Perfluorocarbon in vitreoretinal surgery and preoperative bevacizumab in diabetic tractional retinal detachment

AIM: To describe the en bloc perfluorodissection(EBPD) technique and to demonstrate the applicabilityof using preoperative intravitreal bevacizumab duringsmall-gauge vitreoretinal surgery(23-gauge transconjunctival sutureless vitrectomy) in eyes with advancedproliferative diabetic retinopathy(PDR) with tractionalretinal detachment(TRD).METHODS: This is a prospective, interventional caseseries. Participants included 114(eyes) with advancedproliferative diabetic retinopathy and TRD. EBPD wasperformed in 114 eyes(consecutive patients) during23-gauge vitrectomy with the utilization of preoperativebevacizumab(1.25 mg/-0.05 mL). Patients mean age was 45 years(range, 21-85 years). Surgical time had a mean of 55 min(Range, 25-85 min). Mean follow up of this group of patients was 24 mo(range, 12-32 mo). Main outcome measures included best-corrected visual acuity(BCVA), retinal reattachment, and complications.RESULTS: Anatomic success occurred in 100%(114/-114) of eyes. Significant visual improvement [≥ 2 Early Treatment Diabetic Retinopathy Study(ETDRS) lines] was obtained in 69.2%(79/-114), in 26 eyes(22.8%) BCVA remained stable, and in 8 eyes(7%) BCVA decreased(≥ 2 ETDRS lines). Final BCVA was 20/-50 or better in 24% of eyes, between 20/-60 and 20/-400 in 46% of eyes, and worse than 20/-400 in 30% of eyes. Complications included cataract in 32(28%) eyes, iatrogenic retinal breaks in 9(7.8%) eyes, vitreous hemorrhage requiring another procedure in 7(6.1%) eyes, and phthisis bulbi in 1(0.9%) eye.CONCLUSION: This study demonstrates the usefulne-ss of using preoperative intravitreal bevacizumab and EBPD during smallgauge vitreoretinal surgery in eyes with TRD in PDR.

The outcomes of pars plana vitrectomy without endotamponade for tractional retinal detachment secondary to proliferative diabetic retinopathy

AIM:To evaluate the outcomes of pars plana vitrectomy(PPV) without the use of an ocular tamponade in patients having tractional retinal detachment(TRD) secondary to proliferative diabetic retinopathy(PDR).METHODS:It was an interventional study conducted at the Department of Ophthalmology,B.V.Hospital,Bahawalpur,Pakistan,from July 2011 to July 2012.A total of 75 patients(84 eyes) having TRD secondary to PDR were treated by PPV without using an ocular tamponade.All patients included in the study had a tractional retinal detachement secondary to proliferative diabetic retinopathy but didn’t have or develop retinal breaks before or during the study period.The surgical procedure included a PPV combined with the removal of the tractional retinal membranes and the application of endolaser photocoagulation to the retina.The mean follow-up period was 12 months. RESULTS:Successful retinal reattachement was observed in 78 of the operated eyes(92.8%).In these patients,the retina remained attached till the end of the one year follow-up period.Improvement in best corrected visual acuity(BCVA) was seen in 63 eyes(75%).The visual acuity remained unchanged in 9 eyes(10.7%).Mean improvement in BCVA was 2.00 +1.24 at baseline to 1.24+1.22(P【0.05) at the end of the followup period.CONCLUSION:In the absence of the retinal breaks,a TRD secondary to PDR can be successfully treated by pars plana vitrectomy without the use of an ocular tamponade.

Reducing Operation Emissions and Improving Work Efficiency Using a Pure Electric Wheel Drive Tractor

In response to the problems of excessive greenhouse-gas and particulate emissions and the low traction efficiency of conventional diesel tractors in the field,a purely electric wheel-side drive tractor was studied,including an electric motor drive system,a battery ballast system,and an electro–hydraulic suspension system.This paper develops a dynamics model of an electric tractor-ploughing unit under complex soil conditions,leading to the proposal of an active control method for drive wheel torque and a joint control method for the traction force of the suspension system and the front-and rear-axle loads of a tractor.Finally,the tractor is prototyped and assembled,and ploughing tests are carried out.The ploughing results show that the active torque-distribution control method proposed in this study reduces the tractor slip by 14.83%and increases the traction efficiency by 10.28%compared with the average torquedistribution mode.Compared with the conventional traction control mode,the joint control method for traction and ballast proposed in this paper results in a 3.7%increase in traction efficiency,a 15.05%decrease in slip,and a 4.9%reduction in total drive motor energy consumption.This study will help to improve the operation quality and traction efficiency of electric tractors in complex soil conditions.

