Kinematics ofmandibular advancement devices(MADs):Why do some MADs move the lower jaw backward duringmouth opening?

Mandibular advancement devices(MADs)are widely used treatments for obstructive sleep apnea.MADs function by advancing the lower jaw to open the upper airway.To increase patient comfort,most patients allow the mouth to be opened.However,not all systems maintain the lower jaw in a forward position during mouth opening,which results in the production of a retrusion that favors the collapse of the upper airway.Furthermore,the kinematic behavior of the mechanism formed by the mandible-device assembly depends on jaw morphology.This means that,during mouth opening,some devices cause lower jaw protrusion in some patients,but cause its retraction in others.In this study,we report the behavior of well-known devices currently on themarket.To do so,we developed a kinematic model of the lower jawdevice assembly.Thismodelwas validated for all devices analyzed using a high-resolution camera system.Our results show that some of the devices analyzed here did not produce the correct behavior during patient mouth opening.

Adaptability of bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection

Background:Several reconstructive techniques have been used to reconstruct scalp defects.Numerous researchers have studied the utilization of bipedicled scalp advancement flaps for scalp defect coverage.In this study,we will assess the adaptability of a bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection.Methods:This study was performed at the Plastic Surgery Department,Fayoum University Hospital,on 20 patients with huge scalp tumors treated by adequate excision and reconstructed using a bipedicled scalp advancement flap from December 2021 to July 2023.Results:The study was conducted on 20 patients:16(80%)were men and 4(20%)were women presenting with large scalp tumors.The mean age was 57.4 years(33-68 years).The sites of the tumors were 10(50%)occipital,6(30%)parietal,and 4(20%)parieto-occipital.No major complications occurred postoperatively,and the bipedicled flaps survived well in all cases,with no necrosis.Conclusion:Huge scalp defects after tumor resection can be safely reconstructed with a large versatile bipedicled advancement scalp flap,either transversely or longitudinally oriented,with favorable functional results and accepted aesthetic results,apart from the alopecic area over the grafted donor site,which can be treated by tissue expansion if desired later.

Humanomics Creates New Form of Human Advancement in China

Humanomics in the new era,a development format generated and developed from Chinese modernisation practice,created a new form of human advancement and inspired the cause of human progress,said a report released by Xinhua News Agency on 3 December 2023.

How do advancements in technology affect the development and use of textile binders?

The textile industry is constantly evolving,and advancements in technology are playing a pivotal role in shaping the development and use of textile binders.According to Reports and Insights,the global textile binder market is expected to reach a value of USD 5.33 billion by 2032,exhibiting a healthy CAGR of 4.4%.This growth is fueled by a confluence of factors,with technological innovation at the forefront.Let's delve into how these advancements are impacting the landscape of textile binders。

The Advancements of Medical Textiles:A Patent Perspective

The healthcare sector is advancing in many aspects,including smart devices,surgical robots,AR/VR consultation,etc.Medical textiles are one such aspect where we have observed tremendous growth in innovation.Before the pandemic,the CAGR of patent filing in medical textiles was~12.5%.Postpandemic,it increased to 42.6%.From the patent publishing data,we saw that the US,Japan,India,and Germany are the top four countries in which innovations in medical textiles are on the rise.The extent of the growth is due to the constant improvements and innovations in both textile technology and medical materials.

Efficacy of invisible advancement correction for mandibular retraction in adolescents based on Pancherz analysis

