Lag Group Research Articles

The Effects of STRA6 Regulation of the Circadian Rhythm on Choroidal Neovascularization.

This study aims to investigate the relationship among STRA6, circadian rhythm, and choroidal neovascularization (CNV) formation, as well as the regulatory mechanism of STRA6 in CNV under circadian rhythm disturbances. C57BL/6J male mice (aged 6 weeks) were randomly divided into control and jet lag groups (using a time shift method every 4days to disrupt the molecular clock's capacity to synchronize with a stable rhythm). A laser-induced CNV model was established in both the control and the jet lag group after 2 weeks of jet lag. The size of CNV lesions and vascular leakage were detected by morphological and imaging examination on the seventh day post laser. STRA6 was screened by full transcriptome sequencing. Bioinformatics analysis was conducted to assess the variation and association of STRA6 in the GSE29801 dataset. The effects of STRA6 were evaluated both in vivo and in vitro. The pathway mechanism was further elucidated and confirmed through immunofluorescence of paraffin sections and Western blotting. The disturbance of circadian rhythm promotes the formation of CNV. Patients with age-related macular degeneration (AMD) exhibited higher levels of STRA6 expression compared to the control group, and STRA6 was enriched in pathways related to angiogenesis. In addition, CLOCK and BMAL1, which are initiators that drive the circadian cycle, had regulatory effects on STRA6. Knocking down STRA6 reversed the promotion of CNV formation caused by circadian rhythm disturbance in vivo, and it also affected the proliferation, migration, and VEGF secretion of RPE cells without circadian rhythm in vitro, as well as impacting endothelial cells. Through activation of the JAK2/STAT3/VEGFA signaling pathway in unsynchronized RPE cells, STRA6 promotes CNV formation. This study suggests that STRA6 reduces CNV production by inhibiting JAK2/STAT3 phosphorylation after circadian rhythm disturbance. The results suggest that STRA6 may be a new direction for the treatment of AMD.

281. TOTAL LAPAROSCOPIC VERSUS OPEN GASTRIC PULL-UP FOLLOWING MINIMALLY INVASIVE THORACOSCOPIC ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

Abstract Backgroud The use of minimally invasive esophagectomy (MIE) as a treatment for patients with esophageal cancer has recently become more common worldwide. However, the laparoscopic approach for reconstruction and abdominal lymph node dissection has not fully investigated. The aim of the present study was to evaluate the technical feasibility of alimentary tract reconstruction with laparoscopically assisted gastric pull-up compared with open laparotomy gastric pull-up following minimally invasive thoracoscopic esophagectomy. Methods 63 esophageal cancer patients who underwent minimally invasive thoracoscopic esophagectomy between 2011 and 2020 were included in the present study. For reconstruction, 25 patients underwent open laparotomy gastric pull-up (OLG) while 38 patients underwent laparoscopically assisted gastric pull-up (LAG). We compared the outcomes between the two groups. Results No significant difference was observed in physical and tumor status between the two groups. The mean operative time was significantly longer in LAG group (549 vs 621 min, p = 0.010) and blood loss was significantly lower in LAG (561 vs 134 mL, p < 0.001). The mean number of harvested lymph nodes (47.2 vs 46.2, p = 0.840) were similar. The postoperative course showed lower incidences of overall complications (64% vs 32%, p = 0.011). No difference was observed in each complication between the two groups. Conclusions The findings suggest that laparoscopically assisted gastric pull-up is feasible and more effective in preventing postoperative complications.

Lag Group Consensus of High-Order Multiagent Systems in Directed Network Settings

This article studies lag group consensus problems of multiagent systems with directed information transformations. Agents in the network are divided into finite groups, and modeled by high-order systems. Distributed consensus protocols with constant lags are presented to realize the lag group consensus: the states of the agents in a group approach to a consensus value asymptotically, while there exist given ratios between the final values of different groups. Necessary and sufficient criteria for the lag group consensus are obtained by the Laplace transformation. Finally, theoretical results are proved to be effective by several simulation results.

