Which approach of total hip arthroplasty is the best efficacy and least complication?

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.

Total flavonoids of Astragalus membranaceus protect against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced neurotoxicity in mice by inhibiting ferroptosis through SLC7A11/GPX-4 signaling pathway

Parkinson’s disease(PD)is a common neurodegenerative disorder with no cure.Astragalus membranaceus is used in Chinese culture as a food supplement to boost immunity.The present study aimed to explore the neuroprotective effects of total flavonoids extracted from A.membranaceus(TFA)and their protective mechanisms.TFA offered neuroprotection against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)in the mouse model of Parkinsonism,by improving behavior performance in the gait analysis and pole test,and inhibiting the decline of tyrosine hydroxylase(TH)positive neurons and TH protein expression in substantia nigra of mice.TFA also prevented 1-methyl-4-phenylpyridinium(MPP+)induced neurotoxicity in SHSY5Y cells,by increasing GSH and GSH/GSSG ratio,and reducing reactive oxygen species.In addition,the neuroprotective effects of TFA were associated with its ability to restore MPTP/MPP+induced downregulation of SLC7A11 and glutathione peroxidase 4(GPX-4).In conclusion,we demonstrated that TFA exerted significant neuroprotection against MPTP/MPP+induced neurodegeneration by inhibiting ferroptosis through the regulation of SLC7A11/GPX-4 axis,suggesting the use of TFA as a possible food supplement in the prevention of PD.

Quantification of Total Phenols, Total Flavonoids, Total Anthocyanins and Evaluation of Antioxidant and Antiradical Activities of Detarium Senegalense Extracts from Chad

The aim of the present work is to assess the value of Detarium Senegalense by determining the content of total phenols, total flavonoids and total anthocyanins, and by evaluating the free radical scavenging activity of Detarium Senegalense extracts. For this purpose, sequential extraction using solvents of increasing polarity was essential. The various extracts obtained underwent phytochemical and biochemical analyses. Phytochemical screening revealed the presence of flavonoids, alkaloids, tannins, polyphenols, anthocyanins and steroids/terpenes. Quantitative analysis of total polyphenols, total flavonoids and total anthocyanins yielded the following results: total flavonoids (0.803 ± 0029 mg EQ/100g P for acetone extract of roots and 0.871 ± 0.401 mg EQ/100g P for methanol extract of leaves);total polyphenols (23.298 ± 12.68 mg EAG/100g P for acetone extract of roots and 24.69 ± 0.49 401 mg EAG/100g P for methanol extract of leaves);total monomeric anthocyanins (44.697 ± 0.939 mg EC3G/100g P and 16.699 ± 0.193 mg EC3G/100g P respectively for acetone and methanol extracts of stem bark). DPPH free radical scavenging activity was 1.674 ± 0.023 mg/mL for the acetone extract and 0.934 ± 0.24 mg/mL for the methanol extract of roots. .

Total Electron Content Diurnal and Seasonal Variations and Response to Solar Events at Koudougou Station in Burkina Faso

In this paper, we studied the seasonal behavior of the total electron content (TEC) during a part of solar cycle 24 ascending, maximum and decreasing phases at Koudougou station (Latitude: 12°15'09"N Longitude: 2°21'45"W). Response of TEC to solar recurrent events is presented. The highest values of the TEC in 2014, 2015 and 2016 were recorded on March and October, while in 2013 they were recorded on April and November, corresponding to equinox months. This observation shows that TEC values at the equinoxes are higher than those of solstices. Moreover, the monthly TEC varies in phase with the sunspots number showing a linear dependence of the TEC on solar activity. The ionospheric electron contents are generally very low both before noon and during the night, but quite high at noon and after noon. This pattern of TEC variation is due to the fluctuation of incident solar radiation on the Earth’s equatorial ionosphere. During quiet periods, the number of free electrons generated is lower than that generated during recurrent periods, which shows a positive contribution of recurrent activity to the level of the TEC. Investigations have also highlighted a winter anomaly and equinoctial asymmetry in TEC behavior at Koudougou station.

