Total Number Of Operations Research Articles

Место эстетической хирургии нижних конечностей в современной ортопедии

Introduction Correction of the shape of the lower extremities for aesthetic purposes has specific features that are associated with the role of the patient in the treatment process and assessment of results. An important element is the relationship between the appearance of the limb and changes in the axes of the skeleton. Aim of study Assessment of many-years of experience in orthopedic correction of the shape of the lower extremities for aesthetic purposes, discussion of possibilities, analysis of problems and search for possible ways to prevent them. Methods The material of the study was 123 patients who underwent aesthetic surgical correction in the period from 2005 to 2020. Their results were followed in the period from 6 months to 11 years. In all cases, operations were performed simultaneously on both limbs. The total number of operations, thus, amounted to 246. The main indication for surgery was the so-called true O-shaped curvature (varus deformity) of the lower extremities. In all cases, the main elements of the operation were osteosynthesis with the Ilizarov apparatus and osteotomy of the tibia. Wires and half-pins were used as transosseous elements. To assess the main reference lines and angles (RLA), X-ray examination of the lower extremities was performed with the capture of the hip and ankle joints. Results and discussion Corrective manipulations in the group of patients led to a change in the position of the main RLA. Before treatment, MAD value was 15 ± 7 mm, after correction MAD = -2 ± 4 mm, before surgery MPTA = 85 ± 40, after correction MPTA = 91 ± 20. Subjective satisfaction was reported in 114 (92.7 %) cases. Subjectively unsatisfactory results were recorded in 4 (3.3 %) cases; objectively unsatisfactory results were detected in 5 (4.1 %) cases. Conclusions Aesthetic surgery of the lower extremities is a part of orthopedic practice and has its specific features due to the goal of realizing the patient's wishes about changing the appearance of the lower extremities indirectly by performing operations on the skeleton. Corrective interventions should be considered as a preventive measure aimed at preventing the development of gonarthrosis in old age. The key to a good result is careful selection of candidates for surgery and their compliance, along with a thorough explanation of the principles and features of correction.

Retrospective study of cochlear implantations at a single facility focusing on postoperative complications

ObjectiveAlthough cochlear implantation (CI) is a relatively safe operation, postoperative complications sometimes occur. We reviewed the frequency and severity of complications of CI at our hospital. We compared our results with previously reported complications and considered measures to improve patient outcomes. MethodsThis retrospective study examined the medical records of 70 patients who received CI between March 2005 and December 2018. We collected the following data: age at the time of the first surgery, etiology of hearing impairment, date of implantation, type of implanted devices, and complications. Surgical complications were divided by time into perioperative, early, and late, and by severity into major or minor. ResultsRecords of 38 adults and 32 children were analyzed. Bilateral CI was performed in 16 patients, 8 of whom were sequential, and unilateral CI was performed in 54 patients. The total number of operations was 78 for 86 CI. Complications were observed in 15 of 78 operations (19%), and the rates of minor and major complications were 15% and 4%, respectively. Complication rates were 21% (8/39) for children and 10% (4/39) for adults. All of the perioperative and early complications were minor. There were three major complications, all of which were infections presenting with mastoiditis and subcutaneous or subperiosteal abscesses. One case required reimplantation twice because of recurrent mastoiditis and temporal abscess. ConclusionsThere was no significant difference in the incidence of complications between children and adults, but all major complications were infection in pediatric cases. Careful attention is needed to prevent postoperative infection.

Common Kernels and Convolutions in Binary- and Ternary-Weight Neural Networks

A new algorithm for extracting common kernels and convolutions to maximally eliminate the redundant operations among the convolutions in binary- and ternary-weight convolutional neural networks is presented. Precisely, we propose (1) a new algorithm of common kernel extraction to overcome the local and limited exploration of common kernel candidates by the existing method, and subsequently apply (2) a new concept of common convolution extraction to maximally eliminate the redundancy in the convolution operations. In addition, our algorithm is able to (3) tune in minimizing the number of resulting kernels for convolutions, thereby saving the total memory access latency for kernels. Experimental results on ternary-weight VGG-16 demonstrate that our convolution optimization algorithm is very effective, reducing the total number of operations for all convolutions by [Formula: see text], thereby reducing the total number of execution cycles on hardware platform by 22.4% while using [Formula: see text] fewer kernels over that of the convolution utilizing the common kernels extracted by the state-of-the-art algorithm.

