Background
The purpose of this study was to evaluate the optimal timing and measures of the sinus tarsi approach for calcaneus fractures to avoid iatrogenic injury of the sural nerve and to assess ...for wound complications.
Methods:
A case series of 53 patients with calcaneus fractures treated by a single surgeon with the sinus tarsi approach was retrospectively analyzed. On the basis of the delay time from injury to surgery, patients were classified into 4 groups: immediate (0–3 days), early (4–6 days), intermediate (7–14 days), and late (14–18 days). All patients were followed for at least 1 year to observe wound conditions. The rate of wound complications and iatrogenic sural nerve injury was described. Incisions were classified into 2 groups: group A included patients with incisions extending posterior to the lateral malleolus, and group B included patients with incisions confined anterior to the lateral malleolus. The rates of nerve injury were compared between both groups. Forty-three patients with 52 Sanders type II fractures were included.
Results:
The average time to surgery from injury was 8.8 days (range, 0–18 days). The overall postoperative rate of wound complications was 5.8% (3 of 52). In the immediate group, deep infections and wound necrosis were found in 2 of 8 fractures (25%). In the early group, 1 of 15 fractures developed superficial infection (6.7%). In the intermediate and late groups, no wound complication was identified. Iatrogenic sural nerve injury was recorded in 5 of 52 patients (9.6%). Group A had 33% (4 of 12) nerve injuries and group B had 2.5% (1 of 40) (P = .009). In 70% of cases, a main branch of the sural nerve was directly under the incision.
Conclusions:
The sinus tarsi approach was generally effective and safe for calcaneus fractures. However, it was relatively risky to perform open reduction and internal fixation by the sinus tarsi approach within 6 days of injury. Because the sural nerve is in the vicinity of the approach, iatrogenic injury should be avoided by the use of careful planning and meticulous manipulations.
Level of Evidence
Therapeutic; Level III, comparative study.
Due to the poor dynamic positioning precision of the Global Positioning System (GPS), Time Series Analysis (TSA) and Kalman filter technology are used to construct the positioning error of GPS. ...According to the statistical characteristics of the autocorrelation function and partial autocorrelation function of sample data, the Autoregressive (AR) model which is based on a Kalman filter is determined, and the error model of GPS is combined with a Kalman filter to eliminate the random error in GPS dynamic positioning data. The least square method is used for model parameter estimation and adaptability tests, and the experimental results show that the absolute value of the maximum error of longitude and latitude, the mean square error of longitude and latitude and average absolute error of longitude and latitude are all reduced, and the dynamic positioning precision after correction has been significantly improved.
Abstract
Background
The existence of a “bare area” at the anterior plateau has been observed in cases where anteromedial and/or anterolateral proximal tibial locking plates are used for fixation in ...the treatment of hyperextension tibial plateau fractures (HTPF). The objective of this study is to introduce the rim plate fixation technique and evaluate its clinical efficacy.
Methods
A retrospective analysis was conducted on HTPF patients who underwent treatment with a combination of rim plate and proximal tibial locking plate at our hospital between April 2015 and December 2019. All patients were followed up for a minimum of one year. Open reduction and internal fixation were performed using anteromedial/posteromedial and/or anterolateral approaches for all cases. The surgical strategies employed for rim plate fixation were introduced, and both radiographic and clinical outcomes were assessed.
Results
Thirteen patients were enrolled in the study, with an average follow-up time of 4.3 years. Satisfactory reduction was achieved and radiographically maintained in all cases. Additionally, all patients exhibited satisfactory clinical functions, as evidenced by a mean hospital for special surgery (HSS) knee score of 96.2 ± 2.0 (range: 90–98). Furthermore, no wound complications or implant breakage were observed in this series.
Conclusion
The combination of the rim plate and proximal tibial plate proved to be an effective fixation configuration, resulting in satisfactory clinical outcomes.
The Hemispherical Resonator Gyroscope (HRG) has many advantages such as high precision, high reliability and long life-time, it is widely used in the space-launcher and the satellites. The HRG has ...been mechanized to operate in the distinct operating modes, the Force to Rebalanced (FTR) mode and the Whole Angle (WA) mode. In the paper, different from the traditional control algorithm is based on average methods which usually used for the WA mode, a new electrostatic control algorithm is presented, which based on the vector composition and decomposition method to control the equivalent drive force in order to track the phase of the standing wave. The mathematics model and the control algorithm are presented in the paper, and the hardware experimental circuit system is implemented, the HRG has a range of more than 300°/s with the linearity of 40 ppm. Meanwhile, the energy transition efficiency increases by an order of magnitude.
