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.

基于PLCSIM Advanced和Simulink的自动化生产线仿真实训平台设计

为解决自动化生产线实训线下课程实验硬件套数不足、实验时长和场地受限等问题,提升教学质量,设计了一种基于PLCSIM Advanced和Simulink的自动化生产线仿真实训平台。该仿真平台以实训设备为依托,使用Simulink搭建被控对象仿真模型,在PLCSIM Advanced仿真控制器中编写控制算法,通过应用程序接口(application programming interface,API)通信实现对象模型与控制器间数据的实时交换和仿真。以纸张张力控制设备为例,介绍了仿真实训平台搭建和实施过程。实践教学表明,该仿真平台提高了自动化生产线实训课程的教学成效,激发了学生实践学习的兴趣,提升了学生发现、解决复杂工程问题的能力,让学生深刻体会到团队合作和有效沟通的重要性。

Present situation and prospect of immunotherapy for unresectable locally advanced esophageal cancer during peri-radiotherapy

Four major studies(Checkmate577,Keynote-590,Checkmate649 and Attraction-4)of locally advanced esophageal cancer published in 2020 have established the importance of immunotherapy,represented by anti-programmed death protein(PD)-1 in postoperative adjuvant treatment and advanced first-line treatment of locally advanced or advanced esophageal cancer and esophagogastric junction cancer,from the aspects of proof of concept,long-term survival,overall survival rate and progression-free survival.For unresectable or inoperable nonmetastatic esophageal cancer,concurrent radiotherapy and chemotherapy is the standard treatment recommended by various guidelines.Because its curative effect is still not ideal,it is necessary to explore radical radiotherapy and chemotherapy in the future,and it is considered to be promising to combine them with immunotherapeutic drugs such as anti-PD-1.This paper mainly discusses how to combine radical concurrent radiotherapy and chemotherapy with immunotherapy for unresectable local advanced esophageal cancer.

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.

Clinical diagnostic advances in intestinal anastomotic techniques:Hand suturing,stapling,and compression devices

The development of intestinal anastomosis techniques,including hand suturing,stapling,and compression anastomoses,has been a significant advancement in surgical practice.These methods aim to prevent leakage and minimize tissue fibrosis,which can lead to stricture formation.The healing process involves various phases:hemostasis and inflammation,proliferation,and remodeling.Mechanical staplers and sutures can cause inflammation and fibrosis due to the release of profibrotic chemokines.Compression anastomosis devices,including those made of nickel-titanium alloy,offer a minimally invasive option for various surgical challenges and have shown safety and efficacy.However,despite advancements,anastomotic techniques are evaluated based on leakage risk,with complications being a primary concern.Newer devices like Magnamosis use magnetic rings for compression anastomosis,demonstrating greater strength and patency compared to stapling.Magnetic technology is also being explored for other medical treatments.While there are promising results,particularly in animal models,the realworld application in humans is limited,and further research is needed to assess their safety and practicality.

Recent Progress in Reinforcement Learning and Adaptive Dynamic Programming for Advanced Control Applications

Reinforcement learning(RL) has roots in dynamic programming and it is called adaptive/approximate dynamic programming(ADP) within the control community. This paper reviews recent developments in ADP along with RL and its applications to various advanced control fields. First, the background of the development of ADP is described, emphasizing the significance of regulation and tracking control problems. Some effective offline and online algorithms for ADP/adaptive critic control are displayed, where the main results towards discrete-time systems and continuous-time systems are surveyed, respectively.Then, the research progress on adaptive critic control based on the event-triggered framework and under uncertain environment is discussed, respectively, where event-based design, robust stabilization, and game design are reviewed. Moreover, the extensions of ADP for addressing control problems under complex environment attract enormous attention. The ADP architecture is revisited under the perspective of data-driven and RL frameworks,showing how they promote ADP formulation significantly.Finally, several typical control applications with respect to RL and ADP are summarized, particularly in the fields of wastewater treatment processes and power systems, followed by some general prospects for future research. Overall, the comprehensive survey on ADP and RL for advanced control applications has d emonstrated its remarkable potential within the artificial intelligence era. In addition, it also plays a vital role in promoting environmental protection and industrial intelligence.

