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Abstract Background Venous thromboembolism (VTE) is a common complication after hip arthroplasty. Here, we investigated the clinical efficacy and safety of prophylactic aspirin vs. conventional therapy in hip arthroplasty for femoral neck fracture. Methods Patients who underwent total hip arthroplasty and hemiarthroplasty for femoral neck fractures between April 2021 and April 2024 were prospectively enrolled. Group A received oral aspirin (100 mg, once daily) as VTE prophylaxis; Group LR received low-molecular-weight heparin (4,250 U, once daily) sequentially followed by rivaroxaban (10 mg, once daily). The patients were followed up for 90 days postoperatively. Safety and efficacy were comprehensively evaluated based on postoperative VTE incidence, laboratory blood tests, bleeding events, and other complications. Results Group A was noninferior to Group LR in preventing VTE (incidence rates of 11.6% and 10.1%, respectively, with a rate difference of 1.5%, 95% CI: 0.7–2.3%, P for non-inferiority test = 0.017). There was no significant difference between the groups in the incidence of bleeding events (3.3 vs. 8.4%; P = 0.092). Furthermore, the rates of other complications did not differ significantly between groups. Conclusion In patients undergoing hip arthroplasty for femoral neck fractures, the efficacy and safety of oral aspirin for preventing VTE was similar to that of low-molecular-weight heparin followed by rivaroxaban.

Objectives: To investigate the preventive effect of intraarticularly administered vancomycin on acute postoperative periprosthetic joint infection (PJI) in total joint arthroplasty (TJA). Methods: Consecutive patients who underwent unilateral primary TJA were prospectively enrolled. The patients were divided into vancomycin group and control group according to whether 1 g of vancomycin powder suspended in 30 ml normal saline was intraarticularly administered after arthrotomy closure. Acute postoperative PJI and aseptic wound complication were evaluated within 3 months postoperatively. Vancomycin-associated toxicity including acute renal failure, ototoxicity and anaphylaxis was also evaluated. Results: In terms of demographic parameters and comorbidities, no significant difference was found between the two groups. Intra-articular vancomycin significantly lowered the risk of acute postoperative PJI after primary TJA (P = 0.015) and primary total knee arthroplasty (P = 0.031). However, for patients who underwent total hip arthroplasty, the PJI rate was comparable between the two groups. Overall, the risk of aseptic wound complication between the two groups was also similar. Vancomycin-associated acute renal injury, ototoxicity, or anaphylaxis was not observed. Conclusions: Intra-articular injection of 1 g of vancomycin suspension after arthrotomy closure during TJA lowered the risk of acute postoperative PJI without increasing the risk of aseptic wound complication and vancomycin-associated systemic toxicity.

Phosphaturic mesenchymal tumors (PMT) are rare and distinctive tumors that typically result in paraneoplastic syndrome known as tumor-induced osteomalacia (TIO). We report a case of bilateral osteoporotic femoral neck fracture caused by PMT. PMT was surgically resected, followed by sequential treatment of bilateral femoral neck fractures with total hip arthroplasty (THA). A 49-year-old perimenopausal woman experienced consistent bone pain with limb weakness persisting for over 2 years. Initially, she was diagnosed with early osteonecrosis of the femoral head and received nonsurgical treatment. However, from 2020 to 2022, her pain extended to the bilateral shoulders and knees with increased intensity. She had no positive family history or any other genetic diseases, and her menstrual cycles were regular. Physical examination revealed tenderness at the midpoints of the bilateral groin and restricted bilateral hip range of motion, with grade 3/5 muscle strength in both lower extremities. Laboratory findings revealed moderate anemia (hemoglobin 66 g/L), leukopenia (2.70 × 109/L), neutropenia (1.28 × 109/L), hypophosphatemia (0.36 mmol/L), high alkaline phosphatase activity (308.00 U/L), and normal serum calcium (2.22 mmol/L). After surgery, additional examinations were performed to explore the cause of hypophosphatemic osteomalacia. After definitive diagnosis, the patient underwent tumor resection via T11 laminectomy on August 6, 2022. Six months after the second THA, the patient regained normal gait with satisfactory hip movement function without recurrence of PMT-associated osteomalacia or prosthesis loosening. By providing detailed clinical data and a diagnostic and treatment approach, we aimed to improve the clinical understanding of femoral neck fractures caused by TIO.

