Average Operation Research Articles

Learning Curve Associated With Thoracoscopic Anterior Vertebral Body Tether and Double Anterior Vertebral Body Tether for Idiopathic Scoliosis: Analysis of Three Independent Surgeons.

Anterior vertebral body tether (VBT) is a fusionless approach to treat idiopathic scoliosis, and surgeons are beginning to implement the technique into current practice. This study aims to evaluate the learning curve for single and double VBT. A retrospective review of 3 surgeons' first 40 single and 20 double VBT was performed. Skeletally immature patients with idiopathic scoliosis who underwent thoracic (single) or thoracolumbar (double) VBT were included. Thoracic VBT was done via video-assisted thoracoscopic surgery and lumbar VBT through a mini-open retroperitoneal approach. Primary outcomes of interest were operative time, radiation exposure, and radiographic correction. Pooled and individual-surgeon analyses were performed. A total of 180 patients were included: 120 single and 60 double. Mean age was 12.7 years, and 87.8% were female. Mean segments tethered was 7.8 in single and 11.0 in double. Mean preoperative thoracic scoliosis was 51.5: single 50.5° and double 53.3°. Mean lumbar scoliosis was 36.4°: single 30.0° and double 49.0°. Average operating time was 276.2 minutes; double VBT was significantly longer (217.3 vs 394.0 minutes, P < .001). Mean blood loss was 198.5 mL, and mean fluoroscopy dose was 73.0 mGy. For single VBT, there was a decrease in operative time (283.3-174.8 minutes, P < .001) and fluoroscopy dose (70.1-53.5 mGy, P = .047) over time. Every 10 cases resulted in a 31.4 minute decrease in operative time (P < .001). There were no intraoperative complications. Single VBT resulted in 54.9% thoracic curve correction. Double VBT achieved 53.0% thoracic and 56.7% lumbar correction. There were no differences in curve correction across the learning curve. VBT is viable fusionless surgical option for scoliosis. As expected, increased experience resulted in shorter operative time; the threshold for such improvement seems to be 10 cases. Importantly, adequate and consistent curve correction can be achieved at the start of the learning curve while mitigating complications.

A Consensus-Based 360 Degree Feedback Evaluation Method with Linguistic Distribution Assessments

The 360 degree feedback evaluation method is a multidimensional, comprehensive assessment method. Evaluators may hesitate among multiple evaluation values and be simultaneously constrained by the biases and cognitive errors of the evaluators, evaluation results are prone to unfairness and conflicts. To overcome these issues, this paper proposes a consensus-based 360 degree feedback evaluation method with linguistic distribution assessments. Firstly, evaluators provide evaluation information in the form of linguistic distribution. Secondly, utilizing an enhanced ordered weighted averaging (OWA) operator, the model aggregates multi-source evaluation information to handle biased evaluation information effectively. Subsequently, a consensus-reaching process is established to coordinate conflicting viewpoints among the evaluators, and a feedback adjustment mechanism is designed to guide evaluators in refining their evaluation information, facilitating the attainment of a unanimous evaluation outcome. Finally, the improved 360 degree feedback evaluation method was applied to the performance evaluation of the project leaders in company J, thereby validating the effectiveness and rationality of the method.

Experimental Biomass Gasification in Updraft Gasifier with Gas Outlet at Reduction Zone and Air Supply using Suction Blower

Rice husk gasification is increasingly attractive, particularly with updraft gasifier type, because of its simple construction and ease of operation. However, updraft gasifier has a disadvantage of generating substantial amounts of tar. Tar will decompose into combustible gas when exposed to high temperatures. The reduction zone has a high temperature for tar decomposition to occur. Therefore, in this research, updraft gasifier was modified by positioning gas outlet at the reduction zone and inducing gasification air supply using a blower. Modifications are made by moving the gas outlet from the top to the middle or reduction area. The initial start-up of the system uses a blown air supply system, then after the syngas are produced by the operation, it is replaced with a sucked air supply. Two blowers are used, namely an exhalation or blowing blower for initial start and a suction blower for continuous operation. The fuel used was low bulk density, specifically rice husks. The aim was to characterize the modified gasifier, focusing on parameters such as operating time, duration of gas combustion, air-to-rice husks ratio, and flame color. Typically, the experiments were conducted under constant of air velocity and fuel quantity. The results showed that the average operating time, duration of flammable gas, and air-to-rice husks ratio were 74.25 minutes, 52.28 minutes, and 7.6 kg air/kg husk, respectively, and the flame produced was a bluish-yellow color that indicates a reduction tar.

