Position Of Segment Research Articles

Human and bird detection and classification based on Doppler radar spectrograms and vision images using convolutional neural networks

The study investigated object detection and classification based on both Doppler radar spectrograms and vision images using two deep convolutional neural networks. The kinematic models for a walking human and a bird flapping its wings were incorporated into MATLAB simulations to create data sets. The dynamic simulator identified the final position of each ellipsoidal body segment taking its rotational motion into consideration in addition to its bulk motion at each sampling point to describe its specific motion naturally. The total motion induced a micro-Doppler effect and created a micro-Doppler signature that varied in response to changes in the input parameters, such as varying body segment size, velocity, and radar location. Micro-Doppler signature identification of the radar signals returned from the target objects that were animated by the simulator required kinematic modeling based on a short-time Fourier transform analysis of the signals. Both You Only Look Once V3 and Inception V3 were used for the detection and classification of the objects with different red, green, blue colors on black or white backgrounds. The results suggested that clear micro-Doppler signature image-based object recognition could be achieved in low-visibility conditions. This feasibility study demonstrated the application possibility of Doppler radar to autonomous vehicle driving as a backup sensor for cameras in darkness. In this study, the first successful attempt of animated kinematic models and their synchronized radar spectrograms to object recognition was made.

Accuracy of mandibular proximal segment position using virtual surgical planning and custom osteosynthesis plates

The purpose of this study was to determine whether the use of custom osteosynthesis plates increased the accuracy of proximal segment position following bilateral sagittal split osteotomy in a cohort of 30 patients when compared to a control group of 25 patients who had surgery with conventional plates. Surgery was performed by a single surgeon between October 2015 and December 2017. Post-surgical cone beam computed tomography scans were segmented using Mimics Innovation Suite (Materialise NV), and surface-based superimposition was achieved using ProPlan CMF (Materialise NV). However, there was a tendency for the rotational error to be smaller in the custom group than in the control group. The root mean square error in both groups and for all variables fell within clinical parameters of 2 mm and 4°. In conclusion, the results of this study indicate that customized mandibular fixation plates do not necessarily improve the accuracy of the proximal segments post-surgically; however they may be of benefit in individual patients.

Intervertebral disc degeneration relates to biomechanical changes of spinal ligaments

BACKGROUND CONTEXTThe ligamentum flavum (LF), the inter- and supraspinous ligament (ISL&SSL) and the intertransverse ligament (ITL) are relevant spinal structures for segmental stability. The biomechanical effect of degeneration and aging on their biomechanical properties remains largely unknown. PURPOSEThe aim of this study was to assess the material properties of the ITL, ISL&SSL and LF and to correlate parameters of biomechanical function with LF-thickness, intervertebral disc (IVD) degeneration and age. STUDY DESIGNBiomechanical cadaveric study. METHODSMRI- and CT-scans of 50 human lumbar segments (Th12-L5) were used to assess the ISL (acc. to Keorochana), the grade of IVD degeneration (acc. to Pfirrmann) and to quantify LF-thickness. The ITL, ISL&SSL and LF were resected in the neutral position of the spinal segment with a specifically developed method to conserve initial strain. Ramp to failure testing was performed (0.5 mm/s) to record initial tension, slack length, stiffness and ultimate strength. The relationship between the biomechanical characteristics and age and radiological parameters were analyzed. There are no study-specific conflicts of interest and no external funding was received for this study. RESULTSWith aging, a significant reduction in initial tension (r=-0.5, p<.01) and ultimate strength (r=-0.41, p<.01) of the LF was observed, while the effect on LF-stiffness and the characteristics of the other ligaments was non-significant. IVD-degeneration was correlated with a significant reduction in stiffness (r=-0.47, p=.001; r=-0.36, p=.01) and ultimate strength (r=-0.3, p=.04; r=-0.36, p=.01) of the LF and ISL&SSL respectively and a significant reduction in initial tension (r=-0.4, p<.01) of the LF. For the ITL, no significant correlation was observed. Comparing Pfirrman 2 to 5, this reduction was 40% to 80% for stiffness 60% to 70% for ultimate strength and 88% for initial tension of the LF. ISL&SSL-stiffness between Kerorochana grade A and D differed significantly (p=.03), while all other comparisons were non-significant (p>.05). LF-thickness did not correlate with the biomechanical properties of the LF (p>.05). CONCLUSIONSAging is primarily related to biomechanical changes to the LF. IVD-degeneration is related to a relevant reduction in stiffness and ultimate strength of the LF and ISL&SSL, with a similar trend for the ITL. The ISL-specific Keorochana grading system provides only minimal biomechanical information and LF-thickness does not provide biomechanical information. CLINICAL SIGNIFICANCEPatient age and the degenerative state of the IVD can be used to evaluate the biomechanical characteristics of the dorsal spinal ligaments, which can be helpful in selecting the optimal surgical procedure (e.g. in decompression surgery) for a specific situation.