ObjectivesTo investigate the efficacy of serum protein electrophoresis (SPE) in the diagnosis of periprosthetic joint infection (PJI) after hip and knee arthroplasty.MethodsThe medical records of patients undergoing hip and knee arthroplasty at a class A tertiary hospital between August 2013 and January 2021 were retrospectively investigated. A total of 179 patients were included and divided into two groups: 66 patients in the PJI group and 113 patients in the aseptic loosening (AL) group. Serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), D-dimer, Fibrinogen, Serum albumin and the proportion of serum protein in SPE were compared between the two groups. The diagnostic sensitivity and specificity were determined using the receiver operating characteristic (ROC) curve, and the diagnostic value was compared using the area under the ROC curve (AUC).ResultsThere was no significant difference in age, sex and body mass index (BMI) between PJI group and AL group (P>0.05), but there was significant difference in the ratio of hip to knee (X2 = 22.043, P

The low-permeability characteristic of sandstone-type uranium deposits has become the key geological bottleneck during the in-situ leaching mining, seriously restricting the development and utilization of uranium resources in China. At present, the blasting-enhanced permeability (BEP) and acidizing-enhanced permeability (AEP) are confirmed to be mainstream approaches to enhance the reservoir permeability of low-permeability sandstone-type uranium deposit (LPSUD). To clarify the synergistic effect of BEP and AEP, the acid-rock reaction and dynamic impact experiments were conducted, aiming to study the effect of chemical reactions on pore structure, dynamic mechanical properties and failure pattern of sandstone. Results show that with the increasing acid-rock reaction time, the total pore volume of samples is promoted largely and exhibits obvious chemical damage. The change of pore volume depends on the pore size, the 100–1000 nm and 1000–10000 nm pores are more susceptible to acid-rock reactions. The dynamic peak strength and the dynamic elastic modulus are decreased and the dynamic peak strain and strain rate are increased when lengthening the acid-rock reaction time, whose evolution laws can be fitted by the logistic expression, the linear expression and the exponential expression, respectively. The acid-rock reactions also have an influence on the fracture development of samples after the dynamic impact. The damaged fractures on the end faces of samples grow from the isolated short fracture, the isolated long fracture to the fracture network, and the damaged fractures on the sides of samples develop from the non-penetration fractures, penetration fractures to the multi-branch fractures. This study clarifies the physical and chemical combined damage mechanism, demonstrates the potential of reservoir stimulation by uniting the BEP and the AEP, and provides a theoretical reference for the reservoir stimulation of LPSUD.

Introduction: Total knee arthroplasty (TKA) has been recognized as the most efficacious surgical intervention for individuals suffering from advanced arthritis; however, there is ongoing debate on the technical details of the procedure. It remains unknown whether preservation of the posterior cruciate ligament (PCL) significantly affects the mid-to long-term performance of ADVANCE® medial-pivotal (AMP) knee implants to enhance patient satisfaction. The hypothesis of this study was to investigate whether the preservation of the PCL has a substantial impact on the functional outcomes of medial pivot (MP) implants in patients undergoing TKA. Therefore, this study aimed to compare the midterm clinical and radiographic outcomes of cruciate-retaining (CR) and cruciate-substituting (CS) TKA using MP prostheses. Methods: We included 376 consecutive patients who underwent unilateral TKA between January 2011 and April 2014. Follow-up evaluations were conducted in April 2021. After propensity score matching analysis, clinical and radiological outcomes and complication rates were compared between patients in the CR and CS groups. Results: The postoperative outcomes in the two groups significantly improved the preoperative conditions of the patients (all p > 0.05). The postoperative outcomes (WOMAC score, p = 0.517; KSS, p = 0.107; KSFS, p = 0.240; ROM, p = 0.795; FJS, p = 0.822) and radiographic outcomes (preoperative FTA, p = 0.997; postoperative FTA, p = 0.646; aLDFA, p = 0.094; aMPTA, p = 0.970; PTS, p = 0.243) were comparable between the two groups. The complication and revision rates between the groups were not statistically significant (p = 0.34). The Kaplan–Meier cumulative survival of patients in the CRTKA and CSTKA groups was 100 % and 98.6 %, respectively. Conclusions: This study supports the hypothesis that when MP prostheses are used, both CR and CS procedures achieve equally good mid-to long-term clinical and radiographic outcomes and complication rates. These findings suggest that PCL preservation may not significantly affect the overall performance of MP implants in patients undergoing TKA.

