• Nonlinear Functional Analysis and Applications
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• v.27 no.1
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• pp.1-22
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• 2022

The purpose of this research is to formulate a new proximal-type algorithm to solve the equilibrium problem in a real Hilbert space. A new algorithm is analogous to the famous two-step extragradient algorithm that was used to solve variational inequalities in the Hilbert spaces previously. The proposed iterative scheme uses a new step size rule based on local bifunction details instead of Lipschitz constants or any line search scheme. The strong convergence theorem for the proposed algorithm is well-proven by letting mild assumptions about the bifunction. Applications of these results are presented to solve the fixed point problems and the variational inequality problems. Finally, we discuss two test problems and computational performance is explicating to show the efficiency and effectiveness of the proposed algorithm.

• Structural Engineering and Mechanics
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• v.86 no.5
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• pp.635-645
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• 2023

This study aims to simulate the mechanical behavior of the total prosthesis model of Charnley (CMK3) by the 3D finite element method and to determine the state of the stresses in the femoral components (prosthesis, cement, and bone). The components are subjected to a dynamic load due to three activities (normal walking, climbing stairs, and standing up a chair). Static loading is by selecting the maximum load for the same activities mentioned. The results show that the maximum stresses in the proximal part of the cement are very important. Moreover, new results obtained for different parameters were discussed in detail. It is understood that current research provides important lessons for the surgeon to contribute to the clinical diagnosis of durable implantations and a better understanding of the process of bone remodeling and bone prosthesis.

• Nuclear Engineering and Technology
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• v.55 no.10
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• pp.3515-3524
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• 2023

A reinforcement learning framework is proposed for the control problem of outlet steam pressure of the once-through steam generator(OTSG) in this paper. The double-layer controller using Proximal Policy Optimization(PPO) algorithm is applied in the control structure of the OTSG. The PPO algorithm can train the neural networks continuously according to the process of interaction with the environment and then the trained controller can realize better control for the OTSG. Meanwhile, reinforcement learning has the characteristic of difficult application in real-world objects, this paper proposes an innovative pretraining method to solve this problem. The difficulty in the application of reinforcement learning lies in training. The optimal strategy of each step is summed up through trial and error, and the training cost is very high. In this paper, the LSTM model is adopted as the training environment for pretraining, which saves training time and improves efficiency. The experimental results show that this method can realize the self-adjustment of control parameters under various working conditions, and the control effect has the advantages of small overshoot, fast stabilization speed, and strong adaptive ability.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.126-129
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• 2024

The square flap method has been successful in releasing contracture bands at various body regions. However, the original square flap method alone may not be efficient in releasing long contracture bands. We, therefore, proposed an extended design to the traditional design, which is called the "square-plus flap." A 4-year-old girl presented with a postburn web-like contracture band over the right axilla. We marked a square flap technique at the center of the contracture band and then two additional Z-plasties were placed on both edges of the flap. After the release and securing of the square flap, the adjacent distal Z-plasty was then transposed and sutured in their new locations. We do not need to incise the proximal Z-plasty as we could achieve complete relaxation of the contracture band. This novel modification can be added to the plastic surgeon's armamentarium for releasing long postburn contracture bands involving distinct body regions.

• Clinical Endoscopy
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• v.55 no.5
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• pp.605-614
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• 2022

The double-guidewire method has been increasingly used in endoscopic procedures for biliary and pancreatic diseases in recent years, including endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography-related procedures. In addition, double-lumen catheters with uneven distal and proximal lumen openings have been introduced, making it possible to easily create a double-guidewire situation, and the usefulness of the double-guidewire technique using uneven double-lumen cannulas has been widely reported. Although the advantages of using two guidewires depend on the particular situation and the appropriate use of the two guidewires, deepening the knowledge of the double-guidewire method will contribute greatly to troubleshooting in daily practice. In this review, the usefulness of the double-guidewire technique is discussed with respect to two main areas: selective insertion of guidewires and devices and biliary cannulation.

