Average Operation Research Articles

Comparison of percutaneous mechanical thrombectomy and surgical thrombectomy in the treatment of acute arteriovenous graft thrombosis

Objective: To compare the efficacy between percutaneous mechanical thrombectomy and surgical thrombectomy in the treatment of acute arteriovenous graft thrombosis (AVG). Methods: The clinical data of acute thrombosis AVG patients treated in the Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University from January 2020 to December 2021 were retrospectively analyzed. Patients were divided into percutaneous mechanical thrombectomy group and surgical thrombectomy group according to treatment methods. Baseline information, technical success rate, complication rate, and 24-month primary and secondary patency rates of the two groups were analyzed. Results: A total of 130 patients aged (54.1±14.2) years were enrolled in the study, including 66 males and 64 females. There were 78 patients in the percutaneous mechanical thrombectomy group and 52 patients in surgical thrombectomy group. No statistically significant differences in gender, age, comorbidities, and lesion characteristics between the two groups were detected (all P>0.05). The technical success rate in the mechanical thrombectomy group was 98.7% (77/78), and the complication rate was 5.1% (4/78), while the technical success rate in the surgical thrombectomy group was 94.2% (49/52), and the complication rate was 9.6% (5/52). There were no statistically significant differences in the technical success rate and complication rate between the two groups (all P>0.05). The average operation time of mechanical thrombectomy was significantly shorter than that of surgical thrombectomy [(62.8±13.9) min vs (77.0±17.6) min, P<0.001]. The Kaplan-Meier survival analysis indicated the primary patency rates of the mechanical thrombectomy group at 12 and 24 months after thrombectomy were 62.8% and 38.5%, respectively, while the primary patency rates of the surgical thrombectomy group at 12 and 24 months were 57.7% and 36.5%, respectively. There was no statistically significant difference in the primary patency rate between the two groups (P=0.641). The secondary patency rates of the mechanical thrombectomy group at 12 and 24 months were 98.7% and 94.9%, respectively, while the secondary patency rates of the surgical thrombectomy group at 12 and 24 months were 92.3% and 82.7%, respectively. The secondary patency rates of the mechanical thrombectomy group were higher than those of the surgical thrombectomy group (P=0.020). Conclusion: Mechanical thrombectomy is a safe and effective treatment for acute AVG thrombosis, with the advantages of shorter operation time and higher secondary patency rate compared with surgical thrombectomy.

2d van der Waal SiC/borophene heterostructure as a promising anode for high-capacity Li ion battery: First principles study

We constructed SiC/borophene heterostructure based on the method of commensurate lattice with supercell approach and studied the structural, electronic and electrochemical properties using density functional theory (DFT). The interfacial binding energy of SiC/borophene is as high as −26.07 meV/Å2. Significant amounts of charge were found to drift from SiC to borophene, resulting in interfacial charge redistribution and increased Li binding affinity on the surfaces. The electronic properties of SiC/borophene showed pronounced metallic conductivity, a trait conducive to anodic applications in electrochemical cells. The calculated Li adsorption energy at the interface of SiC/borophene is −2.23 eV. Multiple layer adsorption is also observed, with the heterostructure retaining much of its structural integrity after adatom adsorption, indicating possible good cycling stability. At the maximum concentration, the Li storage capacity for SiC/borophene is 1980.63 mAh/g, surpassing a large variety of other reported 2D complexes. Also, an overall average operating voltage of 1.06 V is maintained in the structure, which is in proximity of the optimal 1.5 V threshold requisite for anodic operations. The diffusion energy barriers associated with lithium ion migration across the three distinct adsorption sites of the heterostructure all reveal a nominal magnitude with the lowest barrier energy of 0.54 eV at the top of borophene adsorption layer and site. These findings show that SiC/borophene could be used as an anode in very high-capacity lithium-ion batteries.