The method of increasing the efficiency of the man-machine system functioning by improving the quality of decision support system software

The article addresses improving the performance of man-machine systems (MMS) by improving the quality of decision support system software (DSSS). The proposed solutions are based on existing models and methods, which have been analysed in detail in a scientific study, in particular the application of methodical static application debugging in certain solutions obtained. It is proposed to use the methods for solving the problem of MMS control according to the vector criterion as the basis for solving this problem. A mechanism for synthesizing a comprehensive plan of operations to improve the quality of the DSS software is proposed, and the possibility of analysing the step-by-step implementation of a plan to obtain an analytical assessment is shown. For this purpose, a comprehensive plan is presented in the form of a relevance tree, built in accordance with the provisions of graph theory and the rank approach. The time complexity of the algorithms implementing the relevance tree tasks was evaluated. Based on the formalized solutions obtained, it was found that the maximum number of edges for a graph that implements the relevance tree does not exceed , the number of views of edges does not exceed , that is, the total number of operations that implements the scanning of edges and adding them to the weighted minimum cover (WMC) does not exceeds . It is established that during the implementation of the operation of adding ribs in the WMC, at each step, after the fixation of the previous result, the number of ribs to be examined decreases, so the total complexity of the algorithms will not exceed . The solutions obtained meet the requirements of DSTU ISO/IEC 9126, ISO DSTU / IEC 14598, and take into account the requirements of the Software Quality Requirements and Evaluation series of standards as the value of the vertices of the event tree graph. In the process of solving the problem, the specificity of the functioning of the MMS was taken into account, the possibility of formalizing various aspects of knowledge (aesthetic, disizional, causal, diontic) and ensuring a given level of efficiency in finding solutions.

Reply re: "Stereotactic Navigation Improves Outcomes of Orbital Decompression Surgery for Thyroid Associated Orbitopathy".

PURPOSE To test whether intraoperative stereotactic navigation during orbital decompression surgery resulted in quantifiable surgical benefit. METHODS This retrospective cohort study examined all consecutive patients who underwent primary orbital decompression surgery for thyroid associated orbitopathy performed by a single surgeon (A.K.) during the periods of 2012-2014 (non-navigated), and 2017-2018 (navigated). The study was HIPAA-compliant, was approved by the Institutional Review Board, and adhered to the tenets of the Helsinki declaration. Recorded parameters included patient age, sex, race, decompression technique (side of operation and walls decompressed), estimated blood loss (EBL), intraoperative complications, times that patient entered and exited the operating room (OR), times of surgical incision and dressing completion, pre- and postoperative best corrected visual acuity (BCVA), proptosis, diplopia, postoperative change in strabismus deviation, and need for subsequent strabismus surgery. Recorded times were used to calculate operating time (initial incision to dressing) and maintenance time (time between OR entry and initial incision and time between dressings and OR exit). The total maintenance time was averaged over total number of operations. Student t test was used to compare surgical times, maintenance times, EBL, and proptosis reduction. Fisher exact test was used to compare BCVA change, strabismus deviation change, resolution or onset of diplopia, and need for corrective strabismus surgery. RESULTS Twenty-two patients underwent primary orbital decompression surgery without navigation, and 23 patients underwent navigation-guided primary orbital decompression surgery. There were no intraoperative complications in either group. The average operative time was shorter in the navigated group for a unilateral balanced decompression (n = 10 vs. 19; 125.8 ± 13.6 vs. 141.3 ± 19.4 min; p-value = 0.019), and a unilateral lateral wall only decompression (n = 13 vs. 3; 80.5 ± 12.8 vs. 93.0 ± 6.1 min; p-value = 0.041). The average maintenance time per surgery was not significantly different between the non-navigated group (51.3 ± 12.7 min) and the navigated group (50.5 ± 6.4 min). There was no significant difference between the navigated and non-navigated groups in average EBL per surgery. There was no significant difference in BCVA change. Average proptosis reduction was larger in the navigated group, but this was not significant. There was a significantly lower proportion of patients who required corrective strabismus surgery following decompression in the navigated group than in the non-navigated group (39.1% vs. 77.3%, p-value = 0.012). CONCLUSIONS Intraoperative stereotactic navigation during orbital decompression surgery has the potential to provide the surgeon with superior spatial awareness to improve patient outcomes. This study found that use of intraoperative navigation reduced operative time (even without factoring in a resident teaching component) while also reducing the need for subsequent strabismus surgery. This study is limited by its size but illustrates that use of intraoperative navigation guidance has substantive benefits in orbital decompression surgery.

