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Fracture in a revolving tube due to creep deformation and thermal-mechanical fatigue is a growing concern in industrial equipment research and production, especially after long-term exposure to corrosion and high-temperature conditions in roasting furnaces. The calcination temperature and residence time are crucial in the catalyst production process, with optimal conditions en-hancing catalyst activity and stability. To improve the longevity of roasting furnaces, optimizing the construction structure of the calciner is critical. This study develops a novel calciner structure and mathematical models to understand the effect of structural parameters on critical performance. Computer simulations, predictive modelling, and rotational velocity analysis of the novel calciner were performed using a DEM. The effects of the baffle angle and overlap ratio on the flow pattern and MRT were studied through simulations and experiments. The main conclusions are as follows: (1) The operating parameter with the greatest effect on the MRT was the rotational angular velocity, followed by the baffle angle and overlap ratio. (2) The MRT calculation based on the numerical method model showed an error of no more than 10.0% compared to the actual measurement data, confirming the model’s accuracy. Our study provides a theoretical foundation for a deeper understanding of the complex MRT and flow field processes within this novel calciner. It also aids in optimizing the working parameters, performance, and structure of pilot equipment while offering fundamental data for future industrial applications.

Traumatic ureteral injuries account for fewer than 1% of traumatic urologic injuries, and those caused by blunt trauma are even rarer than those caused by penetrating trauma. The symptoms associated with ureteral injury may be subtle, with or without hematuria, making it difficult to diagnose. We report the case of a 31-year-old man with a delayed diagnosis of proximal ureter injury after abdominal blunt trauma sustained in a motorcycle traffic accident. The patient underwent emergency laparotomy on admission for liver injury, mesenteric injury, and resultant hemoperitoneum. On postoperative day 6, he underwent angioembolization for suspected remnant intra-abdominal bleeding. Persistent symptoms of flank pain and leukocytosis led to follow-up imaging studies that revealed proximal ureter injury, and the patient underwent unilateral nephrectomy. This case stresses the importance of clinical suspicion for genitourinary injuries in the presence of abdominal trauma.

Objective Summarize the clinical and genetic characteristics of atypical Rett syndrome and developmental epileptic encephalopathy caused by IQSEC2 gene variation. Methods and Results From May 2020 to April 2022, Anhui Provincial Children's Hospital diagnosed and treated 4 children with atypical Rett syndrome and developmental epileptic encephalopathy caused by IQSEC2 gene variation, including 2 males and 2 females were a pair of identical twins. They all had comprehensive developmental delay before onset. At the age of 2 years, all cases gradually exhibited clinical manifestations of atypical Rett syndrome, such as frequent clapping, biting, sleep disorders (increased sleep or difficulty falling asleep), and grinding teeth, followed by developmental regression and seizures. The initial age of epilepsy was from 2 years and 2 months to 2 years and 10 months. All cases started with generalized tonic-clonic seizure, with epileptic spasm occurring between 2 and 11 months of course. Case 2, Case 3 and Case 4 were also accompanied by focal seizures. Four cases with VEEG background of 4-6 Hz θ wave, the VEEG during the interictal phase was a broad multifocal sharp slow complex wave. In Case 2, Case 3 and Case 4,MRI was abnormal, mainly with increased depth of cerebral hemispheric sulcus and gyrus. The whole exome sequencing suggested pathogenicity and possible pathogenic variations in the IQSEC2 gene, Case 1 and Case 2 were frameshift mutations of c. 608dup (p. Gln204Profs*35), while Case 3 and Case 4 were nonsense mutations of c.2231C > A (p.Ser744Ter) and c.2521C > T (p.Gln841Ter), respectively. The four mutation sites have not been reported domestically or internationally. All cases received treatment with multiple antiepileptic seizure medicine. The last follow-up age was from 4 years and 3 months to 6 years and 3 months. All cases were unable to walk alone and had no active language. There were no seizures in Case 1 for 3 years, occasional seizures in Case 2 and Case 4, and frequent seizures in Case 3. Conclusions IQSEC2 gene variation can manifest as atypical Rett syndrome, which can be accompanied by refractory epileptic spasms. Both males and females have severe phenotypes, and the severity of clinical phenotypes at the same mutation site varies. Our report enriches the variation spectrum and clinical phenotype spectrum of the IQSEC2 gene, expands the genetic spectrum of Rett syndrome and developmental epileptic encephalopathy, and provides value for the clinical diagnosis, treatment and subsequent research of this disease.

