,diverse thematic variations,and considerable tourist appeal,these paths have emerged as representative heritage trails,increasingly transforming into a novel tourism product experience that is highly favored by tourists and recognized by government authorities.However,research on ancient roads for tourism in China currently lacks a systematic theoretical framework,as well as relevant policies,regulations,and standards to guide their practical development.Therefore,there is a pressing need to draw upon international best practices and conduct foundational research to develop an experience element system that aligns with the perceptions,behaviors,and consumption characteristics of Chinese tourists,thereby advancing theoretical exploration in this field.This study focuses on the representative Ancient Shu Road as a case study and employs a mixed-method approach that integrates qualitative and quantitative research.It aims to construct a tourist-centric scale for the experience elements of ancient road tourism while analyzing the interactive relationship between these experience elements and tourist needs.This study addresses a significant gap in the development of indicator systems for domestic studies of ancient road tourism experiences.Ultimately,the study establishes a comprehensive scale that encompasses three core categories—trail resources and environment,facilities and services,and modes of tourism activities—along with eight primary dimensions:core resources,surrounding cultural environment,surrounding natural environment,tourism reception facilities and services,infrastructure and support services,information facilities and information services,and outdoor and recreational activities.This scale consists of thirty-two specific items,providing a robust reference for future research endeavors.Additionally,the study proposes specific development strategies related to key mechanisms,spatial configuration,and facility construction to enhance the overall development of ancient road tourism.展开更多
Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell diseas...Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.展开更多
This study evaluated the state of anxiety, depression, post-traumatic stress disorder, general mental health, and mental well-beingamong citizens after a crowd-crush disaster in Korea. Individuals who experienced the ...This study evaluated the state of anxiety, depression, post-traumatic stress disorder, general mental health, and mental well-beingamong citizens after a crowd-crush disaster in Korea. Individuals who experienced the crowd crush had significantly higheranxiety, depression, and post-traumatic stress disorder (PTSD) scores than those who did not (p < 0.001). Additionally,people who avoided the disaster area had significantly higher depression and PTSD scores than those who did not avoid thearea (p < 0.001). Those who directly witnessed the Seoul Halloween crowd crush had a significant difference in PTSD levels ineither group than those who experienced it indirectly (p = 0.005). There was a significant difference in PTSD scores in cases ofdirect damage or death of an acquaintance (p < 0.001). The Seoul Halloween crowd crush caused psychological damagethrough indiscriminate exposure to the public, and symptoms of PTSD appeared over a long period. It is crucial to provideessential resources for ongoing treatment and case management.展开更多
The path planning of Unmanned Aerial Vehicle(UAV)is a critical issue in emergency communication and rescue operations,especially in adversarial urban environments.Due to the continuity of the flying space,complex buil...The path planning of Unmanned Aerial Vehicle(UAV)is a critical issue in emergency communication and rescue operations,especially in adversarial urban environments.Due to the continuity of the flying space,complex building obstacles,and the aircraft's high dynamics,traditional algorithms cannot find the optimal collision-free flying path between the UAV station and the destination.Accordingly,in this paper,we study the fast UAV path planning problem in a 3D urban environment from a source point to a target point and propose a Three-Step Experience Buffer Deep Deterministic Policy Gradient(TSEB-DDPG)algorithm.We first build the 3D model of a complex urban environment with buildings and project the 3D building surface into many 2D geometric shapes.After transformation,we propose the Hierarchical Learning Particle Swarm Optimization(HL-PSO)to obtain the empirical path.Then,to ensure the accuracy of the obtained paths,the empirical path,the collision information and fast transition information are stored in the three experience buffers of the TSEB-DDPG algorithm as dynamic guidance information.The sampling ratio of each buffer is dynamically adapted to the training stages.Moreover,we designed a reward mechanism to improve the convergence speed of the DDPG algorithm for UAV path planning.The proposed TSEB-DDPG algorithm has also been compared to three widely used competitors experimentally,and the results show that the TSEB-DDPG algorithm can archive the fastest convergence speed and the highest accuracy.We also conduct experiments in real scenarios and compare the real path planning obtained by the HL-PSO algorithm,DDPG algorithm,and TSEB-DDPG algorithm.The results show that the TSEBDDPG algorithm can archive almost the best in terms of accuracy,the average time of actual path planning,and the success rate.展开更多