Objectives
Concerns about the coronavirus disease 2019 (COVID‐19) pandemic resulted in unprecedented challenges to the management of geriatric hip fractures. We aimed to evaluate the effects of the ...COVID‐19 surge on the time to surgery and 1 year mortality in geriatric patients with hip fracture at a large, urban Level 1 trauma center in Beijing, and to guide the management of geriatric hip fracture patients throughout the COVID‐19 pandemic.
Methods
This single‐center retrospective study included consecutive patients aged ≥65 years and injured 3 weeks prior to admission. Demographic and surgical data were collected between January 20 and May 31, 2020, and from the same period in 2019. Mortality data and functional status were collected at follow‐up of 1‐year after surgery. The primary outcomes were time to surgery and 1 year mortality.
Results
There were no significant differences in sex, fracture type, and surgical pattern between the 2020 (n = 261) and 2019 time‐matched (n = 307) cohorts. The time from admission to surgery was significantly delayed in the 2020 cohort compared with that in the 2019 cohort (48.9 h vs 20.5 h, p < 0.001). Fewer patients underwent surgery within 48 h in the 2020 cohort (65.5% vs 87.6%, p < 0.001). Surgical delay was also associated with an increased risk of inpatient complications (30.2% vs 20.8%, p = 0.010), however there was no significant difference in the 1‐year mortality rate, nor between pre‐injury and 1 year follow‐up mobility as assessed by Parker score. Only approximately half of the patients in both groups completely returned to their pre‐injury mobility levels.
Conclusions
The COVID‐19 pandemic has significantly increased the surgery waiting time for geriatric patients with hip fractures, which resulted in increased inpatient complications without a higher mortality rate within 1 year. This reinforces the importance of maintaining timely and protocolized care for geriatric hip fractures throughout any subsequent waves of the pandemic.
The COVID‐19 pandemic has led to severe disruptions to the geriatric hip fracture services，patients experienced a longer time to surgery, with increased inpatient complications. However, there is no significant effect on mortality rate and functional status at 1 year of follow‐up. This study indicated that maintaining timely and protocolized hip fracture care remains essential for geriatric patients during the pandemic.
The Coriolis Vibratory Gyroscopes are a type of sensors that measure angular velocities through the Coriolis effect. The resonator is the critical component of the CVGs, the vibrational ...characteristics of which, including the resonant frequency, frequency mismatch, Q factor, and Q factor asymmetry, have a great influence on the performance of CVG. The frequency mismatch and Q factor of the resonator, in particular, directly determine the precision and drift characteristics of the gyroscope. Although the frequency mismatch and Q factor are natural properties of the resonator, they can change with external conditions, such as temperature, pressure, and external forces. In this paper, the influence of electrostatic forces on the vibrational characteristics of the fused silica cylindrical resonator is investigated. Experiments were performed on a fused silica cylindrical resonator coated with Cr/Au films. It was shown that the resonant frequency, frequency mismatch, and the decay time slightly decreased with electrostatic forces, while the decay time split increased. Lower capacitive gaps and larger applied voltages resulted in lower frequency mismatch and lower decay time. This phenomenon was theoretically analyzed, and the variation trends of results were consistent with the theoretical analysis. This study indicates that, for fused silica cylindrical resonator with electrostatic transduction, the electrostatic influence on the Q factor and frequency, although small, should be considered when designing the capacitive gap and choosing bias voltages.
Hemispherical Resonator Gyro (HRG) is a new type gyro with high precision, high reliability, shock resistance, no need of preheating, short start time, and long life. It is a kind of vibrating gyro ...with standing wave rotating along the sensitive base of annular precession, has a unique application prospect in the field of high precision inertial sensors, and is widely used in unmanned aerial vehicle control in complex environments. Based on the theory of the structure characteristics of the hemispherical resonator, the mathematical model of energy of the resonator is established to research the rule of resonant frequency when the hemispherical resonator is rotated around the central axis. In this paper, the influence of precession factor, which are the top angle, the bottom angle, and wall unevenness of the hemispherical resonator, are analyzed. A series of hemispherical resonator models are constructed by ANSYS software to prove the results of theoretical research. The simulation results show that precession factor of the hemispherical resonator is more sensitive of the top angle than the bottom angle, and the error of angular velocity which is caused by the change of the top angle is larger than that which is caused by the change of the bottom angle.