Selecting optimal celestial object for space observation in the realm of complex spherical fuzzy systems

The sensible selection of celestial objects for observation by the James Web Space Telescope (JWST) is pivotal for the precise decision-making (DM) process, aligning with scientific priorities and instrument capabilities to maximize valuable data acquisition to address key astronomical questions within the constraints of limited observation time. Aggregation operators are valuable models for condensing and summarizing a finite set of data of imprecise nature. Utilization of these operators is critical when addressing multi-attribute decision-making (MCDM) challenges. The complex spherical fuzzy (CSF) framework effectively captures and represents the uncertainty that arises in a DM problem with more precision. This paper presents two novel aggregation operators, namely the complex spherical fuzzy Yager weighted averaging (CSFYWA) operator and the complex spherical fuzzy Yager weighted geometric (CSFYWG) operator. Many fundamental structural properties of these operators are delineated, and thereby an improved score function is suggested that addresses the limitations of the existing score function within the CSF system. The newly defined operators are applied to formulate an algorithm for MADM problems to tackle the challenges of ambiguous data in the selection process. Moreover, these strategies are effectively applied to handle the MADM problem of selecting the optimal astronomical object for space observation within the CSF context. Additionally, a comparative analysis is also performed to demonstrate the validity and superiority of the proposed techniques compared to the existing strategies.

Clinical efficacy of ureteroscopy-assisted laparoscopic ureteroplasty in the treatment of ureteral stricture after pelvic surgery

ObjectiveThis study is to investigate the safety and efficacy of ureteroscope-assisted laparoscopic ureteroplasty in treating ureteral stricture after pelvic surgery.MethodsA retrospective analysis of the clinical data of 95 patients treated for ureteral stricture at Ganzhou People's Hospital from June 2017 to March 2023 after pelvic surgery. In this group, 49 patients underwent ureteroscope and laparoscopic ureteroplasty under lithotomy position. The control group consisted of 46 patients who underwent simple laparoscopic ureteroplasty in a supine position. Postoperative data from both groups were collected and compared, including operation time, amount of blood loss during surgery, postoperative hospital stay, incidence of complications, success rate of ureteroplasty, and effectiveness of the operation.ResultsThe success rate of end-to-end ureteral anastomosis in the observation group was 93.88%, and the operation effectiveness rate was 100%. The success rate in the control group was 78.26% and the operation effectiveness rate was 89.1%.The average operation time and intraoperative blood loss in the observation group were (121.3 ± 44.6) min and (137.5 ± 34.2) ml, respectively, while in the control group they were (151.2 ± 52.3) min and (165.6 ± 45.8) ml, the difference were statistically significant (P < 0.05). The incidence of perioperative complications in the observation group was 2%, significantly lower than that in the control group (19.6%) (P < 0.05).ConclusionUreteroscope-assisted laparoscopic ureteroplasty for ureteral stricture after pelvic surgery has the advantages of shortened operation time, increased success rate, and reduced incidence of complications, making it an optional surgical scheme in clinical practice.

High average power (105 W) Fe:ZnSe laser pumped by radiation of laser diode side-pumped Er:YAG lasers.

A high average power re-frequency operation Fe:ZnSe laser using laser diode side-pumped free-running Er:YAG lasers as activating sources is presented. Two pieces of subsurface layer doped Fe:ZnSe polycrystal are adoptive in a reflective resonator configuration and face-cooled by liquid nitrogen. A maximal Fe:ZnSe laser power of 105 W at a wavelength of 4.1 μm is achieved upon pumping by ten home-made Er:YAG lasers with fiber coupled output working at a frequency of 250 Hz and a pulse duration of ∼420 μs. Corresponding to the maximum Fe:ZnSe laser power, the optical-optical efficiency and slope efficiency with respect to the absorbed pump power are 43% and 44% respectively. The beam quality factor M2 is measured to be 3.4. To the best of our knowledge, it is the highest output average power of an Fe:ZnSe laser reported.

Inhibiting the Jahn-Teller Effect of Manganese Hexacyanoferrate via Ni and Cu Codoping for Advanced Sodium-Ion Batteries.