Total Electron Content during Recurrent and Quiet Geomagnetic Periods at the Koudougou Station in Burkina Faso

In this work, the comparative study of total electron content (TEC) between recurrent and quiet geomagnetic periods of solar cycle 24 at Koudougou station with geographical coordinates 12°15'N;- 2°20'E was addressed. This study aims to analyze how geomagnetic variations influence the behavior of TEC in this specific region. The geomagnetic indices Kp and Dst were used to select quiet and recurrent days. Statistical analysis was used to interpret the graphs. The results show that the mean diurnal TEC has a minimum before dawn (around 0500 UT) and reaches a maximum value around 1400 UT, progressively decreasing after sunset. In comparison, the average diurnal TEC on recurrent days is slightly higher than on quiet days, with an average difference of 7 TECU. This difference increases with the level of geomagnetic disturbance, reaching 21 TECU during a moderate storm. The study also reveals significant monthly variations, with March and October showing the highest TEC values for quiet and recurrent days, respectively. Equinox months show the highest mean values, while solstice months show the lowest. Signatures of semi-annual, winter and equatorial ionization anomalies were observed. When analyzing annual variations, it was found that the TEC variation depends significantly on F10.7 solar flux, explaining up to 98% during recurrent geomagnetic activity and 92% during quiet geomagnetic activity.

Physicochemical and Biochemical Characterization, Total Phenolic and Energy Value from Bulbs of Different Onion (Allium cepa L.) Varieties in Senegal

The purpose of this study is to investigate the physicochemical properties of some local varieties of onion (Allium cepa L.) and compare them with an imported variety, all collected in May 2021. Proteins, reducing sugars, lipids, and polyphenol content were estimated according to the AFNOR standardized methods. The determination of calcium, magnesium, iron, sodium, potassium and phosphorus was performed by atomic absorption spectrophotometer coupled with a CCD detector. The results highlighted an average acidity of 0.377% ± 0.002% lower than the value of the imported variety which is 0.520% ± 0.001%. Local varieties have a pH ranging from 6.35 ± 0.003 to 6.42 ± 0.004, while the variety has a pH of 6.36 ± 0.003. The ash and dry matter contents vary respectively from 4.788% ± 0.004% to 8.253% ± 0.003% and 7.945% ± 0.021% to 11.945% ± 0.007% for the local varieties. Moreover, the imported one has ash and dry matter contents of 5.175% ± 0.007% and 10.035% ± 0.021% respectively. The results show that the protein, reducing sugar and lipid contents in the local onion varieties vary respectively from 2.815 ± 0.000 to 15.634 ± 0.001 g·100 g-1;4.691 ± 0.001 to 12.596 ± 0.002 g·100 g-1 and 0.006 ± 0.001 to 0.050 ± 0.057 g·100 g-1. Furthermore, the imported variety has a protein, reducing sugar and lipid content of 5.649 ± 0.002;8.565 ± 0.002 g·100 g-1 and 0.011 ± 0.010 g·100 g-1 respectively. The maximum levels of total polyphenols are obtained in the imported variety, Bellani and Gandiol, respectively 9.973 ± 0.001, 4.535 ± 0.002, and 3.425 ± 0.006 mg EAG/g of dry matter. The local varieties have a significant calorific intake of between 35.451 ± 0.001 and 112.980 ± 0.003 kcal·100 g-1 compared to the imported one with an energy value of 56.953 ± 0.001 kcal·100 g-1 of dry matter. The bulbs of different onion varieties studied have a fairly high content of mineral elements. The potassium content of local varieties is between 502.16 ± 0.06 mg·100 g-1 and 582.77 ± 0.04 mg·100 g-1 while the imported variety has a content of 536.62 ± 1.30 mg·100 g-1. They note that the local varieties have a better calcium content (249.75 ± 0.07 to 434.20 ± 0.57 mg·100 g-1) and magnesium (142.15 ± 0.07 to 162.60 ± 0.42 mg·100 g-1) than the imported variety (229.58 ± 0.04 mg·100 g-1) except for the varieties White Grano (228.29 ± 0.01 mg·100 g-1) and Rouge Amposta (117.00 ± 0.42 mg·100 g-1) respectively. These results reveal that Gandiol, Dayo and Orient F1 are nutritionally found better due to their higher antioxidant property, proteins, carbohydrates, and reducing sugar and should be included in diets to supplement our daily allowance needed by the body.

