A accelerated arithmetic algorithm of the dynamic computing regions was designed,and 3-dimensional numerical simulation of isothermal solidification for a binary alloy was implemented.The dendritic growth and the reca...A accelerated arithmetic algorithm of the dynamic computing regions was designed,and 3-dimensional numerical simulation of isothermal solidification for a binary alloy was implemented.The dendritic growth and the recalescence of Ni-Cu binary alloy during the solidification at different cooling rates were investigated.The effects of cooling rate on dendritic patterns and microsegregation patterns were studied.The computed results indicate that,with the increment of the cooling rate,the dendritic growth velocity increases,both the main branch and side-branches become slender,the secondary dendrite arm spacing becomes smaller,the inadequate solute diffusion in solid aggravates,and the severity of microsegregation ahead of interface aggravates.At a higher cooling rate,the binary alloy presents recalescence;while the cooling rate is small,no recalescence occurs.展开更多
The progressive loss of dopaminergic neurons in affected patient brains is one of the pathological features of Parkinson's disease,the second most common human neurodegenerative disease.Although the detailed patho...The progressive loss of dopaminergic neurons in affected patient brains is one of the pathological features of Parkinson's disease,the second most common human neurodegenerative disease.Although the detailed pathogenesis accounting for dopaminergic neuron degeneration in Parkinson's disease is still unclear,the advancement of stem cell approaches has shown promise for Parkinson's disease research and therapy.The induced pluripotent stem cells have been commonly used to generate dopaminergic neurons,which has provided valuable insights to improve our understanding of Parkinson's disease pathogenesis and contributed to anti-Parkinson's disease therapies.The current review discusses the practical approaches and potential applications of induced pluripotent stem cell techniques for generating and differentiating dopaminergic neurons from induced pluripotent stem cells.The benefits of induced pluripotent stem cell-based research are highlighted.Various dopaminergic neuron differentiation protocols from induced pluripotent stem cells are compared.The emerging three-dimension-based brain organoid models compared with conventional two-dimensional cell culture are evaluated.Finally,limitations,challenges,and future directions of induced pluripotent stem cell–based approaches are analyzed and proposed,which will be significant to the future application of induced pluripotent stem cell-related techniques for Parkinson's disease.展开更多
This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal disease...This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.展开更多
BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of ...BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of patients after pancreatic resections.Globally recognized superior mesenteric artery(SMA)first approaches are invariably performed.The mesenteric dissection through the inferior infracolic approach has been discussed in this study emphasizing its post-operative impact on CL which is the cornerstone of this study.AIM To assess incidence,risk factors,clinical impact of CL following root of mesentery dissection,and the different treatment modalities.METHODS This is a retrospective study incorporating the patients who underwent dissection of the root of mesentery with inferior infracolic SMA first approach pancreat-oduodenectomy for the ventral body and uncinate mass of pancreas in the Department of Gastrointestinal and General Surgery of Kathmandu Medical College and Teaching Hospital from January 1,2021 to February 28,2024.Intraop-erative findings and postoperative outcomes were analyzed.RESULTS In three years,ten patients underwent root of mesentery dissection with inferior infracolic SMA first approach pancreatoduodenectomy.The mean age was 67.6 years with a male-to-female ratio of 4:5.CL was seen in four patients.With virtue of CL,Clavien-Dindo grade Ⅱ or higher morbidity was observed in four patients.Two patients had a hospital stay of more than 20 days with the former having a delayed gastric emptying and the latter with long-term total parenteral nutrition requirement.The mean operative time was 330 minutes.Curative resection was achieved in 100%of the patients.The mean duration of the intensive care unit and hospital stay were 2.55±1.45 days and 15.7±5.32 days,respectively.CONCLUSION Root of mesentery dissection with lymphadenectomy and vascular resection correlated with occurrence of CL.After complete curative resection,these were managed with total parenteral nutrition without adversely impacting outcome.展开更多
BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality rates.Approaches to this surgery are still debated,with ...BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality rates.Approaches to this surgery are still debated,with no consensus regarding the superiority of any single approach.AIM To compare early postoperative complications after implementing the direct anterior and posterior approaches(PL)for hip hemiarthroplasty after femoral neck fractures.METHODS This is a comparative,retrospective,single-center cohort study conducted at a university hospital.Between March 2008 and December 2018,273 patients(a total of 280 hips)underwent bipolar hemiarthroplasties(n=280)for displaced femoral neck fractures using either the PL(n=171)or the minimally invasive direct anterior approach(DAA)(n=109).The choice of approach was related to the surgeons’practices;the implant types were similar and unrelated to the approach.Dislocation rates and other complications were reviewed after a minimum followup of 6 mo.RESULTS Both treatment groups had similarly aged patients(mean age:82 years),sex ratios,patient body mass indexes,and patient comorbidities.Surgical data(surgery delay time,operative time,and blood loss volume)did not differ significantly between the groups.The 30 d mortality rate was higher in the PL group(9.9%)than in the DAA group(3.7%),but the difference was not statistically significant(P=0.052).Among the one-month survivors,a significantly higher rate of dislocation was observed in the PL group(14/154;9.1%)than in the DAA group(0/105;0%)(P=0.002).Of the 14 patients with dislocation,8 underwent revision surgery for recurrent instability(posterior group),and one of them had 2 additional procedures due to a deep infection.The rate of other complications(e.g.,perioperative and early postoperative periprosthetic fractures and infection-related complications)did not differ significantly between the groups.CONCLUSION These findings suggest that the DAA to bipolar hemiarthroplasty for patients with femoral neck fractures is associated with a lower dislocation rate(<1%)than the PL.展开更多
This paper provides a comprehensive overview of a phase-field model of fracture in solid mechanics setting. We start reviewing the potential energy governing the whole process of fracture including crack initiation, b...This paper provides a comprehensive overview of a phase-field model of fracture in solid mechanics setting. We start reviewing the potential energy governing the whole process of fracture including crack initiation, branching or merging. Then, a discretization of system of equation is derived, in which the key aspect is that for the correctness of fracture phenomena, a split into tensile and compressive terms of the strain energy is performed, which allows crack to occur in tension, not in compression. For numerical analysis, standard finite element shape functions are used for both primary fields including displacements and phase field. A staggered scheme which solves the two fields of the problem separately is utilized for solution step and illustrated with a segment of Python code.展开更多
