The ionosphere serves as a critical medium for radio signal propagation in outer space. A good morphology of the global TEC distribution is very useful for both ionospheric studies and their relative ...applications. In this work, a deep learning framework was constructed for better spatial estimation in ionospheric TEC. Both the DCGAN and WGAN-GP were considered, and their performances were evaluated with spatial completion for a regional TEC. The performances were evaluated using the correlation coefficient, RMSE, and MAE. Moreover, the IAAC rapid products were used to make comparisons. The results show that both the DCGAN and WGAN-GP outperformed the IAAC CORG rapid products. The spatial TEC estimation clearly goes well with the solar activity trend. The RMSE differences had a maximum of 0.5035 TECu between the results of 2009 and 2014 for the DCGAN and a maximum of 0.9096 TECu between the results of 2009 and 2014 for the WGAN-GP. Similarly, the MAE differences had a maximum of 0.2606 TECu between the results of 2009 and 2014 for DCGAN and a maximum of 0.3683 TECu between the results of 2009 and 2014 for WGAN-GP. The performances of the CORG, DCGAN, and WGAN-GP were also verified for two selected strong geomagnetic storms in 2014 and 2017. The maximum RMSEs were 1.8354 TECu and 2.2437 TECu for the DCGAN and WGAN-GP in the geomagnetic storm on 18 February 2014, respectively, and the maximum RMSEs were 1.3282 TECu and 1.4814 TECu in the geomagnetic storm on 7 September 2017. The GAN-based framework can extract the detailed features of spatial TEC daily morphologies and the responses during geomagnetic storms.
Estimating the intensity of tropical cyclones (TCs) is beneficial for preventing and reducing the impact of natural disasters. Most existing methods for estimating TC intensity utilize ...single-satellite or single-band remote sensing images, but they lack the ability to quantify the uncertainty of the estimation results. However, TC, as a typical chaotic system, often requires confidence intervals for intensity estimates in real-world emergency decision-making scenarios. Additionally, the use of multi-source image inputs contributes to the uncertainty of the model. Consequently, this study introduces a neural network (MTCIE) that utilizes multi-source satellite images to provide probabilistic estimates of TC intensity. The model utilizes infrared and microwave images from multiple satellites as inputs. It uses a dual-branch self-attention encoder to extract TC image features and provides uncertainty estimates for TC intensity. Furthermore, a dataset for estimating the intensity of multi-source TC remote sensing images (MTCID) is constructed through the registration of latitude, longitude, and time, along with data augmentation. The proposed method achieves a MAE of 7.42 kt in deterministic estimation, comparable to mainstream networks like TCIENet. In uncertain estimation, it outperforms methods like MC Dropout in the PICP metric, providing reliable probability estimates. This supports TC disaster emergency decision making, enhancing risk mitigation in real-world applications.
Mold design and construction is typically the most time-consuming and costly process in the fabrication of custom freeform product surfaces. Reconfigurable molds reduce this time and cost; however, ...some opportunities for improvement in reconfigurable systems are still possible in design by reducing system complexity and reconfigure time for a target application. A novel “multi-actuated optimized reconfigurable freeform surface (MORFS)” mold is proposed for the following key targets to (1) design the system for a targeted application, e.g., custom foot orthoses (CFOs), (2) reduce system complexity, (3) reduce system reconfigure time, and (4) ensure accuracy. The MORFS design process involves the following steps: (1) data processing, segmentation, normalization, and dimensionality reduction; (2) design of a novel mechanical subassembly; (3) development of a finite element (FE) flexible shell model of the manufacturing surface mold; (4) design optimization; and (5) development of a machine learning (ML)-based feedback control algorithm. The developed MORFS mold is 29% less complex, and 60% faster as compared with the benchmark study while maintaining the desired accuracy, i.e.
mean
error
≤
1
mm
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Furthermore, the accuracy of the optimized MORFS mold is also increased up to 39% as compared with the unoptimized configuration. The mechanical subassembly of the MORFS mold is improved by conducting design optimization, i.e., the number of actuators is reduced. Furthermore, the system reconfigure time is reduced significantly by using the FE model based ML control algorithm. The proposed design methodology ensured the desired accuracy of the surface construction for a target application. This case study is limited to the construction of freeform surfaces for CFOs; however, the proposed MORFS design methodology may be used to improve the time, complexity, and cost aspects of manufacturing in different areas including aerospace, automotive, biomechanics, and civil.