Simultaneous ipsilateral nephrectomy during kidney transplantation in autosomal dominant polycystic kidney disease: a matched pair analysis of 193 consecutive cases

BackgroundIn end-stage renal transplant recipients with autosomal-dominant polycystic kidney disease (ADPKD), the imperative, optimal timing, and technique of native nephrectomy remains under discussion. The Freiburg Transplant Center routinely performs a simultaneous ipsilateral nephrectomy.MethodsFrom April 1998 to May 2017, we retrospectively analyzed 193 consecutive ADPKD recipients, receiving per protocol simultaneous ipsilateral nephrectomy and compared morbidity, mortality, and outcome with 193 non-ADPKD recipients of a matched pair control.ResultsThe incidence of surgical complications was similar with respect to severe medical, surgical, urological, vascular, and wound-related complications as well as reoperation rates and 30-day mortality. Intraoperative blood transfusions were required more often in the ADPKD (22.8%) compared with the control group (6.7%; p < 0.0001). Early postoperative urinary tract infections occurred more frequent (ADPKD 40.4%/control 29.0%; p = 0.0246). Time of surgery was prolonged by 30 min (ADPKD 169 min; 95%CI 159.8–175.6 min/control 139 min; 95%CI 131.4–145.0 min; p < 0.0001). One-year patient (ADPKD 96.4%/control 95.8%; p = 0.6537) and death-censored graft survival (ADPKD 94.8%/control 93.7%; p = 0.5479) were comparable between both groups.ConclusionsWith respect to morbidity and mortality, per protocol, simultaneous native nephrectomy is a safe procedure. Especially in asymptomatic ADPKD KTx recipients, the number of total operations can be reduced and residual diuresis preserved up until transplantation. In living donation, even preemptive transplantation is possible.

Long-Term Effect of Multiple Operations on Psychosocial Function in Teenage Cleft Lip and Palate Patients.

Cleft lip and palate patients undergo a significant number of interventions during their childhood and adolescence. Although the intention of such interventions is to improve psychosocial functioning, there exists a paucity of data on the psychosocial outcomes of the burden of care on cleft children. In this work, the long-term effects of quantity and timing of childhood operations on teenagers with cleft lip and palate were evaluated. Cleft lip and palate patients (aged 14 to 17 years; n = 55) and an age-matched unaffected cohort (n = 14) prospectively enrolled from two institutions were administered the anger, anxiety, and depressive symptoms instruments from the Pediatric Patient-Reported Outcomes Measurement Information System. Total number of operations and operations stratified by age groups (0 to 7, 8 to 10, 11 to 13, and 14 to 17 years) were evaluated in relationship to instrument scores. Descriptive statistics, independent t tests, Pearson correlations, and multiple linear regression analyses were conducted. No differences in overall psychosocial functioning were found between the cleft lip and palate and comparison groups. Total quantity of childhood operations did not correlate to psychosocial functioning of cleft lip and palate teenagers. However, multiple linear regression analyses demonstrated that increased number of operations in the 8- to 10-year-old age range predicted increased anxiety and depressive symptoms in teenagers (β = 0.38, p = 0.009; and β = 0.29, p = 0.03, respectively). It was previously reported by the authors' group that the 8- to 10-year-old age range is an at-risk period for psychosocial distress in children with craniofacial anomalies. Their current work demonstrates that increased number of operations during this time frame may result in long-term consequences in anxiety and depression in cleft lip and palate patients. Risk, II.