Editorial for advances in slope deformation and failure analysis methods

We are privileged to be invited by the Honorary Editor-in-Chief,Professor Qihu Qian,Editor-in-Chief,Professor Xia-Ting Feng,and the editorial staff of the Journal of Rock Mechanics and Geotechnical Engineering(JRMGE),to serve as Guest Editors for this Special Issue(SI).In literature there have been new advancements in monitoring techniques,advanced numerical modelling,optimization algorithms,artificial intelligence and data science introduced for slope engineering.The newly proposed approaches show great potential for improving slope design,construction,and risk assessment.

Conversion therapy for unresectable hepatocellular carcinoma:Advances and challenges

Recently,the World Journal of Gastrointestinal Oncology published an article entitled“Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of the literature”,in which the authors shared their successful experience with complete surgical resection after multidisciplinary conversion therapy.The study by Chu et al demonstrates the great challenges that the advanced hepatocellular carcinoma(HCC)poses to surgical oncology,reveals the complexity of conversion therapy for unresectable HCC,emphasizes the important role of a multidisciplinary management model in conversion therapy,and enriches our understanding of the dynamics of personalized treatment for different patients.At present,conversion therapy is a hot research topic in the treatment of unresectable HCC,which has brought new hope to many patients with moderately advanced HCC.However,there are still many urgent problems to be solved in conversion therapy.Here,we would like to further discuss the advances and challenges of conversion therapy for unresectable HCC with the authors and the general readers.

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.

Clinical outcomes of second-line chemotherapy in patients with advanced pancreatic adenocarcinoma:a real-world study

Objective:Little progress has been made in recent years using first-line chemotherapy,including gemcitabine combined with nab-paclitaxel,FOLFIRINOX,and NALIRIFOX,for advanced pancreatic adenocarcinoma(APC).In addition,the optimal second-line chemotherapy regimen has not been determined.This study aimed to compare the effectiveness of different types of second-line chemotherapy for APC.Methods:Patients with APC who received first-line treatment from January 2008 to January 2021 were considered eligible for this retrospective analysis.The primary and secondary endpoints were overall survival(OS)and progression-free survival(PFS),respectively.Results:Four hundred and thirty-seven and 617 patients were treated with 5-fluorouracil-and gemcitabine-based chemotherapy as first-line treatment,respectively.Demographic and clinical features,except age and liver metastasis,were comparable between the two groups(P<0.05).The median OS was 8.8 and 7.8 months in patients who received a 5-fluorouracil-and gemcitabine-based combined regimen for first-line therapy,respectively(HR=1.244,95%CI=1.090–1.419;P<0.001).The median OS was 5.6 and 1.9 months in patients who received second-line chemotherapy and supportive care,respectively(HR=0.766,95%CI=0.677–0.867;P<0.001).The median PFS was not significantly differently between gemcitabine or 5-fluorouracil monotherapy and combination therapy.Conclusions:A 5-fluorouracil-or gemcitabine-based combined regimen was shown to be as effective as a single 5-fluorouracil or gemcitabine regimen as second-line therapy for patients with APC.

Recent advances and perspectives of zinc metal-free anodes for zinc ion batteries

Zinc-ion batteries(ZIBs) are recognized as potential energy storage devices due to their advantages of low cost, high energy density, and environmental friendliness. However, zinc anodes are subject to unavoidable zinc dendrites, passivation, corrosion, and hydrogen evolution reactions during the charging and discharging of batteries, becoming obstacles to the practical application of ZIBs. Appropriate zinc metal-free anodes provide a higher working potential than metallic zinc anodes, effectively solving the problems of zinc dendrites, hydrogen evolution, and side reactions during the operation of metallic zinc anodes. The improvement in the safety and cycle life of batteries creates conditions for further commercialization of ZIBs. Therefore, this work systematically introduces the research progress of zinc metal-free anodes in “rocking chair” ZIBs. Zinc metal-free anodes are mainly discussed in four categories: transition metal oxides,transition metal sulfides, MXene(two dimensional transition metal carbide) composites, and organic compounds, with discussions on their properties and zinc storage mechanisms. Finally, the outlook for the development of zinc metal-free anodes is proposed. This paper is expected to provide a reference for the further promotion of commercial rechargeable ZIBs.