In this article, a novel scalarization technique, called the improved objective-constraint approach, is introduced to find efficient solutions of a given multiobjective programming problem. The presented scalarized pr...In this article, a novel scalarization technique, called the improved objective-constraint approach, is introduced to find efficient solutions of a given multiobjective programming problem. The presented scalarized problem extends the objective-constraint problem. It is demonstrated that how adding variables to the scalarized problem, can lead to find conditions for (weakly, properly) Pareto optimal solutions. Applying the obtained necessary and sufficient conditions, two algorithms for generating the Pareto front approximation of bi-objective and three-objective programming problems are designed. These algorithms are easy to implement and can achieve an even approximation of (weakly, properly) Pareto optimal solutions. These algorithms can be generalized for optimization problems with more than three criterion functions, too. The effectiveness and capability of the algorithms are demonstrated in test problems.展开更多
Soil tensile strength is a critical parameter governing the initiation and propagation of tensile cracking.This study proposes an eco-friendly approach to improve the tensile behavior and crack resistance of clayey so...Soil tensile strength is a critical parameter governing the initiation and propagation of tensile cracking.This study proposes an eco-friendly approach to improve the tensile behavior and crack resistance of clayey soils.To validate the feasibility and efficacy of the proposed approach,direct tensile tests were employed to determine the tensile strength of the compacted soil with different W-OH treatment concentrations and water contents.Desiccation tests were also performed to evaluate the effectiveness of W-OH treatment in enhancing soil tensile cracking resistance.During this period,the effects of W-OH treatment concentration and water content on tensile properties,soil suction and microstructure were investigated.The tensile tests reveal that W-OH treatment has a significant impact on the tensile strength and failure mode of the soil,which not only effectively enhances the tensile strength and failure displacement,but also changes the brittle failure behavior into a more ductile quasi-brittle failure behavior.The suction measurements and mercury intrusion porosimetry(MIP)tests show that W-OH treatment can slightly reduce soil suction by affecting skeleton structure and increasing macropores.Combined with the microstructural analysis,it becomes evident that the significant improvement in soil tensile behavior through W-OH treatment is mainly attributed to the W-OH gel's ability to provide additional binding force for bridging and encapsulating the soil particles.Moreover,desiccation tests demonstrate that W-OH treatment can significantly reduce or even inhibit the formation of soil tensile cracking.With the increase of W-OH treatment concentration,the surface crack ratio and total crack length are significantly reduced.This study enhances a fundamental understanding of eco-polymer impacts on soil mechanical properties and provides valuable insight into their potential application for improving soil crack resistance.展开更多
BACKGROUND Advancements in laparoscopic technology and a deeper understanding of intra-hepatic anatomy have led to the establishment of more precise laparoscopic hepatectomy(LH)techniques.The indocyanine green(ICG)flu...BACKGROUND Advancements in laparoscopic technology and a deeper understanding of intra-hepatic anatomy have led to the establishment of more precise laparoscopic hepatectomy(LH)techniques.The indocyanine green(ICG)fluorescence navi-gation technique has emerged as the most effective method for identifying hepatic regions,potentially overcoming the limitations of LH.While laparoscopic left hemihepatectomy(LLH)is a standardized procedure,there is a need for innova-tive strategies to enhance its outcomes.important anatomical markers,surgical skills,and ICG staining methods.METHODS Thirty-seven patients who underwent ICG fluorescence-guided LLH at Qujing Second People's Hospital between January 2019 and February 2022 were retrospectively analyzed.The cranial-dorsal approach was performed which involves dissecting the left hepatic vein cephalad,isolating the Arantius ligament,exposing the middle hepatic vein,and dissecting the parenchyma from the dorsal to the foot in order to complete the anatomical LLH.The surgical methods,as well as intra-and post-surgical data,were recorded and analyzed.Our hospital’s Medical Ethics Committee approved this study(Ethical review:2022-019-01).RESULTS Intraoperative blood loss during LLH was 335.68±99.869 mL and the rates of transfusion and conversion to laparotomy were 13.5%and 0%,respectively.The overall incidence of complications throughout the follow-up(median of 18 months;range 1-36 months)was 21.6%.No mortality or severe complications(level IV)were reported.CONCLUSION LLH has the potential to become a novel,standardized approach that can effectively,safely,and simply expose the middle hepatic vein and meet the requirements of precision surgery.展开更多
BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications o...BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications of hip approaches remains inconclusive.This study conducted an umbrella review to systematically appraise previous meta-analysis(MAs)including conventional posterior approach(PA),and minimally invasive surgeries as the lateral approach(LA),direct anterior approach(DAA),2-incisions method,mini-lateral approach and the newest technique direct superior approach(DSA)or supercapsular percutaneouslyassisted total hip(SuperPath).AIM To compare the efficacy and complications of hip approaches that have been published in all MAs and randomized controlled trials(RCTs).METHODS MAs were identified from MEDLINE and Scopus from inception until 2023.RCTs were then updated from the latest MA to September 2023.This study included studies which compared hip approaches and reported at least one outcome such as Harris Hip Score(HHS),dislocation,intra-operative fracture,wound compliData were independently selected,extracted and assessed by two reviewers.Network MA and cluster rank and surface under the cumulative ranking curve(SUCRA)were estimated for treatment efficacy and safety.RESULTS Finally,twenty-eight MAs(40 RCTs),and 13 RCTs were retrieved.In total 47 RCTs were included for reanalysis.The results of corrected covered area showed high degree(13.80%).Among 47 RCTs,most of the studies were low risk of bias in part of random process and outcome reporting,while other domains were medium to high risk of bias.DAA significantly provided higher HHS at three months than PA[pooled unstandardized mean difference(USMD):3.49,95%confidence interval(CI):0.98,6.00 with SUCRA:85.9],followed by DSA/SuperPath(USMD:1.57,95%CI:-1.55,4.69 with SUCRA:57.6).All approaches had indifferent dislocation and intraoperative fracture rates.SUCRA comparing early functional outcome and composite complications(dislocation,intra-operative fracture,wound complication,and nerve injury)found DAA was the best approach followed by DSA/SuperPath.CONCLUSION DSA/SuperPath had better earlier functional outcome than PA,but still could not overcome the result of DAA.This technique might be the other preferred option with acceptable complications.展开更多