Abstract Purpose To compare the effect of vancomycin presoak treatment of grafts during anterior cruciate ligament reconstruction on the incidence of postoperative infection or septic arthritis. Methods Studies published before May 3, 2022 investigating vancomycin presoak of grafts during anterior cruciate ligament reconstruction were searched in the PubMed and Cochrane Central Register of Controlled Trials. Studies were screened, and data on the incidence of postoperative infection or septic arthritis were extracted and included in the analysis. Results Thirteen studies were included for analysis after search screening, yielding a total of 31,150 participants for analysis, of whom 11,437 received graft vancomycin presoak treatment, and 19,713 did not receive treatment. Participants who received vancomycin treatment had significantly lower infection rates (0.09% versus 0.74%; OR 0.17; 95% CI 0.10, 0.30; P

PurposeTo assess the alterations in bone mineral density and bone turnover marker concentrations following the administration of denosumab and romosozumab therapies in patients with osteoporosis.MethodsPubMed was searched for studies published until January 28, 2023, that investigated the clinical efficacy and bone turnover marker changes of denosumab and romosozumab in the treatment of osteoporosis, with a minimum follow-up of 3 months in each study. Studies were screened, and data on changes in bone mineral density (BMD), P1NP, and TRACP-5b levels after treatment were extracted and included in the analysis.ResultsSix studies were analyzed. At 3 months after treatment, the romosozumab group showed greater changes in lumbar BMD and bone turnover markers. BMD of total hip and femoral neck was relatively delayed. Beginning at 6 to 12 months, romosozumab showed greater changes in bone mineral density and markers of bone turnover.ConclusionBoth romosozumab and denosumab have antiosteoporotic effects, with greater effects on BMD and bone turnover markers observed within 12 months of romosozumab treatment.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42023395034.

Abstract Background The postoperative clinical outcomes has been extensively demonstrated to correlate with the coronal alignment after total knee arthroplasty (TKA). However, in different studies, either the hip-knee-ankle angle (HKA) on a full-length radiograph or the femorotibial angle (FTA) on a short knee film was used to categorize the postoperative coronal alignment. Meanwhile, several different FTA ranges were regarded as neutral alignment in different studies. As a result, it is still unknown that how FTA on short knee films and HKA related to each other. The FTA may be able to become an accurate proxy of HKA to predict the coronal alignment. The purpose of this study was to explore the correlation between the FTA and the HKA after TKA and to find the most accurate FTA range. Methods About 223 patients were included in this study and standard weight-bearing short knee films as well as full-length radiographs were acquired. The pre- and postoperative FTA, as well as the postoperative anatomical lateral distal femoral angle (aLDFA) and anatomical medial proximal tibial angle (aMPTA) were measured on short knee films by two orthopedic surgeons independently. On full-length films, the pre- and postoperative FTA, the pre- and postoperative HKA, as well as the postoperative mechanical lateral distal femoral angle (mLDFA) and mechanical medial proximal tibial angle (mMPTA) were also recorded by two other surgeons independently. Pearson correlation analysis was performed to compare FTA and HKA, aMTPA and mMTPA, aLDFA and mLDFA, respectively. Results The postoperative FTA and HKA had a good correlation (r = 0.86). The agreements were reached 82.7%, 71.0%, and 68.2% of all patients using three previously reported FTA ranges. When analyzing the independent alignment of the tibial tray and the femoral component, 84.1% and 57.9% of all patients was reached an agreement on the classification. Conclusions On most occasions, the consistence between the FTA and HKA in assessing the coronal limb alignment of the lower extremity and the tibial component is satisfactory. However, the postoperative full-length film is still needed to evaluate accurately the coronal alignment of the femoral component.