Autonomous umanned aerial vehicle(UAV) manipulation is necessary for the defense department to execute tactical missions given by commanders in the future unmanned battlefield. A large amount of research has been devo...Autonomous umanned aerial vehicle(UAV) manipulation is necessary for the defense department to execute tactical missions given by commanders in the future unmanned battlefield. A large amount of research has been devoted to improving the autonomous decision-making ability of UAV in an interactive environment, where finding the optimal maneuvering decisionmaking policy became one of the key issues for enabling the intelligence of UAV. In this paper, we propose a maneuvering decision-making algorithm for autonomous air-delivery based on deep reinforcement learning under the guidance of expert experience. Specifically, we refine the guidance towards area and guidance towards specific point tasks for the air-delivery process based on the traditional air-to-surface fire control methods.Moreover, we construct the UAV maneuvering decision-making model based on Markov decision processes(MDPs). Specifically, we present a reward shaping method for the guidance towards area and guidance towards specific point tasks using potential-based function and expert-guided advice. The proposed algorithm could accelerate the convergence of the maneuvering decision-making policy and increase the stability of the policy in terms of the output during the later stage of training process. The effectiveness of the proposed maneuvering decision-making policy is illustrated by the curves of training parameters and extensive experimental results for testing the trained policy.展开更多
Introduction: Priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. Ho...Introduction: Priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. However, the management is often late because of the delay in consultation, which is characteristic in our context. The purpose of our study is to describe the clinical and therapeutic aspects of patients who presented with priapism at the Yaoundé Central Hospital as well as to propose a present synthesis concerning the management of priapism. Methodology: We conducted a descriptive cross-sectional study with a retrospective recruitment method in the urology department of the YCH. It extended over a period of 6 months from January 2022 to June 2022. We reviewed the files of patients seen within a period spanning 10 years from January 1<sup>st</sup>, 2011 to January 31<sup>st</sup>, December 2021. The study population consisted of patients who had been hospitalized and treated for priapism. We carried out consecutive and non-exhaustive sampling. Results: During the study, we collected data from the medical files of 13 patients. The median age was 25 years, with extremes of 12 and 82 years. Most of the patients were between 20 and 30 years old (38.5%). Most of the patients were single (69.2%). Sickle cell disease was the main comorbidity encountered during the study (76.9%). The median time from onset of symptoms to consultation was 10 [6 - 20.5] hours, with extremes of 1 and 264 hours. All patients presented with painful penile erection (100%). There was concomitant multifocal pain in 38.5% of cases suggestive of vaso-occlusive crises (VOC). The symptoms occurred in a non-traumatic context in the majority of cases (92.3%). The T-shunt was the most used surgical technique (84.6%). The median duration of surgery was 36 [35 - 40] minutes with extremes of 25 and 60 minutes, the majority being operated in less than 45 minutes (84.6%). The frequency of postoperative complications was 46.2%, dominated by weak erections/loss of erections (38.5%). The median duration of hospitalisation was 4 [3 - 5.5] days, with extremes 2 and 20 days of hospitalisation. Resumption of sexual activity was reported in 8 patients (61.5%). The time to recovery was mostly greater than 6 weeks (62.5%). Conclusion: Priapism remains a urological emergency. The prognosis depends on the patients’ promptness in consulting. The T-Shunt is an effective surgical technique in the event of failure of medical treatment.展开更多
In space-oriented design,the guide logo is often combined with the overall visual style and spatial positioning of the space design through the designer’s whims.With the development of digital technology and the appl...In space-oriented design,the guide logo is often combined with the overall visual style and spatial positioning of the space design through the designer’s whims.With the development of digital technology and the application of artificial intelligence,the practice of designers is reflected in the integration of digital information into media content and physical objects.Digital-oriented identity from touch,voice to eye sensing;static and dynamic conversion of multi-dimensional presentation,real to virtual possibilities are expanded,so that people experiencing in space can produce a variety of morphological perception and virtual immersion experience.展开更多
BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is b...BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.展开更多
This article explores the role of smart textiles in transforming healthcare environments into spaces that prioritize patient well-being. We will examine the advantages of smart textiles in healthcare settings, such as...This article explores the role of smart textiles in transforming healthcare environments into spaces that prioritize patient well-being. We will examine the advantages of smart textiles in healthcare settings, such as the real-time monitoring of vital signs through connected clothing. Additionally, we will introduce metadesign as a design approach that considers the interactions between users, healthcare environments, and technologies to create fulfilling experiences. By combining the advanced features of smart textiles with a patient-centered metadesign approach, it becomes possible to create care spaces that cater to patient needs. The objective of this article is to present the integration of metadesign in the design of smart textiles as a process aimed at enhancing the quality of the patient user experience. In this process, we will emphasize the collaborative approach and embrace technological innovation to harness the potential for ongoing improvement and provide users with high-quality experiences. Lastly, we will underscore the significance of adopting a multidimensional approach to evaluate the impact of smart textiles on the patient user experience.展开更多
