Purpose/Significance In order to learn the origin and the development status of the international smart learning environment, It provides a certain reference for further improving the relevant ...research and practice in the field of intelligent learning environment. Method/Process This article used 402 documents collected in the Web of Science database as the data source, and analyzed the co-occurrence and co-citation analysis of key literatures, institutions, journals, and authors in the field of smart learning environment with the help of the bibliometric tool CiteSpace software. Result/Conclusion It is revealed that the smart learning environment stems from changes in the learning environment under technological development. The traditional learning environment can no longer meet the diverse needs of the "indigenous people" in the modern information age. The learning environment needs to be updated to make students’ learning more efficient and convenient. At the same time, the smart learning environmen
Long ureteral defects have remained a challenge to urologists for a long time. Bowel interposition, including ileal ureter, appendiceal interposition and reconfigured colon substitution, has gained ...wide acceptance, even though it is a complicated procedure and associated with some potential complications. Mucus obstruction and metabolic disorders are common complications of intestinal substitution. To circumvent these troubles, modified techniques, such as tapering the bowel graft, intestinal onlay flap and the Yang–Monti procedure, are used. In particular, Yang–Monti ileal ureter replacement is a highly effective option for ureteral reconstruction, and the incidence of complications would be significantly reduced in select patients. After being combined with the Boari flap or psoas hitch technique, the length of intestinal segment used can also be significantly reduced. Most recent long‐term results suggest that ileal ureter replacement with antireflux anastomosis seems to be remarkably free of complications, and we highly praise the distal nipple valve technique. Appendiceal interposition is available for patients with normal appendix, and usually this procedure is limited to reconstructing the right ureter. Appendiceal onlay ureteroplasty has emerged as a feasible and effective option to manage patients with complex proximal and mid‐ureteral strictures of the right side. The colon is rarely used for ureteral reconstruction because of its large caliber and mucous surface area. However, a reconfigured colon segment is a good substitute to reconstruct long‐segment ureteral defects, and long‐term follow up confirmed minimal complications and improved renal function. This review provides a comprehensive perspective on complex ureteral reconstruction and replacement using intestinal segments, in particular, ileal ureter replacement.
Potential DMRs were selected based on receiver operating characteristic (ROC) analysis performed using the methylation level (mean β value of probes within each window). ...the β values of the 25 ...DMRs were analyzed in 440 BCa, 21 BCa-NAT, 324 kidney renal clear cell carcinoma (KIRC), 275 kidney renal papillary cell carcinoma (KIRP) samples from The Cancer Genome Atlas (TCGA) database, and 656 healthy blood samples from the Gene Expression Omnibus (GEO) database. After considering the background noise in healthy blood/NATs and the feasibility of primer design, eight DMRs were selected for further testing in 30 healthy blood samples and 20 normal urine samples using polymerase chain reaction (PCR) and Sanger sequencing. Furthermore, a positive detection of this molecular urine test, followed by more sensitive narrow-band imaging or photodynamic diagnosis, could decrease false-negative rates when compared with white light cystoscopy. ...this simple and efficient diagnostic test has great clinical application prospects.
Objective
The present study aimed to evaluate renal function, complications, and changes in tumor size after transarterial embolization for patients with renal angiomyolipomas.
Methods
We performed a ...meta-analysis of transarterial embolization in patients with renal angiomyolipomas from January 1994 to April 2018. Endpoints of interest were the estimated glomerular filtration rate, serum creatinine levels, blood urea nitrogen levels, complications, and reduction of tumors.
Results
A total of 30 studies comprising 653 patients were included. A total of 32.0% of patients were treated by urgent transarterial embolization for spontaneous ruptured renal angiomyolipomas. Other patients sought to relieve symptoms or received embolism prophylactically. The estimated glomerular filtration rate showed no significant difference between before and after embolization. In 363 patients with data on complications, post-embolization syndrome occurred most frequently (54.0%). Only 16 (4.4%) patients had major complications. The diameter of sporadic angiomyolipomas was reduced by a mean of 2.09 cm (95% confidence interval CI, 0.73–3.45 cm; I2 = 29.3%) and they were reduced in size by 30.0% (95% CI, 16.0%–44.0%; I2 = 27.9%).
Conclusions
Transarterial embolization of renal angiomyolipomas affects renal function preservation, with a low complication rate. Transarterial embolization is useful for sporadic and tuberous sclerosis complex-related angiomyolipomas.
Spirals, tilings, and hyperbolic geometry are important mathematical topics with outstanding aesthetic elements. Nonetheless, research on their aesthetic visualization is extremely limited. In this ...paper, we give a simple method for creating Escher-like hyperbolic spiral patterns. To this end, we first present a fast algorithm to construct Euclidean spiral tilings with cyclic symmetry. Then, based on a one-to-one mapping between Euclidean and hyperbolic spaces, we establish two simple approaches for constructing spiral tilings in hyperbolic models. Finally, we use wallpaper templates to render such tilings, which results in the desired Escher-like hyperbolic spiral patterns. The method proposed is able to generate a great variety of visually appealing patterns.