Manganese (Mn)-based Prussian blue analogs (PBAs) are of great interest as a prospective cathode material for sodium-ion batteries (SIBs) due to their high redox potential, easy synthesis, and low cost. However, the Jahn-Teller effect and low electrical conductivity of Mn-based PBA cause poor structure stability and unsatisfactory performance during the cycling. Herein, a novel nickel- and copper-codoped K2Mn[Fe(CN)6] cathode is developed via a simple coprecipitation strategy. The doping elements improve the electrical conductivity of Mn-based PBA by reducing the bandgap, as well as suppress the Jahn-Teller effect by stabilizing the framework, as verified by the density functional theory calculations. Simultaneously, the substitution of sodium with potassium in the lattice is beneficial for filling vacancies in the PBA framework, leading to higher average operating voltages and superior structural stability. As a result, the as-prepared Mn-based cathode exhibits excellent reversible capacity (116.0 mAh g-1 at 0.01 A g-1) and superior cycling stability (81.8% capacity retention over 500 cycles at 0.1 A g-1). This work provides a profitable doping strategy to inhibit the Jahn-Teller structural deformation for designing stable cathode material of SIBs.

Buck technique supplemented by temporary intersegmental pedicle screw fixation to repair lumbar spondylolysis in youth

BackgroundLumbar spondylolysis is a bone defect in the pars interarticularis of the lumbar vertebral, which is a common cause of low back pain in youth. Although non-surgical treatment is a mainstream option, surgery is necessary for patients with persistent symptoms. Buck technique is widely used as a classical direct repair technique, but it cannot achieve reduction of low-grade spondylolisthesis and reconstruction of lumbosacral sagittal balance. We have described a novel surgical procedure based on Buck technique with temporary intersegmental pedicle screw fixation, and report a series of clinical outcomes in 5 patients to provide a reference for the clinical treatment of young lumbar spondylolysis.MethodsFive young patients with symptomatic lumbar spondylolysis with a mean age of 19.20 ± 5.41 years underwent surgical treatment after an average of 7.60 ± 1.52 months of failure to respond to conservative treatment, using a new surgical procedure based on Buck technique combined with temporary intersegmental pedicle screw fixation.ResultsFive patients were successfully operated without serious complications such as nerve and vascular injury. The average operation time was 109.00 ± 7.42 min, the interpretative average blood loss was 148.00 ± 31.14 ml, and the average fusion time was 11.20 ± 1.64 months. All patients were followed up for 2 years after surgery, and the visual analogue score (VAS) of low back pain and Oswestry disability index (ODI) scores were significantly improved compared with those before surgery, and the Henderson’s evaluation were rated excellent or good. After the removal of the internal fixation, it was observed that temporary intersegmental fixation could repair the isthmus, reduce lumbar spondylolisthesis, and reconstruct the sagittal balance of the lumbosacral vertebrae while preserving lumbar motion and preventing intervertebral disc degeneration. Postoperative MRI indicated the Pfirrmann classification of the affected discs: 1 case from grade III to grade II, 3 cases from grade II to grade I, and 1 case remained grade II.ConclusionsBuck technique supplemented by temporary intersegmental pedicle screw fixation is a highly applicable and effective method for the treatment of adolescent lumbar spondylolysis. The isthmic fusion is accurate, and temporary intersegmental fixation can effectively prevent disc degeneration and reconstruct the sagittal balance of lumbosacral vertebra.

Effect of endoscopic full-thickness resection assisted by distal serosal turnover with floss traction for gastric submucosal masses