Objective To summarize and evaluate the characteristics of current recurrent spontaneous abortion (RSA) animal models at home and abroad, and to provide reference and guidance for the standardized preparation of RSA models.Methods"Recurrent spontaneous abortion" and "animal model" were used as co-keywords in CNKI, Wanfang, VIP, PubMed and Web of Science databases to search the RSA animal experimental literature, covering the period up to January 20, 2024, and a total of 1 411 articles were collected. The analysis focused on construction methods and essential elements of RSA animal models, the modeling process and result evaluation, as well as the application of these models in pharmacological and pharmacodynamic research. An Excel table was established for systematic analysis and discussion. Results A total of 138 experimental studies were obtained after screening. In constructing RSA animal models, immunological models were the most widely used in Western medicine (96.92%), with the Clark model being the main one (92.31%). In traditional Chinese medicine (TCM) models, 70.00% were kidney deficiency-luteal inhibition-syndrome combination models, 20.00% were kidney deficiency and blood stasis models, and 10.00% were deficiency-heat syndrome models. Most animals were selected at 6-8 weeks (33.86%) and 8 weeks (32.28%) of age. The majority of animals were paired for mating at 18:00 on the day of cage pairing. In 81.03% of literatures, vaginal plugs were checked once the following morning, with 8:00 being the most common time (17.02%). The most commonly used drug administration cycle was 14 days of continuous gavage after pregnancy. Among the tested drugs, Western drugs were mainly protein-based (29.17%), while TCM drugs were mainly TCM decoction (81.11%). The most frequently used methods for detecting indicators included visual observation of embryos (22.54%), western blot (15.96%), PCR (13.58%), ELISA (12.91%), HE staining (10.80%) and immunohistochemistry (9.39%). Conclusion The etiology of RSA is complex, and corresponding animal models should be established based on different etiologies. Clark model is commonly used in the construction of Western medicine model, while the kidney deficiency-luteal inhibition-syndrome combination model is predominant in TCM. RSA animal model is widely used in related research, but systematic evaluation needs to be strengthened.

Abstract Background During the prolonged COVID-19 pandemic, hospitals became focal points for normalised prevention and control. In this study, we investigated the feasibility of an inpatient bed reservation system for cancer patients that was developed in the department?s public WeChat account. We also explored its role in improving operational efficiency and nursing quality management, as well as in optimising nursing workforce deployment. Methods We utilised WeChat to facilitate communication between cancer patients and health care professionals. Furthermore, we collected data on admissions, discharges, average number of hospitalisation days, bed utilisation rate, and the number of bed days occupied by hospitalised patients through the hospital information system and nurses? working hours and competency levels through the nurse scheduling system. The average nursing hours per patient per day were calculated. Through the inpatient bed reservation system, the number of accepted admissions, denied admissions, and cancelled admissions from the reservation system were collected. The impact of the bed reservation system on the department?s operational efficiency was analysed by comparing the number of hospitalisation discharges before and after reservations, as well as the average hospitalisation and bed utilisation rates. By comparing nurses? working hours per month and average nursing hours per patient per day, the system?s impact on nurses? working hours and nursing quality indicators was analysed. Results The average hospitalisation length, bed utilisation rate, and nurses? working hours were significantly lower, and the average number of nursing hours per patient per day was significantly higher after the implementation of the reservation system. The full-cycle bed information management model for cancer patients did not affect the number of discharged patients. Conclusion Patients? ability to reserve bed types from home in advance using the department?s official WeChat-based inpatient bed reservation system allowed nurses to prepare for their work ahead of time. This in turn improved the operational efficiency of the department and nursing quality, and it optimised the deployment of the nursing workforce

The metamaterial with artificial synthetic gauge field has been proved as an excellent platform to manipulate the transport of the electromagnetic wave. Here we propose an inhomogeneous spoof surface plasmonic metasurface to construct an in-plane pseudo-magnetic field, which is generated by engineering the gradient variation of the opened Dirac cone corresponding to spatially varying mass term. The chiral zeroth-order Landau level is induced by the strong pseudo-magnetic field. Based on the bulk state propagation of the chiral Landau level, the photonic Dirac waveguide is designed and demonstrated in the experimental measurement, in which the unidirectionally guided electromagnetic mode supports the high-capacity of energy transport. Without breaking the time-reversal symmetry, our proposal structure paves a new way for realizing the artificial in-plane magnetic field and photonic Dirac waveguide in metamaterial, and have potential for designing integrated photonic devices in practical applications.

