The electric vehicle industry has witnessed significant growth in recent years, prompting heightened research interest in its various components. The suspension system, serving as a critical ...power-transmitting device between the frame and the axle, has garnered particular focus. This system is pivotal in meeting the dual performance objectives of ensuring driving smoothness and enhancing maneuvering stability. Accordingly, this study investigates the structural types of suspension systems and advances the design of a suspension guiding mechanism specifically tailored for electric vehicles. At the same time, the dynamic model of active suspension is constructed, and the algorithm for optimizing and establishing the active suspension system for electric vehicles is used. The simulation experiments on the suspension system, the control optimization method of the system in this paper’s car body spring loaded mass acceleration response, dynamic deflection ring, and the control input are stable between -0.4~0.5m/s², -0.005~0.01m and the suspension system’s between -0.7~0.6N, respectively. Moreover, the car body displacement and speed are gradually stabilized at about ±0 compared to the motion speed. In this paper, the suspension system can effectively solve the problem of automobile damping control and reduce the impact suffered by the body so as to improve the smoothness of the body in the process of driving and the operation of the stability of the new for the development and improvement of the suspension system in the electric vehicle industry to provide a reliable method.
Study design
A meta-analysis.
Background
Hip fracture (HF), as common geriatric fracture, is related to increased disability and mortality. Preoperative deep vein thrombosis (DVT) is one of the most ...common complications in patients with hip fractures, affecting 8–34.9% of hip fracture patients. The study aimed to assess the risk factors of preoperative DVT after hip fractures by meta-analysis.
Methods
An extensive search of the literature was performed in the English databases of PubMed, Embase, and the Cochrane Library; and the Chinese databases of CNKI and WAN FANG. We collected possible predictors of preoperative DVT from included studies, and data analysis was conducted with RevMan 5.3 and STATA 12.0.
Results
A total of 26 English articles were included, and the rate of DVT was 16.6% (1627 of 9823 patients) in our study. Our findings showed that advanced age
p
= 0.0003, OR = 0.13 95% CI (0.06, 0.21), female patients
p
= 0.0009, OR = 0.82 95% CI (0.72, 0.92), high-energy injury
p
= 0.009, OR = 0.58 95% CI (0.38, 0.87), prolonged time from injury to admission
p
< 0.00001, OR = 0.54 95% CI (0.44, 0.65), prolonged time from injury to surgery
p
< 0.00001, OR = 2.06, 95% CI (1.40, 2.72), hemoglobin
p
< 0.00001, OR = − 0.32 95% CI (− 0.43, − 0.21), coronary heart disease
p
= 0.006, OR = 1.25 95% CI (1.07, 1.47), dementia
p
= 0.02, OR = 1.72 95% CI (1.1, 2.67), liver and kidney diseases
p
= 0.02, OR = 1.91 95% CI (1.12, 3.25), pulmonary disease
p
= 0.02, OR = 1.55 95% CI (1.07, 2.23), smoking
p
= 0.007, OR = 1.45 95% CI (1.11, 1.89), fibrinogen
p
= 0.0005, OR = 0.20 95% CI (0.09, 0.32), anti-platelet drug p = 0.01, OR = 0.51 95% CI (0.30, 0.85), C-reactive protein
p
= 0.02, OR = 5.95 95% CI (1.04, 10.85), < 35 g/l albumin
p
= 0.006, OR = 1.42 95% CI (1.1, 1.82), and thrombosis history
p
< 0.00001, OR = 5.28 95% CI (2.85, 9.78) were risk factors for preoperative DVT.
Conclusions
Many factors, including advanced age, female patients, high-energy injury, prolonged time from injury to admission, prolonged time from injury to surgery, patients with a history of coronary heart disease, dementia, liver and kidney diseases, pulmonary disease, smoking, and thrombosis, fibrinogen, C-reactive protein, and < 35 g/l albumin, were found to be associated with preoperative DVT. Our findings suggested that the patient with above characteristics might have preoperative DVT.
