Issues concerning on the continental shelf and in the exclusive economic zone between Turkey and the Greek Cypriot Administration (GCA) have been more controversial. This study answers the following questions:(a) What...Issues concerning on the continental shelf and in the exclusive economic zone between Turkey and the Greek Cypriot Administration (GCA) have been more controversial. This study answers the following questions:(a) What is the main arguments of the Parties?(b) How the exclusive economic zone could be declared?(c) Does median line applicable to the delimitation law without taken the related circumstances in the Eastern Mediterranean?(d) Can any maps on claimed exclusive economic zone borders publish without maritime boundary delimitation agreements, officially? The main intent of the study is to evaluate the different perspectives of the Parties on maritime delimitation and to evaluate the boundaries of the exclusive economic zone bounded by the European Union on the European Asia and Europe Africa Interconnected Cable Network Projects maps in the Eastern Mediterranean.展开更多
Objective To explore an ideal method for the correction of the secondary nasolabial deformities of bilateral cleft lip. Methods From January 2013 to December 2018 ,repairing nose and lip in median of the median upper ...Objective To explore an ideal method for the correction of the secondary nasolabial deformities of bilateral cleft lip. Methods From January 2013 to December 2018 ,repairing nose and lip in median of the median upper lip flap and lower lip Abbe flap in 13 patients with secondary nasolabial deformity of cleft lip, implanting artificial nose prosthesis when necessary. Results All the flaps were survived and nose appearance was greatly improved. The shape of the upper lip turned more similar to normal. Coordination between upper lip and lower lip was appropriate. Conclusion The median upper lip flap combined with lower lip Abbe flap to repair the secondary nasolabial deformities of bilateral cleft lip is effective . Goo d cosmetic results can be obtained.展开更多
Nerve regeneration after delayed nerve repair is often unsuccessful.Indeed,the expression of genes associated with regeneration,including neurotrophic and gliotrophic factors,is drastically reduced in the distal stump...Nerve regeneration after delayed nerve repair is often unsuccessful.Indeed,the expression of genes associated with regeneration,including neurotrophic and gliotrophic factors,is drastically reduced in the distal stump of chronically transected nerves;moreover,Schwann cells undergo atrophy,losing their ability to sustain regeneration.In the present study,to provide a three-dimensional environment and trophic factors supporting Schwann cell activity and axon re-growth,we combined the use of an effective conduit(a chitosan tube)with a promising intraluminal structure(fresh longitudinal skeletal muscle fibers).This enriched conduit was used to repair a 10-mm rat median nerve gap after 3-month delay and functional and morphometrical analyses were performed 4 months after nerve reconstruction.Our data show that the enriched chitosan conduit is as effective as the hollow chitosan conduit in promoting nerve regeneration,and its efficacy is not statistically different from the autograft,considered the“gold standard”technique for nerve reconstruction.Since hollow tubes not always lead to good results after long defects(>20 mm),we believe that the conduit enriched with fresh muscle fibers could be a promising strategy to repair longer gaps,as muscle fibers create a favorable three-dimensional environment and release trophic factors.All procedures were approved by the Bioethical Committee of the University of Torino and by the Italian Ministry of Health(approval number:864/2016/PR)on September 14,2016.展开更多
Earthquake engineers have made a lot of efforts to derive a comprehensive set of closed form expressions for performance evaluation of frames, which are already presented in guidelines such as SAC/FEMA. These analytic...Earthquake engineers have made a lot of efforts to derive a comprehensive set of closed form expressions for performance evaluation of frames, which are already presented in guidelines such as SAC/FEMA. These analytical expressions have been developed to estimate the annual probability of exceeding a limit state. In the process of such seismic assessments, some essential assumptions are adopted to simplify the process. One of these fundamental assumptions declares that drift demand at any seismic intensity level follows a lognormal distribution around its median. To investigate the validity of this assumption, this paper describes a case study of the types of errors that could be produced by using the sample median as the central tendency. Based on the Maximum Likelihood Estimation method as well as other statistical evidence, this paper proposes the use of the sample geometric mean instead of the sample median for the central tendency. Further, the results of seismic reliability evaluations of 4 sample frames are compared based on utilizing both the geometric mean and the sample median. In this process, both first and second order power law fits of the hazard curve are implemented to compare the effects of hazard estimation and the selection of the central tendency on the final results. It is observed in the application example that the sample geometric mean could lead to more accurate results.展开更多
