In this article,the experimental and finite element analysis is utilized to investigate the quasi-static compression features of sandwich constructions built with tapered tubes.3D printing technology was utilized to c...In this article,the experimental and finite element analysis is utilized to investigate the quasi-static compression features of sandwich constructions built with tapered tubes.3D printing technology was utilized to create the hollow centers of the tapering tubes,with and without corrugations.The results demonstrate that the energy absorption(EA)and specific energy absorption(SEA)of the single corrugated tapered tube sandwich are 51.6% and 19.8% higher,respectively,than those of the conical tube sandwich.Furthermore,the results demonstrate that energy absorbers can benefit from corrugation in order to increase their efficiency.Additionally,the tapered corrugated tubes'resistance to oblique impacts was studied.Compared to a straight tube,the tapered tube is more resistant to oblique loads and has a lower initial peak crushing force(PCF),according to numerical simulations.After conducting a parametric study,it was discovered that the energy absorption performance of the sandwich construction is significantly affected by the amplitude,number of corrugations,and wall thickness.EA and SEA of DTS with corrugation number of 8 increased by 17.4%and 29.6%,respectively,while PCF decreased by 9.2% compared to DTS with corrugation number of 10.展开更多
Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Hea...Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Health Clinical Center.A total of 115patients underwent ultrasound-guided puncture biopsy,followed by MGIT 960 culture(culture),smear,Gene Xpert MTB/RIF(Xpert),and histopathological examination.These assays were performed to evaluate their effectiveness in diagnosing EPTB in comparison to two different diagnostic criteria:liquid culture and composite reference standard(CRS).Results When CRS was used as the reference standard,the sensitivity and specificity of culture,smear,Xpert,and histopathological examination were(44.83%,89.29%),(51.72%,89.29%),(70.11%,96.43%),and(85.06%,82.14%),respectively.Based on liquid culture tests,the sensitivity and specificity of smear,Xpert,and pathological examination were(66.67%,72.60%),(83.33%,63.01%),and(92.86%,45.21%),respectively.Histopathological examination showed the highest sensitivity but lowest specificity.Further,we found that the combination of Xpert and histopathological examination showed a sensitivity of 90.80%and a specificity of 89.29%.Conclusion Ultrasound-guided puncture sampling is safe and effective for the diagnosis of EPTB.Compared with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower specificity.The combination of histopathology with Xpert showed the best performance characteristics.展开更多
This paper presents the first-ever investigation of Menger fractal cubes'quasi-static compression and impact behaviour.Menger cubes with different void ratios were 3D printed using polylactic acid(PLA)with dimensi...This paper presents the first-ever investigation of Menger fractal cubes'quasi-static compression and impact behaviour.Menger cubes with different void ratios were 3D printed using polylactic acid(PLA)with dimensions of 40 mm×40 mm×40 mm.Three different orders of Menger cubes with different void ratios were considered,namely M1 with a void ratio of 0.26,M2 with a void ratio of 0.45,and M3with a void ratio of 0.60.Quasi-static Compression tests were conducted using a universal testing machine,while the drop hammer was used to observe the behaviour under impact loading.The fracture mechanism,energy efficiency and force-time histories were studied.With the structured nature of the void formation and predictability of the failure modes,the Menger geometry showed some promise compared to other alternatives,such as foams and honeycombs.With the increasing void ratio,the Menger geometries show force-displacement behaviour similar to hyper-elastic materials such as rubber and polymers.The third-order Menger cubes showed the highest energy absorption efficiency compared to the other two geometries in this study.The findings of the present work reveal the possibility of using additively manufactured Menger geometries as an energy-efficient system capable of reducing the transmitting force in applications such as crash barriers.展开更多
The high variability of shock in terrorist attacks poses a threat to people's lives and properties,necessitating the development of more effective protective structures.This study focuses on the angle gradient and...The high variability of shock in terrorist attacks poses a threat to people's lives and properties,necessitating the development of more effective protective structures.This study focuses on the angle gradient and proposes four different configurations of concave hexagonal honeycomb structures.The structures'macroscopic deformation behavior,stress-strain relationship,and energy dissipation characteristics are evaluated through quasi-static compression and Hopkinson pressure bar impact experiments.The study reveals that,under varying strain rates,the structures deform starting from the weak layer and exhibit significant interlayer separation.Additionally,interlayer shear slip becomes more pronounced with increasing strain rate.In terms of quasi-static compression,symmetric gradient structures demonstrate superior energy absorption,particularly the symmetric negative gradient structure(SNG-SMS)with a specific energy absorption of 13.77 J/cm~3.For dynamic impact,unidirectional gradient structures exhibit exceptional energy absorption,particularly the unidirectional positive gradient honeycomb structure(UPG-SML)with outstanding mechanical properties.The angle gradient design plays a crucial role in determining the structure's stability and deformation mode during impact.Fewer interlayer separations result in a more pronounced negative Poisson's ratio effect and enhance the structure's energy absorption capacity.These findings provide a foundation for the rational design and selection of seismic protection structures in different strain rate impact environments.展开更多