Models to Simulate Effective Coverage of Fire Station Based on Real-Time Travel Times

In recent years,frequent fire disasters have led to enormous damage in China.Effective firefighting rescues can minimize the losses caused by fires.During the rescue processes,the travel time of fire trucks can be severely affected by traffic conditions,changing the effective coverage of fire stations.However,it is still challenging to determine the effective coverage of fire stations considering dynamic traffic conditions.This paper addresses this issue by combining the traveling time calculationmodelwith the effective coverage simulationmodel.In addition,it proposes a new index of total effective coverage area(TECA)based on the time-weighted average of the effective coverage area(ECA)to evaluate the urban fire services.It also selects China as the case study to validate the feasibility of the models,a fire station(FS-JX)in Changsha.FS-JX station and its surrounding 9,117 fire risk points are selected as the fire service supply and demand points,respectively.A total of 196 simulation scenarios throughout a consecutiveweek are analyzed.Eventually,1,933,815 sets of valid sample data are obtained.The results showed that the TECA of FS-JX is 3.27 km^(2),which is far below the standard requirement of 7.00 km^(2) due to the traffic conditions.The visualization results showed that three rivers around FS-JX interrupt the continuity of its effective coverage.The proposed method can provide data support to optimize the locations of fire stations by accurately and dynamically determining the effective coverage of fire stations.

Subsequent total joint arthroplasty: Are we learning from the first stage?

BACKGROUND With the increasing incidence of total joint arthroplasty(TJA),there is a desire to reduce peri-operative complications and resource utilization.As degenerative conditions progress in multiple joints,many patients undergo multiple proce-dures.AIM To determine if both physicians and patients learn from the patient’s initial arth-roplasty,resulting in improved outcomes following the second procedure.METHODS The institutional database was retrospectively queried for primary total hip arth-roplasty(THA)and total knee arthroplasty(TKA).Patients with only unilateral THA or TKA,and patients undergoing same-day bilateral TJA,were excluded.Patient demographics,comorbidities,and implant sizes were collected at the time of each procedure and patients were stratified by first vs second surgery.Outcome metrics evaluated included operative time,length of stay(LOS),disposition,90-d readmissions and emergency department(ED)visits.RESULTS A total of 642 patients,including 364 undergoing staged bilateral TKA and 278 undergoing bilateral THA,were analyzed.There was no significant difference in demographics or comorbidities between the first and second procedure,which were separated by a mean of 285 d.For THA and TKA,LOS was significantly less for the second surgery,with 66%of patients having a shorter hospitalization(P<0.001).THA patients had significantly decreased operative time only when the same sized implant was utilized(P=0.025).The vast majority(93.3%)of patients were discharged to the same type of location following their second surgery.However,when a change in disposition was present from the first surgery,patients were significantly more likely to be discharged to home after the second procedure(P=0.033).There was no difference between procedures for post-operative readmissions(P=0.438)or ED visits(P=0.915).CONCLUSION After gaining valuable experience recovering from the initial surgery,a patient’s perioperative outcomes are improved for their second TJA.This may be the result of increased confidence and decreased anxiety,and it supports the theory that enhanced patient education pre-operatively may improve outcomes.For the surgical team,the second procedure of a staged THA is more efficient,although this finding did not hold for TKA.