Since the 18th National Congress of the Communist Party of China,the country has established 21 Free Trade Pilot Zones(FTZs),achieving significant pioneering results in reform and opening up and creating a strong demo...Since the 18th National Congress of the Communist Party of China,the country has established 21 Free Trade Pilot Zones(FTZs),achieving significant pioneering results in reform and opening up and creating a strong demonstrative effect nationwide.The basic experience from a decade of FTZs includes:adhering to the centralized and unified leadership of the CPC Central Committee;combining top-level design with encouragement of grassroots innovation;leveraging the distinct characteristics and strengths of FTZs to form a differentiated development pattern;maintaining the integration of opening up with domestic reforms;using openness to drive reforms;and organically combining openness with national security assurance.Under the current and future new circumstances,China’s FTZs face new challenges and tasks.In accordance with the directives of the 20th National Congress of the Communist Party of China,an enhancement strategy for the FTZs needs to be implemented.This involves the following:First,accurately understanding and responding to the changing situation to create strategic opportunities.Second,shifting paradigms to implement innovation-driven strategies,using the new development pattern concept to guide the reform experiments and construction of the FTZs.Third,granting more autonomy to FTZs for reforms,pursuing progress while maintaining stability,and solidly advancing the reform experiments in the FTZs.Fourth,orderly expanding the opening up of the service sector and cautiously advancing the internationalization of the renminbi.Fifth,promoting innovative development in trade to build a strong trade nation.Sixth,establishing synergy with bilateral FTZs,Belt and Road cooperation,and national diplomatic strategies to enhance the linkage effect.展开更多
Plug-in Hybrid Electric Vehicles(PHEVs)represent an innovative breed of transportation,harnessing diverse power sources for enhanced performance.Energy management strategies(EMSs)that coordinate and control different ...Plug-in Hybrid Electric Vehicles(PHEVs)represent an innovative breed of transportation,harnessing diverse power sources for enhanced performance.Energy management strategies(EMSs)that coordinate and control different energy sources is a critical component of PHEV control technology,directly impacting overall vehicle performance.This study proposes an improved deep reinforcement learning(DRL)-based EMSthat optimizes realtime energy allocation and coordinates the operation of multiple power sources.Conventional DRL algorithms struggle to effectively explore all possible state-action combinations within high-dimensional state and action spaces.They often fail to strike an optimal balance between exploration and exploitation,and their assumption of a static environment limits their ability to adapt to changing conditions.Moreover,these algorithms suffer from low sample efficiency.Collectively,these factors contribute to convergence difficulties,low learning efficiency,and instability.To address these challenges,the Deep Deterministic Policy Gradient(DDPG)algorithm is enhanced using entropy regularization and a summation tree-based Prioritized Experience Replay(PER)method,aiming to improve exploration performance and learning efficiency from experience samples.Additionally,the correspondingMarkovDecision Process(MDP)is established.Finally,an EMSbased on the improvedDRLmodel is presented.Comparative simulation experiments are conducted against rule-based,optimization-based,andDRL-based EMSs.The proposed strategy exhibitsminimal deviation fromthe optimal solution obtained by the dynamic programming(DP)strategy that requires global information.In the typical driving scenarios based onWorld Light Vehicle Test Cycle(WLTC)and New European Driving Cycle(NEDC),the proposed method achieved a fuel consumption of 2698.65 g and an Equivalent Fuel Consumption(EFC)of 2696.77 g.Compared to the DP strategy baseline,the proposed method improved the fuel efficiency variances(FEV)by 18.13%,15.1%,and 8.37%over the Deep QNetwork(DQN),Double DRL(DDRL),and original DDPG methods,respectively.The observational outcomes demonstrate that the proposed EMS based on improved DRL framework possesses good real-time performance,stability,and reliability,effectively optimizing vehicle economy and fuel consumption.展开更多
The research aims to explore the transition from monolithic Digital Experience Platforms (DXPs) to Microservices-based DXPs, addressing scalability challenges. The study systematically decomposes monolithic structures...The research aims to explore the transition from monolithic Digital Experience Platforms (DXPs) to Microservices-based DXPs, addressing scalability challenges. The study systematically decomposes monolithic structures into Microservices, emphasizing business capability and subdomain decomposition. Concrete insights, challenges, and solutions encountered during this transformation process are presented. The research contributes valuable insights into the challenges and benefits of adopting Microservices in DXPs. Results highlight the importance of architectural patterns and strategic scaling dimensions for improved performance and scalability. The case study on Backbase’s Engagement Banking Platform showcases successful implementation, providing flexibility, integration, and efficient development in the evolving DXP landscape.展开更多
基金the National Key Research and Development Program of China under Grant 2021YFB3301300the National Natural Science Foundation of China under Grant 62203213+1 种基金the Natural Science Foundation of Jiangsu Province under Grant BK20220332the Open Project Program of Fujian Provincial Key Laboratory of Intelligent Identification and Control of Complex Dynamic System under Grant 2022A0004.
