BACKGROUND Excellent hip joint function facilitates limb recovery and improves the quality of survival.This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and o...BACKGROUND Excellent hip joint function facilitates limb recovery and improves the quality of survival.This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and outcomes in elderly hip fractures patients and to provide evidence for patient rehabilitation and clinical management.AIM To explore the relationship between inflammatory factors and hip function and the interaction between inflammation and health after hip fracture in elderly patients.METHODS The elderly patients who had hip fracture surgery at our hospital between January 1,2021,and December 31,2022 were chosen for this retrospective clinical investigation.Patients with excellent and fair postoperative hip function had their clinical information and characteristics gathered and compared.Age,gender,fracture site,surgical technique,laboratory indices,and other variables that could have an impact on postoperative joint function were all included in a univariate study.To further identify independent risk factors affecting postoperative joint function in hip fractures,risk factors that showed statistical significance in the univariate analysis were then included in a multiple logistic regression analysis.In addition to this,we also compared other outcome variables such as visual analogue scale and length of hospital stay between the two groups.RESULTS A total of 119 elderly patients with hip fractures were included in this study,of whom 37 were male and 82 were female.The results of univariate logistic regression analysis after excluding the interaction of various factors showed that there was a statistically significant difference in interleukin(IL)-6,IL-8,IL-10,C-reactive protein(CRP),and complement C1q(C1q)between the fair and excellent joint function groups(P<0.05).The results of multiple logistic regression analysis showed that IL-6>20 pg/mL[Odds ratio(OR)3.070,95%CI:1.243-7.579],IL-8>21.4 pg/mL(OR 3.827,95%CI:1.498-9.773),CRP>10 mg/L(OR 2.142,95%CI:1.020-4.498)and C1q>233 mg/L(OR 2.339,95%CI:1.094-5.004)were independent risk factors for poor joint function after hip fracture surgery(all P<0.05).CONCLUSION After hip fractures in older patients,inflammatory variables are risk factors for fair joint function;therefore,early intervention to address these markers is essential to enhance joint function and avoid consequences.展开更多
For a special geological structure of columnar jointed rock mass(CJRM),its mechanical properties are strongly affected by the columnar joints.To describe the fracture behaviors of CJRM using the basic theories of inte...For a special geological structure of columnar jointed rock mass(CJRM),its mechanical properties are strongly affected by the columnar joints.To describe the fracture behaviors of CJRM using the basic theories of interface mechanics for composite materials,the interface stresses of the vertical and horizontal joints,which are the two primary joints in the CJRM under triaxial compression,are studied,and their mathematical expressions are derived based on the superposition principle.Based on the obtained interface stresses of the vertical and horizontal joints in the CJRM,the crack initiation of the joint interface in the CJRM is studied using the maximum circumferential stress theory in fracture mechanics.Moreover,based on this investigation,the fracture behaviors of CJRM are analyzed.According to the results of similar material physical model tests for the CJRM,the theoretical study is verified.Finally,the influence of the mechanical parameters of the CJRM on the joint interface stress is discussed comprehensively.展开更多
Fractured hydrate-bearing reservoirs show significantly anisotropic geophysical properties. The joint application of seismic and electromagnetic explorations is expected to accurately assess hydrate resources in the f...Fractured hydrate-bearing reservoirs show significantly anisotropic geophysical properties. The joint application of seismic and electromagnetic explorations is expected to accurately assess hydrate resources in the fractured reservoirs. However, the anisotropic joint elastic-electrical properties in such reservoirs that are the key to the successful application of the joint explorations, remain poorly understood. To obtain such knowledge, we designed and implemented dedicated laboratory experiments to study the anisotropic joint elastic-electrical properties in fractured artificial silica sandstones (with fracture density of about 6.2%, porosity of approximately 25.7%, and mean grainsize of 0.089 mm) with evolving methane hydrate. The experimental results showed that the anisotropic compressional wave velocities respectively increased and decreased with the forming and dissociating hydrate, and the variation in the increasing trend and the decreasing extent of the velocity perpendicular to the fractures were more significant than that parallel to the fractures, respectively. The experimental results also showed that the overall decreasing trend of the electrical conductivity parallel to the fractures was steeper than that perpendicular to the fractures during hydrate formation, and the general variations of the two conductivities with complex trend were similar during hydrate dissociation. The variations in the elastic and electrical anisotropic parameters with forming and dissociating hydrate were also found to be distinct. Interpretation of the experimental results suggested that the hydrate binding to the grains evolved to bridge the surfaces of fractures when saturation exceeded 10% during hydrate formation, and the bridging hydrate gradually evolved to floating in fractures during dissociation. The experimental results further showed that the anisotropic velocities and electrical conductivities were correlated with approximately consistent trends of different slopes during hydrate formation, and the joint elastic-electrical anisotropic parameters exhibited a sharp peak at the hydrate saturation of about 10%. The results suggested that the anisotropic joint properties can be employed not only to accurately estimate hydrate saturation but also possibly to identify hydrate distribution in the fractures.展开更多