Introduction: Even though lumbar puncture (LP) represents an important tool in the diagnosis of certain neurological diseases, this procedure is little practiced by our students. We aimed to evaluate the attitudes and...Introduction: Even though lumbar puncture (LP) represents an important tool in the diagnosis of certain neurological diseases, this procedure is little practiced by our students. We aimed to evaluate the attitudes and practices of students, interns, and residents about LP, and to assess their feelings about how this procedure is taught. Materials and Methods: We conducted a cross-sectional study of 160 participants, using an anonymous questionnaire, to evaluate the attitudes and practices of students, interns and residents in the pediatrics department concerning lumbar puncture. Results: Half of the participants had never performed LP, usually because of the risk involved or lack of confidence, while 20% had performed it more than 4 times. None of the participants had learned to perform the procedure through simulation sessions, while (42%) had learned it under the supervision of a senior physician and had not been able to perform it successfully the first time. Most participants inform the patient about the procedure before performing it. Only 44% of participants acknowledged that LP can be performed under local anesthetic. The sitting position (60%) was by far the most commonly used. Most LPs were performed for diagnostic purposes. Most participants stated that the pediatric ward and the pediatric emergency department are among the departments that perform LP most frequently, and that they would be interested in taking part in simulated lumbar puncture sessions in children in the future. Conclusion: The results of our study show that LP is perceived by students as a risky procedure that is difficult to perform. Teachers should reconsider how this technical procedure is taught, by integrating simulation on mannequins into student training.展开更多
BACKGROUND Ultrasound-guided prostate biopsy is a reliable diagnostic procedure for prostate cancer diagnosis with minimal procedure-related trauma.However,complications,such as massive rectal bleeding may occur after...BACKGROUND Ultrasound-guided prostate biopsy is a reliable diagnostic procedure for prostate cancer diagnosis with minimal procedure-related trauma.However,complications,such as massive rectal bleeding may occur after the puncture.We hypothesized that using a transrectal resectoscope could help treat massive rectal bleeding after transrectal prostate punctures.AIM To identify a simple and effective treatment for massive rectal bleeding after transrectal prostate punctures.METHODS Patients requiring treatment for massive rectal bleeding after transrectal prostate punctures were included.A SIMAI resectoscope was inserted through the anus.Direct electrocoagulation was performed for superficial bleeding points.Part of the rectal mucosa or surface muscle layer was removed to expose deep bleeding points,followed by electrocoagulation.An electric cutting ring was used to compress and stop the bleeding for jet-like points before electrocoagulation.The fluid color in the drainage tube was monitored postoperatively for continuous bleeding.RESULTS Eight patients were included from 2012 to 2022.None of the patients with massive rectal bleeding after the transrectal prostate punctures improved with conventional conservative and blood transfusion treatments.Two patients had an inferior artery embolism,and digital subtraction angiography was ineffective.All patients received emergency transanal prostate resection,which immediately stopped the bleeding.Four days after the procedure,the patients had recovered and were discharged.CONCLUSION Using a transanal prostate resection instrument is a simple,safe,and effective method for treating massive rectal bleeding after transrectal prostate punctures.展开更多
Objective:To evaluate the feasibility and the safety of medial non-papillary percutaneous nephrolithotomy(npPCNL)for the management of large proximal ureteral stones.Methods:We evaluated prospectively collected data o...Objective:To evaluate the feasibility and the safety of medial non-papillary percutaneous nephrolithotomy(npPCNL)for the management of large proximal ureteral stones.Methods:We evaluated prospectively collected data of 37 patients with large proximal ureteral stones more than 1.5 cm in diameter treated by prone npPCNL.Depending on stone size,in-toto stone removal or lithotripsy using the Lithoclast®Trilogy(EMS Medical,Nyon,Switzerland)was performed.Perioperative parameters including operative time(from start of puncture to the skin suturing),stone extraction time(from the first insertion of the nephroscope to the extraction of all stone fragments),and the stone-free rate were evaluated.Results:Twenty-one males and 16 females underwent npPCNL for the management of large upper ureteral calculi.The median age and stone size of treated patients were 58(interquartile range[IQR]:51-69)years and 19.3(IQR:18.0-22.0)mm,respectively.The median operative time and stone extraction time were 25(IQR:21-29)min and 8(IQR:7-10)min,respectively.One case(2.7%)of postoperative bleeding and two cases(5.4%)of prolonged fever were managed conservatively.The stone-free rate at a 1-month follow-up was 94.6%.Conclusion:The npPCNL provides a straight route to the ureteropelvic junction and proximal ureter.Approaching from a dilated portion of the ureter under low irrigation pressure with larger diameter instruments results in effective and safe stone extraction within a few minutes.展开更多
Designing a rock reinforcement element requires knowledge of:geomechanical behaviour,interaction of the reinforcement element with rock mass and the element’s mechanistic response in static and dynamic environments.U...Designing a rock reinforcement element requires knowledge of:geomechanical behaviour,interaction of the reinforcement element with rock mass and the element’s mechanistic response in static and dynamic environments.Using this knowledge the JTech bolt was developed and subjected to a thorough program to test,gather data and validate the bolt performance in varying domains.By conducting FE(finite element)modeling,the simulation reviews the JTech bolt design evaluating the effects of threadbar geometric variation,threadbar and nut engagement results under high stress,coating friction response and effects of thread tolerance extremes on the failure mode.These results determine safety factors,tolerances and quality management criteria.Once manufactured,in-situ system testing,laboratory and underground short encapsulation testing,resin mixing testing,double shear testing and dynamic testing at varying velocity and mass,determine the system’s capacity and effectiveness in static,quasi-static and dynamic mining environments.In this paper,the process and results are described.展开更多
BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to impr...BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.展开更多
Objective: To clarify the role of the “Three Threes” method in clinical teaching of internal jugular vein puncture and explore improvements in teaching methods. Methods: A doctor was assigned to the induction room o...Objective: To clarify the role of the “Three Threes” method in clinical teaching of internal jugular vein puncture and explore improvements in teaching methods. Methods: A doctor was assigned to the induction room of the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital) for two months. The time required for catheterization, the first puncture success rate, and occurrence of puncture-related complications were compared before and after learning the “Three Threes” method. Results: Using the “Three Threes” method reduced the catheterization time by 43%, increased the first puncture success rate by 17%, and led to fewer puncture-related complications. Conclusion: The application of the “Three Threes” method not only improves the success rate of internal jugular vein puncture but also reduces complications, making it easier for students to master the technique.展开更多
Dear Editor,High-flow priapism is a persistent erection,usually caused by blunt perineal trauma,resulting in pathologically increased arterial inflow to the corpora cavernosa[1].The therapeutic strategy of high-flow p...Dear Editor,High-flow priapism is a persistent erection,usually caused by blunt perineal trauma,resulting in pathologically increased arterial inflow to the corpora cavernosa[1].The therapeutic strategy of high-flow priapism,although codified,leaves room for a wide choice of techniques,ranging from conservative management,selective arterial embolization to surgical management[2].The aim of this letter was to report an alternative approach of percutaneous embolization by direct puncture for the treatment of high-flow priapism.展开更多
BACKGROUND The coaxial radiography-guided puncture technique(CR-PT)is a novel technique for endoscopic lumbar discectomy.As the X-ray beam and the puncturing needle are maintained in a parallel and coaxial direction,t...BACKGROUND The coaxial radiography-guided puncture technique(CR-PT)is a novel technique for endoscopic lumbar discectomy.As the X-ray beam and the puncturing needle are maintained in a parallel and coaxial direction,the X-ray beam can be used to guide the trajectory angle,facilitating the choice of the puncture site and providing real-time guidance.This puncture technique offers numerous advantages over the conventional anterior-posterior and lateral radiography-guided puncture technique(AP-PT),especially in cases of herniated lumbar discs with a hypertrophied transverse process or articular process,high iliac crest,and narrowed intervertebral foramen.AIM To confirm whether CR-PT is a superior approach to percutaneous transforaminal endoscopic lumbar discectomy compared to AP-PT.METHODS In this parallel,controlled,randomized clinical trial,herniated lumbar disc patients appointed to receive percutaneous endoscopic lumbar discectomy treatment were recruited from the Pain Management Department of the Affiliated Hospital of Xuzhou Medical University and Nantong Hospital of Traditional Chinese Medicine.Sixty-five participants were enrolled and divided into either a CR-PT group or an AP-PT group.The CR-PT group underwent CR-PT,and the AP-PT group underwent AP-PT.The number of fluoroscopies during puncturing,puncture duration(min),surgery duration(min),VAS score during puncturing,and puncture success rate were recorded.RESULTS Sixty-five participants were included,with 31 participants in the CR-PT group and 34 in the AP-PT group.One participant in the AP-PT group dropped out due to unsuccessful puncturing.The number of fluoroscopies[median(P25,P75)]was 12(11,14)in the CR-PT group vs 16(12,23)in the AP-PT group,while the puncture duration(mean±SD)was 20.42±5.78 vs 25.06±5.46,respectively.The VAS score was 3(2,4)in the CR-PT group vs 3(3,4)in the AP-PT group.Further subgroup analysis was performed,considering only the participants with L5/S1 segment herniation:9 patients underwent CR-PT,and 9 underwent AP-PT.The number of fluoroscopies was 11.56±0.88 vs 25.22±5.33;the puncture duration was 13.89±1.45 vs 28.89±3.76;the surgery duration was 105(99.5,120)vs 149(125,157.5);and the VAS score was 2.11±0.93 vs 3.89±0.6,respectively.All the above outcomes demonstrated statistical significance(P<0.05),favoring the CR-PT treatment.CONCLUSION CR-PT is a novel and effective technique.As opposed to conventional AP-PT,this technique significantly improves puncture accuracy,shortens puncture time and operation time,and reduces pain intensity during puncturing.展开更多
BACKGROUND Meningitis remains a significant source of mortality and morbidity,with an incidence of 1 per 100000 persons in the United States.Guidelines recommend obtaining blood cultures and cerebrospinal fluid(CSF)st...BACKGROUND Meningitis remains a significant source of mortality and morbidity,with an incidence of 1 per 100000 persons in the United States.Guidelines recommend obtaining blood cultures and cerebrospinal fluid(CSF)studies in patients presenting with acute meningitis syndrome,and beginning treatment with broad spectrum antibiotics based on the age and certain predisposing conditions.In some patients however,the diagnostic lumbar puncture(LP)is not performed due to a multitude of reasons,ranging from increased intracranial pressure to failed attempt.In such situations,appropriate therapy is initiated empirically and often continued without establishment of a definitive diagnosis.AIM To determine whether a diagnostic LP in acute meningitis syndrome was associated with a better outcome and less duration of antibiotic therapy,along with potential causes for deferral of procedure.METHODS A retrospective study was conducted amongst the patients presenting to a 360 bedded community hospital in central Massachusetts with a diagnosis of acute meningitis syndrome between January 2010-September 2022.The electronic health records were accessed to collect necessary demographic and clinical data,including etiology of meningitis,lumbar puncture results,reason for procedure deferral,duration of antibiotic therapy and clinical outcome.The patients were subsequently divided into two groups based on whether they received a LP or not,and data was analyzed.RESULTS A total of 169 patients