To develop a realistic simulation model for laparotomy-assisted fetoscopic spina bifida aperta (SBa) surgery, to be used for training purposes and preoperative planning.
Methods
The predefined general requirement was a realistic model of an exteriorized uterus, allowing all neurosurgical steps of the intervention. The uterus was modelled using ultrasound and MRI images of a 25 weeks’ gravid uterus, consisting of flexible polyurethane foam coated with pigmented silicone. The fetal model, contained an opening on the dorsal side for a customizable spinal insert with all the aspects of a SBa, including a cele, placode, and myofascial and skin layer. The model was assessed in a series of validation experiments.
Results
Production costs are low, uterus and fetus are reusable. Placental localization and the level and size of the spinal defect are adjustable, enabling case-specific adaptations. All aspects of the simulator were scored close to realistic or higher for both appearance and functional capacities.
Conclusions
This innovative model provides an excellent training opportunity for centers that are starting a fetoscopic SBa repair program. It is the first simulation model with adjustable spinal defect and placental localisation. Further objective validation is required, but the potential for using this model in preoperative planning is promising. 相似文献
The low activity of Anammox bacteria at low temperatures and competition from nitrite oxidation bacteria(NOB) when treating low strength wastewater have been major bottlenecks in implementing Anammox in mainstream wastewater treatment. By intermittent high strength feeding(IHSF) and stepwise temperature reduction, stable operation of a granular Anammox reactor was realized at low temperatures(down to 15°C) for 28 days when treating low strength synthetic wastewater. The nitrogen loading rate reached 1.23–1.34 kgN/m~3/day,and the total nitrogen removal rate reached 0.71–0.98 kgN/m~3/day. The IHSF enriched the Anammox sludge in high strength cycles and compensated for sludge loss in low strength cycles, and the high concentration of ammonium in high strength cycles inhibited NOB. The 16 SrRNA gene sequencing results revealed that Candidatus Kuenenia was predominant in the reactor at low temperatures. 相似文献
Over the past decade, the Chinese government has developed several plans regulations and policy measures related to the development of renewable energy technologies and has implemented a series of pilot projects. Chinese policymakers have spent several years studying how renewable energy policy models that have been used internationally could be implemented in China. Programs are currently underway to implement pilot renewable portfolio standards, or mandatory market shares (MMS) for renewable energy, in several provinces. This paper examines the primary institutions that are involved in promoting renewable policies in China, the structure of the policies that currently are being drafted, and the status of the complementary, national-level renewable energy law being drafted to provide a legal basis for ongoing local and national-level policies. It then examines the legal requirements for promoting renewable energy legislation under the Chinese law-making system. Finally, it provides recommendations for 相似文献
Environmental Chemistry Letters - Shale gas extraction is increasing worldwide in the context of the energy crisis, yet the associated pollution by this industrial activity is poorly known. Here we... 相似文献
In this study, an approach for the facile, rapid, energy-saving, and sensitive determination of Fe3+ and Cr(VI) was developed. L-arginine/D-glucose carbon quantum dots (Arg/Glu-CQDs), with a photoluminescence quantum yield of 21%, were synthesized from L-arginine and D-glucose through a facile, hydrothermal process. The maximum emission wavelength of Arg/Glu-CQDs was observed at 450 nm, under an excitation wavelength of 365 nm. In addition, Arg/Glu-CQDs exhibited a sensitive and selective response to Fe3+ compared to Fe2+ and other metal ions. The Arg/Glu-CQDs’ fluorescence was noticeably quenched through the inner filter effect (IFE) when Arg/Glu-CQDs were mixed with Fe3+. Accordingly, the Arg/Glu-CQDs/Fe2+ system could selectively detect Cr(VI); Cr(VI) could oxidize Fe2+ to Fe3+ and quench the fluorescence. The fluorescence sensor system (i.e., the Arg/Glu-CQDs/Fe2+ system) showed high sensitivity and excellent selectivity for the detection of Fe3+ and Cr(VI) in river water samples. Satisfactory detection efficiencies ranging from 97.07 to 103.46% were obtained. The cytotoxicity of Arg/Glu-CQDs was evaluated through an MTT assay using A549 cells as the target, to extend the application of Arg/Glu-CQDs to biological systems; the MTT assay indicated that the Arg/Glu-CQDs is non-cytotoxicity. Arg/Glu-CQDs were also successfully imaged in A549 cells indicating further application possibilities in bioimaging.