This study focused on investigating the heat transfer and flow dynamics of a catalyst granule within a pilot calciner, employing both numerical modeling and computational fluid dynamics. The research comprised two primary components: (1) Simulation of the gas flow within the pilot calciner using the Eulerian–Eulerian approach, treating gases and catalyst particles as distinct phases – gas and granular. The model, encapsulating both heat transfer and flow processes, was developed in Fluent software version 16.0. Its accuracy was confirmed against empirical data from a pilot-scale calciner unit. (2) Subsequent to validation, the model was utilized to examine the distribution characteristics within the flow field, including the temperature profiles of gas and particles, the vector velocity field of the gas across different phases, and the overall heat transfer coefficient. This investigation aims to enhance the understanding of the complex heat transfer and flow dynamics in calciners, facilitating the optimization of operational parameters, performance, and structure of pilot-scale equipment. Furthermore, it provides foundational data pertinent to the future exploration of real-world industrial applications.

Na0.5Bi0.49Ti1-xFexO3-δ (NBT) powder materials with x=0, 0.02, 0.04, and 0.06 were prepared by solid-state synthesis method. Flaky ceramic samples were prepared by pressing and sintering at 1000-1150 ℃. The effect of Fe3+ doping amount x on NBT ceramic properties was studied by XRD, SEM and EIS testing. The results show that a new phase NaBiTi6O14 appears in the NBT material after Fe3+ doping, and the content increases with the increase of doping amount. After doping, the sintering temperature of the sample decreases by 100-150 ℃, while the grains become smaller. Within the testing temperature range of 300-700 ℃, the conductivity of samples with x=0.02, 0.04, and 0.06 is on the same order of magnitude at the same temperature, which are about 1000 times higher than that of samples with x=0. The sample with x=0.04 has the highest conductivity, reaching 9.8 mS/cm and 17.0 mS/cm at the test temperatures of 600 ℃ and 700 ℃, respectively.

【Objective】 Utilization of plastic-film mulching is a widespread practice in regions with limited water resources. However, the impact of mulch film color on soil thermal condition, moisture level, salinity, as well as their implications for crop growth in saline-alkali soil remains elusive. This paper aims to bridge this knowledge gap through experimental investigation. 【Method】 The field experiment was carried out a sunflower field in the Hetao Irrigation District of Inner Mongolia with three treatments: black plastic film (BM), transparent plastic film (TM); no-mulching was taken as the control (NM). 【Result】 Both BM and TM mulching films significantly increased the temperature of the 0~15 cm soil layer at the seedling and budding stages of the sunflower by 2.9~5.8 ℃and 5.3~9.0 ℃, respectively. When the soil water matric potential was close to -20 kPa, BM and TM mulching increased the soil moisture content in the 0~20 cm soil layer by 21.3% and 10.6%, respectively, over the NM. Compared to NM, BM and TM mulching reduced soil salinity in the 0~10 cm soil layer by 51.6%~81.7% and 28.9%~80.5%, respectively, over the whole growing season; they also increased the seed yield by 51.8% and 50.1%, and water use efficiency by 49.7% and 48.9%, respectively. Black film mulching affected soil moisture, salt content and crop yield slightly more than the transparent film mulching, but the differences were not significant. 【Conclusion】 Compared with NM, black and transparent film mulching both improved soil moisture in the root zone and reduced salt accumulation in the soil surface, thereby improving yield and water use efficiency of the sunflower. Black film mulching worked slightly better than transparent film mulching though no significant difference was found between them.

Purpose This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity. Methods The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and