Potential applications of single-incision laparoscopic totally preperitoneal hernioplasty

BACKGROUND The totally preperitoneal(TPP)approach is a new concept that was recently introduced.Although the TPP approach combined with single-incision laparoscopic hernia repair has its own advantages,there is little evidence reflecting the characteristics and feasibility of either approach.AIM To analyze the potential applications of single-incision laparoscopic TPP(SILTPP)inguinal hernia hernioplasty for the treatment of inguinal hernias.METHODS A total of 152 SIL-TPP surgeries were performed at the First Affiliated Hospital of Ningbo University from February 2019 to November 2022.A single-port,named Iconport,and standard laparoscopic instruments were used during the operation.Demographic data,intraoperative parameters and short-term postoperative outcomes were collected and retrospectively analyzed.RESULTS The demographic data of 152 patients underwent SIL-TPP were shown in Table 1.The average age was 49.5 years(range from 21 to 81 years).The average body mass index was 27.7 kg/m^(2)(range from 17.7 kg/m^(2) to 35.6 kg/m^(2)).SIL-TPP were conducted successfully in 147 patients.Three patients were converted to the SILtransabdominal preperitoneal laparoscopic herniorrhaphy at the initial stage of the study due to a lack of experience.In 2 patients with incisional hernias,an auxiliary operation hole was added during the SIL-TPP procedure,as required for surgery.The mean operative time was 64.5 minutes(range:36.0-110.0 minutes)for unilateral direct and femoral hernias and 81.6 minutes for indirect hernias(range:40.0-150.0 minutes).The mean postoperative hospital stay was 3.4 days.CONCLUSION SIL-TPP is feasible and has advantages for inguinal hernia repair.SIL-TPP has potential benefits for patients with various abdominal wall hernias.Consequently,doctors should be encouraged to actively apply the TPP approach combined with a single incision in their daily work.

Mortality rate after total knee arthroplasty or total hip arthroplasty in patients with a history of liver transplant

In this editorial I comment on the article by Ahmed et al published in a recent issue of the World J Orthop 2023;14:784-790.It is well known that patients who have undergone a liver transplant(LT)may need to have a total hip arthroplasty(THA)or total knee arthroplasty(TKA)implanted.Ahmed et al stated that the mortality rate in these patients was similar to the one of the general population.However,there are three articles previously published that found higher mortality in LT patients who experienced THA/TKA than in the general population(individuals without LT).Therefore,in this Editorial I would like to point out that there is controversy in the literature regarding whether LT patients undergoing THA/TKA have higher mortality than the general population.Therefore,future research should attempt to resolve this controversy.

Comparison efficacy and safety of total laparoscopic gastrectomy and laparoscopically assisted total gastrectomy in treatment of gastric cancer