Nephronectin is a basement membrane protein comprising five N-terminal epidermal growth factor (EGF)-like repeats, a central linker segment containing an Arg-Gly-Asp (RGD) motif and a C-terminal ...meprin-A5 protein-receptor protein tyrosine phosphatase μ (MAM) domain. Nephronectin has been shown to interact with α8β1 integrin through the central linker segment, but its interactions with other molecules remain to be elucidated. Here, we examined the binding of nephronectin to a panel of glycosaminoglycan (GAG) chains. Nephronectin bound strongly to heparin and chondroitin sulfate (CS)-E and moderately to heparan sulfate (HS), but failed to bind to CS-A, CS-C, CS-D, dermatan sulfate and hyaluronic acid. Deletion of the MAM domain severely impaired the binding of nephronectin to heparin but not CS-E, whereas deletion of the EGF-like repeats reduced its binding to CS-E but not heparin, suggesting that nephronectin interacts with CS-E and heparin through the EGF-like repeats and MAM domain, respectively. Consistent with these results, nephronectin bound to agrin and perlecan, which are heparan sulfate proteoglycans (HSPGs) in basement membranes, in HS-dependent manners. Site-directed mutagenesis of the MAM domain revealed that multiple basic amino acid residues in the putative loop regions were involved in the binding of the MAM domain to agrin. The binding of nephronectin to basement membrane HSPGs was further confirmed by in situ nephronectin overlay assays using mouse frozen tissue sections. Taken together, these findings indicate that nephronectin is capable of binding to HSPGs in basement membranes via the MAM domain, and thereby raise the possibility that interactions with basement membrane HSPGs may be involved in the deposition of nephronectin onto basement membranes.
► Nephronectin bound strongly to heparin and CS-E through distinct domains. ► Nephronectin bound to heparin and CS-E in Ca2+-independent and dependent manners, respectively. ► Nephronectin bound to heparan sulfate proteoglycans (HSPGs) in basement membranes. ► Residues in the MAM domain required for the interaction with agrin were determined. ► Role of HSPGs in basement membrane assembly of nephronectin is proposed.
Display omitted
•The dynamics of physicochemical properties, prokaryotic community and flavors in FGs were comprehensively studied.•The CSFB fermentation process can be clearly divided into early ...(0-25d) and later (25-60d) stages.•A total of 364 genera and 71 volatiles were detected during the CSFB fermentation.•FG starch and total acid had an extremely significant influence on prokaryotic community composition.
Fermented grain (FG), a complex and unique ecosystem, is the main microbial habitats, biochemical reaction system and direct source of flavor compounds for the Chinese strong-flavor Baijiu (CSFB) production. However, the dynamics of physicochemical properties, prokaryotic community and flavor compounds of FGs during the long-term fermentation process are still not completely clear. Here, the above topics on FGs in the actual production process were comprehensively studied by using a combination of physicochemical analysis, GC–MS detection and Illumina HiSeq sequencing methods. The whole fermentation process could be divided into two stages including early (0–25d) and the later stage (25–60d) based on the dynamics of FG physicochemical properties and the changes of prokaryotic community diversity. A total of 41phyla and 364 genera were detected, and 9 of them were dominant genera in FG complex ecosystem, including Lactobacillus, Pediococcus, Ochrobactrum, Bacillus etc. Among them, the dynamics of 29 top10 genera in FGs were mainly influenced by the starch and total acid, followed by NH4+ and ethanol, and 7 genera (hubs, e.g., Clostridium, Methanosaeta, Bacillus, etc.) of them may play important roles in FG ecosystem stability. A total of 71 volatiles including 33 esters, 14 alcohols, 9 fatty acids, 5 phenols, and 10 other compounds were detected in the FGs, and most of them formed in the early stage. Some important flavor substances (e.g., ethyl octanoate, 3-methylbutanol, hexanoate, etc.) increased in the later stage. Moreover, the formation of some flavor compound might require multiple microbes involved. For instance, ten of the top10 genera, including Lactobacillus, Clostridium, Methanosarcina, Sedimentibacter, Bacillus, etc., were significantly and positively correlated with four important esters. This study may help to clarify the complex correlations among prokaryotic community, physicochemical properties and flavors, allow the improvement of CSFB quality by using bioaugmentation and/or controlling environmental factors, and shed more light on the ecological rules guiding community assembly in FGs.
The construction industry has a significant impact on the environment, and green buildings provide an effective means of reducing environmental impact. Green finance can facilitate industrial ...transformation and upgrading, reduce construction costs, attract investment, and promote green industry development. However, traditional financing models still dominate the financing of green building projects, even if they are not in line with the core principles of green building. To solve this problem, this paper establishes a three-party evolutionary game model, which, based on the assumption of finite rationality, considers three core stakeholders: bank and financial institutions, developers, and consumers. The conditions for evolutionary stable equilibrium are identified through an equilibrium analysis of the strategic behavior of each subject, followed by a replication dynamic analysis. Simulation analysis was used to study the effects of key parameters on cooperative behavior and evolution. The results of the study show that (1) The high initial willingness of bank and financial institutions and consumers has a significant driving effect on the market. (2) When the market willingness is high, the government can steer the market towards the desired goal at relatively low policy costs. (3) With the support of green finance, green buildings can still flourish even if the return is slightly lower than traditional building projects. The results of the study reveal cooperative behavior and its evolutionary patterns, which help stakeholders coordinate their goals and promote the development of the green building industry.
PDF