Effect of Lacrimal Endoscopy on Operation Time in Silicone Tube Intubation for Nasolacrimal Duct Obstruction

Purpose: To evaluate the effect of lacrimal endoscopy on operation time in silicone tube intubation for patients with nasolacrimal duct obstruction.Methods: We conducted retrograde chart review of 168 eyes of 107 patients who were diagnosed with acquired nasolacrimal duct obstruction and underwent silicone tube intubation from January 2019 to February 2023. We analyzed relationship between use of lacrimal endoscopy and operation time, and effect of operation time on success rate of surgery according to use of lacrimal endoscopy.Results: Of 168 eyes, 58 eyes underwent silicone tube intubation with lacrimal endoscopy, and 110 eyes underwent silicone tube intubation without lacrimal endoscopy. Average operation time was 10.98 ± 2.24 minutes in the group with lacrimal endoscopy, and 12.44 ± 4.08 minutes in the group without lacrimal endoscopy. Operation time in the group with lacrimal endoscopy was relatively shorter and statistically significant (&lt;i&gt;p&lt;/i&gt; = 0.003). When analyzing correlation between operation time and success rate, success rate decreased by 0.877 times when operation time increased by 1 minute in the entire group, and there was statistical significance (&lt;i&gt;p&lt;/i&gt; = 0.022). There was no statistical significance in the correlation between operation time and success rate in the group with lacrimal endoscopy. And in the group without lacrimal endoscopy, success rate decreased by 0.865 times when operation time increased by 1 minute, and there was statistical significance (&lt;i&gt;p&lt;/i&gt; = 0.019).Conclusions: In silicone tube intubation for nasolacrimal duct obstruction, Lacrimal endoscopy is considered an effective treatment that can shorten operation time and prevent complications while accurately diagnosing cause and extent of obstruction by investigating the inside of the nasolacrimal duct.

A fuel cell powered rack prototype for data center application with waste heat recovery: design consideration and experimental verification

The combination of data center and PEMFC has been a promising data center zero-carbon emission solution. However, the relevant experimental studies are very rare and most work only solved the simple electrical coupling. This paper proposed a new in-rack data center servers and PEMFC coupling design scheme considering both the electrical coupling and thermal management coupling of the servers and PEMFC, and built a cabinet prototype for the first time. The complete multi-condition continuous experiment on the PEMFC system fully demonstrates the servers power supply stability of the prototype with the fast tested power response capability of 4.9 kW in 0.1 s. The experiments under rated condition (when the servers power is 5 kW) were conducted and the carbon emission level and efficiency performance of the prototype are analyzed. Under the rated condition, the highest prototype CHP efficiency is 64.1 % while the prototype can provide 41.6 ℃ hot water with 3.04 L·min-1 and the lowest prototype CHP efficiency is 59.8 % while the prototype can provide 61.1 ℃ hot water with 1.33 L·min-1. The prototype maintains the zero-carbon (or negative carbon) emission of servers. The average operation carbon emission rate is -35 g·h-1. Compared with the full grid supporting data center, the power average prototype operation carbon reduction rate is 0.13 g·s-1·kW-1. The application potential of the proposed data center and PEMFC coupling scheme is demonstrated with the prototype experiment results from the advantage of carbon emission and heat recovery potential.

A Serious Game for Enhancing Rescue Reasoning Skills in Tactical Combat Casualty Care: Development and Deployment Study.

Serious games (SGs) have emerged as engaging and instructional digital simulation tools that are increasingly being used for military medical training. SGs are often compared with traditional media in terms of learning outcomes, but it remains unclear which of the 2 options is more efficient and better accepted in the process of knowledge acquisition. This study aimed to create and test a scenario-based system suitable for enhancing rescue reasoning skills in tactical combat casualty care. To evaluate the effectiveness of the SGs, a randomized, observational, comparative trial was conducted. A total of 148 members from mobile medical logistics teams were recruited for training. Pre- and posttraining assessments were conducted using 2 different formats: a video-based online course (n=78) and a game simulation (n=70). We designed 3 evaluation instruments based on the first 2 levels of the Kirkpatrick model (reaction and learning) to measure trainees' satisfaction, knowledge proficiency, and self-confidence. There were 4 elements that made up the learning path for the SGs: microcourses (video-based online courses), self-test, game simulation, and record query. The knowledge test scores in both groups were significantly higher after the intervention (t154=-6.010 and t138=-7.867, respectively; P<.001). For 5 simulation cases, the average operation time was 13.6 (SD 3.3) minutes, and the average case score was 279.0 (SD 57.6) points (from a possible total of 500 points), with a score rate of only 44% (222/500 points) to 67% (336/500 points). The results indicated no significant difference in trainees' satisfaction between the 2 training methods (P=.04). However, the game simulation method outperformed the video-based online course in terms of learning proficiency (t146=-2.324, P=.02) and self-perception (t146=-5.492, P<.001). Despite the high satisfaction reported by trainees for both training methods, the game simulation approach demonstrated superior efficiency and acceptance in terms of knowledge acquisition, self-perception, and overall performance. The developed SG holds significant potential as an essential assessment tool for evaluating frontline rescue skills and rescue reasoning in mobile medical logistics teams.