Objective·To evaluate the role of 18F-MD-PSMA PET/CT in the initial stage of patients with moderate and high risk prostate cancer (PCa).Methods·A total of 67 patients with moderate and high risk PCa who were treated in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from September 2017 to June 2022 were initially staged by 18F-MD-PSMA PET/CT. Conventional imaging (CI), including multi-parameter magnetic resonance imaging (mp-MRI) and bone scintigraphy (BS), were performed within two weeks before 18F-MD-PSMA PET/CT. Twenty-five patients underwent 18F-FDG PET/CT at the same time. The sensitivity (SEN), specificity (SPEC), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACU) of 18F-MD-PSMA PET/CT in the initial stage were evaluated, and the results were compared with those of 18F-FDG PET/CT, mp-MRI and BS. The consistency of 18F-MD-PSMA PET/CT and CI in terms of primary lesion, regional lymph node metastasis and bone metastasis was evaluated by Kappa consistency test refering to the postoperative pathological T and N staging results and bone metastasis results of clinical follow-up. Kappa coefficient was calculated and compared.Results·Of the 67 patients with PCa, 38 patients underwent radical prostatectomy and had completed pathological data, with 27 patients undergoing regional lymphadenectomy and 1 patient undergoing expanded pelvic lymphadenectomy at the same time. The pathological results were obtained as gold standard. The detection rates of mp-MRI and 18F-MD-PSMA PET/CT in diagnosing intrathecal lesions were both 100%. The SENs in diagnosing bilateral intralobular lesions were 26.3% and 63.2%, respctively; the SPECs were both 75.0%.The Kappa consistency test showed that the consistency of 18F-MD-PSMA PET/CT in diagnosis of extracapsular extension (EPE), seminal vesicle invasion (SVI), and bladder neck invasion (BNI) was higher than that of mp-MRI. Fisher′s exact test showed that there were no statistically significant differences in SEN (P=0.226, P=0.491) and SPEC (P=1.000, P=0.342) between the two methods for diagnosing EPE and SVI, as well as SEN (P=1.000) for diagnosing BNI. In terms of diagnosis of lymph node metastasis, based on the analysis of lymph node numbers, the consistency between 18F-MD-PSMA PET/CT and pathological results was higher than that of mp-MRI (Kappa coefficients of 0.555 and 0.137, respectively). Fisher′s exact test showed that there were no statistically significant differences in SEN and SPEC between the two examination methods (P=0.562, P=0.829). Based on the patients, the consistency between 18F-MD-PSMA PET/CT and pathological results was higher than that of mp-MRI (Kappa coefficients of 0.850 and 0.313, respectively). There was no statistically significant difference in SEN between the two methods (P=1.000). In terms of diagnosis of bone metastasis, based on the analysis of bone lesion numbers, the consistency between 18F-MD-PSMA PET/CT and clinical follow-up results was higher than that of BS (Kappa coefficients of 0.500 and 0.299, respectively). Fisher′s exact test showed that there was no statistically significant difference in SEN between the two methods (P=0.219). Based on the patients, the consistency between 18F-MD-PSMA PET/CT and clinical follow-up results was higher than that of BS (Kappa coefficients of 0.953 and 0.766, respectively). There was no statistically significant difference in SEN between the two methods (P=1.000). The risks of 21 patients (31.3%) were increased after 18F-MD-PSMA PET/CT detection, with 1 patient (1.5%) decreasing. The initial stage of 32 cases (47.8%) were changed after 18F-MD-PSMA PET/CT detection, with 27 cases (40.3%) upstaged and 5 cases (7.5%) downstaged.Conclusion·18F-MD-PSMA PET/CT is superior to CI in the diagnosis of bilateral intralobular lesions, EPE, SVI, regional lymph node metastasis and bone metastasis in intermediate and high risk PCa, and on this basis, the diagnosis of clinical stage and metastatic status of some patients has been changed.

Purpose This study aimed to identify the characteristics of patients injured by high-rotation cutting tools and the factors related to the severity of their injuries. Methods Adult patients (≥18 years), who presented to the emergency department (ED) after a high-rotation cutting tool injury and who were registered in the Korean Emergency Department-based Injury In-depth Surveillance (2011–2018) database, were included. Patients’ demographic characteristics, injury-related factors, and Injury Severity Scores were collected. All included cases were categorized into two groups according to the tool that caused the injury: grinder versus nongrinder. The characteristics of the two groups were compared, and the factors associated with the severity of injuries were investigated. Results Among 8,697 ED visits, 4,603 patients had been using a grinder and 4,094 had been using a nongrinder tool. The most frequently injured body part while using a grinder was the hand (46.4%), followed by the head (23.0%). While using a nongrinder tool, the most frequently injured body part was also the hand (64.0%), followed by the lower leg (11.4%). The odds of a severe injury were affected by patient age (odds ratio [OR], 1.024; 95% confidence interval [CI], 1.020–1.028) and using a grinder (OR, 2.073; 95% CI, 1.877–2.290). The odds of a severe injury using a grinder were higher in arm injuries (OR, 1.60; 95% CI, 1.40–1.83) and multiple-part injuries (OR, 1.998; 95% CI, 1.639–2.437). The odds of a severe injury using a grinder were lower for head injuries (OR, 0.481; 95% CI, 0.297–0.781). Conclusions Injuries from grinders were more likely to affect the head and neck than nongrinder injuries, despite the lower severity. The current lack of regulations on grinders in occupational safety and health standards warrants relevant legislation and the development of applicable safety equipment.