Contralateral C7 nerve transfer surgery is one of the most important surgical techniques for treating total brachial plexus nerve injury. In the traditional contralateral C7 nerve transfer surgery, the whole ulnar ner...Contralateral C7 nerve transfer surgery is one of the most important surgical techniques for treating total brachial plexus nerve injury. In the traditional contralateral C7 nerve transfer surgery, the whole ulnar nerve on the paralyzed side is harvested for transfer, which completely sacrifices its potential of recovery. In the present, novel study, we report on the anatomical feasibility of a modified contralateral C7 nerve transfer surgery. Ten fresh cadavers (4 males and 6 females) provided by the Department of Anatomy, Histology, and Embryology at the Medical College of Fudan University, China were used in modified contralateral C7 nerve transfer surgery. In this surgical model, only the dorsal and superficial branches of the ulnar nerve and the medial antebrachial cutaneous nerve on the paralyzed side (left) were harvested for grafting the contralateral (right) C7 nerve and the recipient nerves. Both the median nerve and deep branch of the ulnar nerve on the paralyzed (left) side were recipient nerves. To verify the feasibility of this surgery, the distances between each pair of coaptating nerve ends were measured by a vernier caliper. The results validated that starting point of the deep branch of ulnar nerve and the starting point of the medial antebrachial cutaneous nerve at the elbow were close to each other and could be readily anastomosed. We investigated whether the fiber number of donor and recipient nerves matched one another. The axons were counted in sections of nerve segments distal and proximal to the coaptation sites after silver impregnation. Averaged axon number of the ulnar nerve at the upper arm level was approximately equal to the sum of the median nerve and proximal end of medial antebrachial cutaneous nerve (left: 0.94:1;right: 0.93:1). In conclusion, the contralateral C7 nerve could be transferred to the median nerve but also to the deep branch of the ulnar nerve via grafts of the ulnar nerve without deep branch and the medial antebrachial cutaneous nerve. The advantage over traditiona展开更多
Our previous studies have confirmed that during nerve transposition repair to injured peripheral nerves,the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively repair dist...Our previous studies have confirmed that during nerve transposition repair to injured peripheral nerves,the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively repair distal nerve and target muscle tissue and restore muscle motor function.To observe the effect of nerve regeneration and motor function recovery after several types of nerve transposition for median nerve defect(2 mm),30 Sprague-Dawley rats were randomly divided into sham operation group,epineurial neurorrhaphy group,musculocutaneous nerve transposition group,medial pectoral nerve transposition group,and radial nerve muscular branch transposition group.Three months after nerve repair,the wrist flexion test was used to evaluate the recovery of wrist flexion after regeneration of median nerve in the affected limbs of rats.The number of myelinated nerve fibers,the thickness of myelin sheath,the diameter of axons and the cross-sectional area of axons in the proximal and distal segments of the repaired nerves were measured by osmic acid staining.The ratio of newly produced distal myelinated nerve fibers to the number of proximal myelinated nerve fibers was calculated.Wet weights of the flexor digitorum superficialis muscles were measured.Muscle fiber morphology was detected using hematoxylin-eosin staining.The cross-sectional area of muscle fibers was calculated to assess the recovery of muscles.Results showed that wrist flexion function was restored,and the nerve grew into the distal effector in all three nerve transposition groups and the epineurial neurorrhaphy group.There were differences in the number of myelinated nerve fibers in each group.The magnification of proximal to distal nerves was 1.80,3.00,2.50,and 3.12 in epineurial neurorrhaphy group,musculocutaneous nerve transposition group,medial pectoral nerve transposition group,and radial nerve muscular branch transposition group,respectively.Nevertheless,axon diameters of new nerve fibers,cross-sectional areas of axons,thicknesses of myelin sheath,wet展开更多