Regional variability of hemorrhage following tonsil surgery in 1,520,234 cases.

To evaluate, whether the regional variability of tonsil surgery in terms of the 16 Federal States of Germany was mirrored by a comparable variability of bleeding complications in male and female patients. A longitudinal population-based inpatient cohort study was performed including all patients who had undergone tonsil surgery between 2005 and 2018. The database was provided by the Federal Statistical Office of Germany and included all inpatient cases after tonsillectomy (with or without adenoidectomy), tonsillotomy, abscess-tonsillectomy and secondary tonsillectomy. The population was stratified by region (16 Federal States) and gender. Operation rates were calculated in relation to the end-year population number of each region. Bleeding percentages were calculated for each calendar year and region as the number of procedures to achieve hemostasis divided by the total number of operations. The surgical rates varied significantly between the 16 Federal States in male, female and all patients (p = 0.001). Revision surgery to achieve hemostasis was predominantly performed in male patients (5.2-11.4% male vs. 3.7-7.6% female patients). Bleeding percentages did not differ significantly from national values in male and female patients in 5 Federal States, but were significantly higher than the national average in 3 Federal States and significantly lower in 7 Federal States for both genders (p < 0.05), while in 1 Federal State it was significantly lower only for the male patients. Pearson's correlation coefficient for surgical and bleeding rates was positive and statistically significant (p < 0.05) for all Federal States, except for two. This phenomenon was emphasized by female gender. Gender had an impact not only on surgical rates but also on bleeding percentages and this was independent from the decrease in the total number of operations. Surprisingly, there was a clear correlation between the rates of both variables in the majority of the Federal States of Germany. It needs further studies to clarify, why a higher prevalence of surgical practice, thus surgical experience, was not followed by lower bleeding complications.

Enhancing Function Approximation Abilities of Neural Networks by Training Derivatives.

A method to increase the precision of feedforward networks is proposed. It requires prior knowledge of a target's function derivatives of several orders and uses this information in gradient-based training. Forward pass calculates not only the values of the output layer of a network but also their derivatives. The deviations of those derivatives from the target ones are used in an extended cost function, and then, the backward pass calculates the gradient of the extended cost with respect to weights, which is then used by a weights update algorithm. The most accurate approximation is obtained when the training starts with all available derivatives that are then step by step excluded from the extended cost function, starting with the highest orders up until only values are trained. Despite a substantial increase in arithmetic operations per pattern (compared with the conventional training), the method allows to obtain 140-1000 times more accurate approximation for simple cases if the total number of operations is equal. This precision also happens to be out of reach for the regular cost function. The method works well for solving differential equations with neural networks. The cost function is the deviation of the equation's residual from zero, and it can be extended by differentiating the equation itself so no prior information is required. This extension allows to solve 2-D nonlinear partial differential equation 13 times more accurately using seven times fewer grid points. The GPU-efficient algorithm for calculating the gradient of the extended cost function is proposed.

Risk factors of non-union in intramedullary stabilized diaphyseal long bone fractures: identifying the role of fracture stabilization strategies and concomitant injuries

PurposeConcomitant chest injury is known to negatively affect bone metabolism and fracture healing, whereas traumatic brain injury (TBI) appears to have positive effects on bone metabolism. Osteogenesis can also be influenced by the timing of fracture stabilization. We aimed to identify how chest injuries, TBI and fracture stabilization strategy influences the incidence of non-union.MethodsPatients with long bone fractures of the lower extremities who had been treated between 2004 and 2014 were retrospectively analysed. Non-union was defined as fracture healing not occurring in the expected time period and in which neither progression of healing nor successful union is expected without intervention. Diverse clinical and radiological parameters were statistically analysed using the Statistical Package for the Social Sciences (SPSS).ResultsThe total number of operations before consolidation was an independent predictor (odds ratio [OR] = 6.416, p < 0.001) for the development of non-union in patients with long bone fractures. More specifically, patients treated according to the damage control orthopaedics (DCO) principle had a significantly higher risk of developing a non-union than patients treated according to the early total care (ETC) principle (OR = 7.878, p = 0.005). Concomitant chest injury and TBI could not be identified as influencing factors for non-union development.ConclusionOur results indicate that the number of operations performed in patients with long bone fractures should be kept as low as possible and that the indication for and the timing of DCO treatment should be meticulously noted to minimize the risk of non-union development.