Guaranteeing CO2 injectivity has been the precondition for implementing the CO2-enhanced coalbed methane recovery (CO2-ECBM), however, it dramatically decreases during the CO2 injection process because it is influenced by the dynamic change of the anisotropic permeability of coal. To reveal and evaluate the CO2 injectivity of coal, the anisotropic permeability test and the CO2 injectivity simulation test were first conducted, then the corresponding numerical models were established and verified by the experimental data. The results show that the permeability of coal in parallel face cleat direction is the largest, followed by the permeability of coal in parallel butt cleat direction and that in vertical bedding direction is the minimum. The peak value of the instantaneous injectivity rate is enhanced and the injection time is prolonged with the increase of the CO2 injection pressure. The total CO2 injectivity rate is nonlinearly increased from 13.61 to 311.87 cm2/MPa min when the CO2 injection pressure raises from 2 to 10 MPa. The anisotropic permeability model is appropriate to describe the dynamic evolution of permeability under different boundary conditions, the CO2 injectivity prediction model can be used to evaluate the CO2 injectivity during the CO2 injection process. Increasing the CO2 injection pressure may temporarily promote CO2 injectivity, while the CO2 injection increment is limited. The CO2 fracturing by phase transition may be an available reservoir stimulation method for enhancing the CO2 injection and should be focused on in the future.

Osteoarthritis (OA) and Parkinson’s disease (PD) are on the rise and greatly impact the quality of individuals’ lives. Although accumulating evidence indicates a relationship between OA and PD, the particular interactions connecting the two diseases have not been thoroughly examined. Therefore, this study explored the association through genetic characterization and functional enrichment. Four datasets (GSE55235, GSE12021, GSE7621, and GSE42966) were chosen for assessment and validation from the Gene Expression Omnibus (GEO) database. Weighted Gene Co-Expression Network Analysis (WGCNA) was implemented to determine the most relevant genes for clinical features. Then, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were carried out to explore the biological processes of common genes, and to display the interrelationships between common genes, the STRING database and the application Molecular Complex Detection Algorithm (MCODE) of Cytoscape software were leveraged to get hub genes. By intersecting the common genes with the differentially expressed genes (DEGs) acquired from GSE12021 and GSE42966, the hub genes were identified. Finally, we validated the diagnostic efficacy of hub genes and explored their correlation with 22 immune infiltrating cells. As a consequence, we discovered 71 common genes, most of which were functionally enriched in antigen processing and presentation, mitochondrial translation, the mRNA surveillance pathway, and nucleocytoplasmic transport. Furthermore, WDR43 was found by intersecting eight hub genes with 28 DEGs from the two validation datasets. Receiver Operating Characteristic (ROC) implied the diagnostic role of WDR43 in OA and PD. Immune infiltration research revealed that T-cell regulatory (Tregs), monocytes, and mast cells resting were associated with the pathogenesis of OA and PD. WDR43 may provide key insights into the relationship between OA and PD.

BackgroundChanges in the neutrophil-lymphocyte ratio (NLR) has been reported to be associated with epilepsy. Here we aim to investigate the correlation of temporal changes of NLR level with seizure severity and the follow-up seizure attacks in patients with epilepsy (PWE).MethodsWe performed a retrospective analysis of the laboratory data including leukocyte count and NLR within 24 h of acute seizure and during the follow-up period of 5–14 days after acute seizure (NLR1, NLR2, respectively) in 115 PWE, and 98 healthy individuals were included as controls in this study. The correlation of laboratory data with seizure types, etiology of epilepsy, anti-seizure drugs (ASDs), seizure severity, and the follow-up seizure attacks in PWE was studied.ResultsLeukocyte count (P < 0.001) and NLR level (P < 0.001) were found significantly different between PWE and controls. On the other hand, a multivariable logistic regression analysis showed that NLR1 level (OR = 2.992, P = 0.001) and admission leukocyte (OR = 2.307, P = 0.002) were both independently associated with acute epileptic seizures. Especially, higher NLR1 level was significantly associated with status epileptics (P = 0.013) and recurrent seizures after admission (P < 0.001). Furthermore, the multivariable logistic regression analysis indicated that higher NLR1 was a predictor for the tendency of the following recurrent seizure attacks (OR = 1.144, P = 0.002). NLR2 was inversely correlated with ASDs taken (P = 0.011). Levels of NLR1 (r = 0.441, P < 0.001) and NLR2 (r = 0.241, P = 0.009) were both positively correlated with seizure severity.ConclusionsSeizures were correlated with the alterations of systemic inflammation reflected by leukocyte and NLR. NLR1 and admission leukocyte were both independently associated with acute epileptic seizures. Higher NLR1 was associated with status epilepticus and independently predicted the tendency of the following epileptic seizures. NLR2 was significantly associated with ASDs taken. Besides, NLR may be used as a biomarker for seizure severity.