admitted with acute meningitis syndrome between September 2010-2022 were included in the study.The mean age of the participants was 54.3 years(SD+/-19.2 years).LP was performed for 130(76.9%)participants,out of which,28(21.5%)showed some growth in CSF culture.The most commonly identified organism was streptococcus pneumoniae.Amongst the 39 patients in whom LP was deferred,the major reasons recorded were:Body habitus(n=6,15.4%),and unsuccessful attempt(n=4,10.3%).While 93(71.5%)patients with LP received antibiotic therapy,only 19(48.7%)patients without LP received the antibiotics,with the principal reason being spontaneous improvement in sensorium without any diagnosed source of infection.The mean duration of antibiotic use was 12.3 days(SD+/-5.6)in the LP group and 11.5 days(SD+/-7.0)in the non-LP group(P=0.56;statistically not significant).We observed higher long term sequalae in the non-LP group(n=6,15.4%)compared to the LP group(n=9,6.9%).Similarly,the death rate was higher in the non-LP group(n=7,18.0%)compared to the LP group(n=9,6.9%).CONCLUSION LP remains the cornerstone for diagnosing meningitis,but often CSF results are unavailable,leading to empiric treatment.Our study identified that body habitus and unsuccessful attempts were the most common reasons for LP not being performed,leading to empiric antibiotic coverage.There was no difference between the duration of antibiotics received by the two groups,but a lower proportion of patients without LP received antibiotics,attributed to a spontaneous improvement in sensorium.However,the residual neurological sequelae and death rates were higher in patients without LP,signifying a potential under-treatment.A LP remains crucial to diagnose meningitis,and a lack of CSF analysis predisposes to under-treatment,leading to higher neurological sequelae and increased chances of death.展开更多
Puncturing has been recognized as a promising technology to cope with the coexistence problem of enhanced mobile broadband(eMBB) and ultra-reliable low latency communications(URLLC)traffic. However, the steady perform...Puncturing has been recognized as a promising technology to cope with the coexistence problem of enhanced mobile broadband(eMBB) and ultra-reliable low latency communications(URLLC)traffic. However, the steady performance of eMBB traffic while meeting the requirements of URLLC traffic with puncturing is a major challenge in some realistic scenarios. In this paper, we pay attention to the timely and energy-efficient processing for eMBB traffic in the industrial Internet of Things(IIoT), where mobile edge computing(MEC) is employed for data processing. Specifically, the performance of eMBB traffic and URLLC traffic in a MEC-based IIoT system is ensured by setting the threshold of tolerable delay and outage probability, respectively. Furthermore,considering the limited energy supply, an energy minimization problem of eMBB device is formulated under the above constraints, by jointly optimizing the resource blocks(RBs) punctured by URLLC traffic, data offloading and transmit power of eMBB device. With Markov's inequality, the problem is reformulated by transforming the probabilistic outage constraint into a deterministic constraint. Meanwhile, an iterative energy minimization algorithm(IEMA) is proposed.Simulation results demonstrate that our algorithm has a significant reduction in the energy consumption for eMBB device and achieves a better overall effect compared to several benchmarks.展开更多
To study the seismic performance of double-skin steelconcrete composite box( DSCB) piers, a total of 11 DSCB pier specimens were tested under bidirectional cyclic loading. The effects of the loading pattern, the ste...To study the seismic performance of double-skin steelconcrete composite box( DSCB) piers, a total of 11 DSCB pier specimens were tested under bidirectional cyclic loading. The effects of the loading pattern, the steel plate thickness, the axial load ratio, the slenderness ratio and the aspect ratio were taken into consideration. The damage evolution process and failure modes of the tested specimens are presented in detail. Test results are also discussed in terms of the hysteretic curve, skeleton curve, ductility and energy dissipation capacity of DSCB pier specimens. It can be concluded that the hysteretic performance of DSCB piers in one direction is affected and weakened by the cyclic loading in the other direction. DSCB piers under bidirectional cyclic loading exhibit good performance in terms of load carrying capacity, ductility, and energy dissipation capacity. Overall, DSCB piers can meet the basic aseismic requirements. The research results can be taken as a reference for using DSCB piers as high piers in bridges in strong earthquakeprone areas.展开更多
The quasi-static and dynamic tensile behaviors in electron beam welded(EBW) Ti-6Al-4V alloy were investigated at strain rates of 10-3 and 103 s-1,respectively,by materials test system(MTS) and reconstructive Hopki...The quasi-static and dynamic tensile behaviors in electron beam welded(EBW) Ti-6Al-4V alloy were investigated at strain rates of 10-3 and 103 s-1,respectively,by materials test system(MTS) and reconstructive Hopkinson bars apparatus.The microstructures of the base metal(BM) and the welded metal(WM) were observed with optical microscope.The fracture characteristics of the BM and WM were characterized with scanning electronic microscope.In Ti-6Al-4V alloy joint,the flow stress of WM is higher than that of BM,while the fracture strain of WM is less than that of BM at strain rates of 103 and 10-3 s-1,respectively.The fracture strain of WM has apparent improvement when the strain rate rises from 10-3 to 103 s-1,while the fracture strain of BM almost has no change.At the same time,the fracture mode of WM alters from brittle to ductile fracture,which causes improvement of the fracture strain of WM.展开更多
A mechanical model of the quasi-static interface of a mode I crack between a rigid and a pressure-sensitive viscoelastic material was established to investigate the mechanical characteristic of ship-building engineeri...A mechanical model of the quasi-static interface of a mode I crack between a rigid and a pressure-sensitive viscoelastic material was established to investigate the mechanical characteristic of ship-building engineering hi-materials. In the stable growth stage, stress and strain have the same singularity, ie (σ, ε) ∝ r^-1/(n-1). The variable-separable asymptotic solutions of stress and strain at the crack tip were obtained by adopting Airy's stress function and the numerical results of stress and strain in the crack-tip field were obtained by the shooting method. The results showed that the near-tip fields are mainly governed by the power-hardening exponent n and the Poisson ratio v of the pressure-sensitive material. The fracture criterion of mode I quasi-static crack growth in pressure-sensitive materials, according to the asymptotic analyses of the crack-tip field, can be viewed from the perspective of strain.展开更多