Dynamic Feature Focusing Network for small object detection

Deep learning has driven research in object detection and achieved proud results. Despite its significant advancements in object detection, small object detection still struggles with low recognition rates and inaccurate positioning, primarily attributable to their miniature size. The location deviation of small objects induces severe feature misalignment, and the disequilibrium between classification and regression tasks hinders accurate recognition. To address these issues, we propose a Dynamic Feature Focusing Network (DFFN), which contains a duo of crucial modules: Visual Perception Enhancement Module (VPEM) and Task Association Module (TAM). Drawing upon the deformable convolution and attention mechanism, the VPEM concentrates on sparse key features and perceives the misalignment via positional offset. We aggregate multi-level features at identical spatial locations via layer average operation for learning a more discriminative representation. Incorporating class alignment and bounding box alignment parts, the TAM promotes classification ability, refines bounding box regression, and facilitates the joint learning of classification and localization. We conduct diverse experiments, and the proposed method considerably enhances the small object detection performance on four benchmark datasets of MS COCO, VisDrone, VOC, and TinyPerson. Our method has improved by 3.4 and 2.2 in mAP and APs, making solid improvements on COCO. Compared to other classic detection models, DFFN exhibits a high level of competitiveness in precision.

The early learning curve of the bipolar enucleation of the prostate: a multicenter cohort study

ObjectivesTo evaluate the early learning curve of BipolEP (Bipolar Enucleation of the Prostate).Subjects/patients and methodsWe conducted a retrospective, multicenter analysis of surgical and functional outcomes of patients treated with BipolEp for BPO (benign prostatic obstruction). We evaluated the first 20 cases of BipolEp performed by four different surgeons in three different countries. The following baseline parameters were obtained: age, IPSS, indwelling catheter, transrectal measured prostate volume, post void residual volume (PVR) and uroflowmetry. The learning curve was analysed based on perioperative parameters and the influence of perioperative parameters was correlated with the sequence of BipolEp cases.Results84 BipolEp operations performed by 4 different surgeons in their early learning curve were studied. Mean prostate volume was 75 ml, 39% of cases had an indwelling catheter and the average operating time was 101 min. Three out of four surgeons performed at least 50% of successful operations according to Trifecta (complete enucleation and morcellation < 90 min., no conversion to TUR-P). Conversion rate to TURP was 11.9% in total which however was driven by a single surgeon with an almost 50% conversion rate. Mean enucleated prostate was 33.3 gr (18-54.5). Intraoperative complications and reported stress incontinence ranged from 0 to 38.1%. At six-weeks review, the IPPS improved by 12.5 (8–16) points and Qmax by 208% (109.8-266.7). Uroflowmetry outcomes correlated with the sequence of cases with a linear improvement during 20 consecutive cases (p = 0.018) in all centres. Major complications (Clavien Dindo ≥ 3) were rare (4.8%) and comparable between the groups.ConclusionSurgeons starting to learn BipolEp can expect to be able to achieve a linear improvement in Uroflow at the six-week postoperative evaluation after 20 consecutive cases. BipolEp can be successfully performed during the early learning curve with an acceptable rate of conversion to standard TUR-P.