A nonlinear stiffness modeling method for collaborative robots（Cobots） is proposed， which is combine the finite element analysis method （FEA） with the virtual joint method （VJM）. This modeling method not only includes the linear and coupled stiffness of the link and joint modules， but also takes into account the nonlinear stiffness of transmission systems of robot， the change rate of Jacobian matrix under loads and the influence of the changes of poses are caused by the load and deadweight on nonlinear stiffness of robot. The structure stiffness matrices of link modules and joint modules are obtained by finite element substructure method. Combined with the nonlinear stiffness model of the transmission system， the nonlinear comprehensive stiffness model of each robot module is established. The static equilibrium pose and the force of each module under external force and self-weight condition are calculated by numerical calculation method. Based on the VJM， a nonlinear stiffness model of robot is built， and the validity of this method is proved by nonlinear finite element simulation.

With the requirement of pose repeatability of robots， searching the optimal arrangement scheme of random motion accuracy of joints can make robot design more reasonable and reduce the development cost of robots. Firstly， based on the analysis of pose repeatability of robots， a mathematical model of pose repeatability is established. The model includes position repeatability and orientation repeatability of robots. Then， with the accuracy optimization evaluation function of maximization of joint motion error， the optimal synthesis of pose repeatability for collaborative robot KUKA iiwa 7 is performed. And the optimal arrangement scheme of random motion accuracy of joints can be obtained. Finally， the method is verified by carrying the pose repeatability test of KUKA iiwa 7， and the results of accuracy design by this method can make robot design more reasonable.

BackgroundGeneralized tonic–clonic seizures (GTCS) are associated with significant disability and sudden unexpected death when they cannot be controlled. We aimed to explore the underlying neural substrate of the different responses to antiseizure drugs between the seizure-free (SF) and non-seizure-free (NSF) patients with GTCS through the amplitude of low-frequency fluctuation (ALFF) method.MethodsWe calculated ALFF among the SF group, NSF group, and healthy controls (HCs) by collecting resting-state functional magnetic resonance imaging (rs-fMRI) data. One-way ANOVA was used to compare the ALFF of the three groups, and post-hoc analysis was done at the same time. Pearson's correlation analysis between ALFF in the discrepant brain areas and the clinical characteristics (disease course and age of onset of GTCS) was calculated after then.ResultsA significant group effect was found in the right fusiform gyrus (R.FG), left fusiform gyrus (L.FG), left middle occipital gyrus (L.MOG), right inferior frontal gyrus (R.IFG), right precentral gyrus (R.PreG), right postcentral gyrus (R.PostG), and left calcarine sulcus (L.CS). The SF and NSF groups both showed increased ALFF in all discrepant brain areas compared to HCs except the R.IFG in the NSF group. Significantly higher ALFF in the bilateral FG and lower ALFF in the R.IFG were found in the NSF group compared to the SF group.ConclusionsHigher ALFF in the bilateral FG were found in the NSF group compared to the SF and HC groups. Our findings indicate that abnormal brain activity in the FG may be one potential neural substrate to interpret the failure of seizure control in patients with GTCS.

Perovskite materials have high potential for the renewable energy sources such as solar PV cells, fuel cells, etc. Different structural distortions such as crystal structure and lattice parameters have a critical impact on the determination of the perovskite’s structure strength, stability, and overall performance of the materials in the applications. To improve the perovskite performance and accelerate the prediction of different structural distortions, few ML models have been established to predict the type of crystal structures and their lattice parameters using the basic atom characteristics of the perovskite materials. In this work, different ML models such as random forest (RF), support vector machine (SVM), neural network (NN), and genetic algorithm (GA) supported neural network (GA-NN) have been established, whereas support vector regression (SVR) and genetic algorithm-supported support vector regression (GA-SVR) models have been assessed for the prediction of the lattice parameters. The prediction model accuracy for the crystal structure classification is almost 88% in average for GA-NN whereas for the lattice constants regression model GA-SVR model gives ~95% in average which can be further improved by accumulating more robust datasets into the database. These ML models can be used as an alternative process to accelerate the development of finding out new perovskite material by providing valuable insight for the behaviours of the perovskite materials.