Control charts are commonly used tools in statistical process control for the detection of shifts in process parameters. Shewhart-type charts are efficient for large shift values, whereas cumulative sum(CUSUM) charts ...Control charts are commonly used tools in statistical process control for the detection of shifts in process parameters. Shewhart-type charts are efficient for large shift values, whereas cumulative sum(CUSUM) charts are effective in detecting medium and small shifts. Control chart use commonly assumes that data are free of outliers and parameters are known or correctly estimated based on an in-control process. In practice, these assumptions are not often true because some processes occasionally have outliers. Monitoring the location parameter is usually based on mean charts, which are seriously affected by violations of these assumptions. In this paper we propose several CUSUM median control charts based on auxiliary variables, and offer comparisons with their corresponding mean control charts. To monitor the location parameter, we examined the performance of mean and median control charts in the presence and absence of outliers. Both symmetric and non-symmetric processes were studied to examine the properties of the proposed control charts to monitor the location parameter using CUSUM control charts. We used different run length measures to study in-control and out-of-control performances of CUSUM charts. Results revealed that our proposed control charts perform much better than the traditional charts in the presence of outliers. A real application of our study was provided using data on concrete compressive strength as it relates to the quality of cement manufacturing.展开更多
BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerve...BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves.Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy.The median nerve size has been studied in non-Nigerian diabetic populations.In attempt to contribute to existing literature,a study in a Nigerian population is needed.AIM To evaluate the cross-sectional area(CSA)of the median nerve using B-mode ultrasonography(USS)and the presence of peripheral neuropathy(PN)in a cohort of adult diabetic Nigerians.METHODS Demographic and anthropometric data of 85 adult diabetes mellitus(DM)and 85 age-and sex-matched apparently healthy control(HC)subjects were taken.A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument(MNSI)was used to grade its severity.Venous blood was taken from the study subjects for fasting lipid profile(FLP),fasting blood glucose(FBG)and glycated haemoglobin(HbA1c)while their MN CSA was evaluated at a point 5 cm proximal to(5cmCATL)and at the carpal tunnel(CATL)by high-resolution Bmode USS.Data was analysed using SPSS version 22.RESULTS The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5cmCATL(P<0.01)and at the CATL(P<0.01)on both sides.The presence of diabetic peripheral neuropathy(DPN)further increased the MN CSA at the CATL(P<0.05)but not at 5cmCATL(P>0.05).However,the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL.There was no significant association between MN CSA and duration of DM and glycemic control.CONCLUSION Thickening of the MN CSA at 5cmCATL and CATL is seen in DM.Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at 5cmCATL.Severity of DPN,duration of DM,and glycemic control had no additional effect on the MN CSA.展开更多
文摘Issues concerning on the continental shelf and in the exclusive economic zone between Turkey and the Greek Cypriot Administration (GCA) have been more controversial. This study answers the following questions:(a) What is the main arguments of the Parties?(b) How the exclusive economic zone could be declared?(c) Does median line applicable to the delimitation law without taken the related circumstances in the Eastern Mediterranean?(d) Can any maps on claimed exclusive economic zone borders publish without maritime boundary delimitation agreements, officially? The main intent of the study is to evaluate the different perspectives of the Parties on maritime delimitation and to evaluate the boundaries of the exclusive economic zone bounded by the European Union on the European Asia and Europe Africa Interconnected Cable Network Projects maps in the Eastern Mediterranean.
文摘Objective To explore an ideal method for the correction of the secondary nasolabial deformities of bilateral cleft lip. Methods From January 2013 to December 2018 ,repairing nose and lip in median of the median upper lip flap and lower lip Abbe flap in 13 patients with secondary nasolabial deformity of cleft lip, implanting artificial nose prosthesis when necessary. Results All the flaps were survived and nose appearance was greatly improved. The shape of the upper lip turned more similar to normal. Coordination between upper lip and lower lip was appropriate. Conclusion The median upper lip flap combined with lower lip Abbe flap to repair the secondary nasolabial deformities of bilateral cleft lip is effective . Goo d cosmetic results can be obtained.
基金the European Community’s Seventh Framework Programme(FP7-HEALTH-2011),No.278612(to SG)Compagnia di San Paolo,No.D86D15000100005InTheCure project(to SR).