Mapping brain development against neurological disorder using contrastive sharing

Cerebral palsy (CP) is a neurological disorder caused by cerebral ischemia and hypoxia during fetal brain development. Early intervention in CP patients has a favorable impact on medications and therapy; however, challenges are associated with early age development, potential recovery, and neuroimaging sensitivity. Previously, the main focus was given on early diagnosis, brain injury characterization, and neurodevelopmental outcomes in infants; however, it is inevitable to study the brain developmental patterns in health controls (HC) and CP children. This study elaborates on the effects of aging on the brains of infants with HC and CP, age ranging from a few months and 17 years using deep learning (DL). The introduced DL-based models, namely SCT-DL and MCT-DL, trained on single contrast MRI (SC-MRI) and coupling of multi-contrast (MC-MRI) to learn vulnerable brain regions associated to brain development. The proposed models are equipped with fully-convolutional-based attention mechanism leveraging average pooling operation, directly passing salient features, parallel partial computing unit, specialized parameter sharing module, fusion, and spatial-channel attention with traversal placement to learn and associate brain development accurately. In addition, the study reports optimal SC-MRI and MC-MRI deeply associated with CP vulnerabilities and association to brain development. The SCT-DL outperformed the counterpart models with accumulative MAE = 1.73 (C11C denotes HC and P denotes CP.= 1.61 and P = 1.63) underlying T1-w, where the MCT-DL is the improved version of SCT-DL and the prediction accuracy reached to MAE = 1.08 (C = 1.01 and P = 1.12) over the coupling of T1-w⊕Sagittal. The trained models result in unmatching and distinct learning patterns for healthy and CP patients. Notably, the age-wise brain development-based results deduce a significance in age association at an early age (around two years) and poor at a later age. The study findings will assist neurodevelopmental processing and clinical practices in radiomics without concerning infants’ uncooperative movement or MRI artifacts.

Transsylvian transopercular peri-central core hemispherotomy for treating epilepsy: anatomy, surgical technique, and clinical outcome.

The objective of this study was to display the anatomical landmarks, surgical technique, and clinical outcome of transsylvian transopercular peri-central core hemispherotomy (TTPH) for treating refractory epilepsy. From 2011 to 2023, 26 patients (12 with Rasmussen syndrome, 8 with hemimegalencephaly/cortical malformations, and 6 with hypoxic-ischemic encephalopathy; mean [range] age 11.3 years [16 months to 35 years]; 13 females; and 13 with right-side pathology) underwent TTPH. The mean (range) follow-up was 88 (14-156) months. The intradural surgical time, use and amount of blood transfusion, postoperative fever, hospital stay, weight at surgery, and seizure onset to surgery interval are reported. TTPH consists of 1) sylvian fissure opening, 2) coagulation of the M2 and M3 branches, 3) frontoparietal opercula removal, 4) suprainsular resection, 5) insula removal, 6) selective amygdalohippocampectomy, 7) disconnection of the posterior temporal and occipital lobes using the tentorium and falx as landmarks, 8) intraventricular callosotomy, and 9) disconnection of the basal frontal lobe. In cortical malformation, the gray-white matter interface serves as a landmark. The average intradural operating time was 7 hours 18 minutes (3 hours 33 minutes to 13 hours 45 minutes); all patients were Engel class I; and 2 patients presented with procedure-related complications (meningitis and transient abducens nerve palsy). No patient required shunt surgery or reoperation. TTPH offers anatomical landmarks as intraoperative guides and has achieved good seizure control and low complication rates.

Development of Aczel-Alsina t-norm based linear Diophantine fuzzy aggregation operators and their applications in multi-criteria decision-making with unknown weight information

Aczel-Alsina t-norm and t-conorm are intrinsically flexible and endow Aczel-Alsina aggregation operators with greater versatility and robustness in the aggregation process than operators rooted in other t-norms and t-conorm families. Moreover, the linear Diophantine fuzzy set (LD-FS) is one of the resilient extensions of the fuzzy sets (FSs), intuitionistic fuzzy sets (IFSs), Pythagorean fuzzy sets (PyFSs), and q-rung orthopair fuzzy sets (q-ROFSs), which has acquired prominence in decision analysis due to its exceptional efficacy in resolving ambiguous data. Keeping in view the advantages of both LD-FSs and Aczel-Alsina aggregation operators, this article aims to establish Aczel-Alsina operation rules for LD-FSs, such as Aczel-Alsina sum, Aczel-Alsina product, Aczel-Alsina scalar multiplication, and Aczel-Alsina exponentiation. Based on these operation rules, we expose the linear Diophantine fuzzy Aczel-Alsina weighted average (LDFAAWA) operator, and linear Diophantine fuzzy Aczel-Alsina weighted geometric (LDFAAWG) operator and scrutinize their distinctive characteristics and results. Additionally, based on these aggregation operators (AOs), a multi-criteria decision-making (MCDM) approach is designed and tested with a practical case study related to forecasting weather under an LD-FS setting. The developed model undergoes a comparative analysis with several prevailing approaches to demonstrate the superiority and accuracy of the proposed model. Besides, the influence of the parameter Λ on the ranking order is successfully highlighted.