BACKGROUND Mandibular retraction is the main etiological mechanism of class II malocclusion in China and the subsequent distal molar relationship can cause functional discomfort in mastication,breathing and the temporomandibular joint.The use of mandibular advancement(MA)devices has recently emerged as an adolescent mandibular retraction treatment;however,current studies regarding the effect thereof are relatively few,and there is lack of sufficient clinical support.AIM To investigate the clinical effect of invisalign MA on the treatment of mandibular retraction in adolescents.METHODS This study included 30 adolescent patients who underwent treatment with the MA appliances from December 2017 to June 2021.The lateral cephalometric data before and after treatment were collected and imported into Dolphin Imaging software.The changes were measured by linear measurement superimposed with lateral cephalometric trajectory based on the Pancherz technology.RESULTS There was no significant difference in the length and position of maxilla before and after the treatment.The position of the mandible moved 3.13 mm,the length increased 4.14 mm,the mandibular ramus length increased 4.09 mm,the body length increased 4.25 mm,and the position of the condyle moved 1.03 mm forward after treatment.Additionally,changes in the incisor sagittal position and labial inclination were observed.The position of the upper incisor point moved back 1.33 mm,without statistical difference,the inclination and tooth angle decreased by 3.44°and 4.06°,respectively;the position of the lower incisor point was moved 2.98 mm,and the inclination and tooth angle increased by 2.62°and 1.23°,respectively.Furthermore,changes in the incisor overjet and molar relationship were seen.Overjet decreased by 4.31 mm,of which 1.78 mm was due to dental factors,accounting for 41.3%of the effect as opposed to 58.7%due to skeletal factors.Molar relationship improved 3.87 mm,with 1.34 mm due to dental factors,and dental and skeletal factors were accounted for 34.6%and 65.4%of the effect,respectively.CONCLUSION For adolescent patients with mandible retraction,invisalign MA can effectively promote the mandible growth,and it was proven to be mainly due to skeletal effects.

Revolutionizing patient care:the latest advancements in clinical pharmacy practice

The world of healthcare is constantly evolving,and one area that has seen significant advancements in recent years is clinical pharmacy practice.1 In the past,pharmacists were mainly responsible for dispensing medications and ensuring that patients understood how to use them safely.However,the role of clinical pharmacists has expanded significantly in recent years,and they now play a critical role in optimizing medication regimens,providing personalized patient counselling,and collaborating with other healthcare professionals to improve patient outcomes.2-3 In the extension of the role of the clinical pharmacist,nowadays health economics is also added,which includes cost-benefit analysis,cost-effectiveness analysis,cost-utilization analysis and costminimization analysis,which will ultimately help the policy and decision makers to make the cost of the drugs affordable,so that all the patient population can avail the benefits.

Penchang Village's Two-Fold Advancement

Panam County of Shigatse City in the Xizang Autonomous Region enjoys the honor of being known as the"hometown of vegetables and fruits"on the plateau.Since the 1990s,with the full support of Shandong Province,it has entered the produce industry and has been able to shed its label as a nationally recognized impoverished county.

A Broad Vision For Global Advancement

Ten years ago,Chinese President Xi Jinping unveiled an economic and infrastructure blueprint to promote connectivity and boost trade and development.To date,the Belt and Road Initiative(BRI)has transformed and improved the lives of millions of people across more than 150 participating countries worldwide.

条带状铁建造的原始矿物组成:进展与问题

原生矿物信息作为前寒武纪条带状铁建造(BIF)研究的最基本命题,是研究BIF成矿规律及其早期地球环境效应的基础。长期以来,将低级变质且保存部分原始矿物及沉积结构的BIF作为研究对象,进而追踪BIF的原始矿物组成与后期演变过程一直是科学家们关心的关键问题。目前,关于BIF原始矿物组成主要有三种认识:三价铁的氢氧化物、铁硅酸盐(成分类似于铁蛇纹石和黑硬绿泥石)和绿锈。其中,绿锈为含二价和三价铁的过渡态化合物,仅可见于局部缺氧环境。由于绿锈的亚稳态性质,对于其在类似于前寒武纪的富硅海洋条件下转变成何种矿物及相关转变的具体途径仍不清楚。因而,当前关于原始铁质矿物的争议主要存在于三价铁的氢氧化物和铁硅酸盐之间,由此引发的对BIF成矿理论及其对古环境指示意义的理解也存在较大分歧。本文系统回顾和评述了近年来BIF原始矿物组成研究的重要进展;在此基础上,认为三价铁的氢氧化物应是BIF最为主要的原始矿物,其次为铁硅酸盐矿物,二者可能在地质历史时间和空间分布上具有差异性。然而,支持铁硅酸盐原始成因的现有证据主要为经典的岩相学特征,急需更多元素和同位素地球化学等方面的佐证。BIF中现有铁质矿物组合应是原始沉淀物在成岩-变质作用条件下发生转变的产物,相较于成岩早期的菱铁矿,磁铁矿可能形成时间偏晚,究竟是生物-有机质成因抑或是菱铁矿的热化学分解成因亟待深入探讨。在此背景下,同时考虑到华北作为国际上BIF的重要产区,且发育不同变质级别的太古宙末期BIF,可能完整记录了BIF的全部历程。因此,可立足于华北,在已有的初步工作基础上,深度挖掘,力图为BIF矿物成因演变规律提供进一步约束,极大深化和推动我国BIF的成因研究。