BACKGROUND The development of laparoscopic technology has provided a new choice for surgery of gastric cancer(GC),but the advantages and disadvantages of laparoscopic total gastrectomy(LTG)and laparoscopic-assisted total gastrectomy(LATG)in treatment effect and safety are still controversial.The purpose of this study is to compare the efficacy and safety of the two methods in the treatment of GC,and to provide a basis for clinical decision-making.AIM To compare the efficacy of totally LTG(TLTG)and LATG in the context of radical gastrectomy for GC.Additionally,we investigated the safety and feasibility of the total laparoscopic esophagojejunostomy technique.METHODS Literature on comparative studies of the above two surgical methods for GC(TLTG group and LATG group)published before September 2022 were searched in the PubMed,Web of Science,Wanfang Database,CNKI,and other Chinese and English databases.In addition,the following search keywords were used:Gastric cancer,total gastrectomy,total laparoscopy,laparoscopy-assisted,esophagojejunal anastomosis,gastric/stomach cancer,total gastrectomy,totally/completely laparoscopic,laparoscopic assisted/laparoscopy assisted/laparoscopically assisted,and esophagojejunostomy/esophagojejunal anastomosis.Review Manager 5.3 software was used for the meta-analysis after two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included studies.RESULTS After layer-by-layer screening,258 pieces of literature were recovered,and 11 of those pieces were eventually included.This resulted in a sample size of 2421 instances,with 1115 cases falling into the TLTG group and 1306 cases into the LATG group.Age or sex differences between the two groups were not statistically significant,according to the meta-analysis,however the average body mass index of the TLTG group was considerably higher than that of the LATG group(P=0.01).Compared with those in the LATG group,the incision length in the TLTG group was significantly shorter(P<0.001),the amount of intraoperative blood loss was significantly lower(P=0.003),the number of lymph nodes removed was significantly greater(P=0.04),and the time of first postoperative feeding and postoperative hospitalization were also significantly shorter(P=0.03 and 0.02,respectively).There were no significant differences in tumor size,length of proximal incisal margin,total operation time,anastomotic time,postoperative pain score,postoperative anal exhaust time,postoperative anastomosis-related complications(including anastomotic fistula,anastomotic stenosis,and anastomotic hemorrhage),or overall postoperative complication rate(P>0.05).CONCLUSION TLTG and esophagojejunostomy are safe and feasible.Compared with LATG,TLTG has the advantages of less trauma,less bleeding,easier access to lymph nodes,and faster postoperative recovery,and TLTG is also suitable for obese patients.

Evaluation of a Wireless Solar Powered Personal Weather Station

We are evaluating dryland cotton production in Martin County, Texas, measuring cotton lint yield per unit of rainfall. Our goal is to collect rainfall data per 250 - 400 ha. Upon selection of a rainfall gauge, we realized that the cost of using, for example, a tipping bucket-type rain gauge would be too expensive and thus searched for an alternative method. We selected an all-in-one commercially available weather station;hereafter, referred to as a Personal Weather Station (PWS) that is both wireless and solar powered. Our objective was to evaluate average measurements of rainfall obtained with the PWS and to compare these to measurements obtained with an automatic weather station (AWS). For this purpose, we installed four PWS deployed within 20 m of the Plant Stress and Water Conservation Meteorological Tower that was used as our AWS, located at USDA-ARS Cropping Systems Research Laboratory, Lubbock, TX. In addition, we measured and compared hourly average values of short-wave irradiance (Rg), air temperature (Tair) and relative humidity (RH), and wind speed (WS), and calculated values of dewpoint temperature (Tdew). This comparison was done over a 242-day period (1 October 2022-31 May 2023) and results indicated that there was no statistical difference in measurements of rainfall between the PWS and AWS. Hourly average values of Rg measured with the PWS and AWS agreed on clear days, but PWS measurements were higher on cloudy days. There was no statistical difference between PWS and AWS hourly average measurements of Tair, RH, and calculated Tdew. Hourly average measurements of Rg and WS were more variable. We concluded that the PWS we selected will provide adequate values of rainfall and other weather variables to meet our goal of evaluating dryland cotton lint yield per unit rainfall.

Longitudinal dependence of the forecast accuracy of the ionospheric total electron content in the equatorial zone