Sintering,a well-established technique in powder metallurgy,plays a critical role in the processing of high melting point materials.A comprehensive understanding of structural changes during the sintering process is e...Sintering,a well-established technique in powder metallurgy,plays a critical role in the processing of high melting point materials.A comprehensive understanding of structural changes during the sintering process is essential for effective product assessment.The phase-field method stands out for its unique ability to simulate these structural transformations.Despite its widespread application,there is a notable absence of literature reviews focused on its usage in sintering simulations.Therefore,this paper addresses this gap by reviewing the latest advancements in phase-field sintering models,covering approaches based on energy,grand potential,and entropy increase.The characteristics of various models are extensively discussed,with a specific emphasis on energy-based models incorporating considerations such as interface energy anisotropy,tensor-form diffusion mechanisms,and various forms of rigid particle motion during sintering.Furthermore,the paper offers a concise summary of phase-field sintering models that integrate with other physical fields,including stress/strain fields,viscous flow,temperature field,and external electric fields.In conclusion,the paper provides a succinct overview of the entire content and delineates potential avenues for future research.展开更多
Hydride precipitation in zirconium cladding materials can damage their integrity and durability.Service temperature and material defects have a significant effect on the dynamic growth of hydrides.In this study,we hav...Hydride precipitation in zirconium cladding materials can damage their integrity and durability.Service temperature and material defects have a significant effect on the dynamic growth of hydrides.In this study,we have developed a phasefield model based on the assumption of elastic behaviour within a specific temperature range(613 K-653 K).This model allows us to study the influence of temperature and interfacial effects on the morphology,stress,and average growth rate of zirconium hydride.The results suggest that changes in temperature and interfacial energy influence the length-to-thickness ratio and average growth rate of the hydride morphology.The ultimate determinant of hydride orientation is the loss of interfacial coherency,primarily induced by interfacial dislocation defects and quantifiable by the mismatch degree q.An escalation in interfacial coherency loss leads to a transition of hydride growth from horizontal to vertical,accompanied by the onset of redirection behaviour.Interestingly,redirection occurs at a critical mismatch level,denoted as qc,and remains unaffected by variations in temperature and interfacial energy.However,this redirection leads to an increase in the maximum stress,which may influence the direction of hydride crack propagation.This research highlights the importance of interfacial coherency and provides valuable insights into the morphology and growth kinetics of hydrides in zirconium alloys.展开更多
A novel phase-field model for the propagation of mixed-mode hydraulic fractures,characterized by the formation of mixed-mode fractures due to the interactions between fluids and solids,is proposed.In this model,the dr...A novel phase-field model for the propagation of mixed-mode hydraulic fractures,characterized by the formation of mixed-mode fractures due to the interactions between fluids and solids,is proposed.In this model,the driving force for the phase field consists of both tensile and shear components,with the fluid contribution primarily manifesting in the tension driving force.The displacement and pressure are solved simultaneously by an implicit method.The numerical solution's iterative format is established by the finite element discretization and Newton-Raphson(NR)iterative methods.The correctness of the model is verified through the uniaxial compression physical experiments on fluid-pressurized rocks,and the limitations of the hydraulic fracture expansion phase-field model,which only considers mode I fractures,are revealed.In addition,the influence of matrix mode II fracture toughness value,natural fracture mode II toughness value,and fracturing fluid injection rate on the hydraulic fracture propagation in porous media with natural fractures is studied.展开更多
The effect of undercooling DT and the interface energy anisotropy parameter e4 on the shape of the equiaxed dendritic tip has been investigated by using a quantitative phase-field model for solidification of binary al...The effect of undercooling DT and the interface energy anisotropy parameter e4 on the shape of the equiaxed dendritic tip has been investigated by using a quantitative phase-field model for solidification of binary alloys.It was found that the tip radius r increases and the tip shape amplitude coefficient A4 decreases with the increase of the fitting range for all cases.The dendrite tip shape selection parameter sdecreases and then stabilizes with the increase of the fitting range,and sincreases with the increase of e4.The relationship between sand e4 follows a power-law function sµea 4,and a is independent of DT but dependent on the fitting range.Numerical results demonstrate that the predicted sis consistent with the curve of microscopic solvability theory(MST)for e4<0.02,and sobtained from our phase-field simulations is sensitive to the undercooling when e4 is fixed.展开更多
Failure analyses of piezoelectric structures and devices are of engineering and scientific significance.In this paper,a fourth-order phase-field fracture model for piezoelectric solids is developed based on the Hamilt...Failure analyses of piezoelectric structures and devices are of engineering and scientific significance.In this paper,a fourth-order phase-field fracture model for piezoelectric solids is developed based on the Hamilton principle.Three typical electric boundary conditions are involved in the present model to characterize the fracture behaviors in various physical situations.A staggered algorithm is used to simulate the crack propagation.The polynomial splines over hierarchical T-meshes(PHT-splines)are adopted as the basis function,which owns the C1continuity.Systematic numerical simulations are performed to study the influence of the electric boundary conditions and the applied electric field on the fracture behaviors of piezoelectric materials.The electric boundary conditions may influence crack paths and fracture loads significantly.The present research may be helpful for the reliability evaluation of the piezoelectric structure in the future applications.展开更多
OBJECTIVE To assess the feasibility and safety of the minimalistic approach to left atrial appendage occlusion(LAAO) guided by cardiac computed tomography angiography(CCTA).METHODS Ninety consecutive patients who unde...OBJECTIVE To assess the feasibility and safety of the minimalistic approach to left atrial appendage occlusion(LAAO) guided by cardiac computed tomography angiography(CCTA).METHODS Ninety consecutive patients who underwent LAAO, with or without CCTA-guided, were matched(1:2). Each step of the LAAO procedure in the computed tomography(CT) guidance group(CT group) was directed by preprocedural CT planning. In the control group, LAAO was performed using the standard method. All patients were followed up for 12 months, and device surveillance was conducted using CCTA.RESULTS A total of 90 patients were included in the analysis, with 30 patients in the CT group and 60 matched patients in the control group. All patients were successfully implanted with Watchman devices. The mean ages for the CT group and the control group were 70.0 ± 9.4 years and 68.4 ± 11.9 years(P = 0.52), respectively. The procedure duration(45.6 ± 10.7 min vs. 58.8 ± 13.0 min,P < 0.001) and hospital stay(7.5 ± 2.4 day vs. 9.6 ± 2.8 day, P = 0.001) in the CT group was significantly shorter compared to the control group. However, the total radiation dose was higher in the CT group compared to the control group(904.9 ± 348.0 m Gy vs.711.9 ± 211.2 m Gy, P = 0.002). There were no significant differences in periprocedural pericardial effusion(3.3% vs. 6.3%, P = 0.8) between the two groups. The rate of postprocedural adverse events(13.3% vs. 18.3%, P = 0.55) were comparable between both groups at 12 months follow-up.CONCLUSIONS CCTA is capable of detailed LAAO procedure planning. Minimalistic LAAO with preprocedural CCTA planning was feasible and safe, with shortened procedure time and acceptable increased radiation and contras consumption. For patients with contraindications to general anesthesia and/or transesophageal echocardiography, this promising method may be an alternative to conventional LAAO.展开更多