Traction power systems for electrified railways:evolution,state of the art,and future trends

Traction power systems(TPSs)play a vital role in the operation of electrified railways.The transformation of conventional railway TPSs to novel structures is not only a trend to promote the development of electrified railways toward high-efficiency and resilience but also an inevitable requirement to achieve carbon neutrality target.On the basis of sorting out the power supply structures of conventional AC and DC modes,this paper first reviews the characteristics of the existing TPSs,such as weak power supply flexibility and low-energy efficiency.Furthermore,the power supply structures of various TPSs for future electrified railways are described in detail,which satisfy longer distance,low-carbon,high-efficiency,high-reliability and high-quality power supply requirements.Meanwhile,the application prospects of different traction modes are discussed from both technical and economic aspects.Eventually,this paper introduces the research progress of mixed-system electrified railways and traction power supply technologies without catenary system,speculates on the future development trends and challenges of TPSs and predicts that TPSs will be based on the continuous power supply mode,employing power electronic equipment and intelligent information technology to construct a railway comprehensive energy system with renewable energy.

Research on the longitudinal protection of a through-type cophase traction direct power supply system based on the empirical wavelet transform

This paper proposes a longitudinal protection scheme utilizing empirical wavelet transform(EWT)for a through-type cophase traction direct power supply system,where both sides of a traction network line exhibit a distinctive boundary structure.This approach capitalizes on the boundary’s capacity to attenuate the high-frequency component of fault signals,resulting in a variation in the high-frequency transient energy ratio when faults occur inside or outside the line.During internal line faults,the high-frequency transient energy at the checkpoints located at both ends surpasses that of its neighboring lines.Conversely,for faults external to the line,the energy is lower compared to adjacent lines.EWT is employed to decompose the collected fault current signals,allowing access to the high-frequency transient energy.The longitudinal protection for the traction network line is established based on disparities between both ends of the traction network line and the high-frequency transient energy on either side of the boundary.Moreover,simulation verification through experimental results demonstrates the effectiveness of the proposed protection scheme across various initial fault angles,distances to faults,and fault transition resistances.

Pars plana vitrectomy with internal limiting membrane plugging assisted by autologous blood for optic disc pit associated with vitreomacular traction

Dear Editor,We report a case of optic disc pit(ODP)associated with vitreomacular traction which has been successfully treated by a combined technique.We have obtained the written informed consent from the patient,and this case study is in accordance with the tenets of the Declaration of Helsinki.

A Loss-model-based Efficiency Optimization Control Method for Induction Traction System of High-speed Train under Emergency Self-propelled Mode

Increasing attention has been paid to the efficiency improvement of the induction traction system of high-speed trains due to the high demand for energy saving. In emergency self-propelled mode, however, the dc-link voltage and the traction power of the motor are significantly reduced, resulting in decreased traction efficiency due to the low load and low speed operations. Aiming to tackle this problem, a novel efficiency improved control method is introduced to the emergency mode of high-speed train traction system in this paper. In the proposed method, a total loss model of induction motor considering the behaviors of both iron and copper loss is established. An improved iterative algorithm with decreased computational burden is then introduced, resulting in a fast solving of the optimal flux reference for loss minimization at each control period. In addition, considering the parameter variation problem due to the low load and low speed operations, a parameter estimation method is integrated to improve the controller's robustness. The effectiveness of the proposed method on efficiency improvement at low voltage and low load conditions is demonstrated by simulated and experimental results.