Level of evidence:
Level III.
Blockchain technology is a promising resource management architecture due to its ability of building trust in a decentralized transaction. Block mining participants, i.e. miners, are incentivized ...with reward for successfully mining blocks. Unfortunately, solving the proof-of-work puzzle consumes substantial computing powers during the mining period, which greatly challenges miners. Mobile devices also fail to participate in mining because of limited resource. To solve these issues, we are motivated to propose a mining framework of alleviating miner's computation-intensive mining burdens, as well as enabling mobile devices' participation. Depending on the proposed model, miners are capable of offloading their computation-intensive tasks to the edge cloud and mobile devices. The interactions among them formulate a muti-leader multi-follower Stackelberg game. We achieve the Subgame Perfect Equilibrium (SPE) in the game, which guarantees three types of participants to realize profit maximization. Simulation results demonstrate the effectiveness of the proposed model.
miRNAs typically downregulate the expression of target genes by binding to their 3'UTR, and dysregulation of miRNAs may contribute to tumorigenesis. Here, we found that miR-346 and miR-138 ...competitively bind to a common region in the 3'UTR of hTERT mRNA and have opposite effects on the expression and function of hTERT in human cervical cancer cells. Furthermore, G-rich RNA sequence binding factor 1 (GRSF1) mediates the miR-346-dependent upregulation of hTERT by binding to the miR-346 middle sequence motif (CCGCAU) which forms a "bulge loop" when miR-346 is bound to the hTERT 3'UTR, facilitating the recruitment of hTERT mRNA to ribosomes to promote translation in an AGO2-independent manner. Conversely, miR-138 suppresses hTERT expression in an AGO2-dependent manner. Interestingly, replacement of the miR-138 middle sequence with that of miR-346 results in an upregulation of hTERT expression in a GRSF1-dependent manner. Moreover, miR-346 depends on GRSF1 to upregulate another target gene, activin A receptor, type IIB (ACVR2B), in which miR-346 "CCGCAU" motif is essential. These findings reveal novel mechanisms of miRNA-mediated upregulation of target gene expression and describe the coordinated action of multiple miRNAs to control the fate of a single target mRNA through binding to its 3'UTR.
Although the incidence of bloodstream infection (BSI) during pregnancy is relatively low, it can lead to unfavorable outcomes. The aim of our study was to analyze the clinical and microbiological ...characteristics of maternal bacteremia and to assess maternal and fetal outcomes.
Our study was a retrospective study conducted in a tertiary women and children's hospital in Guangzhou, China, from 2013 to 2022. Data were extracted from medical records and the laboratory information system. The participants were divided into groups, and the difference between the groups was analyzed.
The incidence of maternal BSI during the 10 years study period was 10.2 cases/10,000 maternities, with a peak found from 2014 to 2016.
(48%) was the predominant causative pathogen, followed by
(13%). Gestational diabetes mellitus (GDM) (15%) was the most common underlying condition among maternal BSI episodes. Urinary tract (13%) and genital tract (28%) were the predominant source of BSI. About 14% of neonates were infected, and BSI was the most common type of infection.
was the predominant pathogen in mother-neonate pairs with concurrent BSI. Premature rupture of membranes (PROM, OR:4.68) and preterm birth (OR:3.98) were the risk factors predicting neonatal infection. More than 85% of the
were resistant to ampicillin (AMP) and 50% of the
were extended-spectrum β-lactamase (ESBL)-producing bacteria.
Maternal BSI is a rare event, but continuous monitoring on the aspects of pathogen composition, antimicrobial resistance characteristics, and risk factors for adverse outcomes remains necessary to further reduce poor outcomes and mitigate bacterial resistance.
Abstract
Background
Due to concomitant factors like frailty and comorbidity, super elderly (≥90 years) patients with hip fracture differ from patients aged 65–89 years in perioperative complications ...and mortality. The integrated management bundle referred to bundled application of multiple clinical measures. The aim of this study was to analyze effect of integrated management bundle on 1-year overall survival and perioperative outcomes in super elderly patients with hip fracture, with multidisciplinary management group serving as the control group.
