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Copyright of Journal of Computer Engineering & Applications is the property of Beijing Journal of Computer Engineering & Applications Journal Co Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this review is to investigate the effective role of local antimicrobial protection for one-stage cemented and cementless hip revision surgery. Twelve studies reporting the results of cemented single-stage procedures with a minimum two-year follow-up were reviewed. When pooling together the data, no infection recurrence was observed on average in 83.3% of the patients (a range of 75.0% to 100%). Only two papers included patients treated without the use of antibiotic-loaded bone cement, with an average infection control of 95.9% in a total of 195 patients. This figure appears to be better than the 80.7% infection control obtained by pooling together all the remaining studies. Concerning cementless one-stage revision, a total of 17 studies, reporting on 521 patients, showed an average of 90.0% (range 56.8% to 100%) no infection recurrence at a minimum two-year follow-up. No comparative study investigated cementless revision with or without local antibacterial protection. The pooled data showed an average infection control of 86.7%, without the application of local antibacterials, compared to 90.1% to 100% with local antimicrobial protection, depending on the technology used. No statistical difference could be found, either considering local antibacterial strategies alone or pooled together. No side effects had been reported by any local antibacterial technique. Local antibacterial protection for one-stage hip revision surgery, although safe and largely performed in the clinical setting, appears to still rely mainly on experts' opinions with no prospective or comparative trial, hence no definitive conclusion can be drawn concerning its effective role in one-stage hip revision surgery. [ABSTRACT FROM AUTHOR]

Background: One-stage bilateral unicompartmental knee arthroplasty (BUKA) is a promising option for patients with bilateral medial knee osteoarthritis. This study aims to compare the safety, early clinical and functional outcomes, and radiological results of conventional vs robotic-assisted medial BUKA. Methods: A retrospective cohort study was conducted involving patients who underwent medial BUKA as a single-stage procedure between April 2016 and January 2022. The study included both conventional (36 procedures) and robotic-assisted techniques (90 procedures) with a minimum follow-up of 6 months. Conventional procedures were performed either simultaneously by two surgical teams or sequentially by one team. Robotic procedures were exclusively performed sequentially by a single team. Data on surgical outcomes, patient-reported outcome measures (International Knee Society score), and radiographic measurements were collected. Results: Among the 63 patients analyzed, robotic-assisted procedures took significantly longer (115 ± 22 minutes) compared to conventional approaches (86.9 ± 12 minutes; P < .0001). No significant differences were observed in complications, length of hospital stay, rehospitalizations, patient-reported outcome measures, or overall clinical outcomes. However, radiographic analysis showed superior joint line restoration in the robotic group (−0.2 ± 0.7 mm vs −1.4 ± 1.35 mm, P = .03) and better tibial implant varus control (0.3° ± 0.6 vs 1° ± 1.8 degrees, P = .03). Conclusions: While robotic-assisted BUKA resulted in longer operative times, clinical outcomes were comparable. Radiographic findings indicated improved implant positioning, suggesting potential benefits in implantation accuracy that warrant further research. Level of Evidence: IV.

Immediate implant placement after extraction has proven to be a dependable and efficient technique for restoring a patient’s appearance and functionality. Dentists can now provide “Teeth within a day” for edentulous patients by using immediate single-stage placement of implants and immediate prosthesis fabrication. The study’s objective is to present a novel strategy that provides better direction for implant bed preparation for immediate implantation at multirooted extraction sites. This novel approach to implant bed preparation can be viewed as a straightforward but useful modification to the customary procedure that permits accurate implant placement at multirooted extraction sites immediately.

ABSTRACT: Immediate implant placement after extraction has proven to be a dependable and efficient technique for restoring a patient's appearance and functionality. Dentists can now provide "Teeth within a day" for edentulous patients by using immediate single-stage placement of implants and immediate prosthesis fabrication. The study's objective is to present a novel strategy that provides better direction for implant bed preparation for immediate implantation at multirooted extraction sites. This novel approach to implant bed preparation can be viewed as a straightforward but useful modification to the customary procedure that permits accurate implant placement at multirooted extraction sites immediately. [ABSTRACT FROM AUTHOR]

Coexisting congenital cystic adenomatous malformation of the lungs and severe pectus excavatum (PE) is an uncommon presentation that poses significant management challenges. Conventionally managed in a staged manner, there are increasing reports of superior outcomes with single-staged concurrent repair with minimally invasive techniques (video-assisted thoracoscopic surgery [VATS] and minimally invasive repair of PE [MIRPE]). The outcome of a single-stage open repair for both anomalies has not been previously reported to the best of our search. We report the successful single-stage management of a 9-month-old infant with both anomalies who had an open lobectomy and modified Ravitch procedure. We aim to report the feasibility and safety of a single-stage concurrent repair of both conditions using open techniques, as VATS and MIRPE are not readily available in our environment.

Abstract Background Chronic osteomyelitis is a debilitating bone infection, characterized by a persistent infection over months to years, poses diagnostic and therapeutic challenges due to its insidious nature and potential for severe bone and soft tissue destruction. This systematic review and meta-analysis aims to review the literature on the treatment of chronic osteomyelitis in long bones and assess cure rates in single versus two-stage surgery. Methods Following the PRISMA guidelines and registered with PROSPERO (ID: CRD42021231237), this review included studies that reported on the management of chronic osteomyelitis in long bones using either a planned one-stage or two-stage surgical approach in adult patients. Databases searched included Medline, Embase, Web of Science, CINAHL, HMIC, and AMED, using keywords related to osteomyelitis, long bones, and surgical management. Eligibility criteria focused on adults with chronic osteomyelitis in long bones, with outcomes reported after a minimum follow-up of 12 months. The meta-analysis utilized the random-effects model to pool cure rates. Results The analysis included 42 studies with a total of 1605 patients. The overall pooled cure rate was 91% (CI 95%) with no significant difference observed between single-stage and two-stage surgeries (X2 = 0.76, P > 0.05). Complications were reported in 26.6% of cases in single-stage procedures and 27.6% in two-stage procedures, with prolonged wound drainage noted as a common issue. Dead space management techniques varied across studies, with antibiotic-loaded calcium sulphate beads used in 30.4% of cases. Conclusion This meta-analysis reveals no significant difference in cure rates between single and two-stage surgical treatments for chronic osteomyelitis in long bones, supporting the efficacy of both approaches. The current treatment strategy should include a combination of debridement, dead space management using local and systematic antibiotics and soft tissue reconstruction if necessary.