基金the grants from the National Natural Science Foundation of China(Nos.52078152 and 12002095)Guangzhou Government-University Union Fund(No.202201020532)。
文摘In this article,the experimental and finite element analysis is utilized to investigate the quasi-static compression features of sandwich constructions built with tapered tubes.3D printing technology was utilized to create the hollow centers of the tapering tubes,with and without corrugations.The results demonstrate that the energy absorption(EA)and specific energy absorption(SEA)of the single corrugated tapered tube sandwich are 51.6% and 19.8% higher,respectively,than those of the conical tube sandwich.Furthermore,the results demonstrate that energy absorbers can benefit from corrugation in order to increase their efficiency.Additionally,the tapered corrugated tubes'resistance to oblique impacts was studied.Compared to a straight tube,the tapered tube is more resistant to oblique loads and has a lower initial peak crushing force(PCF),according to numerical simulations.After conducting a parametric study,it was discovered that the energy absorption performance of the sandwich construction is significantly affected by the amplitude,number of corrugations,and wall thickness.EA and SEA of DTS with corrugation number of 8 increased by 17.4%and 29.6%,respectively,while PCF decreased by 9.2% compared to DTS with corrugation number of 10.
基金funded by the grants from the National Key Research and Development Program of China[2021YFC2301503,2022YFC2302900]the National Natural and Science Foundation of China[82171739,82171815,81873884]。
文摘Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Health Clinical Center.A total of 115patients underwent ultrasound-guided puncture biopsy,followed by MGIT 960 culture(culture),smear,Gene Xpert MTB/RIF(Xpert),and histopathological examination.These assays were performed to evaluate their effectiveness in diagnosing EPTB in comparison to two different diagnostic criteria:liquid culture and composite reference standard(CRS).Results When CRS was used as the reference standard,the sensitivity and specificity of culture,smear,Xpert,and histopathological examination were(44.83%,89.29%),(51.72%,89.29%),(70.11%,96.43%),and(85.06%,82.14%),respectively.Based on liquid culture tests,the sensitivity and specificity of smear,Xpert,and pathological examination were(66.67%,72.60%),(83.33%,63.01%),and(92.86%,45.21%),respectively.Histopathological examination showed the highest sensitivity but lowest specificity.Further,we found that the combination of Xpert and histopathological examination showed a sensitivity of 90.80%and a specificity of 89.29%.Conclusion Ultrasound-guided puncture sampling is safe and effective for the diagnosis of EPTB.Compared with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower specificity.The combination of histopathology with Xpert showed the best performance characteristics.
文摘This paper presents the first-ever investigation of Menger fractal cubes'quasi-static compression and impact behaviour.Menger cubes with different void ratios were 3D printed using polylactic acid(PLA)with dimensions of 40 mm×40 mm×40 mm.Three different orders of Menger cubes with different void ratios were considered,namely M1 with a void ratio of 0.26,M2 with a void ratio of 0.45,and M3with a void ratio of 0.60.Quasi-static Compression tests were conducted using a universal testing machine,while the drop hammer was used to observe the behaviour under impact loading.The fracture mechanism,energy efficiency and force-time histories were studied.With the structured nature of the void formation and predictability of the failure modes,the Menger geometry showed some promise compared to other alternatives,such as foams and honeycombs.With the increasing void ratio,the Menger geometries show force-displacement behaviour similar to hyper-elastic materials such as rubber and polymers.The third-order Menger cubes showed the highest energy absorption efficiency compared to the other two geometries in this study.The findings of the present work reveal the possibility of using additively manufactured Menger geometries as an energy-efficient system capable of reducing the transmitting force in applications such as crash barriers.
基金financially supported by National Natural Science Foundation of China,China (Grant No.52022012)National Key R&D Program for Young Scientists of China,China (Grant No.2022YFC3080900)。
文摘The high variability of shock in terrorist attacks poses a threat to people's lives and properties,necessitating the development of more effective protective structures.This study focuses on the angle gradient and proposes four different configurations of concave hexagonal honeycomb structures.The structures'macroscopic deformation behavior,stress-strain relationship,and energy dissipation characteristics are evaluated through quasi-static compression and Hopkinson pressure bar impact experiments.The study reveals that,under varying strain rates,the structures deform starting from the weak layer and exhibit significant interlayer separation.Additionally,interlayer shear slip becomes more pronounced with increasing strain rate.In terms of quasi-static compression,symmetric gradient structures demonstrate superior energy absorption,particularly the symmetric negative gradient structure(SNG-SMS)with a specific energy absorption of 13.77 J/cm~3.For dynamic impact,unidirectional gradient structures exhibit exceptional energy absorption,particularly the unidirectional positive gradient honeycomb structure(UPG-SML)with outstanding mechanical properties.The angle gradient design plays a crucial role in determining the structure's stability and deformation mode during impact.Fewer interlayer separations result in a more pronounced negative Poisson's ratio effect and enhance the structure's energy absorption capacity.These findings provide a foundation for the rational design and selection of seismic protection structures in different strain rate impact environments.