The longitudinal dependence of the behavior of ionospheric parameters has been the subject of a number of works where significant variations are discovered.This also applies to the prediction of the ionospheric total electron content(TEC),which neural network methods have recently been widely used.However,the results are mainly presented for a limited set of meridians.This paper examines the longitudinal dependence of the TEC forecast accuracy in the equatorial zone.In this case,the methods are used that provided the best accuracy on three meridians:European(30°E),Southeastern(110°E)and American(75°W).Results for the stations considered are analyzed as a function of longitude using the Jet Propulsion Laboratory Global Ionosphere Map(JPL GIM)for 2015.These results are for 2 h ahead and 24 h ahead forecast.It was found that in this case,based on the metric values,three groups of architectures can be distinguished.The first group included long short-term memory(LSTM),gated recurrent unit(GRU),and temporal convolutional networks(TCN)models as a part of unidirectional deep learning models;the second group is based on the recurrent models from the first group,which were supplemented with a bidirectional algorithm,increasing the TEC forecasting accuracy by 2-3 times.The third group,which includes the bidirectional TCN architecture(BiTCN),provided the highest accuracy.For this architecture,according to data obtained for 9 equatorial stations,practical independence of the TEC prediction accuracy from longitude was observed under the following metrics(Mean Absolute Error MAE,Root Mean Square Error RMSE,Mean Absolute Percentage Error MAPE):MAE(2 h)is 0.2 TECU approximately;MAE(24 h)is 0.4 TECU approximately;RMSE(2 h)is less than 0.5 TECU except Niue station(RMSE(2 h)is 1 TECU approximately);RMSE(24 h)is in the range of 1.0-1.7 TECU;MAPE(2 h)<1%except Darwin station,MAPE(24 h)<2%.This result was confirmed by data from additional 5 stations that formed latitudinal chains in the equatorial part of the three meridians.The complete correspondence of the observational and predicted TEC values is illustrated using several stations for disturbed conditions on December 19-22,2015,which included the strongest magnetic storm in the second half of the year(min Dst=-155 nT).

Strategic Placement of Charging Stations for Enhanced Electric Vehicle Adoption in San Diego, California

California mandated that 100% of vehicles sold must be electric by 2035. As electric vehicles (EVs) reach a higher penetration of the car sector, cities will need to provide publicly accessible charging stations to meet the charging demand of people who do not have access to a private charging spot like a personal garage. We have chosen to limit our scope to San Diego County due to its non-trivial size, well-defined shape, and dependence on personal vehicles;this project models 100% of current vehicles as electric, roughly 2.5 million. By planning for the future, our model becomes more useful as well as more equitable. We anticipate that our model will find locations that can service multiple population centers, while also maximizing distance to other stations. Sensitivity analysis and testing of our algorithms are conducted for Coronado Island, an island with 24,697 residents. Our formulation is then scaled to set the parameters for the whole county.

A guidance strategy for rendezvous and docking to the space station in the Earth-Moon NRHO orbit

With the development of space technology,it is possible to build a space station in Earth-Moon space as a transit for Earth-Moon round-trip and entering in the deep space.Rendezvous and docking is one of the key technologies for building an Earth-Moon space station.A guidance strategy for rendezvous and docking from the Earth orbit to the space station in the Earth-Moon NRHO orbit is proposed in this paper,which is suitable for engineering applications.Firstly,the rendezvous and docking process is divided into three sections,i.e.,the large-range orbit transfer section,far-range guidance section,and close-range approaching section.The suitable terminal of large-range orbit transfer is selected according to the eigenvalue of NRHO orbit state transition matrix.The two-impulse guidance method based on the relative motion equation in the three-body problem is adopted for the far-range guidance section.The impulse time and amplitude are solved with the optimization algorithm.The linear constant three-body relative motion equation is proposed for the close-range approaching section,and the rendezvous and docking is completed by a two-stage linear approximation.Finally,a simulation analysis is carried out,and the simulation results show that the adopted dynamics equations and the designed guidance law are effective,and the three flight phases are naturally connected to accomplish the rendezvous and docking mission from the Earth orbit to the space station on the Earth-Moon NRHO.