The new generation of information technology has led to the rapid development of the intelligent level of the cold chain, and the precise control of the development level of the smart cold chain is the prerequisite foundation and guarantee to achieve the key breakthrough of the technical bottleneck and the strategic layout of the development direction. Based on this, an evaluation index system for China's intelligent cold chain development from the dimensions of supply capacity, storage capacity, transportation capacity, economic efficiency and informationization level was conducted. The entropy weight method combined with the technique for order preference by similarity to ideal solution (TOPSIS) was used to quantitatively evaluate the development of intelligent cold chain in 30 Chinese provinces and cities (excluding Tibet, Hong Kong, Macao and Taiwan) from 2017 to 2021. The quantitative evaluation of the level of intelligent cold chain development was conducted. The impact of the evaluation indicators on different provinces and cities was analysed by exploratory spatial data analyses (ESDA) and geographically weighted regression (GWR). The results showed that indicators such as economic development status, construction of supporting facilities and informationization level had greater weight and played a more important role in influencing the construction of intelligent cold chain. The overall level of intelligent cold chain development in China is divided into four levels, with most cities at the third and fourth levels. Beijing and the eastern coastal provinces and cities generally have a better level of intelligent cold chain development, while the southwest and northwest regions are developing slowly. In terms of overall development, the overall development of China's intelligent cold chain is relatively backward, with insufficient inter-regional synergy. The global spatial autocorrelation analysis shows that the variability in the development of China's intelligent cold chain logistics is gradually becoming greater. Through the local spatial autocorrelation analysis, it can be seen that there is a positive spatial correlation between the provinces and cities in East China, and negative spatiality in North China and South China. After geographically weighted regression analysis, it can be seen that the evaluation indicators have significant spatial and temporal heterogeneity in 2017, with the degree of influence changing with spatial location and time, and the spatial and temporal heterogeneity of the evaluation indicators is not significant in 2021. In order to improve the overall development level of China's intelligent cold chain, corresponding development countermeasures are proposed to strengthen the construction of supporting facilities and promote the transformation and upgrading of information technology. This study can provide a scientific basis for the global planning, strategic layout and overall promotion of China's intelligent cold chain.

In recent years, China's cold chain logistics industry has entered a stage of rapid development. At the same time, with the increase of greenhouse gas emissions, green and low-carbon transformation has become a new feature and direction of high-quality and healthy development of the cold chain industry to meet the future development needs of China's low-carbon economy. In view of this, in order to ensure the scientificity of China's low-carbon cold chain logistics evaluation system, in this paper, 30 indicators from the four levels of energy transformation, technological innovation, economic efficiency, and national policy based on different relevant levels were first preliminarily determined, and finally 14 indicators for building China's low-carbon cold chain logistics development evaluation system through consulting experts and the possibility of data acquisition were determined. Data from 2017 to 2021 were selected to conduct a quantitative evaluation of the development level of low-carbon cold chain logistics in China. Firstly, the entropy weight method was used to analyze the weight and obstacle degree of different indicators to explore the impact of different indicators on the development of low-carbon cold chain logistics; Secondly, a weighted decision-making matrix was constructed based on the weights of different indicators, and the technology for order preference by similarity to ideal solution (TOPSIS) evaluation model was used to evaluate the development of low-carbon cold chain logistics in China from 2017 to 2021, in order to determine the development and changes of low-carbon cold chain logistics in China. The research results showed that among the 14 different indicators of the established evaluation system for the development of low-carbon cold chain logistics in China, the growth rate of the use of green packaging materials, the number of low-carbon technical papers published, the proportion of scientific research personnel, the growth rate of cold chain logistics demand for fresh agricultural products, and the reduction rate of hydrochlorofluorocarbon refrigerants account for a relatively large proportion, ranking in the top five, respectively reaching 0.1243, 0.1074, 0.1066, 0.0982, and 0.0716, accounting for more than half of the overall proportion. It has a significant impact on the development of low-carbon cold chain logistics in China. From 2017 to 2021, the development level of China's low-carbon cold chain logistics was scored from 0.1498 to 0.2359, with a year-on-year increase of about 57.5%, indicating that China's low-carbon cold chain logistics development level was relatively fast in the past five years. Although China's low-carbon cold chain logistics development has shown an overall upward trend, it is still in the development stage.