Multi-input power supply systems are mostly used in the field of combined power supply of multiple new energy sources. Multi-input inverters play an important role in these systems; however, they often face the issue of common-mode currents. This paper proposes an improved modulation mod for a non-isolated series simultaneous power supply type dual-input inverter with low common-mode current for new energy generation applications. In this paper, a circuit simulation is designed and a dual-input inverter circuit model is fabricated for experiments, after which it is verified that the improved modulation method can suppress the common-mode current to below 30 mA, providing an effective modulation scheme for mitigating common-mode currents in the joint power supply of multiple new energy sources. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Refrigeration Technology is the property of Shanghai Society of Refrigeration and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A novel ac/dc LED driver with power factor correction and soft-switching functions is proposed. The circuit topology mainly consists of two modified single-ended primary inductance converters (SEPIC) with interleaved operation. The first half stage of SEPIC operates like a boost converter and the second half stage operates like a buck–boost converter. Each boost converter is designed to operate in discontinuous current mode (DCM) to function as a power factor corrector (PFC). The two buck–boost converters that share a commonly coupled inductor are designed to operate at near boundary conduction mode (BCM). Without using any active clamping circuit, auxiliary switch or snubber circuit, the active switches can achieve zero-voltage switching on, and all diodes achieve zero-current switching off. First, operation modes in steady state are analyzed, and the mathematical equations for design component parameters are derived. Finally, a prototype circuit of 180 W rated power was built and tested. Experimental results show satisfactory performance of the proposed circuit. [ABSTRACT FROM AUTHOR]

Background: Chronic osteomyelitis is a debilitating bone infection, characterized by a persistent infection over months to years, poses diagnostic and therapeutic challenges due to its insidious nature and potential for severe bone and soft tissue destruction. This systematic review and meta-analysis aims to review the literature on the treatment of chronic osteomyelitis in long bones and assess cure rates in single versus two-stage surgery. Methods: Following the PRISMA guidelines and registered with PROSPERO (ID: CRD42021231237), this review included studies that reported on the management of chronic osteomyelitis in long bones using either a planned one-stage or two-stage surgical approach in adult patients. Databases searched included Medline, Embase, Web of Science, CINAHL, HMIC, and AMED, using keywords related to osteomyelitis, long bones, and surgical management. Eligibility criteria focused on adults with chronic osteomyelitis in long bones, with outcomes reported after a minimum follow-up of 12 months. The meta-analysis utilized the random-effects model to pool cure rates. Results: The analysis included 42 studies with a total of 1605 patients. The overall pooled cure rate was 91% (CI 95%) with no significant difference observed between single-stage and two-stage surgeries (X2 = 0.76, P > 0.05). Complications were reported in 26.6% of cases in single-stage procedures and 27.6% in two-stage procedures, with prolonged wound drainage noted as a common issue. Dead space management techniques varied across studies, with antibiotic-loaded calcium sulphate beads used in 30.4% of cases. Conclusion: This meta-analysis reveals no significant difference in cure rates between single and two-stage surgical treatments for chronic osteomyelitis in long bones, supporting the efficacy of both approaches. The current treatment strategy should include a combination of debridement, dead space management using local and systematic antibiotics and soft tissue reconstruction if necessary. [ABSTRACT FROM AUTHOR]

Deforming osteoarthritis of the knee joint alters the mechanical axis of the lower limb. This, combined with extra articular deformity of the tibia or femur leads to serious dysfunction of the limb and great disability for the patient. These rare cases present great challenge for the orthopedic surgeon. Most of the cases with mild to moderate deformities can be successfully managed by adjusting intra articular resections, but in those with severe extra articular deformity, an extra articular correctional osteotomy may be required in order to achieve good flexion-extension balance of the knee. We report a case of total knee replacement performed together with correctional osteotomy of the tibia due to extra articular deformity of about 20 degree varus.

In this paper, a single-stage step-down power factor corrector without a full-bridge rectifier is developed, which is designed to operate in discontinuous conduction mode (DCM). In terms of control, the DCM has the advantages of simple control and easy realization, no slope compensation, zero current switching, and no diode reverse current. By sampling the output voltage and using the voltage-follower control to generate the necessary control force to drive the power switch, not only can the output voltage be stabilized at the desired value, but also the input current can be, as much as possible, in the form of a sinusoidal waveform and can follow the phase of the input voltage. Moreover, the harmonic distortion meets the requirements of the IEC6100-3-2 Class D harmonics standard, and, thus, the proposed rectifier is appropriate for the computer, computer monitor, and television receiver. Eventually, by means of mathematical deductions, simulations by PSIM version 9.1, and experimental results, the feasibility and effectiveness of the proposed circuit can be verified. [ABSTRACT FROM AUTHOR]