Methods
In this retrospective cohort study, super elderly patients with hip fracture were included from Jan 2017 to Nov 2020. Patients were retrospectively divided to multidisciplinary management group and integrated management bundle group. The primary outcome was 1- year overall survival, and the secondary outcome was perioperative outcomes. Kaplan-Meier methods was used to compare survival probability. Multivariable Cox’s modeling was used to explain the effect of integrated bundle on 1-year overall survival adjusted for confounders. The perioperative outcomes including complications and in-hospital data of two groups were compared. The multivariable logistic regression was used to explain the effect of integrated bundle on the occurrence of perioperative complications adjusted for confounders. Prognostic factors related to survival was identified by multivariable Cox’s regression analysis.
Results
Ninety-seven patients comprised multidisciplinary management group, and 83 comprised integrated management bundle group. The Kaplan–Meier plots showed that the survival probability of integrated management bundle group was significantly better than multidisciplinary management group (HR:0.435, 95%CI:0.207–0.914,
P
= 0.039). Multivariable analysis after adjustment for confounders showed a 42.8% lower incidence of mortality integrated management bundle group than multidisciplinary management group (HR:0.428, 95%CI:0.186–0.986,
P
= 0.046). Incidence of hypoproteinemia, and electrolyte disturbance in integrated management bundle group was significantly lower than multidisciplinary management group (all
P
< 0.05). In addition, significant reduction was observed in length of stay (
P
< 0.05) in integrated management bundle group. Multivariable logistic regression showed integrated management bundle was independent protective factor of hypoproteinemia, and electrolyte disturbance. mECM score ≥ 6 and ASA score > 2 were independent risk factors of overall survival (HR: 1.940, 95%CI: 1.067–3.525,
P
= 0.030; HR: 2.281, 95%CI: 1.113–4.678,
P
= 0.024).
Conclusions
The integrated management bundle improved 1-year overall survival and played positive effects in improving perioperative outcomes. It might be a more suitable management modality for super elderly patients with hip fracture.
The objective of this study was to identify the risk factors for admission deep venous thrombosis (aDVT) and proximal aDVT in nonagenarians and centenarians with intertrochanteric fracture (IF).
We ...collected statistics on nonagenarians and centenarians with IF admitting from January 2010 to October 2022. Patients with aDVT were considered as the aDVT group and those without aDVT as the non-aDVT group. Additionally, we also conducted a subgroup analysis based on the location of aDVT to investigate the predictors of proximal aDVT. The demographics, comorbidities and admission laboratory examinations of patients were computed by univariate analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analysis.
In our study, the rate of aDVT (109 of 318) was 34.3%, and 5.7% (18 of 318) of patients had proximal aDVT. Logistic regression analysis showed that female patients and a high level of D-dimer were risk factors for aDVT. Similarly, hypoproteinemia and a high level of D-dimer were found to be risk factors for proximal aDVT. ROC curve analysis indicated the cut-off values of D-dimer to predict the aDVT and proximal aDVT were 1.28 mg/L and 1.485 mg/L, respectively.
Our findings investigated the risk factors of aDVT and proximal aDVT in nonagenarians and centenarians with IF and identified the cut-off values of D-dimer, helping us assess the risk of aDVT and proximal aDVT to manage early targeted interventions.
Study Design
A meta-analysis
Introduction
To perform a meta-analysis to explore the risk factors of perioperative hidden blood loss (HBL) in the treatment of intertrochanteric fracture for Chinese ...patients.
Significance
An extensive search of the literature was performed in the English databases of PubMed, Embase, and Cochrane Library and the Chinese databases of CNKI and WAN FANG (up to July 2021). We collected factors including demographic data and surgical factors. Data analysis was conducted with RevMan 5.3 and STATA 12.0.