文摘The reliable operation of high-speed wire rod finishing mills is crucial in the steel production enterprise.As complex system-level equipment,it is difficult for high-speed wire rod finishing mills to realize fault location and real-time monitoring.To solve the above problems,an expert experience and data-driven-based hybrid fault diagnosis method for high-speed wire rod finishing mills is proposed in this paper.First,based on its mechanical structure,time and frequency domain analysis are improved in fault feature extraction.The approach of combining virtual value,peak value with kurtosis value index,is adopted in time domain analysis.Speed adjustment and side frequency analysis are proposed in frequency domain analysis to obtain accurate component characteristic frequency and its corresponding sideband.Then,according to time and frequency domain characteristics,fault location based on expert experience is proposed to get an accurate fault result.Finally,the proposed method is implemented in the equipment intelligent diagnosis system.By taking an equipment fault on site,for example,the effectiveness of the proposed method is illustrated in the system.
文摘Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of HIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned HIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University Hospital Centre (CHUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.2.2.6. Results: One hundred and thirteen HIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with HIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .
基金This research was supported by Meat and Livestock Australia grant P.PSH.1232,the Australasian Pork Research Institute Ltd grant 5A-113,The University of Queensland and The University of Western Australia.
文摘At a time when there is a growing public interest in animal welfare,it is critical to have objective means to assess the way that an animal experiences a situation.Objectivity is critical to ensure appropriate animal welfare outcomes.Existing behavioural,physiological,and neurobiological indicators that are used to assess animal welfare can verify the absence of extremely negative outcomes.But welfare is more than an absence of negative outcomes and an appropriate indicator should reflect the full spectrum of experience of an animal,from negative to positive.In this review,we draw from the knowledge of human biomedical science to propose a list of candidate biological markers(biomarkers)that should reflect the experiential state of non-human animals.The proposed biomarkers can be classified on their main function as endocrine,oxidative stress,non-coding molecular,and thermobiological markers.We also discuss practical challenges that must be addressed before any of these biomarkers can become useful to assess the experience of an animal in real-life.
文摘BACKGROUND The incidence of colorectal cancer(CRC)has increased in recent decades,and ranks fourth among males and third among females in China.Surgical resection remains the most important treatment modality for curative intent in CRC.Several studies found that surgeon volumes and specialization appeared to be associated with improved overall survival(OS).Moreover,numerous reports have suggested that specialization and minimally invasive surgery have gained increased popularity in CRC surgery.However,few studies have specifically examined the role and long-term survival of all stage CRC in a real-world study.AIM To evaluate the effect of surgeon specialization on survival changes and minimally invasive surgery utilization in a real world study.METHODS A retrospective analysis on the association between surgeon specialization and OS between 2008 and 2013 in Zhongshan Hospital CRC database was performed.Standard demographic,clinicopathologic,surgical and follow-up data were obtained from the CRC database.Surgeon specialty was categorized as colorectal surgeon(CS)and general surgeon(GS).CRC patients who underwent primary surgical resection were enrolled.RESULTS A total of 5141 CRC patients who underwent primary surgical resection between 2008 and 2013 were evaluated,1748(34.0%)of these by CS.The percentage of minimally invasive procedures in the CS group showed an increasing trend.There was no benefit associated with surgeon specialization for stage I,II and IV patients.Surgeon specialization exhibited a significant association with OS solely among stage III patients,with 5-year OS rates of 76%and 67%for the CS and GSgroups,respectively(P<0.01).Further analyses found that surgeon specialization was significantly associated with survival only in stage III rectal patients,and the 5-year OS rate in the CS group and GS group was 80%and 67%,respectively(P<0.01).CONCLUSION Surgeon specialization is associated with improved OS after primary surgery in stage III rectal patients.An appropriate surgical technique,perioperative program and adjuvant therapy may contribute to survival benefit in these patients.