Solid-Binding Proteins: Bridging Synthesis, Assembly, and Function in Hybrid and Hierarchical Materials Fabrication.

There is considerable interest in the development of hybrid organic-inorganic materials because of the potential for harvesting the unique capabilities that each system has to offer. Proteins are an especially attractive organic component owing to the high amount of chemical information encoded in their amino acid sequence, their amenability to molecular and computational (re)design, and the many structures and functions they specify. Genetic installation of solid-binding peptides (SBPs) within protein frameworks affords control over the position and orientation of adhesive and morphogenetic segments, and a path toward predictive synthesis and assembly of functional materials and devices, all while harnessing the built-in properties of the host scaffold. Here, we review the current understanding of the mechanisms through which SBPs bind to technologically relevant interfaces, with an emphasis on the variables that influence the process, and highlight the last decade of progress in the use of solid-binding proteins for hybrid and hierarchical materials synthesis.

Principal postural acceleration and myoelectric activity: Interrelationship and relevance for characterizing neuromuscular function in postural control

One approach to investigating sensorimotor control is to assess the accelerations that produce changes in the kinematic state of the system. When assessing complex whole-body movements, structuring the multi-segmental accelerations is important. A useful structuring can be achieved through a principal component analysis (PCA) performed on segment positions followed by double-differentiation to obtain "principal accelerations" (PAs). In past research PAs have proven sensitive to altered motor control strategies, however, the interrelationship between PAs and muscle activation (surface electromyography, sEMG) have never been determined. The purpose of the current study was therefore to assess the relationship between PAs and sEMG signals recorded from muscles controlling the ankle joint during one-leg standing trials. It was hypothesized that medium correlation should be observed when accounting for neurophysiologic latencies (electro-mechanical delay). Unipedal balancing on a level-rigid ground was performed by 25 volunteers. sEMG activities were recorded from the tibialis anterior, peroneus longus, gastrocnemius medialis, and soleus muscles of the stance leg. The first eight PA-time series were determined from kinematic marker data. Then, a cross-correlation analysis was performed between sEMG and PA time series. We found that peak correlation coefficients for many participants aligned at time delays between 0.116 and 0.362s and were typically in the range small to medium (|r| = 0.1 to 0.6). Thus, the current study confirmed a direct association between many principal accelerations PA(t) and muscle activation signals recorded from four muscles crossing the ankle joint complex. The combined analysis of PA and sEMG signals allowed exploring the neuromuscular function of each muscle in different postural movement components.

Investigation on sawing performance of diamond frame saw based on reciprocating swing in processing hard stone

An innovative motion mode of reciprocating swing was introduced in frame saw for cutting hard stones in this research. Further, the theoretical models for the prediction of sawing depth and sawing interval of single segment were established, respectively. Sawing experiments and sawing forces test were conducted on the frame saw prototype with the new motion mode to investigate the cutting performance in sawing two types of hard stones. The results demonstrated that the application of the innovative sawing mode resulted in effective shortening of the length of sawing arc, reduced the number of segments involved in sawing simultaneously, avoided the instability of sawblade, and ensured that the sawn slabs met the requirements of qualified products. The segments on sawblade surface were divided into “front end”, “middle end”, and “rear end” according to the difference in contact pattern between the segment and the block. Segments in the middle of sawblade usually participated in sawing at the same position with unequal forces in forward and backward strokes, and the distribution of the sawing forces depended on the position of segment on sawblade surface. However, segments welded in the front end and rear end of the sawblade made an instantaneous cut once at one of the reversing points with higher sawing forces during reciprocating strokes. The sawing force value was found to be positively correlated with the feed rate, negatively correlated with the spindle speed, and also correlated with the stone characteristics. This new sawing mode provides a new approach for frame sawing machine to improve the sawing performance in sawing hard stones.

