ABSTRACT Introduction: We aim to compare the safety and effectiveness of the KangDuo (KD)-Surgical Robot-01 (KD-SR-01) system and the da Vinci (DV) system for robot-assisted radical nephroureterectomy (RARNU). Materials and Methods: This multicenter prospective randomized controlled trial was conducted between March 2022 and September 2023. Group 1 included 29 patients undergoing KD-RARNU. Group 2 included 29 patients undergoing DV-RARNU. Patient demographic and clinical characteristics, perioperative data, and follow-up outcomes were collected prospectively and compared between the two groups. Results: There were no significant differences in patient baseline demographic and preoperative characteristics between the two groups. The success rates in both groups were 100% without conversion to open or laparoscopic surgery or positive surgical margins. No significant difference was observed in docking time [242 (120-951) s vs 253 (62-498) s, P = 0.780], console time [137 (55-290) min vs 105 (62-220) min, P = 0.114], operative time [207 (121-460) min vs 185 (96-305) min, P = 0.091], EBL [50 (10-600) mL vs 50 (10-700) mL, P = 0.507], National Aeronautics and Space Administration Task Load Index scores, and postoperative serum creatinine levels between the two groups. None of the patients showed evidence of distant metastasis, local recurrence, or equipment-related adverse events during the four-week follow-up. One (3.4%) patient in Group 2 experienced postoperative enterovaginal and enterovesical fistulas (Clavien-Dindo grade III). Conclusions: The KD-SR-01 system is safe and effective for RARNU compared to the DV Si or Xi system. Further randomized controlled studies with larger sample sizes and longer durations are required. Introduction KDSurgical KD Surgical Robot01 Robot 01 Robot-0 KDSR01 KDSR SR (KD-SR-01 (DV robotassisted robot assisted RARNU. . (RARNU) Methods 202 2023 KDRARNU. KDRARNU KD-RARNU DVRARNU. DVRARNU DV-RARNU data followup follow up Results 100 margins 242 [24 120951 120 951 (120-951 25 62498 62 498 (62-498 0.780, 0780 0.780 , 0 780 0.780] 137 [13 55290 55 290 (55-290 10 62220 220 (62-220 0.114, 0114 0.114 114 0.114] 207 [20 121460 121 460 (121-460 18 96305 96 305 (96-305 0.091, 0091 0.091 091 0.091] [5 10600 600 (10-600 5 10700 700 (10-700 0.507, 0507 0.507 507 0.507] scores metastasis recurrence equipmentrelated equipment related fourweek four week followup. up. 3.4% 34 3 4 (3.4% ClavienDindo Clavien Dindo III. III III) Conclusions KD-SR-0 required Robot0 Robot- KDSR0 (KD-SR-0 (RARNU 20 24 [2 12095 12 95 (120-95 6249 6 49 (62-49 078 0.78 78 13 [1 5529 (55-29 6222 22 (62-22 011 0.11 11 12146 46 (121-46 9630 9 30 (96-30 009 0.09 09 [ 1060 60 (10-60 1070 70 (10-70 050 0.50 3.4 (3.4 KD-SR- (KD-SR- 1209 (120-9 624 (62-4 07 0.7 7 552 (55-2 622 (62-2 0.1 1214 (121-4 963 (96-3 00 0.0 106 (10-6 107 (10-7 05 0.5 3. (3. KD-SR (KD-SR (120- (62- 0. (55- (121- (96- (10- (3 (120 (62 (55 (121 (96 (10 ( (12 (6 (5 (9 (1

AbstractA new circle-arc model was established to present the cellular structure. Dynamic response of models with density gradients under constant velocities is investigated by employing Ls-dyna 971. Compared with the uniform models, the quasi-static plateau stress of different layers seems a significant parameter correlated with the deformation mode except for inertia effect when the density gradient is introduced. The impact velocity becomes much more vital on the deformation of the unit cell than the density gradient. The stress at both the impact and stationary sides is investigated in details. Furthermore, the stress-strain curve is compared with the modified shock wave theory. The density gradient does have some remarkable influence on the energy absorption capability, and a certain density gradient is not always beneficial to the energy absorption. Irrespective of the impact velocity, there seems always a critical strain where the energy absorbed by all these specimens could approximate to nearly the same value. So the critical strain-velocity curve is plotted and gives the beneficial area for energy absorption pertinent to density gradients and impact velocity.