Effects of Compound Polysaccharides Derived from Astragalus and Glycyrrhiza on Growth Performance, Meat Quality and Antioxidant Function of Broilers Based on Serum Metabolomics and Cecal Microbiota.

This study aimed to evaluate the effects of dietary supplementation of compound polysaccharides derived from Astragalus and Glycyrrhiza on growth performance, meat quality, antioxidant function, cecal microbiota and serum metabolomics of broilers. A total of 480 one-day-old male Arbor Acres (AA) broilers were randomly divided into four treatments with six replicates comprising 20 broilers each. Treatments: CON group was the basal diet; ANT group was supplemented with Terramycin calcium; LAG group was supplemented with 150 mg/kg Astragalus polysaccharides and 75 mg/kg Glycyrrhiza polysaccharides; HAG group was supplemented with 300 mg/kg Astragalus polysaccharides and 150 mg/kg Glycyrrhiza polysaccharides. The results showed that LAG and HAG supplementation increased growth performance, antioxidant function and meat quality compared with the CON group and ANT group and, especially, the effect of LAG treatment was better than HAG. Analysis of cecal microbiota showed that LAG and HAG supplementation altered cecal microbial diversity and composition in broilers. Serum metabolomics analysis showed that a total of 193 differential metabolites were identified in CON and LAG groups, which were mainly enriched in linoleic acid metabolism and glutathione metabolism pathways. Moreover, there was a close correlation between serum metabolites, cecal microbiota and phenotypic indicators. Conclusion: Dietary supplementation of 150 mg/kg Astragalus polysaccharides and 75 mg/kg Glycyrrhiza polysaccharides could improve the growth performance, antioxidant function and meat quality of broilers by changing the serum metabolites and cecal microbiota composition.

The Safety and Feasibility of Laparoscopic Gastrectomy after Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer.

Background Neoadjuvant chemotherapy is incrementally applied to remedy locally advanced gastric cancer. However, NACT also enhances the difficulty of laparoscopic lymph node dissection. The objective of our study was to evaluate the safety and feasibility of laparoscopic gastrectomy for locally advanced gastric cancer after neoadjuvant chemotherapy. Methods From July 2017 to December 2019, 153 patients who received neoadjuvant chemotherapy and underwent the subsequent surgical procedure were retrospectively enrolled and analyzed in the Gastrointestinal Surgery Department of West China Hospital. According to surgical methods, all the patients were sectionalized into two groups: laparoscopic assistant gastrectomy (LAG, 77 patients) and traditional open gastrectomy (OG, 76 patients). The demographic parameters, preoperative, surgical, pathological, and neoadjuvant chemotherapy features were compared between the two groups. Results A total of 153 patients accepted neoadjuvant chemotherapy and surgical resection in our study. There was no statistically significant difference in demographic parameters and preoperative and neoadjuvant chemotherapy characteristics between the two groups. The LAG group illustrated less intraoperative blood loss (91.1 ± 53.1 ml vs. 125.7 ± 116.9 ml, p=0.010) and shorter postoperative hospital stays (7.9 ± 2.1 days vs. 125.7 ± 116.9 days, p=0.009), when compared to the OG group. Moreover, there was no disparity with respect to operative duration, number of harvested lymph nodes, and postoperative complication rates between the two groups. When considering the Clavien–Dindo classification, no statistically significant difference was indicated in all stratifications with regard to postoperative complications. Conclusion Laparoscopic gastrectomy for locally advanced gastric cancer after neoadjuvant chemotherapy is safe and feasible without increasing postoperative adverse events.

The influence of socioeconomic and environmental determinants on acute myocardial infarction (AMI) mortality from the spatial epidemiological perspective.