论新质生产力的生成:高深知识生产、技术元素整合与产业技术突破

作为普通生产力的进化,新质生产力从根本上构建了现代化国家建设的中国路径。高深知识生产、技术元素整合和产业技术突破是新质生产力生成的3个关键环节。新质生产力的生成以战略性新兴产业与未来产业为依托,表征为新的市场需求的创造与满足,以及生产效率的大幅提升,其关键在于高深知识生产质量的提升、技术元素的充分整合以及产业技术实现从0到1的突破。新质生产力是战略性新兴产业与未来产业发展的重要支撑,面临高深知识生产的难度增加与成本升高、产业周期与经济周期的叠加影响、追赶效应与趋同理论支配下的国家发展瓶颈等困境。以新质生产力应对剧变中的世界秩序,需要考虑科技创新生态系统的复合型结构与自我进化能力,技术元素的自我生成、自我发展和自我增强,以及创新生态的自适应性与多中心结构等因素。面对正在进行的新型工业化革命,需要建立一个面向未来的、能够将高深知识生产与产业技术突破深度融合且不断自我进化的创新生态系统,进而突破传统的消费、信贷以及货币政策驱动的生产与分配模式,在国家层面构筑一个超大型、稳定有效且具备价值提升能力的资产组合。高等教育应当成为政府和社会“永不退出的价值投资”,在世界经济整体下行的经济周期内,国家和社会更应当加大对高等教育的综合投入:根据区域经济与产业经济带的内生需求以及新型知识生产模式建设新型研究型大学集群和学科集群;基于技术要素流动与整合构建新型高等教育创新与激励机制;形成科技革命的回馈循环机制,将高等教育打造成科技创新生态系统的关键环节。

改良膜龈手术在牙龈退缩治疗中的应用

随着人们对美观需求的日益提升,治疗牙龈退缩已经成为牙周科临床常见的患者诉求。临床上主要通过手术的方式治疗牙龈退缩,常见的手术包括游离龈移植术、带蒂瓣技术和双层瓣技术,适应证选择恰当时,通常可以获得满意的效果,但上述术式仍存在一定的不足,如根面覆盖效果不理想等。近年来,学者们针对这些不足陆续提出了一些改良方案来治疗不同程度的牙龈退缩,如改良游离龈移植术,即包含龈乳头及游离龈的牙龈单元移植,可改善受体区血供,提高根面覆盖效果,其针对轻度退缩的部位可获得良好的根面覆盖,同时可增宽角化龈和加深前庭沟,但应用于上颌美学区时可能存在术后牙龈颜色、形态不协调,美学效果欠佳的问题。牙龈瓣采用半厚-全厚-半厚的技术进行制备的改良冠向复位瓣,用于多颗牙牙龈退缩时,以退缩最严重牙为中心的改良切口设计的冠向复位信封瓣技术,可提高根面覆盖效果。不离断龈乳头,使龈瓣形成隧道,以容纳移植物的隧道技术及各种改良的隧道技术,可以有效减少术区的组织损伤,并促进创面愈合。本文通过对各类术式的阐述和文献回顾,总结改良膜龈手术治疗牙龈退缩的临床应用及注意事项,并提出牙龈退缩的治疗方案建议,同时强调牙龈退缩的对因治疗,以达到稳定的根面覆盖效果。创伤小、疗效稳定的手术方式和治疗方法是今后膜龈手术的发展方向。