The Increase in Total Knee Replacement Surgery in China: A 10-Year Real-World Study

Total knee arthroplasty (TKR) is the most common and costly surgical procedure performed, and it is considered one of the most successful clinical interventions for patients suffering from severe knee osteoarthritis (OA). The incidence of TKR, including demographics, incidence rates, lengths of hospital stay, and costs, was estimated from 2010 to 2019 by analyzing data extracted from the Joint Surgery Department in our hospital, which included a total of 6770 patients. We calculated the TKR risk ratios to compare the rate of TKR between different covariables such as gender, age group, and primary diagnoses. The annual volume of TKR increased by fivefold (5.14%), with a higher incidence observed in the 60 to 69 age group constituting approximately 36% of cases. There has also been an increase in incidence among young people (<50), which now stands at 6.2%. The rate ratio (RR) per female vs. male was found to be 3.0 and the RR of OA vs. RA was 0.09. The mean average length of stay (ALOS) in the hospital decreased from 15 to just 5 days during this period. Additionally, the adjusted mean cost per patient increased significantly from ¥ 38261 ± 3630.63 to ¥ 53115.17 ± 2831.35. The majority of TKR recipients were over 60 years old with osteoarthritis being identified as the main causative agent. It is worth noting that women are more susceptible to knee arthritis and there is a concerning shift toward younger individuals being affected by this disease. Our results indicate a rise in in-hospital costs alongside a significant decline in hospital ALOS for TKR procedures. We predict an unprecedented rise in TKR incidence in the coming years due to population aging and improving economic conditions in China.

A Multi-Objective Optimization for Locating Maintenance Stations and Operator Dispatching of Corrective Maintenance

In this study,we introduce a novel multi-objective optimization model tailored for modern manufacturing,aiming to mitigate the cost impacts of operational disruptions through optimized corrective maintenance.Central to our approach is the strategic placement of maintenance stations and the efficient allocation of personnel,addressing a crucial gap in the integration of maintenance personnel dispatching and station selection.Our model uniquely combines the spatial distribution of machinery with the expertise of operators to achieve a harmonious balance between maintenance efficiency and cost-effectiveness.The core of our methodology is the NSGA Ⅲ+Dispatch,an advanced adaptation of the Non-Dominated Sorting Genetic Algorithm Ⅲ(NSGA-Ⅲ),meticulously designed for the selection of maintenance stations and effective operator dispatching.This method integrates a comprehensive coding process,crossover operator,and mutation operator to efficiently manage multiple objectives.Rigorous empirical testing,including a detailed analysis from a taiwan region electronic equipment manufacturer,validated the effectiveness of our approach across various scenarios of machine failure frequencies and operator configurations.The findings reveal that the proposed model significantly outperforms current practices by reducing response times by up to 23%in low-frequency and 28.23%in high-frequency machine failure scenarios,leading to notable improvements in efficiency and cost reduction.Additionally,it demonstrates significant improvements in oper-ational efficiency,particularly in selective high-frequency failure contexts,while ensuring substantial manpower cost savings without compromising on operational effectiveness.This research significantly advances maintenance strategies in production environments,providing the manufacturing industry with practical,optimized solutions for diverse machine malfunction situations.Furthermore,the methodologies and principles developed in this study have potential applications in various other sectors,including healthcare,transportation,and energy,where maintenance efficiency and resource optimization are equally critical.

Simulation of Underground Reservoir Stability of Pumped Storage Power Station Based on Fluid-Structure Coupling

Based on global initiatives such as the clean energy transition and the development of renewable energy,the pumped storage power station has become a new and significant way of energy storage and regulation,and its construction environment is more complex than that of a traditional reservoir.In particular,the stability of the rock strata in the underground reservoirs is affected by the seepage pressure and rock stress,which presents some challenges in achieving engineering safety and stability.Using the advantages of the numerical simulation method in dealing deal with nonlinear problems in engineering stability,in this study,the stability of the underground reservoir of the Shidangshan(SDS)pumped storage power station was numerically calculated and quantitatively analyzed based on fluid-structure coupling theory,providing an important reference for the safe operation and management of the underground reservoir.First,using the COMSOL software,a suitablemechanicalmodel was created in accordance with the geological structure and project characteristics of the underground reservoir.Next,the characteristics of the stress field,displacement field,and seepage field after excavation of the underground reservoir were simulated in light of the seepage effect of groundwater on the nearby rock of the underground reservoir.Finally,based on the construction specifications and Molar-Coulomb criterion,a thorough evaluation of the stability of the underground reservoir was performed through simulation of the filling and discharge conditions and anti-seepage strengthening measures.The findings demonstrate that the numerical simulation results have a certain level of reliability and are in accordance with the stress measured in the project area.The underground reservoir excavation resulted in a maximum displacement value of the rock mass around the caverns of 3.56 mm in a typical section,and the safety coefficient of the parts,as determined using the Molar-Coulomb criterion,was higher than 1,indicating that the project as a whole is in a stable state.