Plenty of epidemiological approaches have been explored to detect the effects of environmental and socioeconomic factors on acute myocardial infarction (AMI) mortality. Whereas, identifying the influence of potential affecting factors on AMI mortality based on a spatial epidemiological perspective was strongly desired. Moreover, the interaction effects of two potential factors on the diseases were always neglected previously. Here, the Geodetector and geographically & temporally weighted regression model (GTWR) combined with multi-source spatiotemporal datasets were introduced to quantitatively determine the relationship between AMI mortality and potential influencing factors across Xi'an during 2014-2016. Besides, Moran's I was adopted to diagnose the spatial autocorrelation of AMI mortality. Some findings were achieved. The number of AMI mortality cases increased from 5075 in 2014 to 6774 in 2016. Air pollutants, meteorological factors, economic status, and topography factors exhibited a significant effect on AMI mortality. The AMI mortality demonstrated an obvious spatial autocorrelation feature during 2014-2016. POP and PE represented the most obvious impact on AMI mortality, respectively. Moreover, the interaction of any two factors was larger than that of the single factor on AMI mortality, and the factors with the strongest interaction vary according to lag groups and ages. The effects of factors on AMI mortality were POP (- 628.925) > PE (140.102) > RD (79.145) > O3 (- 58.438) > E_NH3 (42.370) for male, and POP (- 751.206) > RD (132.935) > E_NH3 (58.758) > PE (- 45.434) > O3 (- 21.256) for female, respectively. This work reminds the local government to continuously control air pollution, strengthen urban planning, and improve the health care of the rural areas for alleviating AMI mortality. Meanwhile, the scheme of the current study supplies a scientific reference for examining the effects of potential impact factors on related diseases using the spatial epidemiological perspective.

Comparison of two strategies for managing in-hospital cardiac arrest

In-hospital cardiac arrest (IHCA) is associated with poor outcomes. There are currently no standards for cardiac arrest teams in terms of member composition and task allocation. Here we aimed to compare two different cardiac arrest team concepts to cover IHCA management in terms of survival and neurological outcomes. This prospective study enrolled 412 patients with IHCA from general medical wards. From May 2014 to April 2016, 228 patients were directly transferred to the intensive care unit (ICU) for ongoing resuscitation. In the ICU, resuscitation was extended to advanced cardiac life support (ACLS) (Load-and-Go [LaG] group). By May 2016, a dedicated cardiac arrest team provided by the ICU provided ACLS in the ward. After return of spontaneous circulation (ROSC), the patients (n = 184) were transferred to the ICU (Stay-and-Treat [SaT] group). Overall, baseline characteristics, aetiologies, and characteristics of cardiac arrest were similar between groups. The time to endotracheal intubation was longer in the LaG group than in the SaT group (6 [5, 8] min versus 4 [2, 5] min, p = 0.001). In the LaG group, 96% of the patients were transferred to the ICU regardless of ROSC achievement. In the SaT group, 83% of patients were transferred to the ICU (p = 0.001). Survival to discharge did not differ between the LaG (33%) and the SaT (35%) groups (p = 0.758). Ultimately, 22% of patients in the LaG group versus 21% in the SaT group were discharged with good neurological outcomes (p = 0.857). In conclusion, we demonstrated that the cardiac arrest team concepts for the management of IHCA did not differ in terms of survival and neurological outcomes. However, a dedicated (intensive care) cardiac arrest team could take some load off the ICU.

The impact of robotic technology on the learning curve for robot-assisted gastrectomy in the initial clinical application stage.