基金supported by the 2022 Capital’s Funds for Health Improvement and Research(CFH)(2022-2-4202).
文摘Objective:The objective of this study is to comprehensively understand the psychological experience of primiparous women during breastfeeding while dealing with lactating mastitis and to establish a reliable foundation for tailored support measures.Methods:Twenty primiparous mothers from a tertiary hospital in Beijing between January and March 2023 were chosen using purposive sampling for semi-structured interviews.After conducting 20 interviews,data saturation was achieved.The Colaizzi’s seven-step analytical approach was employed to analyze,summarize,and refine the identified themes.Results:Among primiparous women afflicted by lactating mastitis,the primary themes regarding breastfeeding attitudes included three key aspects:(1)uncertainty during the initial diagnosis phase,(2)intricate emotional journey during treatment,and(3)positive psychological outlook during the recovery stage.Conclusion:Primiparous women undergoing lactating mastitis experience substantial physical and psychological strain.It is crucial for medical personnel,family caregivers,and society at large to be attuned to the emotions of these patients.Tailored support measures should be offered to enhance patients’physical and mental well-being and facilitate disease recovery.
文摘Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mother To Child Transmission-HIV service utilization should be prioritized so as to alleviate stigma and enhancing a positive experience for these mothers thus reducing on the Mother to Child HIV Transmission burden and mortality rates.
基金The study was reviewed and approved by the Science and Research Office of Tong Ren Hospital(Shanghai), No. AF/SC-08/04.0.
文摘BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.
文摘Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry of Health, community tuberculosis care was introduced with the main goal of reducing tuberculosis-related morbidity and mortality among communities through the expansion of direct observed therapy and community involvement to community settings. The community caregivers were to support tuberculosis patients throughout their treatment period until they were cured or had completed their treatment. Settings: Two major cities of Botswana, Francistown and Gaborone, with more than twenty-two health clinics offering tuberculosis care. Objective: To investigate community caregivers’ experiences and identify programmatic strategies to improve active TB case findings under the community TB care (CTBC) program in Botswana during 2016-2021. Methods: We adopted a descriptive qualitative research design, followed by convenience purposive sampling. We obtained consent and interviewed 40 participants who met the inclusion criteria, 16 out of 73 in Gaborone and 24 out of 38 from Francistown. Results: We interviewed 40 caregivers with a mean age of 43.4 years. Accepting the caregiving role was identified as the main experience by more than two thirds of the caregivers. While at least more than two-fifth felt obligated to care for the patient at home due to personal relations. More than half of the respondents found caregiving difficult or frustrating due to some challenges encountered during the caregiving role. Behavioral modifications were suggested under different subthemes as strategies to improve active case finding. [-rId13-]Conclusion: Acceptance was the major experience in CTBC. Intensification of known programmatic strategies was suggested by caregivers to improve tuberculosis active case finding in CTBC.