To solve the problems of large switching losses and the need for large-capacity electrolytic capacitances in three-phase DC/AC on-board chargers for vehicle-to-grid (V2G) applications, this paper proposes a single-stage bidirectional high-frequency isolated converter that eliminates the need for large-capacity capacitances. Combined with the proposed modulation scheme, it can theoretically reduce the switching loss by about two-thirds with the three-phase converter compared with the conventional modulation scheme, improving the converter's operating efficiency and power density. Firstly, based on the characteristics of the proposed topology, a hybrid modulation scheme is proposed, which combines a phase-shift modulation scheme based on double modulation waves and a sawtooth carrier with a 1/3 modulation scheme, and the theoretical feasibility of the hybrid modulation scheme is verified using a mathematical modeling equation. Secondly, this paper provides a detailed analysis of the four operating modes of the two full-bridge circuits and the commutation process of the three-phase converter within 1/6 of the fundamental frequency cycle (P1 modulation interval). Then, the control strategy is given for the constant-current and constant-voltage charging and constant-current discharging for electric vehicle batteries. Finally, simulation results verify the correctness of the proposed topology and modulation scheme in vehicle–grid interaction. [ABSTRACT FROM AUTHOR]

Low temperature metal hydrides are promising materials for thermal energy storage devices in climatic-oriented niches. Different alloy compositions are prepared and investigated to reach high reversible capacity and heat of formation. Al-substituted alloys show wide plateau region with narrow plateau slope resulted in high reversible capacity up to 1.33 wt% H 2. Alloy LaNi 4.6 Mn 0.2 Al 0.2 with the highest enthalpy change of 35.9 kJ/mol H 2 during hydrogen sorption investigations could be a promising candidate for further TES system investigations. • Low temperature LaNi 5 based alloys are proposed for TES. • High heats of formation are achieved by partial Ni substitution. • The highest capacity reaches 1.33 %wt. H 2 for LaNi 4.75 Al 0.25 • The highest ΔH abs is 35.9 kJ/mol H 2 for LaNi 4.6 Mn 0.2 Al 0.2. [ABSTRACT FROM AUTHOR]

The purpose of this study is to compare outcomes in patients undergoing buried and non-buried free flaps for breast reconstruction, in addition to evaluating the safety and reliability of venous flow couplers. A retrospective review was performed of all patients undergoing free flap breast reconstruction between 2013 and 2023. The primary outcomes were free flap failure, complications and the number of procedures required to complete the reconstructive journey. A total of 322 flaps were performed in 254 consecutive patients, with 47.5% (n = 153) being buried and 52.0% (n = 169) being non-buried reconstructions. The most common flap of choice being deep inferior epigastric artery perforator flaps (81.9%) followed by profunda artery perforator flaps (14.3%). There was no significant difference between the two groups in complications, including flap failure (buried 2.0% vs. non-buried 1.8% p = 0.902). There was a significant reduction in the number of procedures required to complete the reconstructive journey, with 52.2% (n = 59) of patients undergoing single-stage breast reconstruction in the buried group compared with only 25.5% (n = 36) in the non-buried group (p < 0.001). Two (0.6%) patients experienced a false negative in which the signal of the flow coupler was lost but the flap was perfused during re-exploration. No flap losses occurred without being identified in advance by a loss of audible venous flow signal. Buried free flap breast reconstruction is safe and requires fewer operations to complete patients' reconstructive journey. Flow couplers are a safe and effective method of monitoring buried free flaps in breast reconstruction. [ABSTRACT FROM AUTHOR]

Summary: Traditional multiple‐output AC‐DC power supply with power factor correction (PFC) function usually employs a two‐stage cascaded topology that is composed of prestage PFC converter and N independent poststage DC‐DC converters to achieve PFC and voltage or current regulation of N outputs. Hence, the conventional two‐stage cascaded multiple‐output AC‐DC power supply needs N + 1 magnetic components as power inductors or transformers and N + 1 controllers, which increases the cost and size of the multioutput converters. The conventional multiple‐string AC‐DC LED driving circuits usually employ a two‐stage topology to realize PFC and independent current regulation of each LED string. To address the issue of complexity, high cost, and large size of the two‐stage multistring LED driving circuit, a single‐stage triple‐output Cuk PFC converter is proposed by cascading boost converter and single‐inductor triple‐output buck converter with sharing main power switch in this paper. The topology operation principle, control strategy, design consideration, and operation characteristics of the proposed circuit are investigated in detail. With the switch sharing and inductor multiplexing technologies at the same time, the proposed converter utilizes only single‐stage converter to achieve PFC function, independent regulation of triple‐channel output current, and flicker‐free with low twice line frequency LED current ripple. The proposed converter is verified by a 50‐W experimental prototype of LED driver for triple string LEDs. The proposed converter only uses two power inductors and a set of controller to achieve greater than 0.945 PF, up to 90.5% efficiency, low LED current ripple, and independent current regulation for triple LED strings with different forward voltage, which may significantly reduce the cost and size of the traditional AC‐DC multistring LED driving circuit. [ABSTRACT FROM AUTHOR]

Objective: To evaluate clinical efficacy of single stage laparoscopic orchiopexy by modified Prentiss procedure for the treatment of impalpable undescended testis within 2.5 cm from deep ring in children. Study Design: This was a retrospective case series study design. Place and Duration of Study: Department of surgery, section of pediatric surgery. Northern Area Armed Forces Hospital Hafer Al Batin, Saudi Arabia, from June 15, 2011, to Sep 15, 2021. Materials and Methods: All the children admitted with diagnosis of impalpable undescended testis were treated by single stage laparoscopic orchiopexy by modified Prentiss technique during the study period from June 15, 2011, till Sep 15, 2021. The total number of patients was 22. The age of the patients ranged from 1 year to 7 years. Seventeen (77.26 %) children had unilateral (10 with left sided and 7 with right sided) impalpable undescended testis. Five (22.72%) children had bilateral impalpable undescended testis. All the patients were evaluated by ultrasound and MRI abdomen to confirm the abdominal location. The patients were operated by single stage laparoscopic orchiopexy using modified Prentiss technique by single senior pediatric surgeon after confirming the location of testis within 2.5 cm from deep inguinal ring. All the patients were followed up in outpatient clinic after 1 week, after 6 months and after 1 year. The operative time, degree of post- operative pain, per operative and post- operative complications and follow up results were analyzed to evaluate the clinical outcome in terms of testicular location in the scrotum and size. Results: A total of 22 children were treated successfully by single stage laparoscopic orchiopexy by modified Prentiss technique. The age ranged from one year to 7 years at the time of surgery. Ten (45.45%) patients had left sided non-palpable testis, 7 (31.81%) had right sided and 5 (22.72%) children were having bilateral non palpable testis. There was no per-operative complication. One patient (4.54%) had scrotal hematoma which resolved spontaneously. All the children had successful outcome in terms of testicular size and location within scrotum after surgery on follow up of more than one year. There was no case (0%) of testicular atrophy in this series. Thirteen (59%) patients had testis in lowest position of scrotum, eight (36.36%) patients had testis in the middle scrotum and one (4.54%) patient had testis in the neck of the scrotum. Conclusion: Single stage Laparoscopic orchiopexy by modified Prentiss procedure is feasible, safe and effective technique to treat children with impalpable low abdominal undescended testis in children