Abdominal Wall Endoscopic Extraperitoneal Reconstruction Technique &#x0D; in Patients with Primary Midline Hernias and Diastasis &#x0D; of the Rectus Abdominis Muscles

Introduction. The paper focuses on technical features of endoscopic extraperitoneal reconstruction (EER) of the anterior abdominal wall in patients with primary median hernias combined with diastasis of the rectus abdominis muscles, the nuances of the operating room equipment and preparation of patients for intervention.The aim of the study was to analyze the stages and features of the technique for performing endoscopic extraperitoneal reconstruction of the anterior abdominal wall to ensure safe and qualified implementation of the operation in clinical practice.Materials and methods. This research was a prospective study including 45 clinical cases of patients with primary median hernias of the anterior abdominal wall combined with diastasis of the rectus abdominis muscles, who were exposed to endoscopic extraperitoneal reconstruction. The study was performed in the surgical department of the private healthcare facility "Central Clinical Hospital Russian Railways-Medicine" in 2019-2020. The median follow-up was 14 months (8 - 18 months), there were no complications estimated higher than type I according to the Clavien-Dindo classification and relapses.Results and discussion. Successful EER requires thorough preoperative preparation: to connect a second monitor; to distance anesthetic equipment; to ensure the patient is in an extension position in the lumbar segment of the spinal column; to identify principle anatomical landmarks under ultrasound control. The main two stages of EER - mobilization and reconstruction - are performed extraperitoneally in a confined space, and therefore the localization of the ports must be anatomically validated. The major point at the stage of mobilization is to maintain the integrity of the parietal peritoneum, this solves visualization problems and helps to work in the required layer of the anterior abdominal wall. Adherence to the principles of open surgery, namely, orientation of the needle holder at an angle close to 0 to the suture line (white line), and the needles at a right angle; maintaining working angles between the instruments 30-60, - allows effectively performing the reconstructive stage.Conclusion. Thus, a topographic-anatomically based approach to each stage of the operation and adherence to a set of features of the surgical technique allows safely and effectively applying EER for the treatment of patients with primary midline hernias and diastasis of the rectus abdominis muscles.

Accuracy of Computer-Assisted Surgery in Maxillary Reconstruction: A Systematic Review.

Computer-assisted surgery (CAS) in maxillary reconstruction has proven its value regarding more predictable postoperative results. However, the accuracy evaluation methods differ between studies, and no meta-analysis has been performed yet. A systematic review was performed in the PubMed, Embase, and Cochrane Library databases, using a Patient, Intervention, Comparison and Outcome (PICO) method: (P) patients in need of maxillary reconstruction using free osteocutaneous tissue transfer, (I) reconstructed according to a virtual plan in CAS software, (C) compared to the actual postoperative result, and (O) postoperatively measured by a quantitative accuracy assessment) search strategy, and was reported according to the PRISMA statement. We reviewed all of the studies that quantitatively assessed the accuracy of maxillary reconstructions using CAS. Twelve studies matched the inclusion criteria, reporting 67 maxillary reconstructions. All of the included studies compared postoperative 3D models to preoperative 3D models (revised to the virtual plan). The postoperative accuracy measurements mainly focused on the position of the fibular bony segments. Only approximate comparisons of postoperative accuracy between studies were feasible because of small differences in the postoperative measurement methods; the accuracy of the bony segment positioning ranged between 0.44 mm and 7.8 mm, and between 2.90° and 6.96°. A postoperative evaluation guideline to create uniformity in evaluation methods needs to be considered so as to allow for valid comparisons of postoperative results and to facilitate meta-analyses in the future. With the proper validation of the postoperative results, future research might explore more definitive evidence regarding the management and superiority of CAS in maxillary and midface reconstruction.