To evaluate the impact of robotic technology on the learning curve for robot-assisted gastrectomy in the initial clinical application stage and to compare RAG with laparoscopic-assisted gastrectomy using a short-term evaluation. Between September 2016 and December 2018, 111 consecutive distal gastric cancer patients who were candidates for RAG or LAG were prospectively enrolled. Operative findings, morbidity, oncological findings, and the learning curve were analyzed. Thirty patients underwent RAG with the da Vinci Si robot system, and eighty-one patients underwent LAG. Blood loss was lower during RAG than during LAG (133.80 ± 95.28 vs. 178.83 ± 98.37, P = 0.046). The operative time for RAG was significantly longer (304.45 ± 42.08 vs. 281.17 ± 32.69, P = 0.015). The number of retrieved lymph nodes (LNs) was greater (37.33 ± 8.25 vs. 32.78 ± 5.98, P = 0.003) with RAG. Notably, RAG had an advantage in the dissection of No. 9 and 11p LNs (3.56 ± 1.76 vs. 2.78 ± 1.30, P = 0.038; 2.48 ± 0.93 vs. 1.99 ± 0.84, P = 0.015, respectively). Severe complications were less frequent in the RAG group (7 (8.6%) vs. 1 (3.3%), P = 0.003). No significant differences in terms of postoperative recovery were found between the two groups. The learning curve for RAG showed that the cumulative sum value decreased from the 10th case, while it decreased from the 28th case in the LAG group. By means of robotic technology, RAG is better than LAG for the dissection of No. 9 and 11p LNs and for the alleviation of surgical trauma, and the technique is learned more rapidly during the preliminary stage than the LAG technique.

Do air pollutants as well as meteorological factors impact Corona Virus Disease 2019 (COVID-19)? Evidence from China based on the geographical perspective.

The COVID-19 is still a huge challenge that seriously threatens public health globally. Previous studies focused on the influence of air pollutants and probable meteorological parameters on confirmed COVID-19 infections via epidemiological methods, whereas the findings of relations between possible variables and COVID-19 incidences using geographical perspective were scarce. In the present study, data concerning confirmed COVID-19 cases and possible affecting factors were collected for 325 cities across China up to May 27, 2020. The geographically weighted regression (GWR) model was introduced to explore the impact of probable determinants on confirmed COVID-19 incidences. Some results were obtained. AQI, PM2.5, and PM10 demonstrated significantly positive impacts on COVID-19 during the most study period with the majority lag group (P< 0.05). Nevertheless, the relation of temperature with COVID-19 was significantly negative (P< 0.05). Especially, CO exhibited a negative effect on COVID-19 in most study period with the majority lag group. The impacts of each possible determinant on COVID-19 represented significantly spatial heterogeneity. The obvious influence of the majority of possible factors on COVID-19 was mainly detected during the after lockdown period with the lag 21 group. Although the COVID-19 spreading has been effectively controlled by tough measures taken by the Chinese government, the study findings remind us to address the air pollution issues persistently for protecting human health.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11356-021-12934-6.

Astigmatism correction with toric implantable collamer lens in low and high astigmatism groups.

To analyze the target induced astigmatism (TIA), surgically induced astigmatism (SIA), difference vector (DV), and correction index (CI) in the correction of astigmatism with phakic lenses, and its influence on visual acuity, and to analyze the safety and efficacy indexes of the correction of high and low power astigmatism with toric phakic lenses. Retrospective comparative study. The medical records of patients that were operated on at the research center during the period were analyzed. Results were divided into Low Astigmatism Group - LAG (33 eyes) and High Astigmatism Group - HAG (93 eyes) according to the implanted toric ICL lens power. Preoperative refraction and resultant postoperative refraction were analyzed by vector analysis. Visual acuity pre and postop, with and without optical correction, were compared. A total of 126 eyes were studied. The average preop refraction was -5.02 D sphere with -2.61 D cylinder. The average ICL lens power implanted was -8.31 D sphere +2.77 D cylinder. Refractive remaining was -0.01 ± 0.11 D sphere -0.15 ± 0.28 D cylinder. The arithmetic average angle of error in the astigmatism correction was 1.08°. The resultant cylinder was -0.03 ± 0.12 D and -0.19 ± 0.30 D in the low and high astigmatism groups, respectively, with a mean UDVA -0.01 ± 0.10 and 0.01 ± 0.16 and CDVA -0.03 ± 0.08 and -0.01 ± 0.17 for each group. The safety and efficacy indexes for the low astigmatism group were 1.09 ± 0.16 and 1.05 ± 0.17, respectively, with 1.11 ± 0.17 and 1.06 ± 0.16 for the high astigmatism group. The correction of astigmatism by the implantation of toric phakic lenses of the posterior chamber is safe and effective, independently of the amount of cylinder corrected.