Minimally Invasive Stapled Abdominal Wall Repair: A New Surgical Technique.

Background: Diastasis recti (DR) is a common condition, especially in women after pregnancy, often associated with concomitant hernia defects and defined as a rupture of the midline and a separation of the rectus muscle more than 2 cm. Symptoms related to this are low back pain, urinary incontinence and pelvic prolapse, as well as abdominal bulging and core instability. We analyzed clinical and functional outcomes after treatment of DR alone or associated with midline hernias in 219 patients who underwent a midline reconstruction using miSAR® technique (minimally invasive stapled abdominal wall reconstruction). Methods: Between April 2019 and April 2022, 219 patients were treated with miSAR®. All patients were requested to quantify preoperative and postoperative functional symptoms (urinary incontinence, low back pain, abdominal swelling, and respiratory distress). Results: Twenty-seven men and 192 women underwent the miSAR® technique. The mean body mass index was 23.9 kg/m2. We performed the miSAR® technique in patients affected by incisional midline hernia and umbilical hernia alone or associated with DR. Composite mesh was used in 91.8% of cases. The average operating time was 90 minutes. Seven percent of the patients had postoperative complications, including two retromuscular hematomas, two retromuscular seromas, and one postoperative bleeding event. Two patients were readmitted for bowel obstruction. After surgery, there was symptomatic improvement in urinary incontinence, low back pain, respiratory symptoms, and abdominal swelling; this improvement was confirmed at 6 months and at 1- and 2-year follow-up. At the 1-year follow-up, the overall recurrence rate was 2.83%. Conclusion: miSAR® is a feasible and effective technique and shows promising results in the treatment of DR and ventral hernia. Possible enhancements include use of preoperative Botox to treat defects larger than 6 cm. Multicentric analysis is needed to validate the technique, and longer follow-up is required to assess the recurrence rate.

Preliminary study of a new magnetic compression technique for circumcision in dogs: An experimental animal model

IntroductionTraditional/ritual/medical circumcision can be associated with considerable intraoperative blood loss and a prolonged postoperative healing course. This study investigated the feasibility of the magnetic compression technique (MCT) for circumcision in beagle dogs. MethodsA set of magnetic rings including a daughter magnetic ring (DMR) and a parent magnetic ring (PMR) were designed for circumcision. In eight beagle dogs as the animal model, the DMR was placed between the penis and the foreskin through the glans, and then the PMR was placed outside the penis. The DMR and PMR automatically attracted together to compress the foreskin. The necrosis of the prepuce of the anterior penis was observed daily. The operation time and time to magnetic ring shedding were recorded. Healing of the foreskin stump was visually observed. ResultsThe magnetic rings were successfully installed in all eight dogs, and the operation process was without complication. The average operation time was 3.13 ± 0.92 min (range, 2–4.5 min). Postoperative X-rays showed good attraction of the magnetic rings. Daily post-operative observation showed progressive ischemic necrosis of the anterior foreskin and mild edema of the proximal foreskin. The dogs were generally in good condition and urinated freely. The magnetic rings fell off spontaneously 8–12 days after the operation, and the stump of the foreskin healed well. ConclusionThe MCT may be a new approach for circumcision in a canine model, which suggests its potential for use in humans.