To evaluate the onlay technique using the appendix for ureteral reconstruction and describe the initial experience of nine operations performed by one surgeon.
Nine patients with complex ureteral ...strictures who underwent appendiceal onlay flap ureteroplasty since May 2019 were recruited from our RECUTTER database. There were seven men and two women, with a mean age of 38.9 years; four patients underwent robot-assisted laparoscopic surgery, and five patients underwent traditional laparoscopic surgery. All patients had iatrogenic injuries of the ureter after treatment of stone disease. Seven patients had proximal ureteral strictures, and two had midureteral strictures. The mean stricture length of the nine patients was 3.9 (range 3-4.5) cm. Nephrostomy was performed in seven patients before they presented to our center, and the other two patients had indwelling Double-J ureteral stents.
All nine operations were effectively completed without open conversion. The mean operation time was 182 (range 135-220) minutes, the mean estimated blood loss was 71 (range 20-100) mL, and the mean length of postoperative hospital stay was 9 (range 6-12) days. No postoperative complications of high grade (Clavien-Dindo III and IV) occurred within 30 days of surgery. All the patients had their Double-J ureteral stents and nephrostomy tubes removed after complete ureteroscopy and upper urinary tract urodynamic examination or CTU, which showed that the anastomosis healed well and that the urinary tract was unobstructed, respectively. The objective success rate was 100% (all the patients had endoscopic and radiographic resolution of their ureteral strictures). The subjective success rate was 88.9% (one patient developed recurrent back discomfort and a 0.5 cm calculus was found in her renal pelvis).
Appendiceal onlay flap ureteroplasty is a viable and effective technique for treating complex proximal and middle ureteral strictures at the right side.
Ureteroplasty using onlay grafts or flaps emerged as an innovative procedure for the management of proximal and midureteral strictures. Autologous grafts or flaps used commonly in ureteroplasty ...include the oral mucosae, bladder mucosae, ileal mucosae, and appendiceal mucosae. Oral mucosa grafts, especially buccal mucosa grafts (BMGs), have gained wide acceptance as a graft choice for ureteroplasty. The reported length of BMG ureteroplasty ranged from 1.5 to 11 cm with success rates of 71.4%-100%. However, several studies have demonstrated that ureteroplasty using lingual mucosa grafts yields better recipient site outcomes and fewer donor site complications than that using BMGs. In addition, there is no essential difference in the efficacy and complication rates of BMG ureteroplasty using an anterior approach or a posterior approach. Intestinal graft or flap ureteroplasty was also reported. And the reported length of ileal or appendiceal flap ureteroplasty ranged from 1 to 8 cm with success rates of 75%-100%. Moreover, the bladder mucosa, renal pelvis wall, and penile/preputial skin have also been reported to be used for ureteroplasty and have achieved satisfactory outcomes, but each graft or flap has unique advantages and potential problems. Tissue engineering-based ureteroplasty through the implantation of patched scaffolds, such as the small intestine submucosa, with or without cell seeding, has induced successful ureteral regeneration structurally close to that of the native ureter and has resulted in good functional outcomes in animal models.
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 underground coal mines, the stability of the retracement channel in the surrounding rock is crucial for the safe and efficient retracement of the equipment and to guarantee the continuity of the ...retracement work. To reveal the deformation and damage mechanism of the surrounding rock of an auxiliary retracement channel (ARC) and the determination method for the reasonable spacing of two retracement channels during the end of the mining period, the deviatoric stress field in front of the working face and the change in the shape characteristics of the plastic zone in the ARC are investigated in this paper. The formation of ultimate stress equilibrium, high deviatoric stress, decreasing deviatoric stress, and low deviatoric stress environments in front of the working face during the end of mining occur successively, and the different deviatoric stress environments are the main reasons for the different shape characteristics of the plastic zone in the surrounding rock. The changes in the shape characteristics of the plastic zone correspond to the changes in the shape characteristics in the zone with deviatoric stress and exhibit the following order: full plastic deformation zone, butterfly-shaped zone, elliptical zone, and circular plastic zone. A reasonable spacing determination method for the two retracement channels is proposed: the ARC is arranged in the decreasing deviatoric stress environment, where the surrounding rock plastic zone shape is elliptical, and the ARC is relatively stable. Based on this research result, the spacing of the double retracement channels at the Lijiahao 22-116 working face was determined to be 25 m, which achieved a positive application effect and allowed the safe and efficient retracement of the working face equipment.