Understanding the probabilistic nature of brittle materials due to inherent dispersions in their mechanical properties is important to assess their reliability and safety for sensitive engineering applications.This is...Understanding the probabilistic nature of brittle materials due to inherent dispersions in their mechanical properties is important to assess their reliability and safety for sensitive engineering applications.This is all the more important when elements composed of brittle materials are exposed to dynamic environments,resulting in catastrophic fatigue failures.The authors propose the application of a non-intrusive polynomial chaos expansion method for probabilistic studies on brittle materials undergoing fatigue fracture when geometrical parameters and material properties are random independent variables.Understanding the probabilistic nature of fatigue fracture in brittle materials is crucial for ensuring the reliability and safety of engineering structures subjected to cyclic loading.Crack growth is modelled using a phase-field approach within a finite element framework.For modelling fatigue,fracture resistance is progressively degraded by modifying the regularised free energy functional using a fatigue degradation function.Number of cycles to failure is treated as the dependent variable of interest and is estimated within acceptable limits due to the randomness in independent properties.Multiple 2D benchmark problems are solved to demonstrate the ability of this approach to predict the dependent variable responses with significantly fewer simulations than the Monte Carlo method.This proposed approach can accurately predict results typically obtained through 105 or more runs in Monte Carlo simulations with a reduction of up to three orders of magnitude in required runs.The independent random variables’sensitivity to the system response is determined using Sobol’indices.The proposed approach has low computational overhead and can be useful for computationally intensive problems requiring rapid decision-making in sensitive applications like aerospace,nuclear and biomedical engineering.The technique does not require reformulating existing finite element code and can perform the stochastic study by direct pre/post-processing.展开更多
High-energy gamma-ray radiography has exceptional penetration ability and has become an indispensable nondestructive testing(NDT)tool in various fields.For high-energy photons,point projection radiography is almost th...High-energy gamma-ray radiography has exceptional penetration ability and has become an indispensable nondestructive testing(NDT)tool in various fields.For high-energy photons,point projection radiography is almost the only feasible imaging method,and its spatial resolution is primarily constrained by the size of the gamma-ray source.In conventional industrial applications,gamma-ray sources are commonly based on electron beams driven by accelerators,utilizing the process of bremsstrahlung radiation.The size of the gamma-ray source is dependent on the dimensional characteristics of the electron beam.Extensive research has been conducted on various advanced accelerator technologies that have the potential to greatly improve spatial resolution in NDT.In our investigation of laser-driven gamma-ray sources,a spatial resolution of about 90μm is achieved when the areal density of the penetrated object is 120 g/cm^(2).A virtual source approach is proposed to optimize the size of the gamma-ray source used for imaging,with the aim of maximizing spatial resolution.In this virtual source approach,the gamma ray can be considered as being emitted from a virtual source within the convertor,where the equivalent gamma-ray source size in imaging is much smaller than the actual emission area.On the basis of Monte Carlo simulations,we derive a set of evaluation formulas for virtual source scale and gamma-ray emission angle.Under optimal conditions,the virtual source size can be as small as 15μm,which can significantly improve the spatial resolution of high-penetration imaging to less than 50μm.展开更多
We read and discussed the study entitled“Complication rates after direct anterior vs posterior approach for Hip Hemiarthroplasty in elderly individuals with femoral neck fractures”with great interest.The authors hav...We read and discussed the study entitled“Complication rates after direct anterior vs posterior approach for Hip Hemiarthroplasty in elderly individuals with femoral neck fractures”with great interest.The authors have done justice to the topic of comparison of anterior and posterior surgical approaches for bipolar hemiarthroplasty which has been an everlasting debate in the existing literature.However,there are certain aspects of this study that need clarification from the authors.展开更多
The differences in complication rates between the direct anterior and posterior approaches for hemiarthroplasty in elderly patients with femoral neck fractures are not yet fully understood.Dislocation,a severe complic...The differences in complication rates between the direct anterior and posterior approaches for hemiarthroplasty in elderly patients with femoral neck fractures are not yet fully understood.Dislocation,a severe complication associated with increased mortality and often requiring additional surgery,may occur less frequently with the direct anterior approach compared to the posterior approach.Careful consideration of patient demographics is essential when planning the surgical approach.Future research in this area should focus on robust randomized controlled trials involving elderly patients recovering from femoral neck fractures.展开更多
基金Project(10964004)supported by the National Natural Science Foundation of ChinaProject(20070231001)supported by Research Fund for the Doctoral Program of Higher Education of China+1 种基金Project(096RJZA104)supported by the Natural Science Foundation of Gansu Province,ChinaProject(SB14200801)supported by the Doctoral Fund of Lanzhou University of Technology
文摘A accelerated arithmetic algorithm of the dynamic computing regions was designed,and 3-dimensional numerical simulation of isothermal solidification for a binary alloy was implemented.The dendritic growth and the recalescence of Ni-Cu binary alloy during the solidification at different cooling rates were investigated.The effects of cooling rate on dendritic patterns and microsegregation patterns were studied.The computed results indicate that,with the increment of the cooling rate,the dendritic growth velocity increases,both the main branch and side-branches become slender,the secondary dendrite arm spacing becomes smaller,the inadequate solute diffusion in solid aggravates,and the severity of microsegregation ahead of interface aggravates.At a higher cooling rate,the binary alloy presents recalescence;while the cooling rate is small,no recalescence occurs.