Multimodel Ensemble Forecast of Global Horizontal Irradiance at PV Power Stations Based on Dynamic Variable Weight

In the present study,multimodel ensemble forecast experiments of the global horizontal irradiance(GHI)were conducted using the dynamic variable weight technique.The study was based on the forecasts of four numerical models,namely,the China Meteorological Administration Wind Energy and Solar Energy Prediction System,the Mesoscale Weather Numerical Prediction System of China Meteorological Administration,the China Meteorological Administration Regional Mesoscale Numerical Prediction System-Guangdong,and the Weather Research and Forecasting Model-Solar,and observational data from four photovoltaic(PV)power stations in Yangjiang City,Guangdong Province.The results show that compared with those of the monthly optimal numerical model forecasts,the dynamic variable weight-based ensemble forecasts exhibited 0.97%-15.96%smaller values of the mean absolute error and 3.31%-18.40%lower values of the root mean square error(RMSE).However,the increase in the correlation coefficient was not obvious.Specifically,the multimodel ensemble mainly improved the performance of GHI forecasts below 700 W m-2,particularly below 400 W m-2,with RMSE reductions as high as 7.56%-28.28%.In contrast,the RMSE increased at GHI levels above 700 W m-2.As for the key period of PV power station output(02:00-07:00),the accuracy of GHI forecasts could be improved by the multimodel ensemble:the multimodel ensemble could effectively decrease the daily maximum absolute error(AE max)of GHI forecasts.Moreover,with increasing forecasting difficulty under cloudy conditions,the multimodel ensemble,which yields data closer to the actual observations,could simulate GHI fluctuations more accurately.

Primary Total Hip Arthroplasty on Complex Hips Conditions in a Low-Resource Setting

Introduction: Total hip arthroplasty of complex morphology is a challenge for the orthopaedic surgeon. Careful analysis of the hip’s anatomy helps to unravel the difficulties and anticipate the procedures to be performed and the implants to be planned. The aim was to identify the types of hip that make first-line THR difficult, specify the technical procedures to be used on these sites, and assess the functional results of the series. Material and Methods: This was a retrospective study that concerned patients operated on for total hip arthroplasty between January 2015 and December 2022 at the medical center “La Grâce” in Bobo-Dioulasso, Burkina Faso. Patients with coxarthrosis (on hip dysplasia, acetabular protrusio, acetabular malunion or neurological hip) and those with ankylosis of the hip, osteonecrosis secondary to neglected dislocation of the hip or hemoglobinopathy were included. Results: A total of 31 total hip replacements were performed in 30 patients. The mean age of patients at the surgery time was 36.2 years with extremes of 17 and 61 years. The male-to-female sex ratio was 1. The main indications for THA were the dysplasic hip osteoarthritis (11 cases) and the neglected hip dislocations (7 cases). In situ femoral neck osteotomy before hip dislocation was performed in seven cases. The acetabulum reconstruction techniques varied from the structural iliac bone graft (n = 3) and cancellous bone graft (n = 4) to the Kerboull plate (n = 1). After 45 months of mean follow-up, all hips were evaluated. The mean PMA score increased from 7.1 [4 - 8] before the surgery to 13.2 [13 - 17]. Conclusion: The large spectrum of challenges in complex hip management requires effective preoperative planning. Preoperative planning minimizes complications and ensures a better outcome.