Effect of endoscopic full-thickness resection assisted by distal serosal turnover with floss traction for gastric submucosal masses

BACKGROUND Complex and high-risk surgical complications pose pressing challenges in the clinical implementation and advancement of endoscopic full-thickness resection(EFTR).Successful perforation repair under endoscopy,thereby avoiding surgical intervention and postoperative complications such as peritonitis,are pivotal for effective EFTR.AIM To investigate the effectiveness and safety of EFTR assisted by distal serosal inversion under floss traction in gastric submucosal tumors.METHODS A retrospective analysis of patients with gastric and duodenal submucosal tumors treated with EFTR assisted by the distal serosa inversion under dental floss traction from January 2023 to January 2024 was conducted.The total operation time,tumor dissection time,wound closure time,intraoperative bleeding volume,length of hospital stay and incidence of complications were analyzed.RESULTS There were 93 patients,aged 55.1±12.1 years.Complete tumor resection was achieved in all cases,resulting in a 100% success rate.The average total operation time was 67.4±27.0 min,with tumor dissection taking 43.6±20.4 min.Wound closure times varied,with gastric body closure time of 24.5±14.1 min and gastric fundus closure time of 16.6±8.7 min,showing a significant difference(P<0.05).Intraoperative blood loss was 2.3±4.0 mL,and average length of hospital stay was 5.7±1.9 d.There was no secondary perforation after suturing in all cases.The incidence of delayed bleeding was 2.2%,and the incidence of abdominal infection was 3.2%.No patient required other surgical intervention during and after the operation.CONCLUSION Distal serosal inversion under dental-floss-assisted EFTR significantly reduced wound closure time and intraoperative blood loss,making it a viable approach for gastric submucosal tumors.

Generalized autoencoder-based fault detection method for traction systems with performance degradation

Fault diagnosis of traction systems is important for the safety operation of high-speed trains.Long-term operation of the trains will degrade the performance of systems,which decreases the fault detection accuracy.To solve this problem,this paper proposes a fault detection method developed by a Generalized Autoencoder(GAE)for systems with performance degradation.The advantage of this method is that it can accurately detect faults when the traction system of high-speed trains is affected by performance degradation.Regardless of the probability distribution,it can handle any data,and the GAE has extremely high sensitivity in anomaly detection.Finally,the effectiveness of this method is verified through the Traction Drive Control System(TDCS)platform.At different performance degradation levels,our method’s experimental results are superior to traditional methods.

Laparoscopic Orchidopexy after 4 Weeks of Testicular Traction with Preservation of Blood Supply: A New Concept for the Treatment of Intra-Abdominal Cryptorchidism: Original Article

Background: Testicular atrophy is recurrent after orchidopexy for intra-abdominal cryptorchidism due to damage to vessels. Fowlers-Stephens and Shehata methods proposed staged orchidopexy, but are still associated to a rate of atrophy greater than 10%. Purpose: We set out to present a new technique that preserves testicular vessels. Our study is aimed at investigating testicular vitality after surgery. Patients and Method: We reviewed files of boys who underwent orchidopexy for 2 years in our department. Those who have been operated for intra-abdominal cryptorchidism with the new technique and aged between 6 months and 14 years old were included in our study. We excluded boys who have been operated before 6 months and after 14 years old and those who did not respect their follow-up plane. Ultrasound (US) outcomes were used to measure testicular volumes and blood flow at each postoperative visit. The Sample population was divided into group A and group B representing testes that were followed respectively for 12 and 24 months. Results: 22 boys with 25 testes were included in our study;11 testes in group A and 14 testes in group B. In each group, we noted a significant difference of UDT volumes from the third month after surgery with respective P-values 0.05. There was no statistical difference between UDT and contra lateral testes volumes 12 months after surgery in group A and 24 months in group B with respective P-values of 0.07 and 0.72. All volume differential indexes were Conclusion: This method offers a new perspective in performing safe orchidopexy for intra abdominal undescended testes.

Analysis of the Characteristics of Materials Obtained by Recycling Scrap Metal in Guinea

The aim of this study was to determine the quality of rebar produced from recycled scrap metal collected throughout the country,and imported rebar sold in the Republic of Guinea.To do this,the samples were subjected to various mechanical tests involving traction,bending and microscopic analysis.In the Lambanyi and Casse Sonfonia samples,all the tensile strength values for diameters 12,14 and 16 were above 550 MPa.Conversely,the iron samples from Baillobaye and the 10 mm diameters of the samples from Casse Sonfonio and Lambanyi have less appreciable values.The limits of elasticity were determined.The various values found vary more or less from the conventional yield strength of the NF A35-016 reference supplied by CBITEC,which is 500 MPa.Microscopic analysis gives us an insight into the internal structure of the iron samples used.This study may provide the company and the vendors with an alternative for their improvements.