The aim of this review is to investigate the effective role of local antimicrobial protection for one-stage cemented and cementless hip revision surgery. Twelve studies reporting the results of cemented single-stage procedures with a minimum two-year follow-up were reviewed. When pooling together the data, no infection recurrence was observed on average in 83.3% of the patients (a range of 75.0% to 100%). Only two papers included patients treated without the use of antibiotic-loaded bone cement, with an average infection control of 95.9% in a total of 195 patients. This figure appears to be better than the 80.7% infection control obtained by pooling together all the remaining studies. Concerning cementless one-stage revision, a total of 17 studies, reporting on 521 patients, showed an average of 90.0% (range 56.8% to 100%) no infection recurrence at a minimum two-year follow-up. No comparative study investigated cementless revision with or without local antibacterial protection. The pooled data showed an average infection control of 86.7%, without the application of local antibacterials, compared to 90.1% to 100% with local antimicrobial protection, depending on the technology used. No statistical difference could be found, either considering local antibacterial strategies alone or pooled together. No side effects had been reported by any local antibacterial technique. Local antibacterial protection for one-stage hip revision surgery, although safe and largely performed in the clinical setting, appears to still rely mainly on experts’ opinions with no prospective or comparative trial, hence no definitive conclusion can be drawn concerning its effective role in one-stage hip revision surgery.

Coexisting congenital cystic adenomatous malformation of the lungs and severe pectus excavatum (PE) is an uncommon presentation that poses significant management challenges. Conventionally managed in a staged manner, there are increasing reports of superior outcomes with single-staged concurrent repair with minimally invasive techniques (video-assisted thoracoscopic surgery [VATS] and minimally invasive repair of PE [MIRPE]). The outcome of a single-stage open repair for both anomalies has not been previously reported to the best of our search. We report the successful single-stage management of a 9-month-old infant with both anomalies who had an open lobectomy and modified Ravitch procedure. We aim to report the feasibility and safety of a single-stage concurrent repair of both conditions using open techniques, as VATS and MIRPE are not readily available in our environment. [ABSTRACT FROM AUTHOR]

A novel ac/dc LED driver with power factor correction and soft-switching functions is proposed. The circuit topology mainly consists of two modified single-ended primary inductance converters (SEPIC) with interleaved operation. The first half stage of SEPIC operates like a boost converter and the second half stage operates like a buck–boost converter. Each boost converter is designed to operate in discontinuous current mode (DCM) to function as a power factor corrector (PFC). The two buck–boost converters that share a commonly coupled inductor are designed to operate at near boundary conduction mode (BCM). Without using any active clamping circuit, auxiliary switch or snubber circuit, the active switches can achieve zero-voltage switching on, and all diodes achieve zero-current switching off. First, operation modes in steady state are analyzed, and the mathematical equations for design component parameters are derived. Finally, a prototype circuit of 180 W rated power was built and tested. Experimental results show satisfactory performance of the proposed circuit.

This paper has the aim to report the status of the HYPLANE project to date. HYPLANE is a horizontal take-off and landing Mach 4.5 bizjet-size aerospaceplane conceived by Trans-Tech and University Federico II of Naples and under study within the industrial-academic ecosystem of the Campania Aerospace District (DAC). HYPLANE has the aim to offer very fast suborbital flight for space tourism, microgravity experimentation and training, and also shortening time to connect two distant airports within a door-to-door scenario. The concept is based on the access to stratospheric altitudes (30 km) for either point-to-point stratospheric or suborbital flights as safe as today's commercial air transportation, by integrating enhanced state-of-the-art aeronautical and space technologies. Essentially, HYPLANE is mostly based on already relatively high TRL technologies which guarantees a sufficiently short time to market. The low wing loading configuration and designed ability to manoeuvre along the flight trajectories at small angles of attack, allow HYPLANE to guarantee accelerations and load factors of the same order as those characterizing the present civil aviation aircraft (FAA/EASA specifications). Thanks to its technical features, it may operate from/to more than 5000 airports all over the world needing short runways to take-off and land, which for point-to-point business aviation is paramount. Furthermore, characteristics such as small dimension, configuration and high cruising altitude determine reduced noise in the airports surrounding and low sonic boom impact on ground. These conditions will further facilitate not only the development of the commercial use of such kind of transportation mean, but also its social acceptability. [ABSTRACT FROM AUTHOR]