新型混合式贯通牵引供电系统及其复合控制策略

电分相与负序等电能质量问题是制约电气化铁路向高速化、重载化发展的桎梏。贯通牵引供电系统为消弭上述问题提供了契机,但既有贯通方案依然存在所需器件数目多、改造成本高、可靠性差等弊端。为此,在充分利用既有牵引变压器基础上,该文设计一种新型混合式贯通牵引供电装置。该装置通过共直流侧与功率均分手段有效抵消输入侧纹波功率,降低有源/无源器件数目与电容容量。同时,针对直流侧二次纹波与负荷功率冲击,提出一种输入端口复合控制策略,有效解决纹波传递与冲击波动问题。最后通过仿真与实验验证所提装置及其控制策略的可行性与可靠性。

过碳酸盐高级氧化技术在水处理中的研究进展

近年来,活化过碳酸盐高级氧化技术具有低成本、安全、稳定等特点,已广泛用于处理水中的各类有机污染物,有望成为一种新兴的环境友好型水处理技术。该文介绍了活化过碳酸盐降解有机污染物的机理;系统综述了均相活化、非均相活化、物理活化、其他活化过碳酸盐的活化方法与活化反应机理;总结了过碳酸盐高级氧化法在水处理中的应用,重点阐述了过碳酸盐高级氧化法在去除水中的有机污染物、膜污染控制、污泥脱水、污泥厌氧消化等方面的应用研究现状;最后,指出目前水处理研究领域活化过碳酸盐高级氧化技术存在的问题,并对未来的重点研究方向进行了展望。

社区高龄老人握力和生活质量的关系研究

目的 本研究基于社会隔离和抑郁2个中介变量,构建多重中介模型,探讨高龄老人的握力对其生活质量的影响机制。方法 于2020年10月-2021年4月,利用方便整群抽样法对上海市400名≥80岁社区高龄老人,采用Lubben社会网络量表(LSNS-6)、老年抑郁量表简表(GDS-5)、世界卫生组织生活质量评定量表老年模块(WHOQOL-OLD)和握力计对高龄老人的社会隔离、抑郁、生活质量及握力进行测量。采用SPSS PROCESS程序检验链式中介效应。结果 相关性分析结果显示:握力、社会隔离、抑郁和生活质量间显著相关(P<0.01)。中介效应,分析结果显示:握力可直接影响高龄老人的生活质量[效应值=0.394;95%CI=(0.219,0.532)],还可以通过3条中介效应链对生活质量造成影响:社会隔离[效应值=0.219;95%CI=(0.125,0.328)],抑郁[效应值=0.054;95%CI=(0.029,0.087)],及社会隔离、抑郁的链式作用[效应值=0.054;95%CI=(0.029,0.087)];总中介效应占总效应的51.2%。结论 握力降低是高龄老人生活质量下降的重要风险因素,且社会隔离和抑郁是这一影响的重要解释机制。社区卫生工作者应重视握力对高龄老人生活质量的影响,并基于社会隔离和抑郁的作用路径制定干预策略,以改善高龄老人的生活质量、促进健康老龄化。

论习近平文化思想的世界观和方法论

习近平文化思想既有文化理论观点维度的创新和突破,又对文化工作布局作了新部署、新要求,标志着我们党对中国特色社会主义文化建设规律的认识达到了新高度,为进一步做好新时代新征程宣传思想文化工作、担负起新的文化使命提供了强大思想武器和科学行动指南。习近平文化思想蕴含着丰富的世界观和方法论,其中坚持人民至上是习近平文化思想的价值立场,坚持自信自立是习近平文化思想的精神气质,坚持守正创新是习近平文化思想的发展路径,坚持问题导向是习近平文化思想的实践原则,坚持系统观念是习近平文化思想的思想方法,坚持胸怀天下是习近平文化思想的境界格局。习近平文化思想是一个开放的和发展的理论体系,必将随着中国式现代化的文化建设不断丰富和完善。

我国先进制造业与生产性服务业融合生态位研究

基于2012-2021年省级面板数据,运用生态位模型测度先进制造业与生产性服务业融合差异与竞争现状。结果表明:先进制造业与生产性服务业融合生态位宽度空间上呈现东高西低分布特征,其中融合基础生态位宽度两极分化极其严重是导致我国生态位宽度呈梯度分布的主要原因。生态位重叠现象普遍,区域间存在激烈竞争,其中地理位置和优势主导产业相近更易形成相同的融合路线,导致重叠度较高。生态位适宜度整体水平偏低,融合子系统生态位适宜度均呈现“东高、中平、西低”特征。

