Energy devices

能源装置
  • 文章类型: Journal Article
    甲状腺切除术相对安全,通常可以作为微创手术进行。尽管它们可能与学习曲线有关,术中附件如能量装置的周到使用,喉返神经监测,和甲状旁腺自发荧光有可能在甲状腺手术的安全性和效率方面取得递增的改善.也许许多这些附件可能是最大的好处,当常规使用经验较少的外科医生或有选择地在高风险的手术,尽管它们在实践中的采用率总体上继续增加。
    Thyroidectomy is relatively safe and often can be done as a minimally invasive procedure. Although they may be associated with a learning curve, thoughtful use of intraoperative adjuncts such as energy devices, recurrent laryngeal nerve monitoring, and parathyroid autofluorescence have the potential to make incremental improvements in the safety and efficiency of thyroid surgery. Perhaps many of these adjuncts may be of greatest benefit when used routinely by less experienced surgeons or selectively in higher-risk operations, although their adoption in practice continues to increase overall.
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  • 文章类型: Journal Article
    智能终端的广泛采用显著提升了可穿戴电子设备的市场潜力。二维(2D)纳米材料显示出很大的灵活性,下一代电子材料的可穿戴电子产品,在能源方面具有潜力,光电子学,和电子。首先,这篇综述集中在二维纳米材料中功能化/缺陷的重要性,讨论了用于可穿戴设备的不同种类的2D材料,以及二维材料的整体结构-性质关系。然后,在这次全面审查中,我们深入研究了基于2D纳米材料的柔性可穿戴电子产品的新兴应用领域,跨越能源等不同领域,医疗卫生,和显示器。进行了细致的探索,阐明了为特定应用定制材料特性所涉及的复杂过程。每个研究方向都被解剖,提供有见地的观点和辩证的评估,阐明未来的轨迹,并激发在这个快速发展的领域富有成果的调查。
    The widespread adoption of smart terminals has significantly boosted the market potential for wearable electronic devices. Two-dimensional (2D) nanomaterials show great promise for flexible, wearable electronics of next-generation electronic materials and have potential in energy, optoelectronics, and electronics. First, this review focuses on the importance of functionalization/defects in 2D nanomaterials, a discussion of different kinds of 2D materials for wearable devices, and the overall structure-property relationship of 2D materials. Then, in this comprehensive review, we delve into the burgeoning realm of emerging applications for 2D nanomaterial-based flexible wearable electronics, spanning diverse domains such as energy, medical health, and displays. A meticulous exploration is presented, elucidating the intricate processes involved in tailoring material properties for specific applications. Each research direction is dissected, offering insightful perspectives and dialectical evaluations that illuminate future trajectories and inspire fruitful investigations in this rapidly evolving field.
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  • 文章类型: Systematic Review
    止血是所有外科手术中的重要步骤。机械止血方法已逐渐被放弃,取而代之的是电外科。这项系统评价的目的是评估微创妇科手术中使用的电外科器械的有效性。
    我们进行了系统评价,包括随机对照试验,前瞻性和回顾性研究,比较腹腔镜妇科手术中使用不同能量装置(ED)的结果。我们提取了关于失血(BL)的数据,平均手术时间,术后疼痛,住院时间和与每个电外科设备相关的并发症。
    我们纳入了30项研究,报告了常规(双极和单极)和创新ED(谐波手术刀,LigaSure,血浆动力学回,雷声,EnSeal,Marseal,凯曼和阿兰)。由于术中BL较少,手术时间较短,因此发现新的ED在复杂手术中更有效。住院时间没有明显减少,使用新能源器械后发现术后疼痛或并发症。
    虽然新的电外科器械看起来是一个吸引人的、更安全的选择,仍然没有足够的证据证明一种血管密封技术优于另一种。因此,单极和传统双极(CB)仍广泛用于腹腔镜妇科。
    UNASSIGNED: Hemostasis is an important step in all surgical procedures. Mechanical methods of hemostasis have been gradually abandoned in favor of electrosurgery. The aim of this systematic review was to evaluate the effectiveness of electrosurgical instruments utilized in minimally invasive gynecological procedures.