Purpose: Perioperative and early post-operative outcomes of Primary Posterior sagittal anorectoplasty (P-PSARP) were evaluated. Method: Retrospective analysis of cases who underwent P-PSARP from 2004 to 2019 was done. Perioperative care, management, complications, voluntary bowel movement, soiling and constipation, graded by Krickenbeck criteria were studied. Results: One hundred fifty six patients (134 girls) underwent P-PSARP at median age of 5 months (3 months to 14 years) in girls and 5(1–10) days in 21 boys. One male cloaca was operated at 5 months age. Of 20 boys, 5, 8, 4, 3 had rectobulbar urethral fistula, rectoprostatic urethral fistula, bladder neck fistula and male cloaca. Girls had vestibular fistula, rectovaginal fistula, vulval anus, anterior ectopic anus, pouch perineal fistulae and posterior anus with H type fistula in 114, 7, 6, 5, 1 and 1. Complications included wound infection, excoriation, oedema, mucosal prolapse, anal stricture, anal retraction and mortality in 6, 4, 5, 4, 4, 1 and 1, respectively. 35/155(12 neonates) required postoperative dilatations for 5(1–12) months. At follow-up, 96/114(84.2%) had voluntary bowel movements. 46/155 (29.7%) and 9/155 had constipation and soiling. 32:14:0 had grade 1:2:3 constipation, treated with diet (grade 1) and laxatives (grade 2) respectively. 4:3:2 had grade 1:2:3 soiling for initial 3 months, treated with bowel management programme. Conclusion: P-PSARP is feasible, subject to proper case selection and good perioperative care, once learning curve is achieved. [ABSTRACT FROM AUTHOR]

Introduction: There has been increased interest in direct-to-implant (DTI) reconstruction in recent years. The goal of this study was to focus on the re-operation rate of DTI in comparison with two-stage tissue expander (TE) reconstruction. Patients and Methods: In total, 165 consecutive patients (222 breasts) underwent skin sparing mastectomy and immediate implant-based reconstruction between January 2010 and December 2019. Patients were divided to TE procedure and DTI (42,180 breasts, respectively). Data collected included demographics, operative details and oncological medical treatment, complications classified according to Clavien–Dindo, capsular contracture Baker 3-4 and re-operation due to complication or due to patient's wish to improve aesthetic appearance. Results: There were significantly more prophylactic mastectomies and BRCA gene mutation in the DTI breast reconstruction group, and more smokers and diabetic patients in the TE group. No significant difference was found in the complication rates between the groups (DTI—26.1%, TE—40.5%). However, major complication and re-operation rate due to complications were significantly different (DTI—16.7% and 10.6%, TE—26.2% and 31%, respectively, p= 0.035, p = 0.008). No significant differences were found in Clavien–Dindo stages between the groups except for Grade 3b. Re-operation due to desire for aesthetic improvement was significantly higher in the TE group (DTI—38%. TE—69%, p=0.0003). Conclusion: DTI immediate breast reconstruction can provide a good alternative to the traditional two-stage TE/implant operation. Both patients and surgeons can be reassured that the majority of the cases are one-stage reconstruction. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

An inferiorly based nasolabial flap (NLF) is a versatile flap for various oral cavity defects. However, it generally necessitates a second stage procedure to release the base at 3 weeks following the initial surgery. Reconstruction for oral cavity defects can be done with the inferiorly based nasolabial flap as a single-stage procedure. In this retrospective clinical audit, we analyzed patients who underwent an inferiorly based NLF reconstruction for oral cavity defect from January 2016 to September 2021. We analyzed the various defects for which this flap was used along with the associated complications and the safety of performing this flap in terms of its flap-related complications and the histopathological features such as margins. Forty-four patients underwent this inferiorly based single-stage NLF. The median age of the patients in the cohort was 56 years, with the majority being men (n = 38, 86.4%). Buccal mucosa and lip were the most common sites of the primary. Twenty-nine patients were per primam and 15 were recurrent cancers. Most had T1 (n = 14, 31.8%) and T2 (n = 19, 43.2%) cancers. The median closest margin was 6 mm and the base was 7 mm. There were no flap losses; however, 6 patients had minor wound breakdown for which secondary suturing was needed. Single-stage NLF is a safe flap that could be considered in select patients for appropriate oral cavity defects. [ABSTRACT FROM AUTHOR]

While advanced technology, increased medical knowledge and improved surgical technique has improved patient outcomes in total joint arthroplasty, prosthetic joint infection still remains one of the leading causes of increased healthcare costs, medical resources and societal burdens in orthopaedic care. Two stage arthroplasty revision remains the gold standard for treatment of prosthetic joint infection. Proponents of single stage revision arthroplasty for infection argue that it results in lower healthcare costs while improving patient reported functional outcomes and with equivalent success rates. Here we review the history of single stage revision arthroplasty, discuss the key principles, highlight the indications and contraindications, and review the reported outcomes with a focus on future developments of single stage revision arthroplasty for hip and knee periprosthetic joint infections.

At present, in arbitrary-oriented object detection, the angular periodicity problem of rotated bounding box described by angle causes an object to have different numerical representations, which leads to uncertainty of rotated bounding box regression. To eliminate the angular periodicity problem, in this article, we propose a novel and simple ellipse parameters representation method for arbitrary-oriented object, which hides the angle of the object in the focal vector of ellipse to avoid direct angle prediction. Moreover, the proposed representation method can enable the arbitrary-oriented object to have only one numerical representation, which is beneficial to alleviate the uncertainty of bounding box regression. In order to adapt the proposed ellipse parameters representation method, we adopt 2-D Gaussian distribution label assign for coarse samples selection, then the Kullback–Leibler divergence loss and SimOTA are used to refine the coarse samples to obtain the best positive samples. We extend the YOLOX with medium parameters as an oriented ship detector according to the proposed ellipse parameters representation method, and conduct the experiments on HRSC2016, RSDD-SAR, and RHRSID to demonstrate the effectiveness of the proposed method. The experimental results show that the proposed representation method achieves impressive results compared with state-of-the-art arbitrary-oriented object detection methods.