基金supported by Singapore National Medical Research Council(NMRC)grants,including CS-IRG,HLCA2022(to ZDZ),STaR,OF LCG 000207(to EKT)a Clinical Translational Research Programme in Parkinson's DiseaseDuke-Duke-NUS collaboration pilot grant(to ZDZ)。
文摘The progressive loss of dopaminergic neurons in affected patient brains is one of the pathological features of Parkinson's disease,the second most common human neurodegenerative disease.Although the detailed pathogenesis accounting for dopaminergic neuron degeneration in Parkinson's disease is still unclear,the advancement of stem cell approaches has shown promise for Parkinson's disease research and therapy.The induced pluripotent stem cells have been commonly used to generate dopaminergic neurons,which has provided valuable insights to improve our understanding of Parkinson's disease pathogenesis and contributed to anti-Parkinson's disease therapies.The current review discusses the practical approaches and potential applications of induced pluripotent stem cell techniques for generating and differentiating dopaminergic neurons from induced pluripotent stem cells.The benefits of induced pluripotent stem cell-based research are highlighted.Various dopaminergic neuron differentiation protocols from induced pluripotent stem cells are compared.The emerging three-dimension-based brain organoid models compared with conventional two-dimensional cell culture are evaluated.Finally,limitations,challenges,and future directions of induced pluripotent stem cell–based approaches are analyzed and proposed,which will be significant to the future application of induced pluripotent stem cell-related techniques for Parkinson's disease.
基金Supported by National Research Foundation of Korea,No.NRF-2021S1A5A8062526.
文摘This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.
文摘BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of patients after pancreatic resections.Globally recognized superior mesenteric artery(SMA)first approaches are invariably performed.The mesenteric dissection through the inferior infracolic approach has been discussed in this study emphasizing its post-operative impact on CL which is the cornerstone of this study.AIM To assess incidence,risk factors,clinical impact of CL following root of mesentery dissection,and the different treatment modalities.METHODS This is a retrospective study incorporating the patients who underwent dissection of the root of mesentery with inferior infracolic SMA first approach pancreat-oduodenectomy for the ventral body and uncinate mass of pancreas in the Department of Gastrointestinal and General Surgery of Kathmandu Medical College and Teaching Hospital from January 1,2021 to February 28,2024.Intraop-erative findings and postoperative outcomes were analyzed.RESULTS In three years,ten patients underwent root of mesentery dissection with inferior infracolic SMA first approach pancreatoduodenectomy.The mean age was 67.6 years with a male-to-female ratio of 4:5.CL was seen in four patients.With virtue of CL,Clavien-Dindo grade Ⅱ or higher morbidity was observed in four patients.Two patients had a hospital stay of more than 20 days with the former having a delayed gastric emptying and the latter with long-term total parenteral nutrition requirement.The mean operative time was 330 minutes.Curative resection was achieved in 100%of the patients.The mean duration of the intensive care unit and hospital stay were 2.55±1.45 days and 15.7±5.32 days,respectively.CONCLUSION Root of mesentery dissection with lymphadenectomy and vascular resection correlated with occurrence of CL.After complete curative resection,these were managed with total parenteral nutrition without adversely impacting outcome.
基金This study was reviewed and approved by the Ethics Committee of the HUB-Hospital Erasme.
文摘BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality rates.Approaches to this surgery are still debated,with no consensus regarding the superiority of any single approach.AIM To compare early postoperative complications after implementing the direct anterior and posterior approaches(PL)for hip hemiarthroplasty after femoral neck fractures.METHODS This is a comparative,retrospective,single-center cohort study conducted at a university hospital.Between March 2008 and December 2018,273 patients(a total of 280 hips)underwent bipolar hemiarthroplasties(n=280)for displaced femoral neck fractures using either the PL(n=171)or the minimally invasive direct anterior approach(DAA)(n=109).The choice of approach was related to the surgeons’practices;the implant types were similar and unrelated to the approach.Dislocation rates and other complications were reviewed after a minimum followup of 6 mo.RESULTS Both treatment groups had similarly aged patients(mean age:82 years),sex ratios,patient body mass indexes,and patient comorbidities.Surgical data(surgery delay time,operative time,and blood loss volume)did not differ significantly between the groups.The 30 d mortality rate was higher in the PL group(9.9%)than in the DAA group(3.7%),but the difference was not statistically significant(P=0.052).Among the one-month survivors,a significantly higher rate of dislocation was observed in the PL group(14/154;9.1%)than in the DAA group(0/105;0%)(P=0.002).Of the 14 patients with dislocation,8 underwent revision surgery for recurrent instability(posterior group),and one of them had 2 additional procedures due to a deep infection.The rate of other complications(e.g.,perioperative and early postoperative periprosthetic fractures and infection-related complications)did not differ significantly between the groups.CONCLUSION These findings suggest that the DAA to bipolar hemiarthroplasty for patients with femoral neck fractures is associated with a lower dislocation rate(<1%)than the PL.
