The comparison of manual and mechanical anastomosis after total pharyngolaryngoesophagectomy

BackgroundTotal pharyngolaryngoesophagectomy (TPLE) is considered as a curative treatment for hypopharynx cancer and cervical esophageal carcinomas (HPCECs). Traditional pharyngo-gastric anastomosis is usually performed manually, and postoperative complications are common. The aim of this study was to introduce a new technique for mechanical anastomosis and to evaluate perioperative outcomes and prognosis.MethodsFrom May 1995 to Nov 2021, a series of 75 consecutive patients who received TPLE for a pathological diagnosis of HPCECs at Sun Yat-sen Memorial Hospital were evaluated. Mechanical anastomosis was performed in 28 cases and manual anastomosis was performed in 47 cases. The data from these patients were retrospectively analyzed.ResultsThe mean age was 57.6 years, and 20% of the patients were female. The rate of anastomotic fistula and wound infection in the mechanical group were significantly lower than that in the manual group. The operation time, intraoperative blood loss and postoperative hospital stays were significantly higher in the manual group than that in the mechanical group. The R0 resection rate and the tumor characteristics were not significantly different between groups. There was no significant difference in overall survival and disease-free survival between the two groups.ConclusionThe mechanical anastomosis technology adopted by this study was shown to be a safer and more effective procedure with similar survival comparable to that of manual anastomosis for the HPCECs patients

Numerical Investigation on Hydrodynamic Performance of a Portable AUV

This paper conducts a numerical investigation on the hydrodynamic performance of a portable autonomous underwater vehicle (AUV). The portable AUV is designed to cruise and perform some tasks autonomously in the underwater world. However, its dynamic performance is strongly affected by hydrodynamic effects. Therefore, it is crucial to investigate the hydrodynamic performance of the portable AUV for its accurate dynamic modeling and control. In this work, based on the designed portable AUV, a comprehensive hydrodynamic performance investigation was conducted by adopting the computational fluid dynamics (CFD) method. Firstly, the mechanical structure of the portable AUV was briefly introduced, and the dynamic model of the AUV, including the hydrodynamic term, was established. Then, the unknown hydrodynamic coefficients in the dynamic model were estimated through the towing experiment and the plane-motion-mechanism (PMM) experiment simulation. In addition, considering that the portable AUV was affected by wave forces when cruising near the water surface, the influence of surface waves on the hydrodynamic performance of the AUV under different wave conditions and submerged depths was analyzed. Finally, the effectiveness of our method was verified by experiments on the standard models, and a physical experiment platform was built in this work to facilitate hydrodynamic performance investigations of some portable small-size AUVs

Spatiotemporal Urban Waterlogging Risk Assessment Incorporating Human and Vehicle Distribution

Due to the increase in frequency and severity, assessing and predicting urban waterlogging risk is critical. The risk assessment framework is based on three factors: hazard, exposure, and vulnerability. The assessment indicators, previously based solely on static indicators, account for the effects of varying temporal and spatial distributions of people and vehicles on the assessment results. Specifically, two dynamic indicators—the population density and the Traffic Performance Index (TPI)—are added to the mix to dynamically assess the risk of waterlogging in the central urban area of Suqian City of Jiangsu Province, China’s central urban area, over various periods. The findings indicate that four–six times more individuals are affected during peak hours than during other periods, and no important roads are within the scope of waterlogging during other periods, while nearly ten important roads will be affected during peak hours. Additionally, the characteristics of the temporal and spatial distribution of waterlogging risk can be more accurately represented by a combination of static and dynamic indicators. The highest risk areas are significantly more prominent during the weekday peak period than during other times; the morning peak is mainly affected by traffic performance indicators, the evening peak is mainly affected by population density, and the main factors affecting the other periods are the same as the other main factors affecting the peak period. The highest risk areas are mainly located in the eastern part of the central urban area of Suqian City, with the lowest risk in the north and south

Vulnerability Assessment and Future Prediction of Urban Waterlogging—A Case Study of Fuzhou

Evaluating waterlogging vulnerability and analyzing its characteristics and future trends can provide scientific support for urban disaster prevention and reduction. For this study, taking Fuzhou as an example, an urban waterlogging vulnerability assessment system was constructed from the three dimensions of exposure, sensitivity, and adaptive capacity. The entropy method was used to evaluate urban waterlogging vulnerability in Fuzhou during 2014–2020. The use of CA–Markov to predict waterlogging vulnerability in 2023, 2026, and 2029 in Fuzhou is an important innovation reported in this paper. Study results showed that: (1) Vulnerability to waterlogging in Fuzhou follows a gradually decreasing “center-southeast” distribution pattern, with Level 5 areas mainly located in Cangshan District, Gulou District, and Taijiang District. (2) Changes in waterlogging vulnerability in Fuzhou from 2014 to 2020 can be divided into five change modes, with changing areas, mainly of the late-change type, accounting for 14.13% of the total area. (3) Prediction accuracy verification shows that the CA–Markov model is suitable for predicting waterlogging vulnerability in Fuzhou with high accuracy and a kappa coefficient of 0.9079. (4) From 2020 to 2029, the vulnerability level of the eastern coastal region of Fuzhou is expected to generally increase, and the vulnerability degree will continue to deteriorate. The proportion of Level 5 vulnerable areas will increase by 4.5%, and the growth rate will increase faster and faster with the passage of time

Cognitive Decline in Chronic Migraine with Nonsteroid Anti-inflammation Drug Overuse: A Cross-Sectional Study

Background. Chronic migraine with medication overuse headache (CM-MOH) is the most common type of chronic migraine, and it increases risk of stroke and white matter lesions. These pathologic changes could induce cognitive decline. However, the alteration of cognitive function in CM-MOH patients is not established. Therefore, we took this study to reveal the cognitive performances in CM-MOH. Methods. This cross-sectional study was conducted between December 2015 and January 2017. Patients were divided into CM-MOH, CMwoMOH (chronic migraine without medication overuse), and MO (migraine without aura) groups. Cognitive function was assessed in all cases during interictal periods using Addenbrooke’s Cognitive Examination Test (ACE-R), Trail Making Test A/B (TMT A/B), and Digit Symbol Test (DST). Detailed headache characteristics and evaluation of anxiety, depression, and living and sleep quality were collected. Results. 116 patients were included in this study. There were 21 CM-MOHs, 20 CMwoMOHs, 35 MOs, and 40 controls. Age and education were the independent risk factors of cognitive decline (P0.05). Meanwhile, CM-MOH got significantly higher scores than MO in anxiety and depression, with poorer performances in sleep and life quality (P<0.05). Conclusion. The risk of cognitive decline increased in chronic migraine patients. Nonsteroid anti-inflammatory drugs overuse had no influence on cognitive performances among chronic migraine sufferers