    UNASSIGNED: We performed a systematic review, including randomized controlled trials, prospective and retrospective studies, comparing the outcomes of different energy devices (EDs) used in laparoscopic gynecologic surgeries. We extracted data about blood loss (BL), mean operative time, post-operative pain, hospital stay and complications associated with each electrosurgical device.
    UNASSIGNED: We included 30 studies reporting comparative outcomes concerning conventional (bipolar and monopolar) and innovative EDs (Harmonic scalpel, LigaSure, Plasma kinetic gyrus, Thunderbeat, EnSeal, Marseal, Caiman and ALAN). New EDs were found to be more efficient in complex surgeries due to less intraoperative BL and shorter operative time. No significant decrease in hospital stay, post-operative pain or complications was found with the use of new energy instruments.
    UNASSIGNED: Although new electrosurgical devices seem an appealing and safer option, there is still insufficient evidence for one vessel-sealing technology to be considered superior to another. Therefore, monopolar and conventional bipolar (CB) are still widely used in laparoscopic gynecology.
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  • 文章类型: Journal Article
    腹腔镜检查期间可使用多种血管密封装置。这项研究的目的是确定在妇科腹腔镜检查期间,外科医生级别和设备特性会影响先进能量设备的选择。
    这是一项通过社交媒体对妇科外科医生进行的全国性横断面研究,利用在线,公开可用,匿名调查。已完成住院医师培训的妇科医生被邀请参加调查。调查完成是自愿的,不涉及进一步的后续行动。基于网络的调查包括六个问题,如果时间允许,可以选择回答另外三个问题。机构审查委员会确定该研究符合豁免条件。
    有92名受访者参与了调查。其中,81人完成了调查,并被纳入分析。女性受访者更年轻,更频繁地报告手套尺寸为6.5或更小。外科医生级别的特征,包括性别,年龄,手套尺寸,案例体积,区域,和练习设置,与首选能源设备没有显著关联。手术室中的设备可用性是与首选能量设备相关的唯一特征(P值=.0076)。其他器件级特性,如最佳热扩散,羽流减少,易用性,设备可靠性,和可教学性与首选能量设备无统计学显著关联。
    妇科腹腔镜检查期间可使用多种先进的能量设备。这些设备具有不同的能量分布,热扩散,和设备尺寸。尽管存在这种多样性,只有手术室的器械可用性影响了外科医生的首选器械选择。
    UNASSIGNED: Multiple vessel-sealing devices are available for use during laparoscopy. The objective of this study is to determine what surgeon-level and device characteristics influence the choice of advanced energy device during gynecologic laparoscopy.
    UNASSIGNED: This is a national cross-sectional study of gynecologic surgeons conducted via social media, utilizing an online, publicly-available, anonymous survey. Gynecologic surgeons who had completed residency training were approached for participation in the survey. Survey completion was voluntary and involved no further follow-ups. The web-based survey consisted of six questions with the option to answer three additional questions if time permitted. The institutional review board determined that this study qualified for exemption.
    UNASSIGNED: There were 92 respondents who participated in the survey. Of these, 81 completed the survey and were included in the analysis. Female respondents were younger and more frequently reported a glove size of 6.5 or less. Surgeon-level characteristics, including gender, age, glove size, case volume, region, and practice setting, were not significantly associated with preferred energy devices. Device availability in the operating room was the only characteristic associated with preferred energy devices (P-value = .0076). Other device-level characteristics such as optimal thermal spread, reduced plume, ease of use, device reliability, and teachability had no statistically significant association with preferred energy devices.
    UNASSIGNED: Multiple advanced energy devices are available for use during gynecologic laparoscopy. These devices have varying energy profiles, thermal spread, and device size. Despite this diversity, only device availability in the operating room influenced the surgeon\'s preferred device selection.