文摘Cultural ancient roads,known in Chinese as gudao,serve as heritage trails that carry historical exchanges across various regions in China.Due to their extensive preservation,wide geographical distribution,diverse thematic variations,and considerable tourist appeal,these paths have emerged as representative heritage trails,increasingly transforming into a novel tourism product experience that is highly favored by tourists and recognized by government authorities.However,research on ancient roads for tourism in China currently lacks a systematic theoretical framework,as well as relevant policies,regulations,and standards to guide their practical development.Therefore,there is a pressing need to draw upon international best practices and conduct foundational research to develop an experience element system that aligns with the perceptions,behaviors,and consumption characteristics of Chinese tourists,thereby advancing theoretical exploration in this field.This study focuses on the representative Ancient Shu Road as a case study and employs a mixed-method approach that integrates qualitative and quantitative research.It aims to construct a tourist-centric scale for the experience elements of ancient road tourism while analyzing the interactive relationship between these experience elements and tourist needs.This study addresses a significant gap in the development of indicator systems for domestic studies of ancient road tourism experiences.Ultimately,the study establishes a comprehensive scale that encompasses three core categories—trail resources and environment,facilities and services,and modes of tourism activities—along with eight primary dimensions:core resources,surrounding cultural environment,surrounding natural environment,tourism reception facilities and services,infrastructure and support services,information facilities and information services,and outdoor and recreational activities.This scale consists of thirty-two specific items,providing a robust reference for future research endeavors.Additionally,the study proposes specific development strategies related to key mechanisms,spatial configuration,and facility construction to enhance the overall development of ancient road tourism.
文摘Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.
基金the National Research Foundation of Korea(NRF)Grant funded by the Korean government(NRF-2023R1A2C2003043)the Chung-Ang University Research Scholarship Grants in 2023.
文摘This study evaluated the state of anxiety, depression, post-traumatic stress disorder, general mental health, and mental well-beingamong citizens after a crowd-crush disaster in Korea. Individuals who experienced the crowd crush had significantly higheranxiety, depression, and post-traumatic stress disorder (PTSD) scores than those who did not (p < 0.001). Additionally,people who avoided the disaster area had significantly higher depression and PTSD scores than those who did not avoid thearea (p < 0.001). Those who directly witnessed the Seoul Halloween crowd crush had a significant difference in PTSD levels ineither group than those who experienced it indirectly (p = 0.005). There was a significant difference in PTSD scores in cases ofdirect damage or death of an acquaintance (p < 0.001). The Seoul Halloween crowd crush caused psychological damagethrough indiscriminate exposure to the public, and symptoms of PTSD appeared over a long period. It is crucial to provideessential resources for ongoing treatment and case management.
基金supported in part by the Hubei Provincial Science and Technology Major Project of China(Grant No.2020AEA011)in part by the National Ethnic Affairs Commission of the People’s Republic of China(Training Program for Young and Middle-aged Talents)(No:MZR20007)+4 种基金in part by the National Natural Science Foundation of China(Grant No.61902437)in part by the Hubei Provincial Natural Science Foundation of China(Grant No.2020CFB629)in part by the Application Foundation Frontier Project of Wuhan Science and Technology Program(Grant No.2020020601012267)in part by the Fundamental Research Funds for the Central Universities,South-Central MinZu University(No:CZQ21026)in part by the Special Project on Regional Collaborative Innovation of Xinjiang Uygur Autonomous Region(Plan to Aid Xinjiang with Science and Technology)(2022E02035)。
文摘The path planning of Unmanned Aerial Vehicle(UAV)is a critical issue in emergency communication and rescue operations,especially in adversarial urban environments.Due to the continuity of the flying space,complex building obstacles,and the aircraft's high dynamics,traditional algorithms cannot find the optimal collision-free flying path between the UAV station and the destination.Accordingly,in this paper,we study the fast UAV path planning problem in a 3D urban environment from a source point to a target point and propose a Three-Step Experience Buffer Deep Deterministic Policy Gradient(TSEB-DDPG)algorithm.We first build the 3D model of a complex urban environment with buildings and project the 3D building surface into many 2D geometric shapes.After transformation,we propose the Hierarchical Learning Particle Swarm Optimization(HL-PSO)to obtain the empirical path.Then,to ensure the accuracy of the obtained paths,the empirical path,the collision information and fast transition information are stored in the three experience buffers of the TSEB-DDPG algorithm as dynamic guidance information.The sampling ratio of each buffer is dynamically adapted to the training stages.Moreover,we designed a reward mechanism to improve the convergence speed of the DDPG algorithm for UAV path planning.The proposed TSEB-DDPG algorithm has also been compared to three widely used competitors experimentally,and the results show that the TSEB-DDPG algorithm can archive the fastest convergence speed and the highest accuracy.We also conduct experiments in real scenarios and compare the real path planning obtained by the HL-PSO algorithm,DDPG algorithm,and TSEB-DDPG algorithm.The results show that the TSEBDDPG algorithm can archive almost the best in terms of accuracy,the average time of actual path planning,and the success rate.