BACKGROUND Complex and high-risk surgical complications pose pressing challenges in the clinical implementation and advancement of endoscopic full-thickness resection (EFTR). Successful perforation repair under endoscopy, thereby avoiding surgical intervention and postoperative complications such as peritonitis, are pivotal for effective EFTR. AIM To investigate the effectiveness and safety of EFTR assisted by distal serosal inversion under floss traction in gastric submucosal tumors. METHODS A retrospective analysis of patients with gastric and duodenal submucosal tumors treated with EFTR assisted by the distal serosa inversion under dental floss traction from January 2023 to January 2024 was conducted. The total operation time, tumor dissection time, wound closure time, intraoperative bleeding volume, length of hospital stay and incidence of complications were analyzed. RESULTS There were 93 patients, aged 55.1 ± 12.1 years. Complete tumor resection was achieved in all cases, resulting in a 100% success rate. The average total operation time was 67.4 ± 27.0 min, with tumor dissection taking 43.6 ± 20.4 min. Wound closure times varied, with gastric body closure time of 24.5 ± 14.1 min and gastric fundus closure time of 16.6 ± 8.7 min, showing a significant difference (P &lt; 0.05). Intraoperative blood loss was 2.3 ± 4.0 mL, and average length of hospital stay was 5.7 ± 1.9 d. There was no secondary perforation after suturing in all cases. The incidence of delayed bleeding was 2.2%, and the incidence of abdominal infection was 3.2%. No patient required other surgical intervention during and after the operation. CONCLUSION Distal serosal inversion under dental-floss-assisted EFTR significantly reduced wound closure time and intraoperative blood loss, making it a viable approach for gastric submucosal tumors.

Minimally Invasive Direct Coronary Artery Bypass Grafting: Sixteen Years of Single-Center Experience.

Background: Coronary artery disease is a major cause of death globally. Minimally invasive direct coronary artery bypass (MIDCAB), using a small left anterior thoracotomy, aims to provide a less invasive alternative to traditional procedures, potentially improving patient outcomes with reduced recovery times. Methods: This retrospective, non-randomized study analyzed 310 patients who underwent MIDCAB between July 1999 and April 2022. Data were collected on demographics, clinical characteristics, operative and postoperative outcomes, and follow-up mortality and morbidity. Statistical analysis was conducted using IBM SPSS, with survival curves generated via the Kaplan-Meier method. Results: The cohort had a mean age of 63.3 ± 10.9 years, with 30.6% females. The majority of surgeries were elective (76.1%), with an average operating time of 129.7 ± 35.3 min. The median rate of intraoperative blood transfusions was 0.0 (CI 0.0-2.0) Units. The mean in-hospital stay was 8.7 ± 5.5 days, and the median ICU stay was just one day. Early postoperative complications were minimal, with a 0.64% in-hospital mortality rate. The 6-month and 1-year mortalities were 0.97%, with a 10-year survival rate of 94.3%. There were two cases of perioperative myocardial infarction and no instances of stroke or new onset dialysis. Conclusions: The MIDCAB approach demonstrates significant benefits in terms of patient recovery and long-term outcomes, offering a viable and effective alternative for patients suitable for less invasive procedures. Our results suggest that MIDCAB is a safe option with favorable survival rates, justifying its consideration in high-volume centers focused on minimally invasive techniques.

Enhancing breast cancer treatment selection through 2TLIVq-ROFS-based multi-attribute group decision making.

Breast cancer is an extremely common and potentially fatal illness that impacts millions of women worldwide. Multiple criteria and inclinations must be taken into account when selecting the optimal treatment option for each patient. The selection of breast cancer treatments can be modeled as a multi-attribute group decision-making (MAGDM) problem, in which a group of experts evaluate and rank alternative treatments based on multiple attributes. MAGDM methods can aid in enhancing the quality and efficacy of breast cancer treatment selection decisions. For this purpose, we introduce the concept of a 2-tuple linguistic interval-valued q-rung orthopair fuzzy set (2TLIVq-ROFS), a new development in fuzzy set theory that incorporates the characteristics of interval-valued q-rung orthopair fuzzy set (IVq-ROFS) and 2-tuple linguistic terms. It can express the quantitative and qualitative aspects of uncertain information, as well as the decision-makers' level of satisfaction and dissatisfaction. Then, the 2TLIVq-ROF weighted average (2TLIVq-ROFWA) operator and the 2TLIVq-ROF weighted geometric (2TLIVq-ROFWJ) operator are introduced as two new aggregation operators. In addition, the multi-attribute border approximation area comparison (MABAC) method is extended to solve the MAGDM problem with 2TLIVq-ROF information. To demonstrate the efficacy and applicability of the suggested model, a case study of selecting the optimal breast cancer treatment is presented. The results of the computations show that the suggested MAGDM model is able to handle imprecision and subjectivity in complicated decision-making scenarios and opens new research scenarios for scholars.