ObjectiveTo investigate the mental health status of the front-line anti-epidemic medical staff during the COVID-19 outbreak， so as to provide references for the targeted psychological intervention and improvement of mental health status.MethodsA total of 162 front-line medical staff who worked in Lanzhou Heavy Particles Hospital of Gansu Province from October to December 2021 were were enrolled， and assessed using self-designed general information questionnaire， Self-rating Anxiety Scale （SAS） and Self-rating Depression Scale （SDS）.ResultsA total of 144 medical staff completed the valid questionnaire survey， and 17 （11.81%） and 19 （13.19%） cases were found to have anxiety and depression， respectively. The detection rate of anxiety yielded statistical difference among medical staff with different anti-epidemic working hours （χ2=10.602， P

Objective To evaluate the mid-term clinical efficacy of total hip replacement using a standardized 3D printed porous trabecular titanium acetabular cup. Methods Clinical data of 23 consecutive patients undergoing total hip replacement with a standardized 3D printed porous trabecular titanium acetabular cup (25 arthroplasties) between February 2016 and August 2018 were collected and retrospectively analyzed in this study. All patients were followed up for 39~69 (51.7±10.7) months. Efficacy evaluation indicators included incidence of postoperative complications and survival rate of prosthesis, as well as visual analog scale (VAS) score, Harris score, acetabular side imaging evaluation and cup survival rate at 6 months after operation and last follow-up. Results No complications were observed in all 25 hip replacements, and the survival rate of cup was 100% during the whole follow-up. The VAS scores were decreased significantly at 6 months postoperatively (1.44±0.82) and last follow-up (0.08±0.27) when compared with the scores preoperatively (7.48±0.96, P < 0.05). The Harris scores were increased significantly at 6 months postoperatively (86.88±3.52) and last follow-up (95.04±1.86) than the pre-operative scores (45.64±4.55, P < 0.05). There were no significant differences in postoperative VAS score and Harris score between the patients with and without periprosthetic radiolucent zone. Conclusion Standardized 3D printed porous trabecular titanium acetabular cup shows its favorable mid-term outcome in total hip arthroplasty, provides high acetabular survival rate, and has certain advantages in reducing aseptic loosening of the prosthesis.

There are few studies on the shape and structure of the channel-type induction heating tundish on multi-physics field. Computational fluid dynamics has been used to study the influence of the structure of the tundish on the macroscopic transport behavior of the tundish with channel induction heating. The results show that increasing the depth of the molten pool is conducive to dynamic behavior of multiphase, the deeper the molten pool, the larger the active area, the longer residence time, the more inclusions removal and the higher ratio of plug to dead volume. Meanwhile, the larger the channel diameter, the more inclusions removal in the receiving chamber and channel. The channel induction heating has enough ability to increase the superheat and temperature compensate for the heat loss caused by the excessive residence time of the molten steel in the tundish. The change in the channel structure is crucial to the macroscopic transport behavior of the fluid. The change in channel diameter has the greatest effect on the multi-physics field in the molten pool.

Abstract Midfacial hypoplasia is a common maxillofacial deformity in patients with cleft lip and palate, which requires surgical treatment. However, trans-sutural distraction osteogenesis (TSDO) remains some disadvantages, including difficulty in accurate location of surgical path, prolonged operation time, and excess surgical bleeding. This study aimed to evaluate the application of an optical surgical navigation system (OSNS) developed for TSDO. Six consecutive patients with midfacial hypoplasia who required TSDO were included in the study. Preoperatively, a head computed tomography was performed, and the data were imported into Mimics software (version: 20.0.0.691, Materialise Inc, Belgium) to design a three-dimensional simulation of the surgical approach. TSDO was performed with the use of OSNS. The accuracy and results of the procedure were initially evaluated by comparing the preoperative and postoperative periods. The patients included five boys and one girl, with an average age of 10 years; five with postoperative cleft lip and palate, and one without combined cleft lip and palate. The surgical procedure was successful, with a postoperative follow-up of 4–5 months. All patients demonstrated good treatment results without complications. In conclusioin, OSNS-assisted TSDO can noninvasively correct midfacial dysplasia, improve surgical precision, reduce bleeding and obtain better clinical results. OSNS can guide the TSDO safely and effectively.