Advances in the study of epicanthus correction

Epicanthus is a half-moon-shaped skin fold diagonally or vertically distributed in front of the medial canthus.In mild cases,it affects aesthetics,whereas in severe cases,it may obscure the patient’s field of vision and even affect the functional development of the eyes in children.Until now,surgery has been the only corrective measure for epicanthus and a bewildering number of epicanthus-related surgical procedures have been reported;however,there is no standardized classification to guide inexperienced plastic surgeons in their study or case selection.Therefore,this review aimed to classify epicanthus accordingly and introduce its corresponding and appropriate surgical treatment modalities.

A Comprehensive Survey on Advanced Persistent Threat (APT) Detection Techniques

The increase in number of people using the Internet leads to increased cyberattack opportunities.Advanced Persistent Threats,or APTs,are among the most dangerous targeted cyberattacks.APT attacks utilize various advanced tools and techniques for attacking targets with specific goals.Even countries with advanced technologies,like the US,Russia,the UK,and India,are susceptible to this targeted attack.APT is a sophisticated attack that involves multiple stages and specific strategies.Besides,TTP(Tools,Techniques,and Procedures)involved in the APT attack are commonly new and developed by an attacker to evade the security system.However,APTs are generally implemented in multiple stages.If one of the stages is detected,we may apply a defense mechanism for subsequent stages,leading to the entire APT attack failure.The detection at the early stage of APT and the prediction of the next step in the APT kill chain are ongoing challenges.This survey paper will provide knowledge about APT attacks and their essential steps.This follows the case study of known APT attacks,which will give clear information about the APT attack process—in later sections,highlighting the various detection methods defined by different researchers along with the limitations of the work.Data used in this article comes from the various annual reports published by security experts and blogs and information released by the enterprise networks targeted by the attack.

A phase Ⅰ study of Hemay022, an irreversible dual EGFR/HER2 tyrosine kinase inhibitor in Chinese patients with HER2-positive advanced breast cancer

Objective: Hemay022 is a novel small-molecule and an irreversible tyrosine kinase inhibitor with the target of epidermal growth factor receptor(EGFR)/human epidermal growth factor receptor 2(HER2), which demonstrated anti-tumor activity in preclinical studies. This first-in-human study evaluated the safety, pharmacokinetics,tolerability and preliminary anti-tumor activity of Hemay022 in HER2-positive advanced breast cancer patients.Methods: Heavily pretreated patients with HER2-positive advanced breast cancer were assigned to eight dose cohorts in a 3+3 dose-escalation pattern at doses of 50-600 mg QD and 300 mg BID. Eligible patients were given a single dose of Hemay022 on d 1 in week 0, followed by once daily continuous doses for four weeks in 28-day cycles.Pharmacokinetic samples were obtained on d 1 and d 28. Clinical responses were assessed every eight weeks.Results: Twenty-eight patients with advanced breast cancer were treated with Hemay022. The most frequently reported drug-related adverse events were diarrhoea(85.7%), vomiting(28.6%), nausea(25.0%) and decreased appetite(17.9%). No grade 4 drug-related adverse events were reported. At 50-600 mg doses, steady state areas under the concentration-time curve and peak concentrations increased with doses. One patient achieved complete response(CR), and three achieved partial response(PR). The objective response rate(ORR) and disease control rate(DCR) were 14.3% and 46.4% in 28 patients, respectively. The median progression-free survival(PFS) was3.98 months.Conclusions: Hemay022 at the dose of 500 mg once daily was well tolerated. The pharmacokinetic properties and encouraging anti-tumor activities of Hemay022 in advanced breast cancer patients warranted further evaluation of Hemay022 for treating breast cancer patients in the current phase Ⅲ trial(No. NCT05122494).