Laparoscopic antegrade spleen-preserving distal pancreatectomy with conservation of the splenic vessels: a prospective multi-centre case series (with video)

Introduction: Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with conservation of the splenic artery and vein (Kimura’ technique) is considered a technically challenging procedure that requires a high level of expertise in laparoscopic and pancreatic surgery. Methods: A prospective descriptive study on 18 patients with laparoscopic “antegrade” spleen-preserving distal pancreatectomy with Kimura’ technique from 2018 to 2023. The perioperative indications, clinical data, intraoperative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: The mean age was 39.4±13.3. Only 2 male patients accounted for 11.1%. The average operating time is 171±23 min. The average blood loss is 65.7±43 ml. The average tumor size is 4.1 cm. The average hospitalization is 9.4 days. The rate of pancreatic fistula is 66.7%. There is no case of transferring open surgery or blood transfusion during surgery. The results of pathological after surgery there were eight cases of solid pseudopapillary tumors, four cases of mucinous cystadenoma, six cases of neuroendocrine tumors. Conclusion: Kimura’s technique for laparoscopic spleen-preserving distal pancreatectomy is safe and feasible, which can be applied to benign tumors in the body and tail of the pancreas. However, this is a difficult technique in laparoscopic surgery that requires surgeons to have a lot of experience and equipment need to be adequate.

Clinical analysis of endonasal endoscopic surgery in esthesioneuroblastoma

Objective:To investigate the clinical characteristics of esthesioneuroblastoma and the efficacy of endonasal endoscopic surgery combined with radiotherapy/chemotherapy. Methods:The clinical and surgical data of 17 patients with esthesioneuroblastoma who underwent endonasal endoscopic surgery in our department from September 2009 to June 2023 were retrospectively analyzed. Results:Among all patients, the modified Kadish stage B was identified in 4 patients, C in 10 patients, and D in 3 patients. Ten of them underwent endonasal endoscopic surgery without neck dissection in one day, whose average operation time is （5.2±2.5） hours and average blood loss is （192±162）mL. Skull base reconstructions were performed in 15 patients, postoperative complications were observed in 3 patients, and negative margins were obtained in 13 patients. All 17 patients were followed up for an average of （49.7±40.2） months. Three patients died and 6 had recurrence and/or metastasis. The 1-year, 2-year and 5-year overall survival rates were 88.2%, 80.2%, and 80.2%, respectively, and the 1-year, 2-year and 5-year disease-free survival rates were 82.4%, 82.4%, and 50.8%, respectively. The 2-year overall survival rates of patients with negative and positive margins were 100% and 25%, respectively, while the 2-year disease-free survival rates were 61.5% and 25.0%, respectively. Conclusion:Endonasal endoscopic surgery combined with radiotherapy/chemotherapy can achieve satisfactory effect in esthesioneuroblastoma, and the prognosis of patients with positive margins is poor.

Clinical application of two types of Hook-Wire needle localization procedures for pulmonary small nodule biopsy.

With the widespread use of low-dose spiral computed tomography (LDCT) and increasing awareness of personal health, the detection rate of pulmonary nodules is steadily rising. To evaluate the success rate and safety of two different models of Hook-Wire needle localization procedures for pulmonary small nodule biopsy. Ninety-four cases with a total of 97 pulmonary small nodules undergoing needle localization biopsy were retrospectively analyzed. The cases were divided into two groups: Group A, using breast localization needle steel wire (Bard Healthcare Science Co., Ltd.); Group B, using disposable pulmonary nodule puncture needle (SensCure Biotechnology Co., Ltd.). All patients underwent video-assisted thoracoscopic surgery (VATS) for nodule removal on the same day after localization and biopsy. The puncture localization operation time, success rate, complications such as pulmonary hemorrhage, pneumothorax, hemoptysis, and postoperative comfort were observed and compared. In Group A, the average localization operation time for 97 nodules was 15.47 ± 5.31 minutes, with a success rate of 94.34%. The complication rate was 71.69% (12 cases of pneumothorax, 35 cases of pulmonary hemorrhage, 2 cases of hemoptysis), and 40 cases of post-localization discomfort were reported. In Group B, the average localization operation time was 25.32 ± 7.83 minutes, with a 100% success rate. The complication rate was 29.55% (3 cases of pneumothorax, 15 cases of pulmonary hemorrhage, 0 cases of hemoptysis), and 3 cases reported postoperative discomfort. According to the data analysis in this study, Group B had a lower incidence of puncture-related complications than Group A, along with a higher success rate and significantly greater postoperative comfort. The disposable pulmonary nodule puncture needle is safer and more effective in pulmonary small nodule localization biopsy, exhibiting increased comfort compared to the breast localization needle. Additionally, the incidence of complications is significantly lower.