文摘This paper provides a comprehensive overview of a phase-field model of fracture in solid mechanics setting. We start reviewing the potential energy governing the whole process of fracture including crack initiation, branching or merging. Then, a discretization of system of equation is derived, in which the key aspect is that for the correctness of fracture phenomena, a split into tensile and compressive terms of the strain energy is performed, which allows crack to occur in tension, not in compression. For numerical analysis, standard finite element shape functions are used for both primary fields including displacements and phase field. A staggered scheme which solves the two fields of the problem separately is utilized for solution step and illustrated with a segment of Python code.
文摘In this article, a novel scalarization technique, called the improved objective-constraint approach, is introduced to find efficient solutions of a given multiobjective programming problem. The presented scalarized problem extends the objective-constraint problem. It is demonstrated that how adding variables to the scalarized problem, can lead to find conditions for (weakly, properly) Pareto optimal solutions. Applying the obtained necessary and sufficient conditions, two algorithms for generating the Pareto front approximation of bi-objective and three-objective programming problems are designed. These algorithms are easy to implement and can achieve an even approximation of (weakly, properly) Pareto optimal solutions. These algorithms can be generalized for optimization problems with more than three criterion functions, too. The effectiveness and capability of the algorithms are demonstrated in test problems.
基金supported by the National Natural Science Foundation of China(Grant Nos.41925012,42230710)Key Laboratory Cooperation Special Project of Western Cross Team of Western Light,Chinese Academy of Sciences(Grant No.xbzg-zdsys-202107).
文摘Soil tensile strength is a critical parameter governing the initiation and propagation of tensile cracking.This study proposes an eco-friendly approach to improve the tensile behavior and crack resistance of clayey soils.To validate the feasibility and efficacy of the proposed approach,direct tensile tests were employed to determine the tensile strength of the compacted soil with different W-OH treatment concentrations and water contents.Desiccation tests were also performed to evaluate the effectiveness of W-OH treatment in enhancing soil tensile cracking resistance.During this period,the effects of W-OH treatment concentration and water content on tensile properties,soil suction and microstructure were investigated.The tensile tests reveal that W-OH treatment has a significant impact on the tensile strength and failure mode of the soil,which not only effectively enhances the tensile strength and failure displacement,but also changes the brittle failure behavior into a more ductile quasi-brittle failure behavior.The suction measurements and mercury intrusion porosimetry(MIP)tests show that W-OH treatment can slightly reduce soil suction by affecting skeleton structure and increasing macropores.Combined with the microstructural analysis,it becomes evident that the significant improvement in soil tensile behavior through W-OH treatment is mainly attributed to the W-OH gel's ability to provide additional binding force for bridging and encapsulating the soil particles.Moreover,desiccation tests demonstrate that W-OH treatment can significantly reduce or even inhibit the formation of soil tensile cracking.With the increase of W-OH treatment concentration,the surface crack ratio and total crack length are significantly reduced.This study enhances a fundamental understanding of eco-polymer impacts on soil mechanical properties and provides valuable insight into their potential application for improving soil crack resistance.
基金Supported by The High-level Talent Training Support Project of Yunnan Province,No.YNWR-MY-2020-053and the Key Project of the Second People's Hospital of Qujing in 2022,No.2022ynkt04。
文摘BACKGROUND Advancements in laparoscopic technology and a deeper understanding of intra-hepatic anatomy have led to the establishment of more precise laparoscopic hepatectomy(LH)techniques.The indocyanine green(ICG)fluorescence navi-gation technique has emerged as the most effective method for identifying hepatic regions,potentially overcoming the limitations of LH.While laparoscopic left hemihepatectomy(LLH)is a standardized procedure,there is a need for innova-tive strategies to enhance its outcomes.important anatomical markers,surgical skills,and ICG staining methods.METHODS Thirty-seven patients who underwent ICG fluorescence-guided LLH at Qujing Second People's Hospital between January 2019 and February 2022 were retrospectively analyzed.The cranial-dorsal approach was performed which involves dissecting the left hepatic vein cephalad,isolating the Arantius ligament,exposing the middle hepatic vein,and dissecting the parenchyma from the dorsal to the foot in order to complete the anatomical LLH.The surgical methods,as well as intra-and post-surgical data,were recorded and analyzed.Our hospital’s Medical Ethics Committee approved this study(Ethical review:2022-019-01).RESULTS Intraoperative blood loss during LLH was 335.68±99.869 mL and the rates of transfusion and conversion to laparotomy were 13.5%and 0%,respectively.The overall incidence of complications throughout the follow-up(median of 18 months;range 1-36 months)was 21.6%.No mortality or severe complications(level IV)were reported.CONCLUSION LLH has the potential to become a novel,standardized approach that can effectively,safely,and simply expose the middle hepatic vein and meet the requirements of precision surgery.
文摘BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications of hip approaches remains inconclusive.This study conducted an umbrella review to systematically appraise previous meta-analysis(MAs)including conventional posterior approach(PA),and minimally invasive surgeries as the lateral approach(LA),direct anterior approach(DAA),2-incisions method,mini-lateral approach and the newest technique direct superior approach(DSA)or supercapsular percutaneouslyassisted total hip(SuperPath).AIM To compare the efficacy and complications of hip approaches that have been published in all MAs and randomized controlled trials(RCTs).METHODS MAs were identified from MEDLINE and Scopus from inception until 2023.RCTs were then updated from the latest MA to September 2023.This study included studies which compared hip approaches and reported at least one outcome such as Harris Hip Score(HHS),dislocation,intra-operative fracture,wound compliData were independently selected,extracted and assessed by two reviewers.Network MA and cluster rank and surface under the cumulative ranking curve(SUCRA)were estimated for treatment efficacy and safety.RESULTS Finally,twenty-eight MAs(40 RCTs),and 13 RCTs were retrieved.In total 47 RCTs were included for reanalysis.The results of corrected covered area showed high degree(13.80%).Among 47 RCTs,most of the studies were low risk of bias in part of random process and outcome reporting,while other domains were medium to high risk of bias.DAA significantly provided higher HHS at three months than PA[pooled unstandardized mean difference(USMD):3.49,95%confidence interval(CI):0.98,6.00 with SUCRA:85.9],followed by DSA/SuperPath(USMD:1.57,95%CI:-1.55,4.69 with SUCRA:57.6).All approaches had indifferent dislocation and intraoperative fracture rates.SUCRA comparing early functional outcome and composite complications(dislocation,intra-operative fracture,wound complication,and nerve injury)found DAA was the best approach followed by DSA/SuperPath.CONCLUSION DSA/SuperPath had better earlier functional outcome than PA,but still could not overcome the result of DAA.This technique might be the other preferred option with acceptable complications.