Stereotactic Navigation Improves Outcomes of Orbital Decompression Surgery for Thyroid Associated Orbitopathy.

To test whether intraoperative stereotactic navigation during orbital decompression surgery resulted in quantifiable surgical benefit. This retrospective cohort study examined all consecutive patients who underwent primary orbital decompression surgery for thyroid associated orbitopathy performed by a single surgeon (A.K.) during the periods of 2012-2014 (non-navigated), and 2017-2018 (navigated). The study was HIPAA-compliant, was approved by the Institutional Review Board, and adhered to the tenets of the Helsinki declaration. Recorded parameters included patient age, sex, race, decompression technique (side of operation and walls decompressed), estimated blood loss (EBL), intraoperative complications, times that patient entered and exited the operating room (OR), times of surgical incision and dressing completion, pre- and postoperative best corrected visual acuity (BCVA), proptosis, diplopia, postoperative change in strabismus deviation, and need for subsequent strabismus surgery. Recorded times were used to calculate operating time (initial incision to dressing) and maintenance time (time between OR entry and initial incision and time between dressings and OR exit). The total maintenance time was averaged over total number of operations. Student t test was used to compare surgical times, maintenance times, EBL, and proptosis reduction. Fisher exact test was used to compare BCVA change, strabismus deviation change, resolution or onset of diplopia, and need for corrective strabismus surgery. Twenty-two patients underwent primary orbital decompression surgery without navigation, and 23 patients underwent navigation-guided primary orbital decompression surgery. There were no intraoperative complications in either group. The average operative time was shorter in the navigated group for a unilateral balanced decompression (n = 10 vs. 19; 125.8 ± 13.6 vs. 141.3 ± 19.4 min; p-value = 0.019), and a unilateral lateral wall only decompression (n = 13 vs. 3; 80.5 ± 12.8 vs. 93.0 ± 6.1 min; p-value = 0.041). The average maintenance time per surgery was not significantly different between the non-navigated group (51.3 ± 12.7 min) and the navigated group (50.5 ± 6.4 min). There was no significant difference between the navigated and non-navigated groups in average EBL per surgery. There was no significant difference in BCVA change. Average proptosis reduction was larger in the navigated group, but this was not significant. There was a significantly lower proportion of patients who required corrective strabismus surgery following decompression in the navigated group than in the non-navigated group (39.1% vs. 77.3%, p-value = 0.012). Intraoperative stereotactic navigation during orbital decompression surgery has the potential to provide the surgeon with superior spatial awareness to improve patient outcomes. This study found that use of intraoperative navigation reduced operative time (even without factoring in a resident teaching component) while also reducing the need for subsequent strabismus surgery. This study is limited by its size but illustrates that use of intraoperative navigation guidance has substantive benefits in orbital decompression surgery.

Fast Bilinear Algorithms for Symmetric Tensor Contractions

Abstract In matrix-vector multiplication, matrix symmetry does not permit a straightforward reduction in computational cost. More generally, in contractions of symmetric tensors, the symmetries are not preserved in the usual algebraic form of contraction algorithms. We introduce an algorithm that reduces the bilinear complexity (number of computed elementwise products) for most types of symmetric tensor contractions. In particular, it lowers the bilinear complexity of symmetrized contractions of symmetric tensors of order s + v {s+v} and v + t {v+t} by a factor of ( s + t + v ) ! s ! ⁢ t ! ⁢ v ! {\frac{(s+t+v)!}{s!t!v!}} to leading order. The algorithm computes a symmetric tensor of bilinear products, then subtracts unwanted parts of its partial sums. Special cases of this algorithm provide improvements to the bilinear complexity of the multiplication of a symmetric matrix and a vector, the symmetrized vector outer product, and the symmetrized product of symmetric matrices. While the algorithm requires more additions for each elementwise product, the total number of operations is in some cases less than classical algorithms, for tensors of any size. We provide a round-off error analysis of the algorithm and demonstrate that the error is not too large in practice. Finally, we provide an optimized implementation for one variant of the symmetry-preserving algorithm, which achieves speedups of up to 4.58 × \times for a particular tensor contraction, relative to a classical approach that casts the problem as a matrix-matrix multiplication.