142P Prognostic analysis of patients with intra-abdominal infectious complications after laparoscopy and open radical gastrectomy for gastric cancer: A propensity score-matching analysis

To investigate the incidence and prognosis of intra-abdominal infectious complications (IaIC) after laparoscopic and open radical gastrectomy for gastric cancer. The data of patients who underwent radical gastrectomy for gastric cancer at the Fujian Medical University Union Hospital from January 2000 to December 2014, retrospectively LAG and OG were used. 1:1 propensity score matching (PSM) was used to reduce biases. The incidence and prognosis of postoperative IaIC in the two groups were analyzed. The incidence of IaIC after OG and LAG was 4.1% and 5.1%, respectively(p=0.264). Cox multivariate analysis showed that IaIC was an independent risk factor for overall survival (OS) of patients undergoing gastrectomy (HR: 1.65, 95%CI: 1.23-2.20, p<0.001). Analysis also showed that LAG was an independent protective factor for OS with IaIC (HR 0.54, 95%CI: 0.31-0.96, p=0.036), and tumor diameter ≥ 50 mm (p=0.01) and pTNM III stage (p<0.001) were independent risk factors. After PSM, the five-year OS rate of patients with IaIC in the LAG was higher than that in the OG (51.1% vs. 32.4%, p=0.042). The independent preoperative risk factors for IaIC include male (OR 1.82, p=0.046) and BMI ≥ 25 (OR 1.88, p=0.021). Among patients with IaIC, the prognostic nutritional index (PNI) in OG group was similar to that in LAG group before operation (p=0.220), but lower than that in LAG group on the 1st, 3rd, and 5th day after surgery (p<0.05). Compared to OG, LAG can improve the prognosis of patients with postoperative IaIC. For high-risk patients with IaIC, LAG is recommended.

Comprehensive biomechanical analysis of three clinically used fixation constructs for posterior malleolar fractures using cadaveric and finite element analysis

Different fixation modalities are available for fixation of posterior malleolar fractures (PMFs), but the best method is still unclear. The purpose of this study was to carry out a comparative biomechanical analysis of three commonly used fixation constructs for PMFs using experimental and finite element analysis (FEA). 15 human cadaveric ankle specimens were randomly divided into three groups. Specimens in group-A were fixed with two anteroposterior (AP) lag screws, group-B with two posteroanterior (PA) lag screws, and for group-C, a posterior plate was used. Each model was subjected to axial load. Outcomes included loads for 0.5 mm, 1 mm, 1.5 mm, and 2 mm vertical displacements of posterior fragments were noted. 3D FE models were reconstructed from computed tomography (CT) images and subjected to vertical loads. The model’s stress, fracture step-off, and resultant strains in implants were also studied in 3D FE models. Significantly higher amounts of mean compressive loads were observed to cause the same amount of vertical displacements in plate group (265 ± 60.21 N, 796 ± 57.27 N, 901.18 ± 8.88 N, 977.26 ± 13.04 N) than AP (102.7 ± 16.78 N, 169.5 ± 19.91 N, 225.32 ± 15.92 N, 269.32 ± 17.29 N) and PA (199.88 ± 31.43 N, 362.80 ± 28.46 N, 431.3 ± 28.12 N, 541.86 ± 36.05 N) lag screws respectively (P < 0.05). Simulated micro-motion analysis demonstrated that fracture step-off values in plate group (0.03 ± 0.001 mm, 0.06 ± 0.003 mm and 0.13 ± 0.010 mm) were the lowest among the three groups (P < 0.001). The cancellous bone showed the highest amount of stress in AP and PA lag groups respectively, whereas the lowest stress was noted in the plate-group. This biomechanical study concluded that posterior plating is biomechanically the most stable fixation construct for PMFs fixation. AP and PA lag screws with higher bone stress and fracture step-off values have a high tendency of bone cut-through and loss of fixation respectively.