文摘Nerve regeneration after delayed nerve repair is often unsuccessful.Indeed,the expression of genes associated with regeneration,including neurotrophic and gliotrophic factors,is drastically reduced in the distal stump of chronically transected nerves;moreover,Schwann cells undergo atrophy,losing their ability to sustain regeneration.In the present study,to provide a three-dimensional environment and trophic factors supporting Schwann cell activity and axon re-growth,we combined the use of an effective conduit(a chitosan tube)with a promising intraluminal structure(fresh longitudinal skeletal muscle fibers).This enriched conduit was used to repair a 10-mm rat median nerve gap after 3-month delay and functional and morphometrical analyses were performed 4 months after nerve reconstruction.Our data show that the enriched chitosan conduit is as effective as the hollow chitosan conduit in promoting nerve regeneration,and its efficacy is not statistically different from the autograft,considered the“gold standard”technique for nerve reconstruction.Since hollow tubes not always lead to good results after long defects(>20 mm),we believe that the conduit enriched with fresh muscle fibers could be a promising strategy to repair longer gaps,as muscle fibers create a favorable three-dimensional environment and release trophic factors.All procedures were approved by the Bioethical Committee of the University of Torino and by the Italian Ministry of Health(approval number:864/2016/PR)on September 14,2016.
文摘Earthquake engineers have made a lot of efforts to derive a comprehensive set of closed form expressions for performance evaluation of frames, which are already presented in guidelines such as SAC/FEMA. These analytical expressions have been developed to estimate the annual probability of exceeding a limit state. In the process of such seismic assessments, some essential assumptions are adopted to simplify the process. One of these fundamental assumptions declares that drift demand at any seismic intensity level follows a lognormal distribution around its median. To investigate the validity of this assumption, this paper describes a case study of the types of errors that could be produced by using the sample median as the central tendency. Based on the Maximum Likelihood Estimation method as well as other statistical evidence, this paper proposes the use of the sample geometric mean instead of the sample median for the central tendency. Further, the results of seismic reliability evaluations of 4 sample frames are compared based on utilizing both the geometric mean and the sample median. In this process, both first and second order power law fits of the hazard curve are implemented to compare the effects of hazard estimation and the selection of the central tendency on the final results. It is observed in the application example that the sample geometric mean could lead to more accurate results.
文摘Contralateral C7 nerve transfer surgery is one of the most important surgical techniques for treating total brachial plexus nerve injury. In the traditional contralateral C7 nerve transfer surgery, the whole ulnar nerve on the paralyzed side is harvested for transfer, which completely sacrifices its potential of recovery. In the present, novel study, we report on the anatomical feasibility of a modified contralateral C7 nerve transfer surgery. Ten fresh cadavers (4 males and 6 females) provided by the Department of Anatomy, Histology, and Embryology at the Medical College of Fudan University, China were used in modified contralateral C7 nerve transfer surgery. In this surgical model, only the dorsal and superficial branches of the ulnar nerve and the medial antebrachial cutaneous nerve on the paralyzed side (left) were harvested for grafting the contralateral (right) C7 nerve and the recipient nerves. Both the median nerve and deep branch of the ulnar nerve on the paralyzed (left) side were recipient nerves. To verify the feasibility of this surgery, the distances between each pair of coaptating nerve ends were measured by a vernier caliper. The results validated that starting point of the deep branch of ulnar nerve and the starting point of the medial antebrachial cutaneous nerve at the elbow were close to each other and could be readily anastomosed. We investigated whether the fiber number of donor and recipient nerves matched one another. The axons were counted in sections of nerve segments distal and proximal to the coaptation sites after silver impregnation. Averaged axon number of the ulnar nerve at the upper arm level was approximately equal to the sum of the median nerve and proximal end of medial antebrachial cutaneous nerve (left: 0.94:1;right: 0.93:1). In conclusion, the contralateral C7 nerve could be transferred to the median nerve but also to the deep branch of the ulnar nerve via grafts of the ulnar nerve without deep branch and the medial antebrachial cutaneous nerve. The advantage over traditiona
基金the National Natural Science Foundation of China,No.31571236,31571235(to YHK,PXZ)the National Key Research and Development Program of China,No.2016YFC1101604(to DYZ)+3 种基金the National Key Basic Research Program of China(973 Program),No.2014CB542200(to BGJ)the Ministry of Education Innovation Program of China,No.IRT_16R01(to BGJ)the Beijing Science and Technology New Star Cross Program of China,No.2018019(to PXZ)the Peking University People’s Hospital Research and Development Funds,No.RDH2017-01(to HLX).
