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With the breakthroughs in artificial intelligence, orthopedic surgical robots have rapidly advanced, presenting good prospects for their applications in the medical field. Prior to the clinical application of this novel medical device, ensuring high reliability is crucial to safeguarding patient safety and surgical quality. Therefore, a thorough understanding of the types of failures and associated risks is essential during both the development and clinical application phases. From the perspectives of both the research and development companies and clinical users, this article comprehensively elucidates the types of failures and their associated risks in orthopedic surgical robots. Furthermore, strategies for addressing high-risk failures are proposed, with the aim of providing guidance for the development and clinical application of orthopedic surgical robot devices, thereby contributing to the high-quality advancement of this field.

BackgroundThough critical to primary care, continuity of care has rarely been examined in China. This study aims to assess the relationship between continuity of care and healthcare costs among patients with chronic diseases within primary care settings in China.MethodsIn this cross-sectional study, we used a social health insurance claims dataset of 1406 patients with hypertension and/or diabetes in Yuhuan City, Zhejiang Province collected in 2017-2019. We measured continuity of care using the Bice-Boxerman Continuity of Care (COC) Index, Herfindahl Index (HI), Sequential Continuity of Care (SECON) Index, Usual Provider of Care (UPC), and a binary variable indicating whether a patient's UPC was a primary care provider. We examined the associations between continuity of care and healthcare costs in the same period and the subsequent year, using ordinary least squares regression for the outpatient costs and two-part regression for the inpatient costs. Based on the regression coefficients, we predicted costs saved if each continuity measure was set to 1 from the status quo.ResultsWhen optimum continuity were to be achieved, 7.12-27.29% of total outpatient costs and 55.38-73.35% of total inpatient costs could be saved compared to the status quo during the two-year study period. If optimum continuity were to be achieved in the first year, 7.47%-21.78% of total outpatient costs and 8.84-40.22% of total inpatient costs could be saved in the second-year.ConclusionsCare continuity indicators were consistently associated with reduced outpatient costs and hospitalization risks. Future health reform in China should further enhance continuity of care in primary care.

BaTiO3 has advantages of high permittivity, low dielectric loss, low cost and environment friendly. However, due to the nonlinear dielectric behavior occurred around the phase transition temperature of BaTiO3 ceramic, its availability in the field of temperature-stable capacitor is limited. To modify the dielectric-temperature properties of BaTiO3, a series of BaTi1-xCexO3 (x=0-0.20) ceramics was synthesized by solid-state reaction method. Ce dopant was introduced into the B-site (Ti-site) of BaTiO3. The effects of Ce dopant on the phase evolution, defect state, microstructure and dielectric properties were investigated. The modifying mechanism was also discussed with the help of first-principles calculation method. In all ceramic samples, it is revealed that Ce element completely enters the B-site of BaTiO3 in the form of Ce4+ ion. With the increase of Ce doping concentration, the room temperature structure of BaTi1-xCexO3 ceramics transforms from tetragonal/pseudo-cubic structure into orthorhombic/tetragonal structure, then into pseudo-cubic structure. Owing to the radius difference between Ce4+ and Ti4+ ions, Ce doping will lead to the rising of lattice parameters, accompanied by the appearance of local distortion and the decrease of long-range ferroelectric order, the variation of band structure, density of states and charge density configuration, as well as the generation of Ba and Ti vacancies. Compared with pure BaTiO3 ceramic, the average grain size of Ce-doped ceramics decreases first and then increases with the increase of Ce content, while the relative density of ceramics increases gradually. The peak dielectric constant of BaTi1-xCexO3 ceramic increases first and then decreases as the Ce concentration increasing. The corresponding temperature is slowly reduced from 122 ℃ to 112 ℃ in the x value range of 0-0.08, then rapidly declines to -3 ℃ in the x value range of 0.08-0.20. BaTi1-xCexO3 ceramics with x≥0.06 have the dielectric behavior of diffused phase transition (DPT). And the x=0.20 ceramic exhibits the typical characteristic of relaxor ferroelectric, with the room temperature dielectric constant of 3258.38, and the |Δεr/εr25 ℃|≤22% temperature range of -60-87 ℃, which matches the requirement of EIA X5S standard. Therefore, it can be concluded that B-site Ce doping will effectively enhance the permittivity stability of BaTiO3 in a variable temperature environment. This will provide some new ideas to develop dielectric materials with stable dielectric properties in wide temperature range.

Owing to the feature of ultrahigh power density, the dielectric capacitors play an increasingly important role in the field of industrial production, basic scientific research, aerospace, and military industry in recent years. However, the relatively low energy storage density of the dielectric capacitors generally leads to their big sizes, which is difficult to meet the miniaturization requirements of future devices. Polymer-ceramic nanocomposites can combine high permittivity of the ceramic fillers and the excellent breakdown strength of the polymer matrix, thus achieving excellent energy storage performance. At present, developing the polymer-ceramic nanocomposites with high energy storage density is the key to realize the miniaturization goal of dielectric capacitors in the future. The current research progress of polymer-ceramic nanocomposites for energy storage capacitor applications from three perspectives was systematically summarized, including regulation of the nanofillers, optimization of the interfaces, and design of the multilayer composite structure. Notably, the influences of the dimension, size, species, hierarchical structure of the nanofillers, interface optimization methods such as surface modification and core-shell structure construction, as well as multilayer structure design such as sandwich structure and gradient structure on the permittivity, breakdown strength and the energy storage density of the nanocomposites were introduced in detail. Meanwhile, the structure-activity relationships between the microstructure of nanocomposites and their energy storage properties were further analyzed and discussed. Finally, based on the challenges and shortcomings of the current research, the important development directions of this field in the future were proposed, including selecting the new 2D nanofillers, enhancing the energy storage efficiency, employing multimode combined optimization strategy, and constructing the corresponding dielectric capacitors.