Convolutional neural network based capacity estimation using random segments of the charging curves for lithium-ion batteries

Capacity estimation is an essential task for battery manage systems to ensure the safety and reliability of lithium-ion batteries. Considering the uncertainty of charging and discharging behavior in practical usage, this paper presents a one-dimensional convolution neural network (1D CNN)-based method that takes random segments of charging curves as inputs to perform capacity estimation for lithium-ion batteries. To improve the robustness and accuracy of the proposed 1D CNN network, a linear decreasing weighted particle swarm optimization algorithm is utilized to optimize the partial hyperparameters of neural network. Experimental data from two sets of batteries with different nominal capacities are employed for verification purpose. It is proved that the proposed method is feasible to provide accurate estimations on capacity degradation for both kinds of batteries. Furthermore, effects of length and relative position of segments on the capacity estimation are also investigated. The analysis results show that a more precise estimation of the battery capacity is prone to be obtained from the segment with a longer length or lower initial SOC.

4D flow MRI: impact of region of interest size, angulation and spatial resolution on aortic flow assessment

Objectives. In cardiovascular magnetic resonance, the 3D time-resolved phase-contrast technique, also known as 4D flow, is gaining increasing attention due to applications that exploit three-directional velocity encoding throughout the cardiac cycle. Blood flow volume assessment usually requires an expert to draw regions of interest (ROI) around the vessel cross section, whereas the errors involved in this estimation have not been thoroughly investigated. Our objective is to quantify the influence of ROI sizing, angulation and spatial resolution of the reconstructed plane employed in blood flow measurements using 4D flow. Approach. Three circular ROIs were drawn around the ascending, arch and descending aorta of healthy volunteers (n = 27) and patients with a dilated ascending aorta or bicuspid valve (n = 37). We applied systematic changes of ROI diameter (up to ±10%), tilt angle (up to ±25°) and spatial resolution (from 0.25 to 2 mm) of the reconstructed oblique planes, calculating the effects on net, forward and backward blood flow volumes. Main results. Patients had a larger ascending aorta than healthy volunteers with similar ages and male sex proportion (60 ± 15 y.o. vs 58 ± 16 y.o. and 84% vs 70%, respectively). Higher forward and backward flow volumes were observed in the ascending aorta and the aortic arch of the patients with respect to controls (p < 0.001), whereas net volumes were similar: 74.0 ± 20.8 ml versus 75.7 ± 21.8 ml (p = 0.37), respectively. The ascending aorta was the most sensitive to ROI modifications. Changes of ±10% in the ROI diameter and ±25° in tilt angles produced flow volume differences of up to 9 ml (10%) and 18 ml (15%) in controls and patients, respectively. Modifying the reconstructed planes spatial resolution produced flow volume changes below 2 ml. Significance. Since the setting of the ROI size and plane angle could produce errors that represent up to 20% of the forward and/or backward aortic flow volume, a good standardization for vessel segmentation and plane positioning is desirable.

Upper Aptian-lower albian seawater composition and OAEs: Geochemistry of Agua Salada and Lampazos Formations, Sonora, Mexico

Upper Aptian-lower Albian seawater composition changes and redox conditions in limestones of the Agua Salada and Lampazos formations in Mexico were investigated by data of major oxides, trace elements, rare-earth elements, and stable isotopes. Most limestones of the Agua Salada Formation (Group 1) show REE + Y patterns consistent with precipitation from seawater whereas limestones from the upper part of the Agua Salada and Lampazos formations (Group 2) have non-seawater-like REE + Y patterns. The relationship among REE and major and trace elements indicates that contamination by detrital input is the main source of REEs, followed by Fe-oxyhydroxides. The variations in Ce anomalies were influenced by paleo-redox conditions. The carbon isotope values, low Mn/Sr ratio and absence of correlation between δ13C vs δ18O values suggest that δ13C retained its original marine signatures during diagenesis. The δ13C curve has several significant negative isotopic excursions in upper Aptian-lower Albian strata. The variations in δ13C values and their negative excursions, fossil evidence, positions of δ13C segments, and correlation of this curve with global reference curves permits documentation of OAE 1 b and the associated sub-events such as Jacob, Kilian, Paquier and Leenhardt sub-events.