Results
Finally, we collected 7 studies including 1377 patients in the final analysis. In our study, female patients (P <.00001), hypertension (P =.008), time from injury to operation (<2 days, P =.02), operation time (≥60 mins, P =.001), fracture type (A2.2 to A3.3, P <.00001), and without anticoagulation (P <.00001) were found to be associated with perioperative HBL in Chinese patients receiving the treatment of the intertrochanteric fracture. However, anesthesia, ASA classification, and body mass index were not associated with perioperative HBL.
Conclusions
In our study, female patients, hypertension, time from injury to operation (<2 days), operation time (≥60 mins), fracture type (A2.2 to A3.3), and without anticoagulation were related to increased risks of perioperative HBL in Chinese patients receiving the treatment for the intertrochanteric fracture. We hope this article can guide for surgeons to reduce perioperative HBL as far as possible in the treatment of intertrochanteric fracture.
Surgical site infection (SSI) is one of the most common complications of orthopedic surgery, which can result in fever, pain, and even life-threatening sepsis. This study aimed to determine the ...predictors of SSI after fasciotomy in patients with acute leg compartment syndrome (ALCS).
We collected information on 125 ALCS patients who underwent fasciotomy in two hospitals between November 2013 and January 2021. Patients with SSI were considered as the SSI group and those without SSI as the non-SSI group. Univariate analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analyses were used to evaluate patient demographics, comorbidities, and admission laboratory examinations.
In our research, the rate of SSI (26 of 125) was 20.8%. Several predictors of SSI were found using univariate analysis, including body mass index (BMI) (p = 0.001), patients with open fractures (p = 0.003), and patients with a history of smoking (p = 0.004). Besides, the levels of neutrophil (p = 0.022), glucose (p = 0.041), globulin (p = 0.010), and total carbon dioxide were higher in the SSI group than in the non-SSI group. According to the results of the logistic regression analysis, patients with open fractures (p = 0.023, OR 3.714), patients with a history of smoking (p = 0.010, OR 4.185), and patients with a higher BMI (p = 0.014, OR 1.209) were related predictors of SSI. Furthermore, ROC curve analysis indicated 24.69 kg/m
as the cut-off value of BMI to predict SSI.
Our results revealed open fractures, BMI, and smoking history as independent risk factors for SSI following fasciotomy in patients with ALCS and determined the cut-off value of BMI, enabling us to individualize the evaluation of the risk for SSI to implement early targeted treatments.
Indoor air pollution resulting from volatile organic compounds (VOCs), especially formaldehyde, is a significant health concern needed to predict indoor formaldehyde concentration (C
f
) in green ...intelligent building design. This study develops a thermal and wet coupling calculation model of porous fabric to account for the migration of formaldehyde molecules in indoor air and cotton, silk, and polyester fabric with heat flux in Harbin, Beijing, Xi’an, Shanghai, Guangzhou, and Kunming, China. The time-by-time indoor dry-bulb temperature (
T
), relative humidity (
RH
), and C
f
, obtained from verified simulations, were collated and used as input data for the long short-term memory (LSTM) of the deep learning model that predicts indoor multivariate time series C
f
from the secondary source effects of indoor fabrics (adsorption and release of formaldehyde). The trained LSTM model can be used to predict multivariate time series Cf at other emission times and locations. The LSTM-based model also predicted C
f
with mean absolute percentage error (MAPE), symmetric mean absolute percentage error (SMAPE), mean absolute error (MAE), mean square error (MSE), and root mean square error (RMSE) that fell within 10%, 10%, 0.5, 0.5, and 0.8, respectively. In addition, the characteristics of the input dataset, model parameters, the prediction accuracy of different indoor fabrics, and the uncertainty of the data set are analyzed. The results show that the prediction accuracy of single data set input is higher than that of temperature and humidity input, and the prediction accuracy of LSTM is better than recurrent neural network (RNN). The method’s feasibility was established, and the study provides theoretical support for guiding indoor air pollution control measures and ensuring human health and safety.
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