文摘Introduction: Even though lumbar puncture (LP) represents an important tool in the diagnosis of certain neurological diseases, this procedure is little practiced by our students. We aimed to evaluate the attitudes and practices of students, interns, and residents about LP, and to assess their feelings about how this procedure is taught. Materials and Methods: We conducted a cross-sectional study of 160 participants, using an anonymous questionnaire, to evaluate the attitudes and practices of students, interns and residents in the pediatrics department concerning lumbar puncture. Results: Half of the participants had never performed LP, usually because of the risk involved or lack of confidence, while 20% had performed it more than 4 times. None of the participants had learned to perform the procedure through simulation sessions, while (42%) had learned it under the supervision of a senior physician and had not been able to perform it successfully the first time. Most participants inform the patient about the procedure before performing it. Only 44% of participants acknowledged that LP can be performed under local anesthetic. The sitting position (60%) was by far the most commonly used. Most LPs were performed for diagnostic purposes. Most participants stated that the pediatric ward and the pediatric emergency department are among the departments that perform LP most frequently, and that they would be interested in taking part in simulated lumbar puncture sessions in children in the future. Conclusion: The results of our study show that LP is perceived by students as a risky procedure that is difficult to perform. Teachers should reconsider how this technical procedure is taught, by integrating simulation on mannequins into student training.
基金Supported by President Fund Innovation Team Project of Hexi University,No.CXTD2022012Gansu Province Education Technology Innovation Project,No.2023B-163.
文摘BACKGROUND Ultrasound-guided prostate biopsy is a reliable diagnostic procedure for prostate cancer diagnosis with minimal procedure-related trauma.However,complications,such as massive rectal bleeding may occur after the puncture.We hypothesized that using a transrectal resectoscope could help treat massive rectal bleeding after transrectal prostate punctures.AIM To identify a simple and effective treatment for massive rectal bleeding after transrectal prostate punctures.METHODS Patients requiring treatment for massive rectal bleeding after transrectal prostate punctures were included.A SIMAI resectoscope was inserted through the anus.Direct electrocoagulation was performed for superficial bleeding points.Part of the rectal mucosa or surface muscle layer was removed to expose deep bleeding points,followed by electrocoagulation.An electric cutting ring was used to compress and stop the bleeding for jet-like points before electrocoagulation.The fluid color in the drainage tube was monitored postoperatively for continuous bleeding.RESULTS Eight patients were included from 2012 to 2022.None of the patients with massive rectal bleeding after the transrectal prostate punctures improved with conventional conservative and blood transfusion treatments.Two patients had an inferior artery embolism,and digital subtraction angiography was ineffective.All patients received emergency transanal prostate resection,which immediately stopped the bleeding.Four days after the procedure,the patients had recovered and were discharged.CONCLUSION Using a transanal prostate resection instrument is a simple,safe,and effective method for treating massive rectal bleeding after transrectal prostate punctures.
文摘Objective:To evaluate the feasibility and the safety of medial non-papillary percutaneous nephrolithotomy(npPCNL)for the management of large proximal ureteral stones.Methods:We evaluated prospectively collected data of 37 patients with large proximal ureteral stones more than 1.5 cm in diameter treated by prone npPCNL.Depending on stone size,in-toto stone removal or lithotripsy using the Lithoclast®Trilogy(EMS Medical,Nyon,Switzerland)was performed.Perioperative parameters including operative time(from start of puncture to the skin suturing),stone extraction time(from the first insertion of the nephroscope to the extraction of all stone fragments),and the stone-free rate were evaluated.Results:Twenty-one males and 16 females underwent npPCNL for the management of large upper ureteral calculi.The median age and stone size of treated patients were 58(interquartile range[IQR]:51-69)years and 19.3(IQR:18.0-22.0)mm,respectively.The median operative time and stone extraction time were 25(IQR:21-29)min and 8(IQR:7-10)min,respectively.One case(2.7%)of postoperative bleeding and two cases(5.4%)of prolonged fever were managed conservatively.The stone-free rate at a 1-month follow-up was 94.6%.Conclusion:The npPCNL provides a straight route to the ureteropelvic junction and proximal ureter.Approaching from a dilated portion of the ureter under low irrigation pressure with larger diameter instruments results in effective and safe stone extraction within a few minutes.
文摘Designing a rock reinforcement element requires knowledge of:geomechanical behaviour,interaction of the reinforcement element with rock mass and the element’s mechanistic response in static and dynamic environments.Using this knowledge the JTech bolt was developed and subjected to a thorough program to test,gather data and validate the bolt performance in varying domains.By conducting FE(finite element)modeling,the simulation reviews the JTech bolt design evaluating the effects of threadbar geometric variation,threadbar and nut engagement results under high stress,coating friction response and effects of thread tolerance extremes on the failure mode.These results determine safety factors,tolerances and quality management criteria.Once manufactured,in-situ system testing,laboratory and underground short encapsulation testing,resin mixing testing,double shear testing and dynamic testing at varying velocity and mass,determine the system’s capacity and effectiveness in static,quasi-static and dynamic mining environments.In this paper,the process and results are described.