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  • 文章类型: Systematic Review
    背景:腋窝淋巴结清扫术(ALND)后的血清瘤形成仍然是一个麻烦的并发症,具有显著的发病率。许多研究试图确定预防血清肿形成的技术。本系统评价和网络荟萃分析的目的是利用现有文献确定独立ALND后预防血清肿的最佳干预措施。
    方法:对过去25年中接受独立ALND或ALND保乳手术的患者血清肿形成的所有比较文章进行了文献检索。关于血清肿形成的数据,临床显著血清肿(CSS),手术部位感染(SSI),并收集血肿。使用随机效应模型进行网络荟萃分析,并使用Bucher方法评估不一致程度。
    结果:共纳入19篇1962例患者的文章。描述了十种预防血清肿形成的不同技术。当结合直接和间接比较时,腋窝引流,直到连续两天每24小时输出小于50ml,结果CSS显着减少。使用能量密封装置,填充,组织胶,或补丁并没有显着降低CSS的发生率。当比较关于SSI的不同技术时,没有观察到有统计学意义的差异。
    结论:为了防止ALND后的CSS,腋窝引流是最有价值和科学证明的措施。根据网络荟萃分析的系统评价结果,当输出<50毫升每24小时连续两天,无论持续时间如何,移除引流似乎是最好的。由于排水政策差异很大,需要一个循证指南.
    BACKGROUND: Seroma formation after axillary lymph node dissection (ALND) remains a troublesome complication with significant morbidity. Numerous studies have tried to identify techniques to prevent seroma formation. The aim of this systematic review and network meta-analysis is to use available literature to identify the best intervention for prevention of seroma after standalone ALND.
    METHODS: A literature search was performed for all comparative articles regarding seroma formation in patients undergoing a standalone ALND or ALND with breast-conserving surgery in the last 25 years. Data regarding seroma formation, clinically significant seroma (CSS), surgical site infections (SSI), and hematomas were collected. The network meta-analysis was performed using a random effects model and the level of inconsistency was evaluated using the Bucher method.
    RESULTS: A total of 19 articles with 1962 patients were included. Ten different techniques to prevent seroma formation were described. When combining direct and indirect comparisons, axillary drainage until output is less than 50 ml per 24 h for two consecutive days results in significantly less CSS. The use of energy sealing devices, padding, tissue glue, or patches did not significantly reduce the incidence of CSS. When comparing the different techniques with regard to SSIs, no statistically significant differences were seen.
    CONCLUSIONS: To prevent CSS after ALND, axillary drainage is the most valuable and scientifically proven measure. On the basis of the results of this systematic review with network meta-analysis, removing the drain when output is < 50 ml per 24 h for two consecutive days irrespective of duration seems best. Since drainage policies vary widely, an evidence-based guideline is needed.
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  • 文章类型: Journal Article
    术后颈部压缩性血肿发生在约0.1%至1.7%的病例中,大多数发生在手术后的前六小时内。甲状腺病理,患者倾向,手术技术是术后血肿的主要危险因素。这篇叙述性综述描述了预测和预防甲状腺手术后出血的最新观点。甲状腺手术后出血的预测因素包括患者相关因素,如男性和年龄,手术相关因素,如甲状腺全切除术和甲状腺恶性肿瘤手术,和外科医生相关因素。在甲状腺手术中保留关键结构后,止血是主要重点。多年来,钳夹技术一直是划分甲状腺主要血管蒂的标准方法。双极电灼已用于小尺寸的血管。然而,先进的双极和超声能量和混合设备现在是可用的选项,可以减少手术时间,而不会增加成本或并发症。如果存在靠近关键结构的小泄放器,并且夹紧扎带技术不可行,止血剂是常用的。引流似乎在预防甲状腺手术后出血后遗症方面没有任何明显的益处。
    Postoperative compressive neck hematoma occurs in approximately 0.1% to 1.7% of cases, most occurring within the first six hours after surgery. Thyroid pathology, patient predisposition, and surgical technique are major risk factors for postoperative hematoma. This narrative review describes current perspectives on predicting and preventing bleeding following thyroid surgery. Predictors of bleeding after thyroid surgery include patient-related factors such as male sex and age, surgery-related factors like total thyroidectomy and operations for thyroid malignancy, and surgeon-related factors. Hemostasis is the primary focus after preserving critical structures in thyroid surgery. The clamp-and-tie technique has been the standard method for dividing the thyroid gland\'s main vascular pedicles for many years. Bipolar electrocautery has been used for vessels of small size. However, advanced bipolar and ultrasound energy and hybrid devices are now available options that may reduce operative time without increasing costs or complications. In cases where small bleeders close to critical structures are present and the clamp-and-tie technique is not feasible, hemostatic agents are commonly used. Drains do not appear to provide any significant benefits in preventing the sequelae of bleeding after thyroid surgery.