The composition characteristics and working principle of the hydraulic rotary system of the azimuth thruster were analyzed. The mathematical model of the rotary dynamic system of the pump-controlled ...hydraulic motor driving the gear reduction mechanism was established. Additionally, a fast tracking method for the azimuth angle of the azimuth thruster was proposed to analyze the rotary azimuth angle, angular velocity and dynamic response characteristics of the hydraulic system for different desired azimuth angles. The simulation results show that the established dynamic model can simulate the rotary motion response process of the real thruster, and can realize the rapid and accurate tracking of the azimuth angle. At the same time, the physical constraints of the rotary dynamic response were established. It provides an important reference for research on the motion control methods of dynamic positioning vessels.
Horseshoe kidney (HSK) is the most common renal fusion anomaly, occurring in 0.25% of the population (1). It presents technical obstacles to pyeloplasty for ureteropelvic junction obstruction (UPJO) ...despite robotic assistance (2, 3). KangDuo-Surgical-Robot-01 (KD-SR-01), an emerging robotic platform in China, has yielded satisfactory outcomes in pyeloplasty (4, 5). We first describe our modified technique of robotic bilateral pyeloplasty for UPJO in HSK using KD-SR-01 system in the Lithotomy Trendelenburg position.
A 36-year-old man with HSK and bilateral UPJO suffered right flank pain due to renal calculi (Figure-1). Repeated double-J stent insertion and ureteroscopy lithotripsy did not relieve his symptoms. A robot-assisted modified bilateral dismembered V-shaped flap pyeloplasty was performed using KD-SR-01 system in the Lithotomy Trendelenburg position.
Total operative time was 298 minutes with 50 ml estimated blood loss. There was no conversion to laparoscopic or open surgery. A follow-up of 14 months showed relieving symptoms and stable renal function. Cine magnetic resonance urography and computed tomography urography revealed improved hydronephrosis and good drainage. No intraoperative or postoperative complications occurred.
It is technically feasible to perform a KD-SR-01-assisted modified bilateral dismembered V-shaped flap pyeloplasty in the Lithotomy Trendelenburg position for HSK. This procedure achieves managing UPJO on both sides without redocking the system and provides a wider operative field. In addition, it may be associated with better ergonomics, better cosmetic outcomes, and less possibility of postoperative bowel adhesion. However, further investigation is still warranted to confirm its safety, efficacy, and advantages over traditional procedures.
In this paper, a model predictive control (MPC) method optimized by an adaptive particle swarm optimization (APSO) algorithm is proposed. Combined with non-singular terminal sliding mode control ...(NTSMC), the inner and outer double-closed-loop control system is constructed to solve the fully actuated autonomous underwater vehicle (AUV) dynamic trajectory tracking control problem. First, the outer loop controller generates the expected optimal velocity commands and passes them to the inner loop velocity controller, which generates the available control inputs to ensure the entire closed-loop trajectory tracking. In the controller design stage, system input and state constraints are effectively considered. After that, a compensator based on an adaptive radial basis function (RBF) neural network (NN) is designed to compensate for the model error and external sea state disturbances and to improve the control accuracy of the system. Then, the stability of the proposed controller is proved based on Lyapunov analysis. Finally, the dynamic trajectory tracking performance of an AUV with different sea state disturbances is verified by simulation, and the simulation results are compared with double-closed-loop PD control and cascade control of standard MPC based on PSO and SMC. The results show that the designed controller is effective and robust.
Abstract Purpose To present the experience of ileal ureter with ileocystoplasty (IUC), and compare the outcomes of IUC in minimally invasive procedures to open procedures. Patients and methods From ...December 2017 to April 2023, twenty patients underwent IUC in open or minimally invasive (including laparoscopic and robotic) procedures. The baseline characteristics, perioperative data and follow-up outcomes were collected. Success was defined as relief of clinical symptoms, stable postoperative serum creatine and absence of radiographic obstruction. The perioperative and follow-up outcomes of open procedures and minimally invasive procedures were compared. Results The etiology included pelvic irradiation (14/20), urinary tuberculosis (3/20) and surgical injury (3/20). Bilateral ureter strictures were repaired in 15 cases. The surgeries conducted consisted of open procedures in 9 patients and minimally invasive procedures in 11 patients. Compared to open procedures, minimally invasive surgeries had less median estimated blood loss (EBL) (100 ml vs. 300 min, p = 0.010) and shorter postoperative hospitalization (27 d vs. 13 d, p = 0.004). Two patients in the open group experienced grade 3 complications (sigmoid fistula and acute cholecystitis in one patient, and pulmonary embolism in another patient). Over a median follow-up period of 20.1 months, the median bladder functional capacity was 300 ml, with a 100% success rate of IUC. Conclusion IUC is feasible in both open and minimally invasive procedures, with acceptable complications and a high success rate. Minimally invasive procedures can have less EBL and shorter postoperative hospitalization than open procedure. However, prospective studies with larger groups and longer follow-up are needed.
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