In view of the issues in the practical teaching of the Digital Electronic Technology, which include outdated practical teaching content, insufficient innovation and comprehensiveness, redundant teaching methods, and a single assessment model, this paper proposes an optimized design for practical teaching content, teaching methods, and assessment mechanisms. The proposed plan adopts a deep integration of theory and practice, flexible expansion based on needs, a combination of multiple teaching models, and a comprehensive assessment mechanism. It adds design experiments and innovative research experiments to enhance the comprehensiveness and innovation of the practical teaching content. Various educational concepts and methods are integrated to form an optimized teaching method that combines multiple models. A comprehensive assessment mechanism is also designed. Through the optimized design of practical teaching courses for the Big Data Engineering, significant teaching achievements have been achieved. The proposed optimized practical teaching plan can effectively address the issues in practical teaching and better cultivate students’ overall quality and innovative spirit.

Information dissemination and the associated change of individual behavior can significantly slow the spread of an epidemic. However, major social events which attract public attention will disturb information spread and affect epidemic transmission in ways that have not been readily quantified. We investigate the interplay between disease spreading and disease-related information dissemination in a two-layer network. We employ the SIR-UAU model with a time dependent coefficient to denote information dissemination. We found that major social events are equivalent to perturbations of information dissemination in certain time intervals and will consequently weaken the effect of information dissemination, and increase prevalence of infection. Our simulation results agree well with the trends observed from real-world data sets. We found that two specific major events explain the trend of the coronavirus epidemic in the US: the online propaganda and international agenda setting of Donald Trump early in 2020 and the 2020 US Presidential Election.

Purpose Trauma is the top cause of death in people under 45 years of age. Deaths from severe trauma can have a negative economic impact due to the loss of people belonging to socio-economically active age groups. Therefore, efforts to reduce the mortality rate of trauma patients are essential. The purpose of this study was to investigate preventable mortality in trauma patients and to identify factors and healthcare-related challenges affecting mortality. Ultimately, these findings will help to improve the quality of trauma care. Methods We analyzed the deaths of 411 severe trauma patients who presented to Gachon University Gil Hospital regional trauma center in South Korea from January 2015 to December 2017, using an expert panel review. Results The preventable death rate of trauma patients treated at the Gachon University Gil Hospital regional trauma center was 8.0%. Of these, definitely preventable deaths comprised 0.5% and potentially preventable deaths 7.5%. The leading cause of death in trauma patients was traumatic brain injury. Treatment errors most commonly occurred in the intensive care unit (ICU). The most frequent management error was delayed treatment of bleeding. Conclusions Most errors in the treatment of trauma patients occurred in early stages of the treatment process and in the ICU. By identifying the main causes of preventable death and errors during the course of treatment, our research will help to reduce the preventable death rate. Appropriate trauma care systems and ongoing education are also needed to reduce preventable deaths from trauma.

Purpose Blunt cardiac injuries (BCI) have a wide clinical spectrum, ranging from asymptomatic myocardial contusion to cardiac rupture and death. BCIs rarely require surgical intervention, but can be rapidly fatal, requiring prompt evaluation and surgical treatment in some cases. The aim of this study was to identify potential factors associated with in-hospital mortality after surgery in patients with BCI. Methods The medical records of 15 patients who had undergone emergency cardiac surgery for BCI between January 2014 and August 2020 were retrospectively reviewed. We included trauma patients older than 18 years admitted to Regional Trauma Center, Gachon University Gil Medical Center during the study period. Clinical and laboratory variables were compared between survivors and non-survivors. Results Non-survivors showed a significantly higher Injury Severity Score (p=0.001) and Abbreviated Injury Scale in the chest region (p=0.001) than survivors. American Association for the Surgery of Trauma-Organ Injury Scale Grade V injuries were significantly more common in non-survivors than in survivors (p=0.031). Non-survivors had significantly more preoperative packed red blood cell (PRBC) transfusions (p=0.019) and were significantly more likely to experience preoperative cardiac arrest (p=0.001) than survivors. Initial pH (p=0.010), lactate (p=0.026), and base excess (BE; p=0.026) levels showed significant differences between the two groups. Conclusions Initial pH, lactate, BE, ventricular injury, the amount of preoperative PRBC transfusions, and preoperative cardiac arrest were potential predictors of in-hospital mortality.