Modified pedicle screw-rod fixation versus open reduction plate fixation for the management of pubic symphysis diastasis: A retrospective study

ObjectiveSurgical intervention and fixation is the recognized measurement to treat pubic symphysis diastasis caused by high-energy trauma. The purpose of this retrospective study was to assess the clinical application of modified pedicle screw-rod fixation (modified PSRF) and open reduction plate fixation (ORPF) for treating pubic symphysis diastasis. MethodsThe data of this retrospective analysis were collected from 32 patients with pubic symphysis diastasis managed with modified PSRF or ORPF from January 2012 to December 2017, with or without posterior fixation. Indicators of clinical assessments including operating time, intraoperative blood loss, relevant surgical complications as well as follow-up were recorded. Majeed scores were performed for functional evaluation, as well as Matta criteria were applied to evaluate the quality of reduction. ResultsThe average time from injury to operation was 2.9 days in modified PSRF group and 3.2 days in ORPF group. Significant differences regarding average operation time (41.8 min versus 64.3 min) and average intraoperative blood loss (46.6 ml versus 304.6 ml) were presented between modified PSRF groups and ORPF group. Neither Majeed scores nor Matta evaluation showed a significant difference between two groups. In ORPF group, the incision infection occurred in one patient and two patients developed loosening of screws. In modified PSRF group, loosening of screws was found in one patient during the operative procedure and one patient experienced femoral nerve palsy. Irritation to the lateral femoral cutaneous nerve (LFCN) was detected in two patients in modified PSRF group. ConclusionsSatisfactory clinical outcomes were provided with applications of both fixation methods for treating pubic symphysis diastasis. Modified PSRF, as a minimal invasive technique, could serve as an effective and reasonable option for treating pubic symphysis diastasis.Level of evidence: III: retrospective cohort study.Trial registration: researchregistry3906.

Транспортная энергоэффективность и экономические принципы организации морского судоходства

Modern problems of ensuring energy efficiency and carbon intensity of marine vessels are considered, taking into account the achievement of profitability of flights. Since January 2023, such issues have been particularly acute for all maritime convention vessels engaged in international transport, taking into account the introduction of amendments to annex VI of the International Convention for the Prevention of Pollution from Ships (MARPOL), developed within the framework of the IMO short-term strategy until 2030 to reduce emissions greenhouse gases from ships. The composition of the world merchant fleet by ship types and deadweight was analyzed, the work of the tram freight market and the features of achieving optimal economic operational speed of the vessel were evaluated, taking into account operational and technical conventional restrictions on carbon intensity. The transport work of the universal vessel Singularity over the past three years has been analyzed, taking into account changes in operational speed and the level of freight rates. An adequate mathematical model has been proposed for assigning an optimal average operating speed to a ship according to a carbon intensity rating. The proposed methodological materials can be used by shipping companies in the commercial and technical operation of the fleet by assigning an operational speed in preparation for the voyage and when carrying out corrective energy efficiency measures to achieve an acceptable level of carbon intensity ratings for marine vessels.

MADM framework based on interval-valued neutrosophic aczel-alsina power average operator and application to translation teaching quality evaluation of college English

The huge demand for translation talents has prompted the universities to focus on improving the quality of translation teaching. As a necessary means to improve the quality of teaching, translation teaching quality evaluation plays a role in guiding, regulating and managing translation teaching, which is an important part of translation teaching. The translation teaching quality evaluation of college English is viewed as the multiple attribute decision making (MADM). The interval-valued neutrosophic sets (IVNSs) are used as an effective tool for characterizing uncertain information during the translation teaching quality evaluation of college English. In this paper, interval-valued neutrosophic number (IVNN) Aczel-Alsina power average (IVNNAAPA) operator is proposed based on the classical Aczel-Alsina operator and power average (PA) operator. Then, IVNNAAPA operator is employed to cope with MADM problem. Finally, the numerical decision example for translation teaching quality evaluation of college English is employed to illustrate the produced method and some comparative models are used to prove the effectiveness of the IVNNAAPA method.