Mental Fatigue Evaluation of Surgical Teams during a Regular Workday in a High-Volume Tertiary Healthcare Center

Introduction: Considering the complex set of manual and psychological tasks a surgeon has to perform during the day, it is very important to assess the surgeon’s fatigability, reaction time, attention, and memory. Objective: Here, we wanted to determine the mental fatigue status of surgeons and how their abilities are affected through a regular workday. Methods: We included 3 senior urologists and 6 urology residents. In a set period of time, we assessed their fatigue through self-assessed fatigue, Samn-Perelli score, and Karolinska sleepiness scale score. Further, reaction time, attention, and memory correlated with the number of the operations in the day, and total number of operations in that day were assessed. Results: As the number of tasks increases, and as the surgeons advance to the end of the workday, they become more fatigued, reaction time ultimately increases, and attention and memory become slightly altered. Conclusions: Complications resulting from the fatigue of surgeons could be serious. Their performance status and skills decrease as they perform more tasks or advance through the day.

Computational complexity reduction of GreenOFDM

The GreenOFDM technique is a new SeLected Mapping Orthogonal Frequency Division Multiplexing (SLM-OFDM) scheme where the same Peak-to-Average Power Ratio (PAPR) reduction is attained at a reduced number of computed IFFTs. Indeed, for the same performance the SLM-OFDM requires computing U IFFTs while the GreenOFDM requires only $2\sqrt {U}$. In this paper, a method specific to the GreenOFDM to further reduce its computational complexity is presented. The results are presented through the probabilistic distributions of the number of computed IFFTs and the total number of operations. The methods being probabilistic, a solution to deal with the induced latency is proposed in order to guarantee real-time operation of the transmitter. Finally, the digital power consumption of the proposed method is proven to be negligible as compared with the High Power Amplifier (HPA) power consumption when implemented in a dedicated processor.

Minimizing the maximum flow time for flexible job shop problem with parallel machines

ABSTRACTThis paper studies a flexible job shop problem with parallel machines considering release time. The objective aims to minimize the maximum flow time. According to the specific characteristics of the problem, we find a property which can reduce the 2d dimension of solution space to d dimension, where d is the total number of operations. To solve the small-scale problem, a branch-and-bound algorithm is proposed. For the medium-scale problem, a heuristic based on a differential evolution algorithm is proposed. A heuristic is tried to solve the large-scale problem. Through computational experiments, the proposed algorithms are proved to be both effective and efficient in solving this flexible job shop problem. Besides, experiments are also conducted to verify that the objective to minimize the maximum flow time is reasonable.

Evolución de operaciones por enfermedades del intestino proximal y glándulas anexas realizadas en Chile entre 2011 y 2016

Introduction: The number of operations performed in Chile due to diseases for the foregut, have been every time more precise and complete in the National Register Data of Statistics in Health (MINSAL), and published in several reports (years 1983, 2005 and 2011). Objectives: a) to incorporate data of new operations not included before and b) to compare the results of high complex operations reported on 2011 and 2016. Material and Methods: from the DEIS (Department of Statistics and Information of Health) we obtained the total number of operations performed during 2016, and the operative mortality at the time of discharge from the hospital for different diseases of the foregut been the majority malignant tumors: esophageal cancer, gastric cancer, pancreatic cancer, liver and bile ducts carcinoma, and cancer of the gallbladder. The results were compared to dose obtained the year 2011. Results: The annual lethality of digestive malignant tumors showed an increase in pancreatic and liver cancer, while a decrease was observed in patients with esophageal cancer al gallbladder cancer. Operations for benign pathology like esophagomiotomy and laparoscopic antireflux surgery showed no mortality, as well as gastric bypass. Laparoscopic cholecistectomy, and laparoscopic sleeve gastrectomy presented a very low mortality. Surgical procedures for malignant diseases showed a decrease in operative mortality compare to 2011, although not significant. Conclusions: The present study shows an increase in the operations for foregut diseases performed during 2016 compared with the year 2011, as well as a decrease in operative mortality.