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  • 文章类型: Journal Article
    采用固态电解质(SSE)的全固态电池(ASSB)由于其固有的安全性,有可能取代更多采用液体电解质的常规电池。与锂金属的相容性和良好的离子导电性。Li7P3S11是一种有前途的SSE,据报道离子电导率约为10mS/cm。然而,其易于通过氧化和水解降解限制了其商业可行性。在这项工作中,我们展示了一种基于激光的SSE处理方法,以提高湿度稳定性。确定了激光功率和扫描速度极大地影响表面形貌,以及所得Li7P3S11样品的化学组成。电化学阻抗谱显示,暴露于空气后,激光处理可以产生比原始对应物更高的离子电导率的SSE。对化学成分的进一步检查揭示了降低P2S74-降解速率的最佳激光加工条件。这项工作证明了基于激光的处理可用于提高SSE稳定性的能力。
    All-solid-state batteries (ASSBs) that employ solid-state electrolytes (SSEs) have the potential to replace more conventional batteries that employ liquid electrolytes due to their inherent safety, compatibility with lithium metal and reputable ionic conductivity. Li7P3S11 is a promising SSE with reported ionic conductivities in the order of 10 mS/cm. However, its susceptibility to degradation through oxidation and hydrolysis limits its commercial viability. In this work, we demonstrate a laser-based processing method for SSEs to improve humidity stability. It was determined that laser power and scanning speed greatly affect surface morphology, as well as the resulting chemical composition of Li7P3S11 samples. Electrochemical impedance spectroscopy revealed that laser treatment can produce SSEs with higher ionic conductivities than pristine counterparts after air exposure. Further examination of chemical composition revealed an optimal laser processing condition that reduces the rate of P2S74- degradation. This work demonstrates the ability of laser-based processing to be used to improve the stability of SSEs.
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  • 文章类型: Journal Article
    可穿戴和植入式设备的最新发展导致了许多,前所未有的能力,产生越来越详细的信息关于用户的健康或提供有针对性的治疗。然而,为这样的系统供电的选择仍然限于传统的电池,这些电池是大的并且具有有毒成分,因此不适合与人体紧密集成。这篇综述对生物流体激活的电化学能源装置进行了深入的概述,一种为生物医学应用而审慎设计的新兴能源。这些非常规能量装置由生物相容性材料组成,其利用各种生物流体的固有化学性质来产生可用的电能。本文介绍了生物燃料电池形式的这种生物流体激活的能量装置的例子,电池,和超级电容器。材料的进步,设计工程,以及构成高性能基础的生物技术,讨论了生物流体激活的能源装置。还包括设备组件的混合制造和异构集成以最大化功率输出的创新。最后,提供了这一新兴领域的主要挑战和未来范围。本文受版权保护。保留所有权利。
    Recent developments in wearable and implanted devices have resulted in numerous, unprecedented capabilities that generate increasingly detailed information about a user\'s health or provide targeted therapy. However, options for powering such systems remain limited to conventional batteries which are large and have toxic components and as such are not suitable for close integration with the human body. This work provides an in-depth overview of biofluid-activated electrochemical energy devices, an emerging class of energy sources judiciously designed for biomedical applications. These unconventional energy devices are composed of biocompatible materials that harness the inherent chemistries of various biofluids to produce useable electrical energy. This work covers examples of such biofluid-activated energy devices in the form of biofuel cells, batteries, and supercapacitors. Advances in materials, design engineering, and biotechnology that form the basis for high-performance, biofluid-activated energy devices are discussed. Innovations in hybrid manufacturing and heterogeneous integration of device components to maximize power output are also included. Finally, key challenges and future scopes of this nascent field are provided.