基金Supported by 2022 Fujian Medical University Qihang Fund General Project Plan,No.2022QH1120。
文摘BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.
文摘Objective: To clarify the role of the “Three Threes” method in clinical teaching of internal jugular vein puncture and explore improvements in teaching methods. Methods: A doctor was assigned to the induction room of the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital) for two months. The time required for catheterization, the first puncture success rate, and occurrence of puncture-related complications were compared before and after learning the “Three Threes” method. Results: Using the “Three Threes” method reduced the catheterization time by 43%, increased the first puncture success rate by 17%, and led to fewer puncture-related complications. Conclusion: The application of the “Three Threes” method not only improves the success rate of internal jugular vein puncture but also reduces complications, making it easier for students to master the technique.
文摘Dear Editor,High-flow priapism is a persistent erection,usually caused by blunt perineal trauma,resulting in pathologically increased arterial inflow to the corpora cavernosa[1].The therapeutic strategy of high-flow priapism,although codified,leaves room for a wide choice of techniques,ranging from conservative management,selective arterial embolization to surgical management[2].The aim of this letter was to report an alternative approach of percutaneous embolization by direct puncture for the treatment of high-flow priapism.
文摘BACKGROUND The coaxial radiography-guided puncture technique(CR-PT)is a novel technique for endoscopic lumbar discectomy.As the X-ray beam and the puncturing needle are maintained in a parallel and coaxial direction,the X-ray beam can be used to guide the trajectory angle,facilitating the choice of the puncture site and providing real-time guidance.This puncture technique offers numerous advantages over the conventional anterior-posterior and lateral radiography-guided puncture technique(AP-PT),especially in cases of herniated lumbar discs with a hypertrophied transverse process or articular process,high iliac crest,and narrowed intervertebral foramen.AIM To confirm whether CR-PT is a superior approach to percutaneous transforaminal endoscopic lumbar discectomy compared to AP-PT.METHODS In this parallel,controlled,randomized clinical trial,herniated lumbar disc patients appointed to receive percutaneous endoscopic lumbar discectomy treatment were recruited from the Pain Management Department of the Affiliated Hospital of Xuzhou Medical University and Nantong Hospital of Traditional Chinese Medicine.Sixty-five participants were enrolled and divided into either a CR-PT group or an AP-PT group.The CR-PT group underwent CR-PT,and the AP-PT group underwent AP-PT.The number of fluoroscopies during puncturing,puncture duration(min),surgery duration(min),VAS score during puncturing,and puncture success rate were recorded.RESULTS Sixty-five participants were included,with 31 participants in the CR-PT group and 34 in the AP-PT group.One participant in the AP-PT group dropped out due to unsuccessful puncturing.The number of fluoroscopies[median(P25,P75)]was 12(11,14)in the CR-PT group vs 16(12,23)in the AP-PT group,while the puncture duration(mean±SD)was 20.42±5.78 vs 25.06±5.46,respectively.The VAS score was 3(2,4)in the CR-PT group vs 3(3,4)in the AP-PT group.Further subgroup analysis was performed,considering only the participants with L5/S1 segment herniation:9 patients underwent CR-PT,and 9 underwent AP-PT.The number of fluoroscopies was 11.56±0.88 vs 25.22±5.33;the puncture duration was 13.89±1.45 vs 28.89±3.76;the surgery duration was 105(99.5,120)vs 149(125,157.5);and the VAS score was 2.11±0.93 vs 3.89±0.6,respectively.All the above outcomes demonstrated statistical significance(P<0.05),favoring the CR-PT treatment.CONCLUSION CR-PT is a novel and effective technique.As opposed to conventional AP-PT,this technique significantly improves puncture accuracy,shortens puncture time and operation time,and reduces pain intensity during puncturing.
文摘BACKGROUND Meningitis remains a significant source of mortality and morbidity,with an incidence of 1 per 100000 persons in the United States.Guidelines recommend obtaining blood cultures and cerebrospinal fluid(CSF)studies in patients presenting with acute meningitis syndrome,and beginning treatment with broad spectrum antibiotics based on the age and certain predisposing conditions.In some patients however,the diagnostic lumbar puncture(LP)is not performed due to a multitude of reasons,ranging from increased intracranial pressure to failed attempt.In such situations,appropriate therapy is initiated empirically and often continued without establishment of a definitive diagnosis.AIM To determine whether a diagnostic LP in acute meningitis syndrome was associated with a better outcome and less duration of antibiotic therapy,along with potential causes for deferral of procedure.METHODS A retrospective study was conducted amongst the patients presenting to a 360 bedded community hospital in central Massachusetts with a diagnosis of acute meningitis syndrome between January 2010-September 2022.The electronic health records were accessed to collect necessary demographic and clinical data,including etiology of meningitis,lumbar puncture results,reason for procedure deferral,duration of antibiotic therapy and clinical outcome.The patients were subsequently divided into two groups based on whether they received a LP or not,and data was analyzed.RESULTS A total of 169 patients admitted with acute meningitis syndrome between September 2010-2022 were included in the study.The mean age of the participants was 54.3 years(SD+/-19.2 years).LP was performed for 130(76.9%)participants,out of which,28(21.5%)showed some growth in CSF culture.The most commonly identified organism was streptococcus pneumoniae.Amongst the 39 patients in whom LP was deferred,the major reasons recorded were:Body habitus(n=6,15.4%),and unsuccessful attempt(n=4,10.3%).While 93(71.5%)patients with LP received antibiotic therapy,only 19(48.7%)patients without LP received the antibiotics,with the principal reason being spontaneous improvement in sensorium without any diagnosed source of infection.The mean duration of antibiotic use was 12.3 days(SD+/-5.6)in the LP group and 11.5 days(SD+/-7.0)in the non-LP group(P=0.56;statistically not significant).We observed higher long term sequalae in the non-LP group(n=6,15.4%)compared to the LP group(n=9,6.9%).Similarly,the death rate was higher in the non-LP group(n=7,18.0%)compared to the LP group(n=9,6.9%).CONCLUSION LP remains the cornerstone for diagnosing meningitis,but often CSF results are unavailable,leading to empiric treatment.Our study identified that body habitus and unsuccessful attempts were the most common reasons for LP not being performed,leading to empiric antibiotic coverage.There was no difference between the duration of antibiotics received by the two groups,but a lower proportion of patients without LP received antibiotics,attributed to a spontaneous improvement in sensorium.However,the residual neurological sequelae and death rates were higher in patients without LP,signifying a potential under-treatment.A LP remains crucial to diagnose meningitis,and a lack of CSF analysis predisposes to under-treatment,leading to higher neurological sequelae and increased chances of death.