Focusing on the forecast of flash flood disasters in small and medium-sized rivers,this paper adopts three data-driven forecast models to forecast the maximum water level increment.With Paitan Town,Zengcheng District,Guangzhou City as the research area,the mathematical modeling and accuracy evaluation of the three models are carried out.The analysis shows that the forecast accuracy of machine learning is the highest,but the forecast results are not interpretable.The forecast accuracy of the similarity analysis model is medium,and the prediction results have good cognition and interpretability.The overall prediction accuracy of the “rainfall-water level increment” relationship model is the lowest,but its operation is simple.The calculation of the similarity analysis model and machine learning model is relatively complex,relying on computer-aided calculation,and the results of the “rainfall-water level increment” relationship model can be plotted as graphs.Considering the forecast accuracy and convenience,multiple models such as the machine learning model and similarity analysis model can be applied for the forecast to improve the forecast accuracy if there is support from auxiliary equipment such as computers and mobile phone applications.Without support from computers and other basic equipment,the “rainfall-water level increment” relationship model can provide a convenient forecast method for flash flood forecast and early warning in small and medium-sized rivers.

Penetrating neck injuries are a surgical challenge. In particular, penetrating neck injuries associated with carotid artery injuries have a high mortality rate. Overt external hemorrhage is unanimously considered as an indication for surgical exploration. The authors present a case of successful surgical management for a penetrating common carotid artery injury using a Pruitt-F3 Carotid Shunt (LeMaitre Vascular Inc., Burlington, MA, USA) in a 60-year-old male patient who was transferred to the level 1 trauma center due to a metal fragment piercing his neck while working. Active pulsatile bleeding was observed from the 3-cm-long external wound on the anterior neck in zone II. Emergent neck exploration showed near-total transection of the left common carotid artery just below the carotid bifurcation. After a Pruitt-F3 Carotid Shunt was applied to the injured carotid artery as a temporary vascular shunt, artificial graft interposition was performed for the injured common carotid artery. The patient experienced cerebral infarction as a complication caused by ischemia-reperfusion of the common carotid artery but was discharged in a suitable state for rehabilitation therapy.

Purpose This study investigated the clinical outcomes of trauma patients with blunt thoracic aortic injuries at a single institution. Methods During the study period, 9,501 patients with traumatic aortic injuries presented to Trauma Center of Gil Medical Center. Among them, 1,594 patients had severe trauma, with an Injury Severity Score (ISS) of >15. Demographics, physiological data, injury mechanism, hemodynamic parameters associated with the thoracic injury according to chest computed tomography (CT) findings, the timing of the intervention, and clinical outcomes were reviewed. Results Twenty-eight patients had blunt aortic injuries (75% male, mean age, 45.9±16.3 years). The majority (82.1%, n=23/28) of these patients were involved in traffic accidents. The median ISS was 35.0 (interquartile range 21.0–41.0). The injuries were found in the ascending aorta (n=1, 3.6%) aortic arch (n=8, 28.6%) aortic isthmus (n=18, 64.3%), and descending aorta (n=1, 3.6%). The severity of aortic injuries on chest CT was categorized as intramural hematoma (n=1, 3.6%), dissection (n=3, 10.7%), transection (n=9, 32.2%), pseudoaneurysm (n=12, 42.8%), and rupture (n=3, 10.7%). Endovascular repair was performed in 71.4% of patients (45% within 24 hours), and two patients received surgical management. The mortality rate was 25% (n=7). Conclusions Traumatic thoracic aortic injuries are life-threatening. In our experience, however, if there is no rupture and extravasation from an aortic injury, resuscitation and stabilization of vital signs are more important than an intervention for an aortic injury in patients with multiple traumas. Further study is required to optimize the timing of the intervention and explore management strategies for blunt thoracic aortic injuries in severe trauma patients needing resuscitation.

The color and contrast of objects in the image will be affected by meteorological factors, especially rain and snow will block part of the image, which will change the information contained in the image. Image restoration under bad weather conditions has practical application value. At present, most of the research focuses on the removal of fog, and the research on complex rain and snow is relatively less. Rain has more prominent features in gradient domain, and it is more distinct from non-rain image texture. In this paper, Generative Adversarial Networks is used to combine the information of image in gradient domain and spatial domain to get better performance of rain removal. Gradient aided coding is used in the generator to generate depth features that are more conducive to rain removal. In the discriminator, the gradient is used as an additional input to provide more recognizable rain and non-rain information, which enhances the discriminator’s ability to distinguish the image generated by the generator and the ground truth. By modifying the network structure of the expanded spatial pyramid pooling (ASPP), the abnormal rain removal results produced by the generator are reduced. Experimental results show that the proposed method improves the performance of rain removal and the visual quality of the generated image.