Using first-principles calculations, a new type of the full-Heusler alloy, namly, Ag2ScGe, with XA configuration, is proposed. The unit cell of the Ag2ScGe alloy consists of 16 atoms, and it is found that there may be two different phases: XA and L21. To determine the stable configuration of the Ag2ScGe alloy, we calculated the formation energy, energy curve, and phonon spectrum of the two configurations of the Ag2ScGe alloy and finally determined the new stable structure, i.e. the XA configuration of the Ag2ScGe alloy. Calculations of the mechanical properties and electronic properties show that this new structure exhibits the properties of a ductile and metallic material with elastic anisotropy. In addition, by calculating the optical properties of this new alloy, it is concluded that Ag2ScGe alloy is a good absorber in the visible light region.

With the rapid growth of vehicle population and vehicle miles traveled, automobile emission has become a severe issue in the metropolitan cities of China. There are policies that concentrate on the management of emission sources. However, improving the operation of the transportation system through apps on mobile devices, especially navigation apps, may have a unique role in promoting urban air quality. Real-time traveler information can not only help travelers avoid traffic congestion, but also advise them to adjust their departure time, mode, or route, or even to cancel trips. Will such changes in personal travel patterns have a significant impact in decreasing emissions? If so, to what extent will they impact urban air quality? The aim of this study is to determine how urban traffic emission is affected by the use of navigation apps. With this work, we attempt to answer the question of whether the real-time traffic information provided by navigation apps can help to improve urban air quality. Some of these findings may provide references for the formulation of urban traffic and environmental policies. Keywords: Real-time traffic information, Mobile devices, Environmental benefits, Agent-based model

Due to the raising economy development of Shenzhen, environmental problems brought by road transport have become more serious. Promoting liquefied natural gas vehicle in the road freight is a key to reduce emissions, change the direction for road freight development, and build a resource-saving society. This article studies the application of liquefied natural gas vehicle in Shenzhen in-depth through official data sets, field investigation, expert consultation, and so on. Economic benefit analysis shows that liquefied natural gas vehicle has the advantage of saving considerable fuel costs for enterprises. Moreover, the Monte-Carlo method is used to evaluate the economic benefits considering a lot of factors. The economic analysis shows that the liquefied natural gas vehicle is more affordable than the diesel vehicle. Finally, the current issues of liquefied natural gas vehicles on the promotion are discussed and some advices are proposed to improve air quality and reduce emissions.

The specialized equipment utilized in long-line tunnel engineering is evolving towards large-scale,multifunctional, and complex orientations. The vibration caused by the high-frequency units during regular operation is supported by the foundation of the units, and the magnitude of vibration and the operating frequency fluctuate in different engineering contexts, leading to variations in the dynamic response of the foundation. The high-frequency units yield significantly diverse outcomes under different startup conditions and times, resulting in failure to meet operational requirements, influencing the normal function of the tunnel, and causing harm to the foundation structure, personnel, and property in severe cases. This article formulates a finite element numerical computation model for solid elements using three-dimensional elastic body theory and integrates field measurements to substantiate and ascertain the crucial parameter configurations of the finite element model. By proposing a comprehensive startup timing function for high-frequency dynamic machines under different startup conditions, simulating the frequency andmagnitude variations during the startup process, and suggesting functions for changes in frequency and magnitude, a simulated startup schedule function for high-frequency machines is created through coupling. Taking into account the selection of the transient dynamic analysis step length, the dynamic response results for the lower dynamic foundation during its fundamental frequency crossing process are obtained. The validation checks if the structural magnitude surpasses the safety threshold during the critical phase of unit startup traversing the structural resonance region. The design recommendations for high-frequency units' dynamic foundations are provided, taking into account the startup process of the machine and ensuring the safe operation of the tunnel. [ABSTRACT FROM AUTHOR]