基金supported by the Key Research and Development Program of Shaanxi (2022GXLH-02-09)the Aeronautical Science Foundation of China (20200051053001)the Natural Science Basic Research Program of Shaanxi (2020JM-147)。
文摘Autonomous umanned aerial vehicle(UAV) manipulation is necessary for the defense department to execute tactical missions given by commanders in the future unmanned battlefield. A large amount of research has been devoted to improving the autonomous decision-making ability of UAV in an interactive environment, where finding the optimal maneuvering decisionmaking policy became one of the key issues for enabling the intelligence of UAV. In this paper, we propose a maneuvering decision-making algorithm for autonomous air-delivery based on deep reinforcement learning under the guidance of expert experience. Specifically, we refine the guidance towards area and guidance towards specific point tasks for the air-delivery process based on the traditional air-to-surface fire control methods.Moreover, we construct the UAV maneuvering decision-making model based on Markov decision processes(MDPs). Specifically, we present a reward shaping method for the guidance towards area and guidance towards specific point tasks using potential-based function and expert-guided advice. The proposed algorithm could accelerate the convergence of the maneuvering decision-making policy and increase the stability of the policy in terms of the output during the later stage of training process. The effectiveness of the proposed maneuvering decision-making policy is illustrated by the curves of training parameters and extensive experimental results for testing the trained policy.
文摘Introduction: Priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. However, the management is often late because of the delay in consultation, which is characteristic in our context. The purpose of our study is to describe the clinical and therapeutic aspects of patients who presented with priapism at the Yaoundé Central Hospital as well as to propose a present synthesis concerning the management of priapism. Methodology: We conducted a descriptive cross-sectional study with a retrospective recruitment method in the urology department of the YCH. It extended over a period of 6 months from January 2022 to June 2022. We reviewed the files of patients seen within a period spanning 10 years from January 1<sup>st</sup>, 2011 to January 31<sup>st</sup>, December 2021. The study population consisted of patients who had been hospitalized and treated for priapism. We carried out consecutive and non-exhaustive sampling. Results: During the study, we collected data from the medical files of 13 patients. The median age was 25 years, with extremes of 12 and 82 years. Most of the patients were between 20 and 30 years old (38.5%). Most of the patients were single (69.2%). Sickle cell disease was the main comorbidity encountered during the study (76.9%). The median time from onset of symptoms to consultation was 10 [6 - 20.5] hours, with extremes of 1 and 264 hours. All patients presented with painful penile erection (100%). There was concomitant multifocal pain in 38.5% of cases suggestive of vaso-occlusive crises (VOC). The symptoms occurred in a non-traumatic context in the majority of cases (92.3%). The T-shunt was the most used surgical technique (84.6%). The median duration of surgery was 36 [35 - 40] minutes with extremes of 25 and 60 minutes, the majority being operated in less than 45 minutes (84.6%). The frequency of postoperative complications was 46.2%, dominated by weak erections/loss of erections (38.5%). The median duration of hospitalisation was 4 [3 - 5.5] days, with extremes 2 and 20 days of hospitalisation. Resumption of sexual activity was reported in 8 patients (61.5%). The time to recovery was mostly greater than 6 weeks (62.5%). Conclusion: Priapism remains a urological emergency. The prognosis depends on the patients’ promptness in consulting. The T-Shunt is an effective surgical technique in the event of failure of medical treatment.
文摘In space-oriented design,the guide logo is often combined with the overall visual style and spatial positioning of the space design through the designer’s whims.With the development of digital technology and the application of artificial intelligence,the practice of designers is reflected in the integration of digital information into media content and physical objects.Digital-oriented identity from touch,voice to eye sensing;static and dynamic conversion of multi-dimensional presentation,real to virtual possibilities are expanded,so that people experiencing in space can produce a variety of morphological perception and virtual immersion experience.
文摘BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.
文摘This article explores the role of smart textiles in transforming healthcare environments into spaces that prioritize patient well-being. We will examine the advantages of smart textiles in healthcare settings, such as the real-time monitoring of vital signs through connected clothing. Additionally, we will introduce metadesign as a design approach that considers the interactions between users, healthcare environments, and technologies to create fulfilling experiences. By combining the advanced features of smart textiles with a patient-centered metadesign approach, it becomes possible to create care spaces that cater to patient needs. The objective of this article is to present the integration of metadesign in the design of smart textiles as a process aimed at enhancing the quality of the patient user experience. In this process, we will emphasize the collaborative approach and embrace technological innovation to harness the potential for ongoing improvement and provide users with high-quality experiences. Lastly, we will underscore the significance of adopting a multidimensional approach to evaluate the impact of smart textiles on the patient user experience.