基金supported by the National Science and TechnologyMajor Project,China(No.J2019-IV-0014-0082)the National Key Research and Development Program of China(No.2022YFB4600700)+1 种基金the National Overseas Youth Talents Program,China,the Research Fund of State Key Laboratory of Mechanics and Control for Aerospace Structures,China(No.MCMS-I-0422K01)a project funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions,China.
文摘Sintering,a well-established technique in powder metallurgy,plays a critical role in the processing of high melting point materials.A comprehensive understanding of structural changes during the sintering process is essential for effective product assessment.The phase-field method stands out for its unique ability to simulate these structural transformations.Despite its widespread application,there is a notable absence of literature reviews focused on its usage in sintering simulations.Therefore,this paper addresses this gap by reviewing the latest advancements in phase-field sintering models,covering approaches based on energy,grand potential,and entropy increase.The characteristics of various models are extensively discussed,with a specific emphasis on energy-based models incorporating considerations such as interface energy anisotropy,tensor-form diffusion mechanisms,and various forms of rigid particle motion during sintering.Furthermore,the paper offers a concise summary of phase-field sintering models that integrate with other physical fields,including stress/strain fields,viscous flow,temperature field,and external electric fields.In conclusion,the paper provides a succinct overview of the entire content and delineates potential avenues for future research.
基金Project supported by the National Natural Science Foundation of China (Grant Nos.U2230401,U1930401,and 12004048)the National Key Research and Development Program of China (Grant No.2021YFB3501503)+1 种基金the Science Challenge Project (Grant No.TZ2018002)the Foundation of LCP。
文摘Hydride precipitation in zirconium cladding materials can damage their integrity and durability.Service temperature and material defects have a significant effect on the dynamic growth of hydrides.In this study,we have developed a phasefield model based on the assumption of elastic behaviour within a specific temperature range(613 K-653 K).This model allows us to study the influence of temperature and interfacial effects on the morphology,stress,and average growth rate of zirconium hydride.The results suggest that changes in temperature and interfacial energy influence the length-to-thickness ratio and average growth rate of the hydride morphology.The ultimate determinant of hydride orientation is the loss of interfacial coherency,primarily induced by interfacial dislocation defects and quantifiable by the mismatch degree q.An escalation in interfacial coherency loss leads to a transition of hydride growth from horizontal to vertical,accompanied by the onset of redirection behaviour.Interestingly,redirection occurs at a critical mismatch level,denoted as qc,and remains unaffected by variations in temperature and interfacial energy.However,this redirection leads to an increase in the maximum stress,which may influence the direction of hydride crack propagation.This research highlights the importance of interfacial coherency and provides valuable insights into the morphology and growth kinetics of hydrides in zirconium alloys.
基金Project supported by the National Natural Science Foundation of China(No.42202314)。
文摘A novel phase-field model for the propagation of mixed-mode hydraulic fractures,characterized by the formation of mixed-mode fractures due to the interactions between fluids and solids,is proposed.In this model,the driving force for the phase field consists of both tensile and shear components,with the fluid contribution primarily manifesting in the tension driving force.The displacement and pressure are solved simultaneously by an implicit method.The numerical solution's iterative format is established by the finite element discretization and Newton-Raphson(NR)iterative methods.The correctness of the model is verified through the uniaxial compression physical experiments on fluid-pressurized rocks,and the limitations of the hydraulic fracture expansion phase-field model,which only considers mode I fractures,are revealed.In addition,the influence of matrix mode II fracture toughness value,natural fracture mode II toughness value,and fracturing fluid injection rate on the hydraulic fracture propagation in porous media with natural fractures is studied.
基金the National Key Research and De-velopment Program of China(Grant No.2021YFB3502600)Shenzhen Science and Technology Program(Grant No.JCYJ20220530161813029).
文摘The effect of undercooling DT and the interface energy anisotropy parameter e4 on the shape of the equiaxed dendritic tip has been investigated by using a quantitative phase-field model for solidification of binary alloys.It was found that the tip radius r increases and the tip shape amplitude coefficient A4 decreases with the increase of the fitting range for all cases.The dendrite tip shape selection parameter sdecreases and then stabilizes with the increase of the fitting range,and sincreases with the increase of e4.The relationship between sand e4 follows a power-law function sµea 4,and a is independent of DT but dependent on the fitting range.Numerical results demonstrate that the predicted sis consistent with the curve of microscopic solvability theory(MST)for e4<0.02,and sobtained from our phase-field simulations is sensitive to the undercooling when e4 is fixed.
基金Project supported by the National Natural Science Foundation of China(Nos.12072297 and12202370)the Natural Science Foundation of Sichuan Province of China(No.24NSFSC4777)。
文摘Failure analyses of piezoelectric structures and devices are of engineering and scientific significance.In this paper,a fourth-order phase-field fracture model for piezoelectric solids is developed based on the Hamilton principle.Three typical electric boundary conditions are involved in the present model to characterize the fracture behaviors in various physical situations.A staggered algorithm is used to simulate the crack propagation.The polynomial splines over hierarchical T-meshes(PHT-splines)are adopted as the basis function,which owns the C1continuity.Systematic numerical simulations are performed to study the influence of the electric boundary conditions and the applied electric field on the fracture behaviors of piezoelectric materials.The electric boundary conditions may influence crack paths and fracture loads significantly.The present research may be helpful for the reliability evaluation of the piezoelectric structure in the future applications.
