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A novel pneumatic-electric hybrid actuator is studied and developed to enable precise positioning within a cylinder stroke in industrial automation. The proposed actuator will also allow engineers to overcome the defects of bias torque and structural coupling in the parallel type of pneumatic-electric hybrid actuators. The novel hybrid actuator consists of a coaxial cylinder layout, the motor lead screw pair, and the position sensor; a serial driving pattern is applied. A special reconfigurable positioning structure is designed for both the fixed and moving module; therefore, a decoupling motion can be achieved for the fast pneumatic motion and the electric precise fine-tuning motion without interference. In this paper, the authors presented the structure of this novel pneumatic-electric hybrid actuator and the accompanying mathematical model for pneumatic-electrical driving. Additionally, the control strategy with proportional-fuzzy mode and the subsection frequency control mode are presented. Experimental results show that the pneumatic-electric hybrid actuator has satisfying motion characteristics, including high speed, low overshoot, and small load sensitivity. Its positioning accuracy is ±0.01 mm, with a positioning time within 2 s, which is better than that of current pneumatic localizable actuators and pneumatic-electric hybrid actuators.
Objective: To compare patient survival outcomes between completion hysterectomy and conventional surveillance in locally advanced adenocarcinoma of the cervix after concurrent chemoradiotherapy (CCRT). Methods: Patients with adenocarcinoma of the cervix after CCRT were identified in a tertiary academic center database from 2004 to 2018. Patients received completion hysterectomy or surveillance after CCRT. We compared the progression-free survival (PFS) and overall survival (OS) between the patients with or without adjuvant hysterectomy. Surgery features, operative complications, and pathologic characteristics were documented. Patient outcomes were also analyzed according to clinicopathologic factors. Results: A total of 78 patients were assigned to completion surgery and 97 to surveillance after CCRT. The PFS was better in the surgery group compared to the CCRT only group, at 3 years the PFS rates were 68.1% and 45.2%, respectively (hazard ratio [HR]=0.46; 95% confidence interval [CI]=0.282–0.749; p=0.002). Adjuvant surgery was also associated with a higher rate of OS (HR=0.361; 95% CI=0.189–0.689; p=0.002), at 3 years, 87.9% and 67%, respectively. Tumor stage, size, lymph-vascular space invasion (LVSI), lymphadenopathy were associated with PFS but not with OS. Hysterectomy specimens revealed 64.1% (50/78) of the patients had pathologic residual tumor. Patients age less than 60, tumor size over 4 cm, stage IIB and persistent residual disease after CCRT were most likely to benefit from hysterectomy. Hysterectomy was associated with a lower rate of locoregional recurrence but did not reach statistical significance (5.13% vs. 13.5%, p=0.067). Conclusion: Completion hysterectomy after CCRT was associated with better survival outcome compared with the current standard of care.
Banerjee, Amit,Bernoulli, Daniel,Zhang, Hongti,Yuen, Muk-Fung,Liu, Jiabin,Dong, Jichen,Ding, Feng,Lu, Jian,Dao, Ming,Zhang, Wenjun,Lu, Yang,Suresh, Subra American Association for the Advancement of Scienc 2018 Science Vol.360 No.6386
<P>Diamonds have substantial hardness and durability, but attempting to deform diamonds usually results in brittle fracture. We demonstrate ultralarge, fully reversible elastic deformation of nanoscale (similar to 300 nanometers) single-crystalline and polycrystalline diamond needles. For single-crystalline diamond, the maximum tensile strains (up to 9%) approached the theoretical elastic limit, and the corresponding maximum tensile stress reached similar to 89 to 98 gigapascals. After combining systematic computational simulations and characterization of pre- and postdeformation structural features, we ascribe the concurrent high strength and large elastic strain to the paucity of defects in the small-volume diamond nanoneedles and to the relatively smooth surfaces compared with those of microscale and larger specimens. The discovery offers the potential for new applications through optimized design of diamond nanostructure, geometry, elastic strains, and physical properties.</P>