Outcomes of Bridge Plating Versus Standard Fixation in Geriatric Ankle Fractures

Category:Ankle, TraumaIntroduction/Purpose:Ankle fractures represent one of the most common injuries encountered by foot and ankle specialists. Internal fixation of the lateral malleolus can be achieved by several different techniques, most commonly by lag screw and neutralization plating. However, ankle fractures in older patients often present technical challenges as osteoporotic bone is more commonly encountered which may require bridge plating techniques. This study compares outcomes in patients over age 50 years who underwent ORIF of the lateral malleolus with either a bridge plate or lag screw and neutralization plate technique.Methods:This retrospective study evaluated 56 patients with closed ankle fractures, aged over 50 years who underwent open reduction internal fixation of the lateral malleolus. These were divided into two groups: 36 patients had fixation with one or more lag screws and a neutralization plate, and 20 patients had fixation with a bridge plate technique. Fractures were stabilized with lag screw fixation when feasible, while bridge plating was utilized in patients where lag screw fixation was not possible. SF-36 scores were attained at a minimum one-year post-op. Final radiographs and complications were recorded.Results:The lag group had a mean age of 63 years, 17% men, 61% with syndesmotic screw fixation, and 56% with medial malleolus fixation. The bridge group had a mean age of 65 years, 15% men, 60% with syndesmotic screw fixation, and 70% with medial malleolus fixation. At minimum one-year, SF-36 physical component summary score was 74.2 ± 19.4 in the lag group vs 63.2 ± 24.8 in the bridge plate group (p=0.049). The SF-36 mental component summary score was 89.2 ± 12 in the lag group vs 75.5 ± 22.7 in the bridge plate group (p=0.009). One patient in each group required return to the OR for irrigation and debridement for infection. No patients experienced fixation failure and all fractures demonstrated union on final radiograph.Conclusion:In the present study of patients over age 50 years who underwent ORIF of an ankle fracture, as compared with bridge plating, lag screw and neutralization plating is associated with superior one-year SF-36 physical and mental summary scores with similar rates of complications. However, additional research is needed to determine to what degree this difference is causative or correlative with confounding variables as fixation technique was not found to be an independent predictor of SF-36 outcomes in this small cohort.

Lag Group Consensus for the Second-order Nonlinear Multi-agent Systems via Adaptive Control Approach

Second-order nonlinear multi-agent system whose agents could be divided into multiple subgroups is considered in this paper. In order to avoid congestion, lag group consensus of the considered system is investigated via adaptive protocol. Without constraint on the topology of the system, sufficient conditions for the lag group consensus are proposed analytically. Finally, the efficiency of the proposed methodology is illustrated by numerical simulation.

Utilizing prestin as a predictive marker for the early detection of outer hair cell damage