基金supported by the Logistics Support Ministry of China (No.22BJZ41)the Capital's Funds for Health Improvement and Research (No.CFH2024-2-5071)。
文摘OBJECTIVE To assess the feasibility and safety of the minimalistic approach to left atrial appendage occlusion(LAAO) guided by cardiac computed tomography angiography(CCTA).METHODS Ninety consecutive patients who underwent LAAO, with or without CCTA-guided, were matched(1:2). Each step of the LAAO procedure in the computed tomography(CT) guidance group(CT group) was directed by preprocedural CT planning. In the control group, LAAO was performed using the standard method. All patients were followed up for 12 months, and device surveillance was conducted using CCTA.RESULTS A total of 90 patients were included in the analysis, with 30 patients in the CT group and 60 matched patients in the control group. All patients were successfully implanted with Watchman devices. The mean ages for the CT group and the control group were 70.0 ± 9.4 years and 68.4 ± 11.9 years(P = 0.52), respectively. The procedure duration(45.6 ± 10.7 min vs. 58.8 ± 13.0 min,P < 0.001) and hospital stay(7.5 ± 2.4 day vs. 9.6 ± 2.8 day, P = 0.001) in the CT group was significantly shorter compared to the control group. However, the total radiation dose was higher in the CT group compared to the control group(904.9 ± 348.0 m Gy vs.711.9 ± 211.2 m Gy, P = 0.002). There were no significant differences in periprocedural pericardial effusion(3.3% vs. 6.3%, P = 0.8) between the two groups. The rate of postprocedural adverse events(13.3% vs. 18.3%, P = 0.55) were comparable between both groups at 12 months follow-up.CONCLUSIONS CCTA is capable of detailed LAAO procedure planning. Minimalistic LAAO with preprocedural CCTA planning was feasible and safe, with shortened procedure time and acceptable increased radiation and contras consumption. For patients with contraindications to general anesthesia and/or transesophageal echocardiography, this promising method may be an alternative to conventional LAAO.
文摘Understanding the probabilistic nature of brittle materials due to inherent dispersions in their mechanical properties is important to assess their reliability and safety for sensitive engineering applications.This is all the more important when elements composed of brittle materials are exposed to dynamic environments,resulting in catastrophic fatigue failures.The authors propose the application of a non-intrusive polynomial chaos expansion method for probabilistic studies on brittle materials undergoing fatigue fracture when geometrical parameters and material properties are random independent variables.Understanding the probabilistic nature of fatigue fracture in brittle materials is crucial for ensuring the reliability and safety of engineering structures subjected to cyclic loading.Crack growth is modelled using a phase-field approach within a finite element framework.For modelling fatigue,fracture resistance is progressively degraded by modifying the regularised free energy functional using a fatigue degradation function.Number of cycles to failure is treated as the dependent variable of interest and is estimated within acceptable limits due to the randomness in independent properties.Multiple 2D benchmark problems are solved to demonstrate the ability of this approach to predict the dependent variable responses with significantly fewer simulations than the Monte Carlo method.This proposed approach can accurately predict results typically obtained through 105 or more runs in Monte Carlo simulations with a reduction of up to three orders of magnitude in required runs.The independent random variables’sensitivity to the system response is determined using Sobol’indices.The proposed approach has low computational overhead and can be useful for computationally intensive problems requiring rapid decision-making in sensitive applications like aerospace,nuclear and biomedical engineering.The technique does not require reformulating existing finite element code and can perform the stochastic study by direct pre/post-processing.
基金This work was supported by the National Natural Science Foundation of China(Grant Nos.12175212,11991071,12004353,11975214,and 11905202)the National Key R&D Program of China(Grant No.2022YFA1603300)+1 种基金the Science Challenge Project(Project No.TZ2018005)the Sciences and Technology on Plasma Physics Laboratory at CAEP(Grant No.6142A04200103).
文摘High-energy gamma-ray radiography has exceptional penetration ability and has become an indispensable nondestructive testing(NDT)tool in various fields.For high-energy photons,point projection radiography is almost the only feasible imaging method,and its spatial resolution is primarily constrained by the size of the gamma-ray source.In conventional industrial applications,gamma-ray sources are commonly based on electron beams driven by accelerators,utilizing the process of bremsstrahlung radiation.The size of the gamma-ray source is dependent on the dimensional characteristics of the electron beam.Extensive research has been conducted on various advanced accelerator technologies that have the potential to greatly improve spatial resolution in NDT.In our investigation of laser-driven gamma-ray sources,a spatial resolution of about 90μm is achieved when the areal density of the penetrated object is 120 g/cm^(2).A virtual source approach is proposed to optimize the size of the gamma-ray source used for imaging,with the aim of maximizing spatial resolution.In this virtual source approach,the gamma ray can be considered as being emitted from a virtual source within the convertor,where the equivalent gamma-ray source size in imaging is much smaller than the actual emission area.On the basis of Monte Carlo simulations,we derive a set of evaluation formulas for virtual source scale and gamma-ray emission angle.Under optimal conditions,the virtual source size can be as small as 15μm,which can significantly improve the spatial resolution of high-penetration imaging to less than 50μm.
文摘We read and discussed the study entitled“Complication rates after direct anterior vs posterior approach for Hip Hemiarthroplasty in elderly individuals with femoral neck fractures”with great interest.The authors have done justice to the topic of comparison of anterior and posterior surgical approaches for bipolar hemiarthroplasty which has been an everlasting debate in the existing literature.However,there are certain aspects of this study that need clarification from the authors.
文摘The differences in complication rates between the direct anterior and posterior approaches for hemiarthroplasty in elderly patients with femoral neck fractures are not yet fully understood.Dislocation,a severe complication associated with increased mortality and often requiring additional surgery,may occur less frequently with the direct anterior approach compared to the posterior approach.Careful consideration of patient demographics is essential when planning the surgical approach.Future research in this area should focus on robust randomized controlled trials involving elderly patients recovering from femoral neck fractures.