Background The ideal management plan for patients diagnosed with concomitant cholelithiasis and choledocholithiasis has been a great matter of debate among hepatobiliary surgeons. Some surgeons prefer a single-stage approach (laparoscopic cholecystectomy LC with laparoscopic common bile duct exploration, LCBDE), while others prefer two-stage approaches (preoperative endoscopic stone extraction followed by interval LC). Herein, we compare the outcomes of the previous two approaches in our Egyptian tertiary care setting. Methods Sixty-four patients were eligible for our randomized trial and were randomly assigned into two groups: Group A was scheduled for the single-stage approach and Group B was scheduled for the two-stage approach. Periprocedural outcomes, including success rates, were assessed in the two groups. Results Failed stone extraction was encountered in three patients in Group B (success rate 90.62%). However, we were able to completely free the CBD in all patients in Group A (100% success). Operative time was significantly prolonged in Group A (173.13 vs. 75.97 min in Group B). However, Group A patients had a shorter hospitalization period compared with Group B (5 vs. 7 days). Bile leakage was more encountered in Group A, while the incidence of pancreatitis was higher in Group B. All patients were conservatively managed with no further intervention. Conclusion A higher, but not statistically significant, success rate was reported with the single-stage approach. Despite this, this technique was preferred due to a shorter hospital stay and higher clearance rates reported in our study. [ABSTRACT FROM AUTHOR]

Summary: Since the output voltage accuracy of the off‐grid inverter is low with the proportional‐integral (PI) control and a two‐stage inverter is often used in the low input voltage application, a single‐stage buck‐boost off‐grid inverter with feedforward control is proposed. The proposed inverter consists of a buck‐boost converter and a full‐bridge inverter. The buck‐boost converter operates at high frequency, while the full‐bridge inverter operates at line frequency. Therefore, the intermediate bus voltage is controlled as the unipolar half‐cycle sinusoidal voltage wave to reduce the voltage stress of semiconductors, and film capacitors can be used as intermediate bus capacitors for high reliability and high power density. The operating principle is illustrated. Design guidelines and example are given. The stability analysis and external characteristic analysis are given. A 500‐W proposed inverter is constructed to verify the theoretical analysis. [ABSTRACT FROM AUTHOR]

In this paper, a single-stage step-down power factor corrector without a full-bridge rectifier is developed, which is designed to operate in discontinuous conduction mode (DCM). In terms of control, the DCM has the advantages of simple control and easy realization, no slope compensation, zero current switching, and no diode reverse current. By sampling the output voltage and using the voltage-follower control to generate the necessary control force to drive the power switch, not only can the output voltage be stabilized at the desired value, but also the input current can be, as much as possible, in the form of a sinusoidal waveform and can follow the phase of the input voltage. Moreover, the harmonic distortion meets the requirements of the IEC6100-3-2 Class D harmonics standard, and, thus, the proposed rectifier is appropriate for the computer, computer monitor, and television receiver. Eventually, by means of mathematical deductions, simulations by PSIM version 9.1, and experimental results, the feasibility and effectiveness of the proposed circuit can be verified.

Summary: Introduction: Acellular dermal matrices (ADM) have been suggested to allow for different approaches and reduce the risk of postoperative complications in implant-based breast surgery. Surgeons seem to embrace ADMs around the world, although a lack of consistent evidence regarding the factors that increase the risk of major postoperative complications remains. Purpose: To develop and internally validate a model to predict the risk of a major postoperative complication in breast reconstructive surgery with and without an ADM. Methodology: The DBIR is an opt-out registry that holds characteristics of all breast implant surgeries in the Netherlands since 2015. Using a literature-driven preselection of predictors, multivariable mixed-effects logistic regression modelling was used to develop the prediction model. Results: A total of 2939 breasts were eligible, of which 11% underwent an ADM-assisted procedure (single-stage or two-stage). However, 31% underwent a two-stage procedure (with or without the use of ADM). Of all breasts, 10.2% developed a major postoperative complication. Age (OR 1.01), delayed timing (OR 0.71), and two-stage technique (OR 4.46) were associated with the outcome. Conclusion: The data suggest that ADM use was not associated with a major postoperative complication, while two-stage reconstructions were strongly associated with an increased risk of major complications. Despite these findings, ADMs are not as popular in the Netherlands as in the USA. The predictive capabilities of the developed model are mediocre to poor, but because of the above findings, we believe that the role of the two-stage technique as a golden standard should be put up for debate.

The anchor-free network represented by a Fully Convolutional One-Stage object detector (FCOS) avoids the hyperparameter setting issue caused by the preset anchor boxes; however, the result of the horizontal bounding boxes cannot indicate the precise boundary and orientation of the arbitrary-oriented ship detection in synthetic-aperture radar images. To solve this problem, this paper proposes a detection algorithm named FCOSR. First, the angle parameter is added to the FCOS regression branch to output the rotatable bounding boxes. Second, 9-point features based on deformable convolution are introduced to predict the ship confidence and the boundary-box residual to reduce the land false alarm and improve the accuracy of the boundary box regression. Finally, in the training stage, the rotatable adaptive sample selection strategy is used to allocate appropriate positive sample points to the real ship to improve the network detection accuracy. Compared to the FCOS and currently published anchor-based rotatable detection networks, the proposed network exhibited faster detection speed and higher detection accuracy on the SSDD+ and HRSID datasets with the mAPs of 91.7% and 84.3%, respectively. The average detection time of image slices was only 33 ms.

The elastocaloric effect denotes the ability of a material to release or absorb heat when the material is stretched and released respectively. This effect may be used to design an alternative cooling device. This work focuses on the development of a cooling device using natural rubber (NR) as the elastocaloric material. It consists of a solid–solid heat exchange between a cyclically stretched elastocaloric material and two exchangers, respectively put in contact with the elastocaloric material when it is stretched or released. An experimental device was designed and tested in order to assess the temperature span and cooling power ( PC ) achievable by NR based single stage device. The effect of the thickness of the NR is also discussed. It is shown that it was possible to transfer nearly 60% of the heat absorption potential of the NR from the cold heat exchanger. From the measurements, the highest PC was found to be 390 mW (430 W kg ^−1 ) for a 600 µ m thick sample, and 305 mW (540 W kg ^−1 ) for a 400 µ m thick sample. The temperature span was found to be similar for both materials, ranging 1.5 °C–1.9 °C.