Which Cities are More Attractive for Business Investment?

A good business environment is the soft power and core competitiveness for urban economic development,and is a key element to attract business investment.Recently,the“Top 50 Cities with Business Investment Attraction”(hereinafter referred to as the Survey)released by the Big Data Research Institute of Qi Chacha shows that the siphonic effect of the first-tier cities is significant,and in the past five years,enterprises in Shanghai,Beijing and Shenzhen have been invested in the most frequently.

Thermomechanical Characterization of Laterite Matrix Reinforced with Typha Material for Thermal Insulation in Building

Every person, in every country and on every continent, will be affected in one way or another by climate change. A climate cataclysm is looming on the horizon due to greenhouse gas emissions. This explains a strong demand for air conditioning in the years to come, hence the need for good thermal insulation at a lower cost. However, a policy of prevention, adaptation, and resilience is necessary for the protection of the environment in the future. This work aims to respond to the United Nations SDGs 7, 11 and 13. This paper presents the results of thermomechanical characterizations of the Typha additive (0%, 5%, 10%, 15%, 20%) in laterite matrices. First, we carried out a thermal characterization using the asymmetric hot plane method, which led to thermal conductivity and effusivity in different proportions. Next, mechanical tests were carried out to determine the traction and compression of each material with a matest press. Those which made it possible to obtain results according to the percentage for the thermal tests: a conductivity varying between 0.7178 W/m·K to 0.0597 W/m·K and an effusivity varying between 942.5392 J/m2·K·s1/2 at 287.0855 J/m2·K·s1/2 and for mechanical tests: traction varying between 0.035 MPa to 0.034 MPa and compression varying between 0.1115 MPa to 0.0805 MPa for the different samples. The exploitation of the results allowed us to study the conductivity, effusivity, traction, and compression as a function of their densities.

Applications

CRRC introduces 10.4 MW freight electric locomotive to domestic service in China CRRC claims this eight-axle electric locomotive to be the world's most powerful permanent magnet direct-drive heavy-duty freight electric locomotive,with a maximum traction power of10,400 kilowatts.

Lasting Attraction

High-level opening up and policies to attract foreign direct investment(FDI)were hot topics during the annual sessions of the National People’s Congress(NPC)and the Chinese People’s Political Consultative Conference(CPPCC)National Committee,China’s key annual political meetings commonly known as Two Sessions.

Device-assisted traction methods in colorectal endoscopic submucosal dissection and options for difficult cases

Endoscopic submucosal dissection(ESD)procedure has a longer procedure time and higher perforation rate than endoscopic mucosal resection owing to technical complications,including a poor field of vision and inadequate tension for the submucosal dissection plane.Various traction devices were developed to secure the visual field and provide adequate tension for the dissection plane.Two randomized controlled trials demonstrated that traction devices reduce colorectal ESD procedure time compared with conventional ESD(C-ESD),but they had limitations,including a single-center fashion.The CONNECT-C trial was the first multicenter randomized controlled trial comparing the C-ESD and traction device-assisted ESD(T-ESD)for colorectal tumors.In the T-ESD,one of the device-assisted traction methods(S-O clip,clip-with-line,and clip pulley)was chosen according to the operator’s discretion.The median ESD procedure time(primary endpoint)was not significantly different between C-ESD and T-ESD.For lesions≥30 mm in diameter or in cases treated by nonexpert operators,the median ESD procedure time tended to be shorter in T-ESD than in C-ESD.Although T-ESD did not reduce ESD procedure time,the CONNECT-C trial results suggest that T-ESD is effective for larger lesions and nonexpert operators in colorectal ESD.Compared with esophageal and gastric ESD,colorectal ESD has some difficulties,including poor endoscope maneuverability,which may be associated with prolonged ESD procedure time.T-ESD may not effectively improve these issues,but a balloon-assisted endoscope and underwater ESD may be promising options and these methods can be combined with T-ESD.