基于臭氧氧化的垃圾渗滤液深度处理工艺优化及中试验证

针对实际垃圾渗滤液深度处理工艺流程优化开展中试实验。深度处理采用混凝沉淀+臭氧氧化+生物活性碳工艺,针对垃圾渗滤液传统工艺过程中的MBR出水、纳滤浓缩液的处理效果和运行成本进行研究。结果表明:以臭氧氧化为基础的深度处理工艺经过参数优化调整后,处理MBR出水时有机物、氨氮和总氮去除率分别为97.3%、71.76%和42.26%,处理纳滤浓缩液时有机物、氨氮和总氮去除率分别达到98.82%、74.41%和22.53%。其中,臭氧氧化对有机物处理能力最强,深度处理后COD浓度可直接满足排放限值,但是氨氮在后续的臭氧氧化环节和生物活性碳吸附环节存在较大波动。长期成本核算分析表明:处理MBR出水的运行成本为约92.10元/吨;处理纳滤浓缩液的运行成本为约166.00元/吨。最后根据中试研究成果实现了以臭氧氧化为基础的纳滤浓缩液处理工艺的工程转化,为该工艺市场应用奠定基础。

桂滇黔地区局部晚期鼻咽癌同期放化疗联合尼妥珠单抗靶向治疗前瞻性临床研究

目的探究同期放化疗联合尼妥珠单抗靶向治疗桂滇黔交界地区局部晚期鼻咽癌患者的临床效果。方法选取2021年7月~2022年7月于右江民族医学院附属医院收治来自桂滇黔交界少数民族地区,经病理确诊的局部晚期鼻咽癌患者80例为本次研究对象,将其随机分为对照组(标准同期放化疗)和观察组(在对照组基础上联合尼妥珠单抗治疗),每组各40例。对比两组患者的肿瘤标志物水平、氧化应激指标、不良反应、并发症及近期临床疗效的变化情况。结果治疗后,两组患者的超氧化物歧化酶(superoxide dismutase,SOD)、细胞角蛋白19片段(cytokeratin 19 fragment antigen21-1,CYFRA21-1)、鳞状细胞癌相关抗原(squamous cell carcinoma associated antigen,SCCAg)、铁蛋白(serum ferritin,SF)水平明显降低,一氧化氮(NO)、丙二醛(MDA)明显升高;且观察组的SCCAg、SF、CYFRA21-1、NO、MDA水平较对照组低,SOD水平较对照组高(P<0.05)。与对照组比,观察组的客观缓解率明显上升(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。两组的并发症发生率比较,差异无统计学意义(P>0.05)。结论使用同期放化疗联合尼妥珠单抗治疗可有效改善桂滇黔交界少数民族地区局部晚期鼻咽癌患者近期生存率及临床疗效,调节肿瘤标志物及氧化应激水平,缓解病情。

晚期恶性肿瘤患者癌因性疲乏现状及其影响因素

目的 了解晚期恶性肿瘤患者抗肿瘤治疗期间癌因性疲乏现状,并分析其影响因素,为临床护理干预提供依据。方法 采用便利抽样法,选取2022年1月至8月在北京市某三级甲等综合医院肿瘤内科住院并接受抗肿瘤治疗的279例晚期恶性肿瘤患者作为研究对象,采用癌症疲乏量表(cancer fatigue scale,CFS)、化疗消化道症状量表(chemotherapy-related gastrointestinal symptoms inventory,CGISI)、营养风险筛查2002量表(nutritional risk screening 2002,NRS2002)进行调查,采用Logistic回归分析患者癌症疲乏得分的影响因素。结果 279例患者均完成研究。204例(73.1%)患者存在癌因性疲乏。Logistic回归分析显示,体质量指数(body mass index,BMI)、文化程度、家庭人均月收入和糖尿病均是癌因性疲乏的影响因素(均P<0.05)。结论 晚期恶性肿瘤患者在抗肿瘤治疗期间癌因性疲乏发生率较高,BMI过低、文化程度低、家庭人均月收入较低及糖尿病为晚期恶性肿瘤患者癌因性疲乏的危险因素,可据此实施针对性干预,降低疲乏发生率。