文摘Our previous studies have confirmed that during nerve transposition repair to injured peripheral nerves,the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively repair distal nerve and target muscle tissue and restore muscle motor function.To observe the effect of nerve regeneration and motor function recovery after several types of nerve transposition for median nerve defect(2 mm),30 Sprague-Dawley rats were randomly divided into sham operation group,epineurial neurorrhaphy group,musculocutaneous nerve transposition group,medial pectoral nerve transposition group,and radial nerve muscular branch transposition group.Three months after nerve repair,the wrist flexion test was used to evaluate the recovery of wrist flexion after regeneration of median nerve in the affected limbs of rats.The number of myelinated nerve fibers,the thickness of myelin sheath,the diameter of axons and the cross-sectional area of axons in the proximal and distal segments of the repaired nerves were measured by osmic acid staining.The ratio of newly produced distal myelinated nerve fibers to the number of proximal myelinated nerve fibers was calculated.Wet weights of the flexor digitorum superficialis muscles were measured.Muscle fiber morphology was detected using hematoxylin-eosin staining.The cross-sectional area of muscle fibers was calculated to assess the recovery of muscles.Results showed that wrist flexion function was restored,and the nerve grew into the distal effector in all three nerve transposition groups and the epineurial neurorrhaphy group.There were differences in the number of myelinated nerve fibers in each group.The magnification of proximal to distal nerves was 1.80,3.00,2.50,and 3.12 in epineurial neurorrhaphy group,musculocutaneous nerve transposition group,medial pectoral nerve transposition group,and radial nerve muscular branch transposition group,respectively.Nevertheless,axon diameters of new nerve fibers,cross-sectional areas of axons,thicknesses of myelin sheath,wet
基金Project supported by the National Natural Science Foundation of China(Nos.11371077 and 11471065)the Fundamental Research Funds for the Central Universities,China(No.DUT15LK28).
文摘Control charts are commonly used tools in statistical process control for the detection of shifts in process parameters. Shewhart-type charts are efficient for large shift values, whereas cumulative sum(CUSUM) charts are effective in detecting medium and small shifts. Control chart use commonly assumes that data are free of outliers and parameters are known or correctly estimated based on an in-control process. In practice, these assumptions are not often true because some processes occasionally have outliers. Monitoring the location parameter is usually based on mean charts, which are seriously affected by violations of these assumptions. In this paper we propose several CUSUM median control charts based on auxiliary variables, and offer comparisons with their corresponding mean control charts. To monitor the location parameter, we examined the performance of mean and median control charts in the presence and absence of outliers. Both symmetric and non-symmetric processes were studied to examine the properties of the proposed control charts to monitor the location parameter using CUSUM control charts. We used different run length measures to study in-control and out-of-control performances of CUSUM charts. Results revealed that our proposed control charts perform much better than the traditional charts in the presence of outliers. A real application of our study was provided using data on concrete compressive strength as it relates to the quality of cement manufacturing.
文摘BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves.Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy.The median nerve size has been studied in non-Nigerian diabetic populations.In attempt to contribute to existing literature,a study in a Nigerian population is needed.AIM To evaluate the cross-sectional area(CSA)of the median nerve using B-mode ultrasonography(USS)and the presence of peripheral neuropathy(PN)in a cohort of adult diabetic Nigerians.METHODS Demographic and anthropometric data of 85 adult diabetes mellitus(DM)and 85 age-and sex-matched apparently healthy control(HC)subjects were taken.A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument(MNSI)was used to grade its severity.Venous blood was taken from the study subjects for fasting lipid profile(FLP),fasting blood glucose(FBG)and glycated haemoglobin(HbA1c)while their MN CSA was evaluated at a point 5 cm proximal to(5cmCATL)and at the carpal tunnel(CATL)by high-resolution Bmode USS.Data was analysed using SPSS version 22.RESULTS The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5cmCATL(P<0.01)and at the CATL(P<0.01)on both sides.The presence of diabetic peripheral neuropathy(DPN)further increased the MN CSA at the CATL(P<0.05)but not at 5cmCATL(P>0.05).However,the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL.There was no significant association between MN CSA and duration of DM and glycemic control.CONCLUSION Thickening of the MN CSA at 5cmCATL and CATL is seen in DM.Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at 5cmCATL.Severity of DPN,duration of DM,and glycemic control had no additional effect on the MN CSA.