Relation between frontal plane center of mass position stability and foot elevation during obstacle crossing

High foot elevation during obstacle crossing is viewed as a conservative strategy in older adults, but excessive foot elevation may result in large mediolateral center of mass (CoM) displacement. Since an incorrect transfer of CoM can lead to balance loss during locomotion, both appropriate foot elevation and CoM position must be controlled and coordinated by adjusting body segment positions. However, no studies have revealed time profiles of CoM position by coordinated segment movements and the relation of foot elevation with CoM position during obstacle crossing. Twenty-five healthy older adults crossed an obstacle (depth: 1 cm, width: 60 cm, height: 8 cm) during comfortable-speed walking. Synergy indices were calculated during lead- and trail-limb swing using uncontrolled manifold analysis. High synergy index values indicate a strong multi-joint kinematic synergy, or co-fluctuations in segment movements, to control CoM position. The maximum foot heights of the swing limbs were calculated as the maximum vertical distance between the most distal foot point and the ground. In the mediolateral direction, synergy index values during early lead-limb swing were significantly greater than during early trail-limb swing, and in the vertical direction, large synergy index values were found during early- and mid-swing phases. Moreover, maximum trail-foot height was correlated to vertical synergy index during early phase. CoM position was not well controlled by a kinematic synergy during trail-limb swing and the low control of CoM position was observed with great trail-foot height. The results suggest that a conservative strategy with great trail-foot height would not always be helpful for successful obstacle crossing.

Implementation Technology for Development of a Brand Communication in Company PT. XYZ

The study was conducted at Catering Service Company. The high competition of catering business requires the right brand communication strategy to communicate the uniqueness of the catering product in order to increase brand awareness. The purpose of this study is to define the right brand communication strategy by identifying external and internal factors, performing SWOT analysis, define segmentation, targeting and brand positioning. The research approach used is a qualitative and descriptive method with data collection using interviews and document studies. The results of the study shows that some competencies possessed by the company can be used as long-term competitive advantage. While other competencies are competitive equality because they also owned by competitors. These competitiveness should be communicated well to the target customers. Conclusion, Type of business for The Catering Company is Business to Business (B2B) for catering services to industrial (factory), training centers and events, and Business to Consumer (B2C) for wedding catering services. Marketing activities that will be carried out are integrated marketing communication (IMC) through Above the Line (ATL), Below the Line (BTL) and Through the Line (TTL). Brand Communication should be done with more focus and consistent, as well as need dedicated team to perform brand communication.

Anatomical Variations of the Anterior Part of the Circle of Willis - An Autopsic Study

The arterial circle of Willis (CoW), also called the arterial circle or circulus arteriosus cerebri, represents an anastomotic arterial canal located at the base of the brain, in the inter peduncular fossa, which connects the internal carotid and the verte brobasilar system. The purpose of this study is to identify anomalies/anatomical variants of the anterior part of CoW in the population of the North-Eastern region of Romania by researching macroscopic aspects of the constituent arteries of CoW obtained during the autopsy procedure. There was noted the presence or absence, variations in the shape, position, or trajectory of each arterial segment of the anterior part of the CoW, comparing them with the outcomes from other various international studies.

A Morphological Study of Anatomical Variations in 96 Circles of Willis: an Autopsic Evaluation and Literature Review