基金supported by the Natural Science Foundation of China (No.62171051)。
文摘Puncturing has been recognized as a promising technology to cope with the coexistence problem of enhanced mobile broadband(eMBB) and ultra-reliable low latency communications(URLLC)traffic. However, the steady performance of eMBB traffic while meeting the requirements of URLLC traffic with puncturing is a major challenge in some realistic scenarios. In this paper, we pay attention to the timely and energy-efficient processing for eMBB traffic in the industrial Internet of Things(IIoT), where mobile edge computing(MEC) is employed for data processing. Specifically, the performance of eMBB traffic and URLLC traffic in a MEC-based IIoT system is ensured by setting the threshold of tolerable delay and outage probability, respectively. Furthermore,considering the limited energy supply, an energy minimization problem of eMBB device is formulated under the above constraints, by jointly optimizing the resource blocks(RBs) punctured by URLLC traffic, data offloading and transmit power of eMBB device. With Markov's inequality, the problem is reformulated by transforming the probabilistic outage constraint into a deterministic constraint. Meanwhile, an iterative energy minimization algorithm(IEMA) is proposed.Simulation results demonstrate that our algorithm has a significant reduction in the energy consumption for eMBB device and achieves a better overall effect compared to several benchmarks.
基金The National Natural Science Foundation of China(No.5117810151378112)the Doctoral Fund of Ministry of Education(No.20110092110011)
文摘To study the seismic performance of double-skin steelconcrete composite box( DSCB) piers, a total of 11 DSCB pier specimens were tested under bidirectional cyclic loading. The effects of the loading pattern, the steel plate thickness, the axial load ratio, the slenderness ratio and the aspect ratio were taken into consideration. The damage evolution process and failure modes of the tested specimens are presented in detail. Test results are also discussed in terms of the hysteretic curve, skeleton curve, ductility and energy dissipation capacity of DSCB pier specimens. It can be concluded that the hysteretic performance of DSCB piers in one direction is affected and weakened by the cyclic loading in the other direction. DSCB piers under bidirectional cyclic loading exhibit good performance in terms of load carrying capacity, ductility, and energy dissipation capacity. Overall, DSCB piers can meet the basic aseismic requirements. The research results can be taken as a reference for using DSCB piers as high piers in bridges in strong earthquakeprone areas.
文摘The quasi-static and dynamic tensile behaviors in electron beam welded(EBW) Ti-6Al-4V alloy were investigated at strain rates of 10-3 and 103 s-1,respectively,by materials test system(MTS) and reconstructive Hopkinson bars apparatus.The microstructures of the base metal(BM) and the welded metal(WM) were observed with optical microscope.The fracture characteristics of the BM and WM were characterized with scanning electronic microscope.In Ti-6Al-4V alloy joint,the flow stress of WM is higher than that of BM,while the fracture strain of WM is less than that of BM at strain rates of 103 and 10-3 s-1,respectively.The fracture strain of WM has apparent improvement when the strain rate rises from 10-3 to 103 s-1,while the fracture strain of BM almost has no change.At the same time,the fracture mode of WM alters from brittle to ductile fracture,which causes improvement of the fracture strain of WM.
基金Supported by Heilongjiang Province Foundation under Grant No.LC08C02
文摘A mechanical model of the quasi-static interface of a mode I crack between a rigid and a pressure-sensitive viscoelastic material was established to investigate the mechanical characteristic of ship-building engineering hi-materials. In the stable growth stage, stress and strain have the same singularity, ie (σ, ε) ∝ r^-1/(n-1). The variable-separable asymptotic solutions of stress and strain at the crack tip were obtained by adopting Airy's stress function and the numerical results of stress and strain in the crack-tip field were obtained by the shooting method. The results showed that the near-tip fields are mainly governed by the power-hardening exponent n and the Poisson ratio v of the pressure-sensitive material. The fracture criterion of mode I quasi-static crack growth in pressure-sensitive materials, according to the asymptotic analyses of the crack-tip field, can be viewed from the perspective of strain.