Application of Improved Class of Weighted Averaging Operators in Intuitionistic Fuzzy Ann Guided MAGDM E-Commerce Problems

Objectives: To propose a novel and improvised Artificial Neural Network (ANN) technique to solve Multiple Attribute Group Decision Making (MAGDM) problems and an improved class of Aggregation operators for combining Intuitionistic Fuzzy Set (IFS) matrices for the ANN algorithm. Methods: A novel class of improved aggregation operators namely the Improved Intuitionistic Fuzzy Weighted Arithmetic Averaging (IM-IFWAA) operator and the Improved Intuitionistic Fuzzy Ordered Weighted Averaging (IM-IFOWA) operator are proposed in this work. The proposed improved class of aggregation operators will aggregate the IFS matrix data sets appearing in the form of matrices and then the revised input vectors which is then fed into the ANN algorithm following Delta, Perceptron, and Hebb Learning Rule for the next phase. Findings: Aggregating the Intuitionistic Fuzzy set information or data in today’s digital world is a tedious task in the field of MAGDM problem-solving. In this work, two new classes of operators for aggregating the data sets are proposed namely the IM-IFWAA operator and the IM-IFOWA operator which will improve the performance of the ANN. Necessary theorems for the proposed operators are proved to provide consistency of the same. The input created using the aforementioned operators is then fed into the novel ANN algorithm for further computations. Varieties of learning rules are then engaged for ranking of the best alternative for the decision problem. The developed theory is supported by a numerical example which is computed using all the proposed techniques. Novelty: Most of the research done on Intuitionistic Fuzzy Artificial Neural Network models are based on learning rules or using some other calculations. The proposed methods of using novel and improvised aggregation operators for ANN are used to find the inputs for ANN where varieties of learning rules for ANN are employed for effective decision analysis. Keywords: ANN, Learning Rules, MAGDM, Intuitionistic Fuzzy Sets, Weighted Aggregation Operator

Liposuction Through an Axillary Fold Incision Combined with a Small Areola Incision to Treat Gynecomastia.

Gynecomastia is a progressive disease characterized by enlarged breasts, affecting a significant proportion of men. Persistent gynecomastia negatively affects the psychological and emotional development of patients; therefore, surgical intervention is required. In this article, we describe a surgical technique, where liposuction through an axillary incision is used in combination with a single small periareolar incision, to obtain the most minimal scars in the treatment of gynecomastia. Between June 2021 and June 2023, 125 patients with different Simon grades of gynecomastia were enrolled. The patients' basic conditions and operation processes were recorded. Following surgery, a score was assigned according to the five main aesthetic aspects of the surgical procedure. In total, 125 patients with gynecomastia were treated with a pre-axillary fold incision combined with a small areolar incision. There were 17 cases of Simon grade I, 46 grade IIA, 42 grade IIB, and 20 grade III. The average operation time was 45.8min, the average liposuction volume was 250.5mL, the average glandular tissue volume was 50.5g, intraoperative blood loss ranged from 15 to 60mL, and the average hospital stay was 3.2days. Regarding the postoperative aesthetic effect, doctors scored > 4 points, and the patient satisfaction score was > 7.5, which fully affirmed the aesthetic effect of this method. Treatment of gynecomastia through an anterior axillary fold incision combined with a small areolar incision is safe and feasible, involving a simple procedure, short operation time, and few complications. Its efficacy and cosmetic effects could lead to its use as a primary surgical method to treat gynecomastia. 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 Table of Contents or online Instructions to Authors www.springer.com/00266 .

Does the addition of perineal block enhance pain control after a haemorrhoidectomy? A prospective randomized, double-blind placebo-controlled study.

Haemorrhoidectomy is associated with severe postoperative pain, a long rehabilitation, and QoL worsening for months. Most patients experience mild-to-moderate postoperative pain. We aimed to evaluate the intraoperative perineal block role for patients undergoing haemorrhoidectomy. In this prospective randomized, double-blind, placebo-controlled study, eligible patients with III-IV stage haemorrhoids were randomized to the experimental group (EG) with intraoperative perineal block and spinal anaesthesia and the control one (CG) only with spinal anaesthesia. During the postoperative period, the opioid consumption rate was evaluated as a primary endpoint, and the postoperative pain level according to VAS, systemic analgesics consumption, readmission, and complication rate, the timing of returning to work, patients' QoL, and overall satisfaction according to SF-36 were evaluated as secondary endpoints. One hundred patients completed the study (48 in EG and 52 in CG). Patients of the EG had less postoperative pain intensity (P < 0.0001), required less opioid analgesia (P = 0.03), and had longer pain-free postoperative periods (P = 0.0002). 90% of patients in the CG required additional NSAID injections for adequate analgesia compared with only 58% in the EG. The average hospital stays, complication rate, and average operation duration didn't reach clinical significance. General health evaluation according to the SF-36 score and the median satisfaction rate was better in the EG (P < 0.001 and P = 0.012, respectively). The administration of the perianal block is safe and effective and should be administered to appropriate patients undergoing anorectal surgery.