Aim and background: Because circle of Willis provides the best collateral source of blood flow in arterial occlusive disorders, identifying anatomical variants that could be present at this level is especially essential in planning surgery for cerebral aneurysms. Given the fact that the frequency of these anatomical variations of circle of Willis has not yet been sufficiently evaluated in the Romanian population until presently, we have conducted a research in a regional health unit, where there are admitted patients with neurological and neurosurgical diseases living in the North-Eastern region of Romania, in order to identify morphological features of the constituent vessels of fresh circles of Willis at the moment of the autopsy of the deceased patients in the Emergency Clinical Hospital „Prof. dr. N. Oblu” Ia�?i. There has been noted the presence or absence, variations of shape, position or trajectory of each arterial segment. In the end, our results were compared with those from literature in order to identify some particular pattern of this anastomotic structure in the population of the North-Eastern region of Romania. Materials and Methods: The present research is a descriptive in-hospital observational study on the morphology of the circles of Willis of 96 patients who died of various medical causes in the Emergency Clinical Hospital “Prof. dr. N. Oblu” Ia�?i, in a period of 30 months, to whom an anatomo-clinical autopsy was performed in order to determine the cause of death. Results: From the total of 96 available human brains, 28 cases (29.17%) were classified as ”atypical” as they expressed anatomical variants of the constituent vessels. Among the 28 deceased patients with atypical CW, the M: F ratio was 1.15 and the average age of the entire group was 61.78 years. From the 28 atypical circles of Willis, 19 of them (67.86%) presented multiple anatomical variants, and only 9 cases (32.14%) had a single anatomical variant. Among multiple variants of the vessels of the circle of Willis, we identified the association of two (32.14%), three (25%), four (7.14%), or five (3.57%) anatomical variants of those seven constituent arteries. Eight types of variations of the constituent arteries of the circle of Willis were identified: absence of a vessel, partial fetal ACP, hypoplasia, duplication, fenestration, azygos, common trunk with another vessel at the origin, longer length with sinuous trajectory. Conclusion: Our results showed intermediate values between those reported in various studies performed on circles of Willis obtained at autopsies. These differences can be interpreted as possible peculiarities of the population in North-Eastern region of Romania. Unlike all other studies with which we compared the results obtained, in our research two thirds of cases with variations presented multiple anatomical variants, including five simultaneous variants.

Адаптивні стратегії підприємств у цифровому середовищі

The article is aimed at substantiating the basics of adaptive control in the digital environment. The author puts forward and verifies a thesis on the necessity to develop adaptive strategic management amid the digital transformation of business on the basis of agile principles, which allow the most complete implementation of the customer-oriented approach. The author defines the adaptive strategy in the digital environment as a model of the company's adaptation to the digitalization of its interaction with customers, partners, competitors and other contact audiences. It has been suggested and proven that adaptive strategies are competitive in nature. Based on this hypothesis, adaptive strategies are systematized by the degree of their relevance in the digital environment. Strategies of cost optimization, differentiation, and focusing with reference to business digitalization are considered. The adaptive toolkit of these strategies is expanded by using more flexible methods and approaches. It is proved that the strategy of cost optimization is implemented thanks to such tools as business automation models, virtual product chains, combining real and virtual content of production processes (Building Information Model, blockchain technologies), and smart working model. A company can effectively differentiate its products and services by the digitalization of the existing products and services and the creation of new ones, convergence of consumer expectations based on SMAC (Social, Mobility, Analytics, Cloud) technologies, and through the omnichannel service of different customer groups. It is established that thanks to digital marketing and such technologies as authentic interaction, content marketing, social media marketing, performance branding, and affiliate marketing a company can strengthen its position in a certain market segment (or niche) and implement a customer-oriented approach. Risk management in the design of adaptive strategies in the digital environment can be seen as a prospect for further research

СОВРЕМЕННЫЕ ПРОБЛЕМЫ РЕГУЛИРОВАНИЯ РОЗНИЧНЫХ ЦЕН НА ПРОДОВОЛЬСТВИЕ

The stages of using various methods of regulating retail prices for food products in Russia are traced: from the enactment of regulations on price liberalization and the establishment of State regulated prices for a number of consumer goods, including some foodstuffs in the 1990s, to adjustments to existing legislation on the organization of trade activities in the face of soaring prices for socially important foodstuffs at the end of 2020. Negative price changes in the food sector during this period coincided with the negative dynamics of population incomes, the compression of solvent demand, which was the result of a new global challenge - the COVID-19 pandemic. The reasons for the adoption in 2009 of the Law on the basics of state regulation of trade activities in the Russian Federation, consisting in the need to protect the interests of end consumers, small agribusiness, producers and suppliers of agrifood products in the conditions of rapid growth of retail chains and the formation of their dominant position in the food market segment, are shown. The proposals contained in the economic literature aimed at changing the share of retail chains in the food market were systematized and analyzed. The importance of developing institutional regulation of this process in the direction of accounting for the total share of all retail chains in the circulation of food products within the boundaries of the administrativeterritorial formation was noted. The feasibility of expanding the list of socially significant essential food products for which maximum permissible retail prices can be set is justified. Based on the experience of price regulation in developed market economies, it has been noted that it is advisable to actively use this method of managing aggregate demand in a crisis economy. At the same time, the priority of indirect regulation of food prices by expanding the competitive environment by improving the development and implementation of antitrust laws is emphasized.