• Journal of Sensor Science and Technology
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• v.26 no.4
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• pp.239-244
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• 2017

Noninvasive, cuffless, and continuous blood pressure (BP) monitoring is essential to prevent and control hypertension. A well-known existing method for this measurement is pulse transit time (PTT), which has been investigated by many researchers as a promising approach. However, the fundamental principle of the PTT method is based on the time interval taken by a pulse wave to propagate between the proximal and distal arterial sites. Consequently, this method needs an independent system with two devices placed at two different sites, which is a problem. Even though some studies attempted to synchronize the system, it is bulky and inconvenient by contemporary standards. To find a more sensitive method to be used in a BP measurement device, this study used radial electrical bioimpedance (REB) as a potential indicator for BP determination. Only one impedance plethysmography channel at the wrist is performed for demonstrating a ubiquitous BP wearable device. The experiment was evaluated on eight healthy subjects with the ambulatory BP monitor on the upper arm as a reference. The results demonstrated the potential of the proposed method by the correlation of estimated systolic (SBP) and diastolic (DBP) BP against the reference at $0.84{\pm}0.05$ and $0.83{\pm}0.05$, respectively. REB also tracked the DBP well with a root-mean-squared-error of $7.5{\pm}1.35mmHg$.

• Clinical Pain
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• v.18 no.1
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• pp.24-30
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• 2019

Objective: Greater occipital nerve block (GONB) is a widely accepted treatment of primary headaches. Two ultrasound (US)-guided blockade techniques exist: 1) the classical distal nerve block technique performed medial to the occipital artery at the superior nuchal line, and 2) the new proximal nerve block technique performed at the obliquus capitis inferior muscle at the level of C2. Our study aim was to perform a head-to-head comparative study of these two US-guided techniques. Method: Forty-nine patients with primary headache treated in our university hospital were recruited. Patients were randomized into two groups of the classical nerve block and the new proximal nerve block techniques. The headache questionnaire was made to assess the intensity of the pain of headache attacks, number of days they experience headache, duration of headache, and amount of pain medication they consumed. Results: In both groups, a decrease in the severity and frequency of the headache was observed. There was no measurable difference in outcome between the two groups. Conclusion: Our study showed that the classic and new proximal techniques are equally effective in decreasing the headache severity and frequency.

• Korean Journal of Applied Biomechanics
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• v.25 no.4
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• pp.371-381
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• 2015

Object : The purpose of this study was to investigate aging-related changes of intrinsic and extrinsic hand muscles in their strength, cross-sectional area and volume, force control, and multi-digit synergies. It was hypothesized that aging would negatively affect distal muscles (intrinsic muscles) more than proximal muscles (extrinsic muscles). Method : Nine young and eleven older right-handed participants underwent MRI scans of the hand and forearm. Muscle cross-sectional areas and volumes of the intrinsic and extrinsic hand muscles were determined. Result : Muscle volume of the intrinsic muscles were larger in the younger group than the older group while muscle volume of the extrinsic muscles did not differ. For the cross-sectional area, both the intrinsic and extrinsic muscles of the younger group were larger than the older group. The maximum strength of the intrinsic muscles of the young group was 31% greater than the older group ($399.1{\pm}26.4$ vs $270.2{\pm}22.9Ncm$, p < 0.05) while the extrinsic muscles showed no significant difference. Although the elderly group showed a trend of decreased force control and multi-digit synergies, no statistical differences were found. These findings indicate aging-related decreases in hand muscle size and strength affect intrinsic muscles more than extrinsic muscles, thus supporting the hypothesis that sarcopenia affects the muscle size and strength of distal muscles more than proximal muscles. Conclusion : The aging-related decreases in hand muscle size and function were more apparent in intrinsic hand muscles, located more distally, than extrinsic muscles, located more proximally.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.279-282
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• 2012

Background: Although more than two third of colorectal cancers are localized on the left side, recent studies suggest a right ward shift in anatomical distribution with increase in proximal colon cancers. The aim of the present study was to determine the anatomical distribution of colorectal cancer in a referral center over a 15 year period. Method: Records of patients who underwent colectomy in the Cancer Institute of Iran from 1994 to 2009 were retrieved. Data including anatomical localization, year of diagnosis, patient age and gender, tumor histology and differentiation, and disease stage were extracted. Tumors located from the cecum to the distal transverse colon were classified as right side and those occurring from the splenic flexure to the descending colon as left-sided. Cancer of rectum and recto-sigmoid junction were considered as rectal cancers. Results: A total of 442 patients including 220 (49/8%) men and 222 (50/2%) women with mean age 53 were included. Most patients were in stage II &III (47.1% and 33% respectively). There were 157 (35.5 %) colon cancers and 285 (64.5%) rectal cancers. 43.3% of the colon cancers were right sided and 56.7% were left sided. There was no statistically significant increase in right sided cancer during the period of the study. There were no significant differences in age at diagnosis, gender, grade and stage of tumor between the right and the left sided cancers. Conclusion: No proximal shift over time was identified in our study.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.222-229
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• 2017

Background: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. Methods: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. Results: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were $156.7^{\circ}$, $152.2^{\circ}$, $61.1^{\circ}$, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. Conclusions: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.