Utilizing aggregation operators based on q-rung orthopair neutrosophic soft sets and their applications in multi-attributes decision making problems

Neutrosophic sets provide greater versatility in dealing with a variety of uncertainties, including independent, partially independent, and entirely dependent scenarios, which q-ROF soft sets cannot handle. Indeterminacy, on the other hand, is ignored completely or partially by q-ROF soft sets. To address this issue, this study offers a unique novel concept as known as q-RONSS, which combines neutrosophic set with q-ROF soft set. This technique addresses vagueness using a set of truth, indeterminacy, and false membership degrees associated with the parametrization tool, with the condition that the sum of the qth power of the truth, indeterminacy, and false membership degrees be less than or equal to one. In addition, this study outlines operational laws for the suggested structure. The main purpose this article is to define some averaging and geometric operators based on the q-rung orthopair neutrosophic soft set. Furthermore, this article provides a step-by-step method and a mathematical model for the suggested techniques. To solve a MADM issue, this research article proposes a numerical example of people selection for a specific position in a real estate business based on a variety of criteria. Finally, to demonstrate the proposed model's superiority and authenticity, this article performs several analyses, including sensitivity analysis, to address the reliability and influence of various parameter "q" values on the alternatives and the ultimate ranking outcomes using the averaging and geometric operators. A comparison of the proposed operators to current operators demonstrates the validity of the proposed structure. Furthermore, a comparison of the proposed structure to current theories demonstrates its superiority by overcoming their limits and offering a more flexible and adaptable framework. Finally, this study reviews the findings and consequences of our research.

Quantum fluctuation dynamics of open quantum systems with collective operator-valued rates, and applications to Hopfield-like networks

We consider a class of open quantum many-body systems that evolves in a Markovian fashion, the dynamical generator being in GKS-Lindblad form. Here, the Hamiltonian contribution is characterized by an all-to-all coupling, and the dissipation features local transitions that depend on collective, operator-valued rates, encoding average properties of the system. These types of generators can be formally obtained by generalizing, to the quantum realm, classical (mean-field) stochastic Markov dynamics, with state-dependent transitions. Focusing on the dynamics emerging in the limit of infinitely large systems, we build on the exactness of the mean-field equations for the dynamics of average operators. In this framework, we derive the dynamics of quantum fluctuation operators, that can be used in turn to understand the fate of quantum correlations in the system. We then apply our results to quantum generalized Hopfield associative memories. Here we show that, asymptotically and at the description level of quantum fluctuations, only a very weak amount of quantum correlations, in the form of quantum discord, emerges beyond classical correlations.

Associated Probabilities’ Aggregations in Fuzzy Collaborative Filtering Recommender System Prediction

AbstractIn this article, the expert evaluations transformed in the multi-attribute decision-making (MADM) model are presented in the discrimination q-rung picture linguistic fuzzy numbers (q-RPLFNs). In the construction of a second-order additive fuzzy measure (TOAFM) the attributes’ interaction indexes and Shapley values are taken into account. The Shapley entropy maximum principle for identification of associated probabilities class (APC) of a TOAFM is constructed. Based on the APC of the TOAFM, a new aggregation operators’ class is constructed which represents some hybrid extensions of ordered weighted averaging (OWA), geometric (OWG), the Choquet integral averaging (CA) and geometric (CG) operators under discrimination q-rung orthopair fuzzy (q-ROF) and q-rung picture linguistic fuzzy (q-RPLF) information. These operators, constructed for the q-RPLF and q-ROF environments, take into account the overall pair interactions among attributes. Main properties on the correctness of extensions are proved: for the lower and upper capacities of order 2, all constructed operators consequently coincide with q-ROF and q-RPLF Choquet averaging and geometric operators, respectively. Constructed operators in the evaluation of prediction of fuzzy Collaborative Filtering Recommender Systems (CFRS) are used. New symmetric discrimination measures as some extensions of discrimination measures for the fuzzy CFRS are proposed. Users’ profile data by the constructed operators in the new similarity measure under q-rung picture linguistic environment are aggregated. The developed new approach is schematically described in such a way that it can be “embedded” in any existing CFRS model. An example is given to illustrate the results, for which the software designed to aggregate profile data for similarity comparison provides the use of new and well-known classical aggregation operators.