The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of ...urological procedures using the KD-SR-01 system.
From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed.
A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation UR), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively.
The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.
Ileal ureter replacement is an alternative treatment for various length ureter defects. We present our experience and outcome of ileal ureter replacement in China.
We retrospectively collected data ...of patients who underwent ileal ureter replacement between January 2010 and January 2015. We reviewed the medical history, indications for surgery, operative data, perioperative data, and outcomes. Besides, follow-up data included symptom, urine routine test, serum creatinine, serum electrolyte status, and radiographic test.
There were 23 patients who underwent ileal ureter replacement by the same surgeon. Twenty patients were performed unilateral ileal ureter replacement, two patients underwent a combination of ileal ureter replacement and Boari flap-psoas hitch, and one received bilateral ileal ureter replacement. Among these patients, the main cause leading to surgical treatment was iatrogenic injuries (n = 15), especially urinary surgery procedure (n = 11). The median follow-up time was 45 months. There were 6 early complications and 6 late complications after operation. Only one patient suffered from small bowel-related complication and was cured by conservative treatment. Only the patient who underwent bilateral ileal ureter replacement had metabolic acidosis. And 22 patients (95.7%) had a good renal function.
Ileal ureter replacement is an efficacious and safe procedure for the therapy of long ureteral defects. With appropriate technical considerations, the complication rate may decrease.
This study aims to identify predictive local recurrence risk factors and site-specific local recurrence pattern of upper tract urothelial carcinoma (UTUC) with different primary tumor locations.
...Three hundred and eighty-nine UTUC patients with radical nephroureterectomy were included in this study. Univariate and multivariate Cox proportional hazards regressions were performed to measure the risk of local recurrence. We also mapped the position of local recurrence sites stratified by primary tumor locations.
A total of 73 patients (18.7%) developed local recurrence within a median follow-up of 41 months (range, 3-80 months). For patients with local recurrence, the median interval of local recurrence was 9 months. Ureter tumor, multifocality, T stage, G grade, lymph node metastasis (LNM), lymph node dissection (LND), and lymph vascular invasion (LVI) were all significantly associated with increased local recurrence by univariable analyses (P < 0.05). Only multifocality, T3-4, G3, and LNM remained independent predictors of increased local recurrence by multivariable analyses. Adjuvant radiotherapy could reduce the local recurrence (HR = 0.177; 95% CI 0.064-0.493, P = 0.001). Patients with local recurrence had poorer cancer-specific survival (4-year cancer-specific survival rate 36 ± 7.5% vs 88.4 ± 2.2%, P = 0.000). We evaluated local recurrence pattern stratified by tumor locations. Para-aortic lymph node region was the most common recurrence area for all the patients. Left-sided UTUC had more than 70% recurrent lymph nodes in the left para-aortic region (LPA). For right-sided UTUC patients, recurrent para-aortic lymph nodes distributed in the LPA (33.3%), aortocaval (AC) (41.5%), and right paracaval (RPC) (25.2%) regions. Recurrence in the internal and external iliac regions was only found in the distal ureter group (P < 0.05). Renal pelvic fossa recurrence was only found in renal pelvic tumor (22.2%, P = 0.007). The ureter tumor bed recurrence rate was higher for ureter patients (P = 0.001).
Multifocality, T3-4, G3, and LNM are predictors of higher local recurrence rate of UTUC. Adjuvant radiotherapy can reduce local recurrence rate. Local recurrence patterns are different according to primary tumor locations.
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