Cooling System Design Optimization of an Enclosed PM Traction Motor for Subway Propulsion Systems

This paper presents the design optimization of a self-circulated ventilation system for an enclosed permanent magnet(PM)traction motor utilized in the propulsion systems for subway trains.In order to analyze accurately the machine's inherent cooling capacity when the train is running,the ambient airflow and the related heat transfer coefficient(HTC)are numerically investigated considering synchronously the bogie installation structure.The machine is preliminary cooled with air ducts set on the motor shell,and the fluidic-thermal field distributions with only the shell air duct cooling are numerically calculated.During simulations,the HTC obtained in the former steps is applied to the external surface of the machine to model the inherent cooling characteristic caused by the train movement.To reduce the temperature rise and thus guarantee the motor's working reliability,an internal self-circulated air cooling system is proposed according to the machine temperature distribution.The air enclosed in the end-caps is driven by the blades mounted on both sides of the rotor core and forms two air circuits to bring the excessive power losses generated in the heating components to cool regions.The fluid flow and temperature rise distributions of the cooling system's structural parameters are further improved by the Taguchi method in order to confirm the efficacy of the internal air cooling system.

Visualized analysis of research on myopic traction maculopathy based on CiteSpace

AIM:To analyze the global scientific output concerning myopic traction maculopathy(MTM)and to summarize the research frontiers and hot topics of MTM related researches.METHODS:Data were collected for bibliometric and visualization analyses from Web of Science(WOS)Core Collection.Exported records were analyzed for titles,publication years,research institutions,journal names,authors,keywords,and abstracts using CiteSpace software version 6.1.RESULTS:A total of 839 related studies were analyzed,the publication volume increased annually,with Asia the most active region of MTM research.Optical coherence tomography angiography,optical coherence tomography,macular hole,high myopia,macular buckling were identified as the focus of the current research.Progression,association,classification and shape were identified as the major research frontiers.CONCLUSION:MTM is a major cause of visual loss in pathological myopic eyes.During the preceding 17y,the number of annual publications in MTM research increased gradually.Studies on the progression nature of MTM,genome-wide association study and proper classification of MTM might still be the frontiers of MTM researches.

Eight-year follow-up on postoperative improvement protocol in extensive metoidioplasty transgenders:A case series

Background:This study aimed to evaluate the long-term penile size among patients who underwent extensive metoidioplasty.Methods:An evaluation was conducted on 7 out of 14 patients(mean age:29.71±13.76 years)who participated in a 2015 study that introduced a postoperative protocol to improve penile size after extensive metoidioplasty.Five transsexual females(46XX karyotype)and two patients with 5-alpha reductase deficiency were retrospectively followed up in 2023 to assess the long-term efficacy of the protocol at a specialized clinic in a general hospital in Tehran,Iran.All participants were informed about the study and consented to participate.Results:Five patients achieved increased penile size from their 2015 measurements(mean,29.00±13.34 mm).Five patients requested a larger sized penile traction device to continue the protocol.Conclusion:The long-term implementation of this protocol can result in increased penile size.We advise highly motivated patients to continue practicing the protocol to achieve better results.

Two traction methods that can facilitate esophageal endoscopic submucosal dissection

Different traction devices that can provide a visual field and attain appropriate tension at the dissection plane during endoscopic submucosal dissection(ESD)have been developed.Clip-with-line(CWL)is a classic traction device that can offer per-oral traction toward the direction where the line is drawn.A multicenter randomized controlled trial(CONNECT-E trial)comparing the conventional ESD and CWL-assisted ESD(CWL-ESD)for large esophageal tumors was conducted in Japan.This study showed that CWL-ESD was associated with a shorter procedure time(defined as the time from initiating submucosal injection to completing tumor removal)without increasing the risk of adverse events.Multivariate analysis revealed that whole-circumferential lesion and abdominal esophageal lesion were independent risk factors for technical difficulties,which were defined as a procedure time of>120 min,perforation,piecemeal resection,inadvertent incision(any accidental incision caused by the electrosurgical knife within the marked area),or handover to another operator.Therefore,techniques other than CWL should be considered for these lesions.Several studies have shown the usefulness of endoscopic submucosal tunnel dissection(ESTD)for such lesions.A randomized controlled trial conducted at five Chinese institutions showed that compared with the conventional ESD,ESTD had a significantly reduced median procedure time for lesions covering≥1/2 of the esophageal circumference.In addition,a propensity score matching analysis conducted at a single Chinese institution showed that compared with the conventional ESD,ESTD had a shorter mean resection time for lesions at the esophagogastric junction.With the appropriate use of CWL-ESD and ESTD,esophageal ESD can be performed more efficiently and safely.Moreover,the combination of these two methods may be effective.