PurposeTo evaluate prestin as a biomarker for the identification of early ototoxicity. Materials and methodsRats (n = 47) were randomly assigned to five groups: low-dose (LAG) or high-dose (HAG) amikacin (200 and 600 mg/kg/day, respectively, for 10 days), low-dose (LCIS)or high-dose (HCIS) cisplatin (single doses of 5 and 15 mg/kg, respectively, for 3 days), and control (n = 8). At the end of the experiment, measurement of distortion product-evoked otoacoustic emissions (DPOAE) were performed to evaluate hearing, then blood samples and both ear tissues were collected under anesthesia. Prestin levels were determined by ELISA. Cochlear damage was evaluated histologically using a 4-point scoring system. ResultsThe mean serum prestin levels were 377.0 ± 135.3, 411.3 ± 73.1, 512.6 ± 106.0, 455.0 ± 74.2 and 555.3 ± 47.9 pg/ml for control, LCIS, HCIS, LAG and HAG groups, respectively. There was significant difference between prestin levels of Control–LCIS-HCIS groups (p = 0.031) and prestin levels of Control-LAG-HAG groups (p = 0.003). There were also significant differences in prestin levels between the low- and high-dose cisplatin and amikacin groups (p = 0.028 and p = 0.011, respectively). Each group had significantly lower DPOAE results at 4, 6 and 8 kHz than control groups (p < 0.001). The LAG, HAG, LCIS and HCIS groups had significantly higher cochlear damage scores than the control group (p < 0.05). ConclusionsHigher doses of cisplatin and amikacin were associated with the greatest increases in serum prestin level and cochlear damage score. The results of this study suggest that prestin is a promising early indicator of cochlear damage.

Biomechanical efficacy of AP, PA lag screws and posterior plating for fixation of posterior malleolar fractures: a three dimensional finite element study

BackgroundClinically there are different fixation methods used for fixation of the posterior malleolar fractures (PMF), but the best treatment modality is still not clear. Few studies have concentrated on this issue, least of all using a biomechanical comparison. The purpose of this study was to carry out a computational comparative biomechanics of three different commonly used fixation constructs for the fixation of PMF by finite element analysis (FEA).MethodsComputed tomography (CT) images were used to reconstruct three dimensional (3D) model of the tibia. Computer aided design (CAD) software was used to design 3D models of PMF. Finally, 3D models of PMF fixed with two antero-posterior (AP) lag screws, two postero-anterior (PA) lag screws and posterior plate were simulated through computational processing. Simulated loads of 500 N, 1000 N and 1500 N were applied to the PMF and proximal ends of the models were fixed in all degrees of freedom. Output results representing the model von Mises stress, relative fracture micro-motion and vertical displacement of the fracture fragment were analyzed.ResultsThe mean vertical displacement value in the posterior plate group (0.52 mm) was lower than AP (0.68 mm) and PA (0.69 mm) lag groups. Statistically significant low amount of the relative micro-motion (P < 0.05) was observed in the posterior plate group.ConclusionsIt was concluded that the posterior plate is biomechanically the most stable fixation method for fixation of PMF.

Emergence and temporal structure of Lead–Lag correlations in collective stock dynamics

Understanding the correlations among stock returns is crucial for reducing the risk of investment in stock markets. As an important stylized correlation, lead–lag effect plays a major role in analyzing market volatility and deriving trading strategies. Here, we explore historical lead–lag relationships among stocks in the Chinese stock market. Strongly positive lagged correlations can be empirically observed. We demonstrate this lead–lag phenomenon is not constant but temporally emerges during certain periods. By introducing moving time window method, we transform the lead–lag dynamics into a series of asymmetric lagged correlation matrices. Dynamic lead–lag structures are uncovered in the form of temporal network structures. We find that the size of lead–lag group experienced a rapid drop during the year 2012, which signaled a re-balance of the stock market. On the daily timescale, we find the lead–lag structure exhibits several persistent patterns, which can be characterized by the Jaccard matrix. We show significant market events can be distinguished in the Jaccard matrix diagram. Taken together, we study an integration of all the temporal networks and identify several leading stock sectors, which are in accordance with the common Chinese economic fundamentals.