A gamma-signal-regulated connected components labeling algorithm

This paper proposes a novel connected components labeling (CCL) approach that introduces a gamma signal to record certain mask pixels’ values to eliminate duplicated pixel checking and regulate the labeling process for higher efficiency. A new block-based two-scan CCL algorithm, Eight-Connected Gamma-Signal-regulated (ECGS) algorithm, is designed and developed by applying this approach to evaluate a block of 2 × 2 pixels (with just 6 mask pixels) in each iteration such that the total number of operations is considerably reduced and the labeling efficiency is significantly improved. The experiments conducted on a public benchmark, YACCLAB (Yet Another Connected Components Labeling Benchmark), have demonstrated that the proposed ECGS algorithm can outperform current state-of-the-art CCL algorithms for a number of digital images.

A survey on the current development of thoracic surgery in tertiary hospitals of China

Objective: To study the current development of thoracic surgery in China. Methods: Chinese Society for Thoracic and Cardiovascular Surgery and Chinese Association for Thoracic Surgeons jointly conducted a network survey to directors of thoracic surgery departments in the tertiary hospitals in China from November to December 2018. The contents of the survey included the basic information of the hospital and the status of thoracic surgery department in the hospital. Rank sum test was used to compare the data between different regional hospitals Results: A total of 636 tertiary hospitals participated in the survey. The total number of beds for thoracic surgery departments was 30 646, with M(Q(R)) of 40(20) (range: 3 to 393) for each hospital. The total number of thoracic surgeons was 6 747, with M(Q(R)) of 9(6) (range: 1 to 75) in each hospital. In 2015, a total of 312 425 operations were performed in the 636 hospitals, with M(Q(R)) of 268(484.5) (range: 4 to 8 320) for each hospital. The total number of lung cancer surgeries was 146 601 in 2015, with M(Q(R)) of 100(216) (range: 0 to 6 911) operations in each hospital. The total number of esophageal cancer operations was 67 076, with M(Q(R)) of 40(95) (range: 0 to 1 550) in each hospital. Minimal invasive thoracic surgery was performed in 94.3% (601/636) of the hospitals, with 86.6% (551/636) of hospitals carried out video-assisted thoracoscopic (VATS) lobectomy. Among the hospitals performing VATS lobectomy, 89.3% (492/551) of them started to perform the technique after 2006, and 93.1% (513/551) of them do single-direction thoracoscopic lobectomy. A total of 403 640 VATS lobectomies had been performed until 2015, including 163 682 cases of single-direction thoracoscopic lobectomy. In 2015, 73.74% (108 116/146 601) lung cancer operations and 37.44% (25 110/67 076) of esophageal cancer resections were performed by minimally invasive technique. The development level of hospitals among eastern, middle and Western China was different significantly on number of doctors, number of total operations, number of lung cancer surgeries, proportion of minimally invasive lung cancer surgery, number of esophageal cancer surgeries, and proportion of minimally invasive esophageal cancer surgery (χ(2)∶7.65 to 60.8, all P<0.05). Conclusions: The discipline of thoracic surgery, especially the minimally invasive thoracic surgery in China is now experiencing a rapid development. The proportion of minimally invasive lung cancer surgery is higher than that of in the developed countries. However, unbalanced development among different regions is still a great challenge in China.