Grid integrated renewable energy sources are greatly benefiting from the use of multilevel inverters, as they inject less total harmonic distortion (THD) and improve the quality of inverter voltage. However, these inverters face challenges due to their high number of switches and complex control. Therefore, it is necessary to explore new configurations with simpler and more effective control methods. In addition, Photovoltaic (PV) systems are being installed in numerous apartments and houses, typically connected to a single phase utility grid. It is crucial to ensure power quality through the use of an inverter connected between the PV system and the utility grid, controlled by the inverter itself. Since PV systems exhibit non-linear behavior, a DC to DC converter is required, along with an appropriate algorithm to maximize power output. However, the inclusion of an additional DC to DC converter can increase the size, cost, and complexity of the system. As a result, single stage grid connected systems have gained popularity for low power applications. Furthermore, the use of a Fuzzy controller has shown superior performance compared to PI controllers, thanks to its ability to adjust gains based on changes in solar irradiance and load. Therefore, this paper introduces a new configuration of a 7 level inverter for single phase single stage grid connected PV systems, incorporating a Fuzzy controller for control. This new configuration only consists of seven switches, making it more streamlined. The paper includes extensive results to validate the effectiveness of the proposed methodology.

Grid connected solar power plants are widely established in many places worldwide. Photovoltaic (PV) based grid connected solar plants are attracting recently due to improved in controlling of power converters. Single stage grid connected systems can reduce number of converters connected in power plants which resultant in reduce cost of the system. However, DC to DC converters are generally used in PV systems to enhance the operation of maximum power point for best utilization. The inverters also can be using to extract maximum power from PV systems through new controlling techniques in power electronics devises. Therefore an extraDC to DC converter is not required to make PV at its maximum power point condition. However, this technology can be used for small scale solar power plants since all PV arrays in solar power plant cannot be received same irradiance. Takagi-Sugeno-Kang (TSK) fuzzy controlleris having significant priority than proportional plus integral controllers when rapid changes are having in input. Hence, TSK based single stage controller is developed in this paper for grid connected 1MW solar plant. Generally distribution system is connected with unbalanced loads, hence these unbalanced loads will create forcefully unbalanced currents in electrical grid. Unbalanced grid currents further create many problems to other loads. Therefore, the proposed controller is designed to help making grid currents balanced during unbalanced local loads. Further, the inverter can compensate reactive power demanded by local loads to minimize reactive power supplied by grid. Extensive results are presented and evaluated through hardware-in-loop on the platform of OPAL-RT to enhance the performance of proposed controller for 1MW grid connected solar plant.

Image instance segmentation is an important part of image processing and computer vision technology about image understanding.With the development of deep learning and deep convolutional neural network,image instance segmentation method based on deep convolutional neural network has made great progress.Instance segmentation task is actually the combination of target detection and semantic segmentation,which can complete the task of recognizing the target contour in the image at thepixel level.Instance segmentation can not only locate the position of the object in the image,segment all the objects from the pixel level,but also mark different individuals of the same category in the image,which is not only the pixel level segmentation of the image,but also the instance level understanding.Firstly,the reason of image segmentation and the function of deep convolution neural network are described.Then,according to the process and characteristics of image instance segmentation methods,the research progress of image instance segmentation is introduced from two-stage and single-stage perspectives,and the advantages and disadvantages of the two methods are described in detail.Then,the design ideas of region,feature extraction and mask are summarized.In addition,the performance evaluation criteria and common public data sets of image instance segmentation methods are summarized,and on this basis,the segmentation accuracy of mainstream image instance segmentation models is compared and evaluated.Finally,it points out the problems and solutions of the current image instance segmentation,summarizes the development of image instance segmentation and prospects for the future.

Simple Summary: For patients with advanced metastatic disease presenting with synchronous multiple long bone impending and complete fractures requiring placement of intramedullary nails (IMN), the optimal timing of bone fixation—whether in a single or multiple stages—is still highly debatable. In this work, we compared perioperative outcomes like overall complications, survival, in-hospital death, and postoperative length of stay among others between patients who have undergone single or multi-stage intramedullary nailing procedures for oncological indications. Our findings revealed that single-stage intramedullary nailing synchronous long-bone metastases in select patients does not increase their risk of perioperative complications and in-hospital mortality but leads to earlier postoperative discharge and initiation of rehabilitation. Thus, our results support single-stage multiple nailing as an efficient and viable therapeutic strategy for select patients with multiple long-bone metastases. Purpose: Determine whether perioperative outcomes differ between patients who have undergone single or multi-stage IMN procedures for impending or completed pathologic fractures. Methods: Patients were classified into single-stage single-bone (SSSB), single-stage multiple-bone (SSMB), and multi-stage multiple-bone (MSMB) based on procedure timing and number of bones involved. Outcome variables compared included length of stay (LOS), in-hospital mortality and survival, initiation of rehabilitation and adjuvant therapy, and perioperative complications. Results: There were 272 IMNs placed in 181 patients (100 males, 81 females, 55.2% and 44.8%, respectively) with a mean age of 66.3 ± 12.1 years. MSMB had significantly longer LOS (24.3 ± 14.2 days) and rehabilitation initiation (3.4 ± 2.5 days) compared to SSSB (8.5 ± 7.7 and 1.8 ± 1.6 days) and SSMB (11.5 ± 7.6 and 2.0 ± 1.6 days) subjects, respectively (both; p < 0.01). Although total perioperative complication rates in SSMB and MSMB were comparable (33.3% vs. 36.0%), they were significantly higher than SSSB (18%) (p = 0.038). MSMB had significantly more (20%) cardiopulmonary complications than SSMB (11.1%) and SSSB (4.5%) (p = 0.027). All groups exhibited comparative survivorship (8.1 ± 8.6, 7.1 ± 7.2, and 11.4 ± 11.8 months) and in-hospital mortality (4.5%, 8.9%, and 4.0%) (all; p > 0.05). Conclusion: In comparison to MSMB, SSMB intramedullary nailing did not result in higher perioperative complication or in-hospital mortality rates in select patients with synchronous long-bone metastases but led to earlier postoperative discharge and initiation of rehabilitation. [ABSTRACT FROM AUTHOR]