Modern Marketing Strategies for Territorial Development: State and Municipal Level

The article reveals the content of the “territorial marketing” concept. The paper's main attention is focused on the fact that nowadays the state and municipal sectors should adhere to key market principles more strictly regarding setting prices, building competitive relations, choosing a target audience, and conducting a communication policy. The idea is substantiated that public sector organizations should be familiar with such concepts as market segmentation and market positioning, the marketing mix and its tools, since even where there is no competition from the private sector, such organizations are forced to compete with each other. The article summarizes the practical experience of territory marketing management, which consists in collecting input data and feedback; monitoring market processes occurring within the state, region or municipality, developing an effective marketing strategy.

Risk factors for intraoperative hemorrhage during cesarean myomectomy

ObjectiveWe intended to identify the risk factors of intraoperative hemorrhage on occasions of a combined operation of myomectomy with cesarean section for patients with uterine leiomyoma. Materials and methodsA retrospective cohort study was done of all patients who underwent cesarean myomectomy for intramural leiomyoma at a single university hospital. Cases identified with subserosal leiomyoma, placental disorder, and comorbid conditions related to coagulopathy were excluded. All the included cases were classified into intraoperative hemorrhage and non-hemorrhage group. Obstetric and demographic factors and parameters of leiomyoma were compared between two groups. ResultsA total of 302 women underwent cesarean myomectomy during the study period. Among these women, 212 pregnant women met the inclusion criteria. Intraoperative hemorrhage occurred in 43 women (20.3%). There was no significant intergroup difference in the number of removed leiomyomas. Multiple logistic regression analysis demonstrated that lower segmental location (odds ratio [OR], 2.827; 95% confidence interval [CI], 1.033–7.734, P = 0.043) and the diameter (OR, 1.167; 95% CI, 1.044–1.305, P = 0.006) were significant independent risk factors for hemorrhage during cesarean myomectomy. The combination of ≥ 8 cm diameter or lower segmental position of the leiomyoma yielded a specificity of 79.3% for operative hemorrhage during cesarean myomectomy. The negative predictive value of this combination was 88.7% for operative hemorrhage with a prevalence of 20%. ConclusionThe large size and lower segmental position of the leiomyoma are significantly risk factors for intraoperative hemorrhage during cesarean myomectomy. If the leiomyoma is located in the uterine fundus or body and its diameter is less than 8 cm, the removal of leiomyoma may be considered at the time of cesarean section.

Selection of the Key Segment Position for Trapezoidal Tapered Rings and Calculation of the Range of Jack Stroke Differences with a Predetermined Key Segment Position

It is generally accepted that selecting the key segment position for trapezoidal tapered rings and controlling the shield machine advancement are challenging tasks for shield tunneling projects. In this work, we propose a method for calculating the key segment position based on the shield tail gap, jack stroke difference, and lining trend. To calculate all possible key segment positions other than that corresponding to the straight joint configuration, the shield tail gap that remains after segment assembly and the jack stroke difference corresponding to the advancement of the segmental lining and lining trend were computed; then, values and importance coefficients were assigned to these factors according to current operating conditions. To ensure that the segmental lining can be assembled successfully with the calculated key position, we established a model to calculate the change in the shield tail gap before and after shield machine advancement based on the spatial relationships of the shield machine, the currently installed segmental rings, and the segment to be installed. Further, we propose a method for calculating the range of jack stroke differences when the predetermined “permitted shield tail gap” and key position are provided. The method is based on the change in the shield tail gap calculated with the above model and the positional relationship between the shield machine’s actual axis and the designed tunnel axis after the current segmental ring has been assembled. The calculated range of jack stroke differences may then be used to control the advancement of the shield machine. We validated the viability of our methods by using the data of Phase 1 works on Line 2 of the Ningbo Rail Transit system.