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  • 文章类型: Journal Article
    背景:在单一阶段的基于光的程序后确定治疗反应者可能很困难。
    目的:我们的目标是训练卷积神经网络(CNN),以检验以下假设:预处理照片中存在可辨别的特征,以识别基于照片的面部色素沉着治疗后的良好反应,并开发一种临床适用的算法来预测治疗结果。
    方法:使用VISIA®皮肤分析系统获得接受基于光的治疗以增强美学的受试者的二百六十四组预处理照片。预处理是通过掩盖照片的面部特征来完成的。每组照片由五种类型的图像组成。基于这些图像开发了基于Resnet50骨干的五个独立训练的CNN,并将这些CNN的结果组合以获得最终结果。
    结果:开发的CNN算法的预测精度接近78.5%,接收器工作特性曲线下的面积为0.839。
    结论:基于预处理图像可以预测光疗对面部皮肤色素沉着的治疗效果。
    BACKGROUND: Identifying treatment responders after a single session of photo-based procedure for hyperpigmentary disorders may be difficult.
    OBJECTIVE: We aim to train a convolutional neural network (CNN) to test the hypothesis that there exist discernible features in pretreatment photographs for identifying favorable responses after photo-based treatments for facial hyperpigmentation and develop a clinically applicable algorithm to predict treatment outcome.
    METHODS: Two hundred and sixty-four sets of pretreatment photographs of subjects receiving photo-based treatment for esthetic enhancement were obtained using the VISIA® skin analysis system. Preprocessing was done by masking the facial features of the photographs. Each set of photographs consists of five types of images. Five independently trained CNNs based on the Resnet50 backbone were developed based on these images and the results of these CNNs were combined to obtain the final result.
    RESULTS: The developed CNN algorithm has a prediction accuracy approaching 78.5% with area under the receiver operating characteristic curve being 0.839.
    CONCLUSIONS: The treatment efficacy of photo-based therapies on facial skin pigmentation can be predicted based on pretreatment images.
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  • 文章类型: Journal Article
    随着人们对新型柔性有机电子器件需求的增加,导电聚合物现在正成为实现这些目标的后起之秀,见证了热电设备领域的重大突破,太阳能电池,传感器,在过去的十年中,水凝胶由于其出色的导电性,溶液处理能力,以及可定制性。然而,这些设备的商业化仍然明显落后于相应的研究进展,由于性能不够高和制造技术有限。导电聚合物薄膜的导电性和微/纳米结构是实现高性能微器件的两个关键因素。在这次审查中,全面总结了使用导电聚合物开发有机器件的最新技术,这将首先描述导电聚合物的常用合成方法和机理。接下来,目前制造导电聚合物薄膜的技术将被提供和讨论。随后,总结和讨论了定制导电聚合物薄膜的纳米结构和微观结构的方法。然后,介绍了基于微/纳米导电薄膜的器件在各个领域的应用,重点介绍了微/纳米结构对器件性能的影响。最后,提出了这个令人兴奋的领域未来发展方向的观点。
    With the increasing demands for novel flexible organic electronic devices, conductive polymers are now becoming the rising star for reaching such targets, which has witnessed significant breakthroughs in the fields of thermoelectric devices, solar cells, sensors, and hydrogels during the past decade due to their outstanding conductivity, solution-processing ability, as well as tailorability. However, the commercialization of those devices still lags markedly behind the corresponding research advances, arising from the not high enough performance and limited manufacturing techniques. The conductivity and micro/nano-structure of conductive polymer films are two critical factors for achieving high-performance microdevices. In this review, the state-of-the-art technologies for developing organic devices by using conductive polymers are comprehensively summarized, which will begin with a description of the commonly used synthesis methods and mechanisms for conductive polymers. Next, the current techniques for the fabrication of conductive polymer films will be proffered and discussed. Subsequently, approaches for tailoring the nanostructures and microstructures of conductive polymer films are summarized and discussed. Then, the applications of micro/nano-fabricated conductive films-based devices in various fields are given and the role of the micro/nano-structures on the device performances is highlighted. Finally, the perspectives on future directions in this exciting field are presented.
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