Assorted carrier‐variable frequency‐random PWM scheme for voltage source inverter

This study presents an assorted carrier-variable frequency random pulse width modulation (AC-VF-RPWM) method in which a new type of mixed carrier wave is proposed for a three-phase voltage source inverter-fed induction motor drive. This study has focused on the reduction of acoustic noise where a deterministic PWM strategy is replaced with a proposed RPWM. Inverted sine carrier, sine carrier and triangle carrier are used to compare with the reference sinusoidal wave to generate the pulse (lead and lag) positions. The two groups (lead and lag) each with three pulse positions are randomly selected and it aims at dispersing the harmonic voltage over a wide band area. The linear feedback shift register-based random bit generation algorithms are used to select the three pulse positions from the lead and lag groups. In addition, a frequency modulator converts the carriers into a randomised frequency, which will give more potency to the randomisation process. The results of co-simulation and experimental evaluation that the proposed method could provide harmonic power spectra of the voltage and current spreading over a much broader band area, as compared with the conventional schemes. In addition, Xilinx XC3S500E FPGA device synthesis results are presented.

Comparison of laparoscopy-assisted gastrectomy versus open gastrectomy with D2 lymphadenectomy in the treatment of advanced gastric cancer

Objective To investigate the safety and efficacy of laparoscopy-assisted D2 radical gastrectomy in the treatment of advanced gastric cancer. Methods From March 2011 to March 2016, one hundred and four cases treated with LAG for advanced gastric cancer in the general surgery department of Gaochun District People Hospital of Nanjing and the 251st Hospital of PLA were collected in the laparoscope group, 104) and 101 cases undergoing gastric cancer surgery from the same period were selected as the control group (open surgery group). A retrospective analysis was performed between the two groups in operation time, intraoperative blood loss, postoperative eating time, ambulation time, exhaust time, postoperative fever, postoperative analgesic use, hospitalization time, postoperative complications, the proximal and distal margins and the number of lymph node dissection. Results The operation time was significantly longer in the LAG group than in the open surgery group (311.2±28.9) min vs.(157.38 ±11.9) min, t=2.899, P<0.01). The intraoperative blood loss in the laparoscope group was less than that in the open surgery group ( (100.3±12.1) ml vs.(200.6±16.3) ml, t=3.014, P<0.01). In addition, the frequency of postoperative analgesia, the first postoperative exhaust time, the first postoperative eating time and the postoperative hospital stay in the laparoscopic group were better than those in the open surgery group (P<0.05). There was no significant difference in the number of lymph node dissection and postoperative complication between the two groups (P=0.264, P=0.575). The survival analysis showed that the overall survival rate in the two groups was equivalent at 6 years after surgery (P=0.623). Conclusion Laparoscopy-assisted radical gastrectomy for advanced gastric cancer is safe and feasible, with acceptable long-term results, and shows better performance in the near future. Key words: Advanced gastric cancer; D2 radical gastrectomy; Laparoscopy; Open surgery

Outcomes of a Culturally Tailored Partially Randomized Patient Preference Controlled Trial to Increase Physical Activity Among Low-Income Immigrant Latinas.

Almost half (47.8%) of adult Latinas report they never engage in any leisure time physical activity (PA) which is an independent risk factor for the development of cardiovascular disease and other chronic illnesses. There is a pressing need to develop and test PA interventions among Latinas. Therefore, the purpose of this study was to evaluate the effects of a PA Intervention for Latinas, a culturally tailored, promotora-facilitated 12-week PA intervention. It was hypothesized that at the completion of the intervention, participants would have (a) higher daily PA levels; (b) improved aerobic fitness, muscle strength, and flexibility; and (c) lower body mass index and percentage of body fat. A partially randomized patient preference trial design with lag group was used to test the intervention. Participants ( N = 76) attended twice weekly, low-impact aerobic/Latin dance PA classes taught by laywomen trained as promotoras. Significant improvements were measured in aerobic fitness, muscle strength and flexibility, and daily PA levels ( p < .001). Sixty percent of the participants attended at least 60% of the PA sessions. Findings suggest laywomen trained as promotoras can successfully facilitate the delivery of an intervention to increase PA among immigrant Latinas.