文摘Since the 18th National Congress of the Communist Party of China,the country has established 21 Free Trade Pilot Zones(FTZs),achieving significant pioneering results in reform and opening up and creating a strong demonstrative effect nationwide.The basic experience from a decade of FTZs includes:adhering to the centralized and unified leadership of the CPC Central Committee;combining top-level design with encouragement of grassroots innovation;leveraging the distinct characteristics and strengths of FTZs to form a differentiated development pattern;maintaining the integration of opening up with domestic reforms;using openness to drive reforms;and organically combining openness with national security assurance.Under the current and future new circumstances,China’s FTZs face new challenges and tasks.In accordance with the directives of the 20th National Congress of the Communist Party of China,an enhancement strategy for the FTZs needs to be implemented.This involves the following:First,accurately understanding and responding to the changing situation to create strategic opportunities.Second,shifting paradigms to implement innovation-driven strategies,using the new development pattern concept to guide the reform experiments and construction of the FTZs.Third,granting more autonomy to FTZs for reforms,pursuing progress while maintaining stability,and solidly advancing the reform experiments in the FTZs.Fourth,orderly expanding the opening up of the service sector and cautiously advancing the internationalization of the renminbi.Fifth,promoting innovative development in trade to build a strong trade nation.Sixth,establishing synergy with bilateral FTZs,Belt and Road cooperation,and national diplomatic strategies to enhance the linkage effect.
文摘Plug-in Hybrid Electric Vehicles(PHEVs)represent an innovative breed of transportation,harnessing diverse power sources for enhanced performance.Energy management strategies(EMSs)that coordinate and control different energy sources is a critical component of PHEV control technology,directly impacting overall vehicle performance.This study proposes an improved deep reinforcement learning(DRL)-based EMSthat optimizes realtime energy allocation and coordinates the operation of multiple power sources.Conventional DRL algorithms struggle to effectively explore all possible state-action combinations within high-dimensional state and action spaces.They often fail to strike an optimal balance between exploration and exploitation,and their assumption of a static environment limits their ability to adapt to changing conditions.Moreover,these algorithms suffer from low sample efficiency.Collectively,these factors contribute to convergence difficulties,low learning efficiency,and instability.To address these challenges,the Deep Deterministic Policy Gradient(DDPG)algorithm is enhanced using entropy regularization and a summation tree-based Prioritized Experience Replay(PER)method,aiming to improve exploration performance and learning efficiency from experience samples.Additionally,the correspondingMarkovDecision Process(MDP)is established.Finally,an EMSbased on the improvedDRLmodel is presented.Comparative simulation experiments are conducted against rule-based,optimization-based,andDRL-based EMSs.The proposed strategy exhibitsminimal deviation fromthe optimal solution obtained by the dynamic programming(DP)strategy that requires global information.In the typical driving scenarios based onWorld Light Vehicle Test Cycle(WLTC)and New European Driving Cycle(NEDC),the proposed method achieved a fuel consumption of 2698.65 g and an Equivalent Fuel Consumption(EFC)of 2696.77 g.Compared to the DP strategy baseline,the proposed method improved the fuel efficiency variances(FEV)by 18.13%,15.1%,and 8.37%over the Deep QNetwork(DQN),Double DRL(DDRL),and original DDPG methods,respectively.The observational outcomes demonstrate that the proposed EMS based on improved DRL framework possesses good real-time performance,stability,and reliability,effectively optimizing vehicle economy and fuel consumption.
文摘The research aims to explore the transition from monolithic Digital Experience Platforms (DXPs) to Microservices-based DXPs, addressing scalability challenges. The study systematically decomposes monolithic structures into Microservices, emphasizing business capability and subdomain decomposition. Concrete insights, challenges, and solutions encountered during this transformation process are presented. The research contributes valuable insights into the challenges and benefits of adopting Microservices in DXPs. Results highlight the importance of architectural patterns and strategic scaling dimensions for improved performance and scalability. The case study on Backbase’s Engagement Banking Platform showcases successful implementation, providing flexibility, integration, and efficient development in the evolving DXP landscape.