OBJECTIVE: To evaluate the effectiveness of the Shanghai Chronic Disease Self-Management Program (CDSMP). METHODS: A randomized controlled trial with six-month follow-up compared patients who received treatment with those who did not receive treatment (waiting-list controls) in five urban communities in Shanghai, China. Participants in the treatment group received education from a lay-led CDSMP course and one copy of a help book immediately; those in the control group received the same education and book six months later. FINDINGS: In total, 954 volunteer patients with a medical record that confirmed a diagnosis of hypertension, heart disease, chronic lung disease, arthritis, stroke, or diabetes who lived in communities were assigned randomly to treatment (n = 526) and control (n = 428) groups. Overall, 430 (81.7%) and 349 (81.5%) patients in the treatment and control groups completed the six-month study. Patients who received treatment had significant improvements in weekly minutes of aerobic exercise, practice of cognitive symptom management, self-efficacy to manage own symptoms, and self-efficacy to manage own disease in general compared with controls. They also had significant improvements in eight indices of health status and, on average, fewer hospitalizations. CONCLUSION: When implemented in Shanghai, the CDSMP was acceptable culturally to Chinese patients. The programme improved participants' health behaviour, self-efficacy, and health status and reduced the number of hospitalizations six months after the course. The locally based delivery model was integrated into the routine of community government organizations and community health services. Chinese lay leaders taught the CDSMP courses as successfully as professionals.

OBJETIVO: Evaluar la eficacia del Programa de Automanejo de Enfermedades Crónicas de Shanghai (PAECS). MÉTODOS: En un ensayo controlado aleatorizado con seguimiento de seis meses se procedió a comparar a los pacientes que recibieron tratamiento con los que no lo recibieron (controles de la lista de espera) en cinco comunidades urbanas de Shanghai (China). Los participantes en el grupo de tratamiento recibieron de inmediato formación mediante un cursillo de PAECS dirigido por un no profesional de la salud, así como un ejemplar de un libro de ayuda; los del grupo control recibieron la misma formación y el mismo libro seis meses después. RESULTADOS: En total, 954 pacientes voluntarios con una historia clínica que confirmaba un diagnóstico de hipertensión, cardiopatía, enfermedad pulmonar crónica, artritis, ictus o diabetes y que vivían en comunidades fueron asignados aleatoriamente al grupo de tratamiento (n=526) o al grupo control (n=428). Globalmente, 430 (81,7%) y 349 (81,5%) pacientes de los grupos tratado y control, repectivamente, terminaron el estudio de seis meses. Los pacientes que recibieron tratamiento experimentaron mejoras significativas en lo que respecta al número de minutos semanales dedicados a ejercicios de aeróbic, los resultados de las pruebas cognitivas y la eficacia del automanejo de la propia enfermedad en general en comparación con los controles. Presentaron asimismo mejoras importantes en ocho indicadores del estado de salud y, como media, menos hospitalizaciones. CONCLUSIÓN: Los pacientes chinos abarcados por el PAECS lo consideraron culturalmente aceptable. Al cabo de seis meses el programa había mejorado el comportamiento sanitario, la eficacia del control autónomo y el estado de salud de los participantes, y reducido el número de hospitalizaciones. El modelo asistencial local se integró en las actividades ordinarias de las organizaciones de gobierno de la comunidad y de los servicios de salud comunitarios. Los chinos no profesionales impartieron los cursillos del PAECS con la misma eficacia que los profesionales.

OBJECTIF: Evaluer l'efficacité du programme d'auto-prise en charge des maladies chroniques (CDSMP) à Shanghai. MÉTHODES: Lors d'un essai contrôlé randomisé avec suivi de six mois, on a comparé les patients ayant reçu un traitement avec des témoins non traités (patients inscrits sur une liste d'attente) dans cinq communautés urbaines de Shanghai (Chine). Les participants du groupe traité ont immédiatement suivi un cours organisé par le CDSMP et dispensé par des non-professionnels de la santé et reçu une brochure d'appui ; les participants du groupe témoin ont reçu les mêmes prestations six mois plus tard. RÉSULTATS: Au total, 954 volontaires dont le dossier médical confirmait un diagnostic d'hypertension, de maladie cardiaque, d'affection pulmonaire chronique, d'arthrite, d'accident vasculaire cérébral ou de diabète et résidant dans la communauté ont été répartis par tirage au sort entre un groupe traité (n = 526) et un groupe témoin (n = 428). Sur ce total, 430 patients du groupe traité (81,7 %) et 349 patients du groupe témoin (81,5 %) ont participé à l'étude jusqu'à la fin, c'est-à-dire pendant six mois. Par rapport aux témoins, les patients traités ont présenté une amélioration significative en ce qui concerne la durée hebdomadaire (en minutes) d'exercice aérobie, la pratique de la prise en charge des symptômes cognitifs, l'auto-efficacité de la prise en charge de leurs symptômes et l'auto-efficacité de la prise en charge de leur maladie en général. Ils présentaient également une amélioration significative de huit indicateurs de l'état de santé et subissaient en moyenne moins d'hospitalisations. CONCLUSION: Mis en œuvre à Shangai, le CDSMP était culturellement acceptable pour les patients chinois. Six mois après le cours, le programme avait amélioré le comportement des participants en rapport avec la santé, leur auto-efficacité et leur état de santé et avait réduit le nombre d'hospitalisations. Le modèle appliqué, conçu au niveau de la communauté, était intégré dans les activités de routine des organismes publics communautaires et des services de santé de la communauté. Les Chinois non professionnels de la santé qui ont dispensé les cours du CDSMP l'ont fait aussi efficacement que des professionnels.