Induced Generalized Intuitionistic Fuzzy OWA Operator on GRA Method for Evaluation of Self-Propelled Artillery System: Ammunition Based Computer Assisted Military Experiment

The Self-Propelled Artillery System selection problem, which is a sub-problem of the Weapon Systems Selection Problems (WSSP), is an extremely important strategic level decision problem and constitutes the main focus of this study. To solve the problem, 3 different weapon systems were evaluated based on 7 criteria. The solution methodology consists of the integration of induced generalized ordered weighted averaging (IG-IFOWA) operator and Grey Relational Analysis (GRA). Such a solution proposal has not been seen in previous WSSP applications. To test the validity and applicability of the proposed methodology, the results of the study were tested on an ammunition-based computer-aided military experiment. The results reveal the effectiveness of the selected weapon system.

Prospective comparison of two surgical approaches for incarcerated and strangulated inguinal hernia: preperitoneal hernioplasty through the lower abdominal median incision and laparoscope (TAPP).

The optimal surgical approach of incarcerated and strangulated inguinal hernia is controversial. Retrospective studies showed that surgical approaches through lower abdominal median incision or laparoscopic are superior to the oblique inguinal incision, respectively. Whether transabdominal laparoscopic approach is superior to the lower abdominal median incision approach needs prospective research.Prospective comparative study of patients with incarcerated and strangulated groin hernia admitted to Jinshan hospital for emergency surgery from January 2018 to June 2022. They were divided into two groups according to different surgical approach. The open preperitoneal repair group (OPR) was operated through the lower abdominal median incision. Laparoscopic preperitoneal repair group (TAPP) was completed under transabdominal laparoscope. The perioperative complications and long-term results of the two groups were compared and analyzed. Eighty-two patients met the inclusion criteria, 40 in OPR group and 42 in TAPP group. Baseline data of the two groups were comparable. Thirteen cases (15.9%) of the two groups underwent intestinal resection and anastomosis. Seventy cases (90.2%) underwent the 1st stage mesh repair, including 5 cases of preperitoneal hernioplasty after intestinal resection. The average operation time of TAPP group was 13min longer (60.7 ± 13.7min vs 47.8 ± 19.8min P < 0.001), and the visual analogue scale pain score at 24h after operation was lower (3.5 ± 1.2 vs 4.4 ± 1.7 P = 0.019) than that of OPR group. There was 1 case of bladder injury (2.5%) in OPR group and 1 case of inferior abdominal artery injury (2.4%) in TAPP group. There was no difference in the rate of the 1st stage hernioplasty between the two groups. In OPR group, 2 cases (5%) extended the incision for more than 2cm, while in TAPP group, 1 case (2.4%) converted to laparotomy. The time of hospital stay (3.2 ± 1.8 d vs 4.3 ± 2.7 d, P = 0.036) and return to normal activities (7.9 ± 2.7 d vs 11.0 ± 4.4 d, P < 0.001) were shorter in TAPP group. The rate of total postoperative complications including chronic pain, surgical-site infection, seroma, hernia recurrence and so on was 11.9% in TAPP group, which was not significantly different from 25% in OPR group (P = 0.212). There were no cases of mesh related infection and death within 30days in both groups.TAPP is safe and feasible for the operation of acute incarcerated inguinal hernia. TAPP had better comfort and faster recovery over open preperitoneal repair for the appropriate patients with incarcerated/strangulated inguinal hernia, which can reduce acute pain, shorten hospital stay and return to normal activities earlier.