SURGICAL TREATMENT FOR ADVANCED COLORECTAL CANCER WITH ABDOMINAL WALL INVASION AND IMPLANTATION

Abstract Aim The prognosis of abdominal wall invasion and implantation from colorectal cancer (CRC) is not good. With radical resection and abdominal wall reconstruction (AWR) technique, locally advanced CRC patients with resectable abdominal wall invasion and implantation may achieve longer tumor-free survival time and an improved quality of life. Methods 15 patients were retrospectively analyzed. All patients underwent preoperative three-dimensional visualization reconstruction of the abdominal wall and evaluation with a multidisciplinary team (MDT). Patient information, including tumor size, defect size, operation time, intraoperative bleeding, length of hospital stays, and other factors, was collected. Results All 15 locally advanced CRC patients with abdominal wall invasion and implantation underwent radical abdominal wall tumor resection followed by AWR. The average tumor dimension and abdominal wall defects after resection were 98.13 ± 71.70 and 270.07 ± 101.95 cm2 respectively; and accurate abdominal wall classification and zoning were obtained for all patients. The average operation time was 431.7 ± 189.2 min, and the average blood loss was 513.3 ± 244.6 ml. The incidence of incisional hernia and CRC recurrence were 6.0% and 13.3%, respectively. Conclusions With comprehensive preoperative evaluation, results of radical resection of abdominal wall invasion and implantation in locally advanced CRC patients is satisfactory and safe.

A novel approach employing hesitant intuitionistic fuzzy linguistic Einstein aggregation operators within the EDAS approach for multicriteria group decision making

The Evaluation based on Distance from Average Solution (EDAS) is a multi-criteria decision analysis (MCDA) technique that uses various distances from average values to make decisions. It bears resemblance to other distance-based approaches like SPOTIS, VIKOR or TOPSIS, except that instead of positive and negative ideal solutions, it uses an average solution. For hesitant intuitionistic fuzzy linguistic term sets (HIFLTSs), we first define several operational laws and aggregation operators. As a follow-up, the hesitating intuitionistic fuzzy linguistic Einstein weighted averaging (HIFLEWA) operator is introduced. In this study, the EDAS technique is used to address a multi-criteria group decision making (MCGDM) issue by utilizing the suggested operational laws and aggregation operators for HIFLTSs, aiming to mitigate the uncertainties of decision makers (DMs). A representative numerical example is employed to illustrate the strength and logical soundness of our proposed method in identifying the optimal choice under the given limitations. A comparison examination with the existing TOPSIS approach is also performed to ensure that the results generated with EDAS are accurate.

Tailored treatment of female indirect inguinal hernias by using single-port laparoscopic percutaneous internal ring suture: a comparison between children and adults

PurposeTo compare the outcome of indirect inguinal hernias repaired by using single-port laparoscopic percutaneous internal ring suture (SPIRS) between the pediatric and adult females.MethodsThe medical records of females who were clinically assessed to have inguinal hernia from Oct. 2016 to May 2022 were reviewed. Patients who received laparoscopy for the diagnosis of the hernia type and customized treatment according to their hernia type were included, while those who chose other operation methods initially were excluded. The patients were divided into the adult and pediatric groups based on their age. The demographic characteristics, hernia types, operation durations, and outcomes were analyzed between these two groups.ResultsA total of 65 adults and 60 children were included in this study. The median age was 38 years. (range: 23–88) for group A and 3 years (range: 0.1–16) for group P. Indirect hernias were present in 85% of adults and 100% of children. All the indirect hernias were repaired by SPIRS uneventfully. Incidence of contralateral patent processus vaginalis was 24% in adults and 50% in children (p = 0.016). The average operation time was 22/46 min (one/two sides) for the adults and 9/15 min (one/two sides) for the pediatrics (p < 0.010 for both). The overall complication rates were 5.4% and 3.3% for the adult and pediatric group respectively (p = 0.106). No recurrence was observed in the pediatric group, but two adults experienced recurrence and another had chronic postoperative inguinal pain, necessitating reoperation. The mean follow-up period was 38.6 ± 15.4 months for adults and 42.8 ± 18.9 months for children (p = 0.198).ConclusionOur results support that the pathogenesis of indirect inguinal hernia for the female adults is due to the non-obliteration of a congenital processus vaginalis. Tailored treatment of the female IIH by using single-port laparoscopic percutaneous internal ring suture may be an alternative for the management of female IHs.