The single-stage high-frequency (HF) isolated ac–dc converter has the advantages of high-power density, long life, and high efficiency. It has a broad application prospect in distributed power generation, ac microgrid, and energy storage system. In this article, its topologies are classified according to the energy storage components. The structure and operating principle of various topologies are introduced. Furthermore, the development of extended multiport single-stage HF isolated ac–dc converter is introduced. On this basis, the advantages and disadvantages, typical characteristics, cost, and power loss of various topologies are analyzed and summarized. Finally, the key issues that need to be solved are pointed out and the development trends are explored. This article aims to provide a reference for the subsequent research on single-stage HF isolated ac–dc converters and the advancement of their practicability. [ABSTRACT FROM AUTHOR]

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Background: Composite rhinectomy defects pose significant challenges due to the nose's complex structure and role in facial esthetics and function. Traditional nasal reconstructions often require multiple stages to restore mucosal lining, structural support, and external skin., Methods: This case series examines the use of a single-stage osteocutaneous radial forearm free flap (OCRFFF) for composite rhinectomy reconstruction. Three patients who underwent composite rhinectomy due to malignancy were treated using OCRFFF, which allows for simultaneous reconstruction of composite nasal defects by incorporating skin, bone, and fascial tissue., Results: All three cases achieved successful postoperative outcomes, demonstrating both cosmetic and functional success without significant long-term complications. The single-stage approach streamlined the reconstructive process, reducing patient recovery time and the need for additional surgeries., Conclusions: OCRFFF is an effective, transformative technique for single-stage nasal reconstruction for composite rhinectomy defects, providing reliable functional and esthetic outcomes, and contributing to advancements in complex nasal defect management., (© 2024 Wiley Periodicals LLC.)

Background: Iatrogenic cervical kyphosis (ICK) often requires complex anterior and posterior correction, which is associated with multiple complications. Consequently, there is a need to investigate alternative treatment approaches that streamline the operative process and markedly diminish postoperative complications. This study, therefore, aimed to evaluate the feasibility and efficacy of a single-stage anterior controllable antedisplacement fusion (ACAF) in revision surgeries for ICK., Methods: A retrospective review was conducted on three ICK cases treated with the ACAF technique in our department from December 2023 to January 2024. The cohort comprised two females and one male. The medical records, symptoms, signs, imaging studies, and 3-month postoperative follow-up data were analyzed to preliminarily evaluate the surgery's feasibility and efficacy., Results: The mean operative time was 222.0 ± 67.5 min, with an average blood loss of 83.3 ± 28.9 mL and an average hospital stay of 11.7 ± 2.9 days. No patient experienced severe complications, such as neurological damage, during surgery. Postoperatively, two patients experienced transient respiratory distress within 2-5 days, managed with low-dose methylprednisolone (80 mg daily) and supplemental oxygen via nasal cannula. At the 3-month follow-up, all patients showed significant symptom improvement and increased cervical Japanese Orthopedic Association scores. Radiographic assessments, including X-rays and computed tomography scans, demonstrated marked improvements in cervical curvature without evidence of screw loosening. Magnetic resonance imaging indicated significant dural sac expansion and alleviation of spinal cord compression., Conclusion: The ACAF technique effectively corrects ICK, offering advantages such as reduced intraoperative blood loss, fewer complications, and shorter operative and hospitalization times compared to traditional combined anterior-posterior corrective approaches. It presents an effective alternative for surgeons performing revision corrective surgery for ICK., (© 2025 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Introduction: Managing choledocholithiasis alongside cholelithiasis has seen significant evolution, presenting options such as single-stage cholecystectomy with common bile duct (CBD) exploration, or a two-stage procedure involving endoscopic retrograde cholangiopancreatography (ERCP) performed before or after cholecystectomy. Evidence from Western settings may not fully capture the unique disease burden and demographic characteristics prevalent in developing countries. Laparoscopic common bile duct exploration (LCBDE) is more commonly performed in the Indian subcontinent compared to Western centers due to limited access to advanced procedures and specialized instrumentation for complex ERCP cases. The high cost and the need for extensive armamentarium in managing failed ERCPs make LCBDE a more feasible option in many Indian centers., Methods: This prospective study, conducted from August 2019 to July 2020 at King George's Medical University, UP, India, included n = 24 patients diagnosed with choledocholithiasis. The operative procedures performed included laparoscopic CBD exploration and cholecystectomy, along with internal endo-biliary drainage. Perioperative outcomes were assessed, and follow-up data were included to monitor any recurrence until 36 months post-surgery., Results: The study population had a mean age of 42.2 years, with 83% (n = of the patients being female). Abdominal pain was the predominant symptom, reported by 91.66% of the patients, followed by nausea/vomiting in 79.20% of cases. The mean CBD diameter observed was consistent with existing literature. The mean operating time was 2.02 h, with primary duct closure taking an average of 13.66 min. Mean blood loss during surgery was 136.25 mL. The average hospital stay was 5.54 days, with the majority of drain removals occurring by the third postoperative day. Complications included fever in 25.0% of the patients and bile leakage in n = 3 out of 24 cases (~12.50%). During the follow-up period, one patient (4.17%) experienced a retained stone., Conclusion: Laparoscopic CBD exploration with primary duct closure and internal biliary drainage appears to be a feasible approach, yielding satisfactory perioperative outcomes. However, further studies are required to firmly establish its superiority over alternative approaches within the Indian context., (© 2024 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)