Analysis of long-term effect of juvenile-onset recurrent respiratory papillomatosis

Objective: To observe the clinical course of children with juvenile-onset recurrent respiratory papillomatosis (JORRP) until 14 years old. Methods: The clinical data of one hundred and twenty cases treated between Januray 1, 2002 and September 30, 2017 in Beijing Tongren Hospital were analyzed retrospectively. Excluding the deaths and the lost, patients who could be ≥ 5 years without recurrence, were defined as the cured group, and < 5 years with recurrence defined as the recurrent group. Furthermore, using statistical methods to analyze the differences of the age of initial operation, total number of operations, invasive lesion, HPV infection, tracheotomy, airway dissemination after tracheotomy and time of tube wear between the two groups. Results: One hundred and three cases were followed up, except for the six deaths.Numbers of operations in eight cases were ≤2, and ≥3 in eighty nine cases.Peak of the primary surgical age were about 4.5 years old, while the self-healing trend occurred at nine years old. In the cured group, forty three cases were cured, with a curative rate of 41.7% (43/103), and there were all fifty four survivors in the recurrent group.The total number of operations, invasive cases, HPV positive cases and the G score of hoarseness in the recurrent group were higher than those in the cured group (F=13.02, χ(2)=13.04, χ(2)=17.37, Z=-4.59, P<0.05). The number of tracheal dissemination caused by tracheotomy in the recurrent group (66.7%, 27.8%)was more than that in the cured group (χ(2)=16.01, P<0.05). Compared with the time of wearing a tracheostomy tube in cured group, the recurrent group was longer ((3.4±3.1) years vs (8.3±6.7) years, χ(2)=7.19, P<0.05). Conclusions: 41.7% of the patients had no relapse for at least five years.There exsisted differences between the cured and recurrent group in the following aspects: the total numbers of surgery, the agression of the lesions, tracheal intratracheal dissemination after tracheotomy, the time of tracheotomy, the HPV typing and the G grading of hoarseness.

Properly designed effort management for highly fluctuating small pelagic fish populations: a case study in a purse seine fishery targeting chub mackerel

MEPS Marine Ecology Progress Series Contact the journal Facebook Twitter RSS Mailing List Subscribe to our mailing list via Mailchimp HomeLatest VolumeAbout the JournalEditorsTheme Sections MEPS 617-618:265-276 (2019) - DOI: https://doi.org/10.3354/meps12688 Properly designed effort management for highly fluctuating small pelagic fish populations: a case study in a purse seine fishery targeting chub mackerel Momoko Ichinokawa*, Hiroshi Okamura National Research Institute of Fisheries Science, Fisheries Research Agency, 2-12-4 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-8648, Japan *Corresponding author: ichimomo@fra.affrc.go.jpAdvance View was available online September 6, 2018 ABSTRACT: Proper fisheries management is difficult in fisheries targeting small pelagic fish that are subject to climate-induced oceanic regime shifts. A favourable regime tends to induce capacity investments, but the results of these investments turn out to be irreducible overcapacity under the next unfavourable regime. The Japanese purse seine fishery studied here, which targets small pelagic fish, is a typical example of such overcapacity. However, we demonstrate that this fishery represents a best practice of properly designed effort management in recent years through its quantitative evaluation. Generalized linear mixed models (GLMMs) applied to daily logbook data revealed that effort restrictions on daily purse seine operations (in terms of the duration and the total number of operations per ship and day) significantly reduced total fishing efforts on chub mackerel. Stochastic simulations based on the parameters estimated in GLMMs quantified the extent of the potential catch reduction by the effort reductions at approximately 20%. Combined with the effect of another concurrently implemented management measure, i.e. day closures, the net effects of the effort management on the total catch reduction were estimated at 30%. Because the quota uptake percentages in this fishery were 60-80% during the study period, we conclude that the effort management helped avoid overshooting of the quota and consequent seasonal closures. KEY WORDS: Input control · Effort limitations · Race to fish · Catch shares Full text in pdf format Supplementary material PreviousNextCite this article as: Ichinokawa M, Okamura H (2019) Properly designed effort management for highly fluctuating small pelagic fish populations: a case study in a purse seine fishery targeting chub mackerel. Mar Ecol Prog Ser 617-618:265-276. https://doi.org/10.3354/meps12688 Export citation RSS - Facebook - Tweet - linkedIn Cited by Published in MEPS Vol. 617-618. Online publication date: May 16, 2019 Print ISSN: 0171-8630; Online ISSN: 1616-1599 Copyright © 2019 Inter-Research.