2G-NPR bolt (the 2nd generation Negative Poisson’s Ratio bolt) is a new type of bolt with high strength, high toughness and no yield platform. It has signifcant efects on improving the shear strength of jointed rock ...2G-NPR bolt (the 2nd generation Negative Poisson’s Ratio bolt) is a new type of bolt with high strength, high toughness and no yield platform. It has signifcant efects on improving the shear strength of jointed rock mass and controlling the stability of surrounding rock. To achieve an accurate simulation of bolted joint shear tests, we have studied a numerical simulation method that takes into account the 2G-NPR bolt's tensile–shear fracture criterion. Firstly, the indoor experimental study on the tensile–shear mechanical properties of 2G-NPR bolt is carried out to explore its mechanical properties under diferent tensile–shear angles, and the fracture criterion of 2G-NPR bolt considering the tensile–shear angle is established. Then, a three-dimensional numerical simulation method considering the tensile–shear mechanical constitutive and fracture criterion of 2G-NPR bolt, the elastoplastic mechanical behavior of surrounding rock and the damage and deterioration of grouting body is proposed. The feasibility and accuracy of the method are verifed by comparing with the indoor shear test results of 2G-NPR bolt anchorage joints. Finally, based on the numerical simulation results, the deformation and stress of the bolt, the distribution of the plastic zone of the rock mass, the stress distribution and the damage of the grouting body are analyzed in detail. The research results can provide a good reference value for the practical engineering application and shear mechanical performance analysis of 2G-NPR bolt.展开更多
This paper describes numerical simulation of hydraulic fracturing using fracture-based continuum modeling(FBCM)of coupled geomechanical-hydrological processes to evaluate a technique for high-density fracturing and fr...This paper describes numerical simulation of hydraulic fracturing using fracture-based continuum modeling(FBCM)of coupled geomechanical-hydrological processes to evaluate a technique for high-density fracturing and fracture caging.The simulations are innovative because of modeling discrete fractures explicitly in continuum analysis.A key advantage of FBCM is that fracture initiation and propagation are modeled explicitly without changing the domain grid(i.e.no re-meshing).Further,multiple realizations of a preexisting fracture distribution can be analyzed using the same domain grid.The simulated hydraulic fracturing technique consists of pressurizing multiple wells simultaneously:initially without permeating fluids into the rock,to seed fractures uniformly and at high density in the wall rock of the wells;followed by fluid injection to propagate the seeded fracture density hydraulically.FBCM combines the ease of continuum modeling with the potential accuracy of modeling discrete fractures and fracturing explicitly.Fractures are modeled as piecewise planar based on intersections with domain elements;fracture geometry stored as continuum properties is used to calculate parameters needed to model individual fractures;and rock behavior is modeled through tensorial aggregation of the behavior of discrete fractures and unfractured rock.Simulations are presented for previously unfractured rock and for rock with preexisting fractures of horizontal,shallow-dipping,steeply dipping,or vertical orientation.Simulations of a single-well model are used to determine the pattern and spacing for a multiple-well design.The results illustrate high-density fracturing and fracture caging through simultaneous fluid injection in multiple wells:for previously unfractured rock or rock with preexisting shallow-dipping or horizontal fractures,and in situ vertical compressive stress greater than horizontal.If preexisting fractures are steeply dipping or vertical,and considering the same in situ stress condition,well pressurization without fluid permeation appears to be the only practical way to induce new fractures and contain fracturing within the target domain.展开更多
Borehole instability in naturally fractured rocks poses significant challenges to drilling.Drilling mud invades the surrounding formations through natural fractures under the difference between the wellbore pressure(P...Borehole instability in naturally fractured rocks poses significant challenges to drilling.Drilling mud invades the surrounding formations through natural fractures under the difference between the wellbore pressure(P w)and pore pressure(P p)during drilling,which may cause wellbore instability.However,the weakening of fracture strength due to mud intrusion is not considered in most existing borehole stability analyses,which may yield significant errors and misleading predictions.In addition,only limited factors were analyzed,and the fracture distribution was oversimplified.In this paper,the impacts of mud intrusion and associated fracture strength weakening on borehole stability in fractured rocks under both isotropic and anisotropic stress states are investigated using a coupled DEM(distinct element method)and DFN(discrete fracture network)method.It provides estimates of the effect of fracture strength weakening,wellbore pressure,in situ stresses,and sealing efficiency on borehole stability.The results show that mud intrusion and weakening of fracture strength can damage the borehole.This is demonstrated by the large displacement around the borehole,shear displacement on natural fractures,and the generation of fracture at shear limit.Mud intrusion reduces the shear strength of the fracture surface and leads to shear failure,which explains that the increase in mud weight may worsen borehole stability during overbalanced drilling in fractured formations.A higher in situ stress anisotropy exerts a significant influence on the mechanism of shear failure distribution around the wellbore.Moreover,the effect of sealing natural fractures on maintaining borehole stability is verified in this study,and the increase in sealing efficiency reduces the radial invasion distance of drilling mud.This study provides a directly quantitative prediction method of borehole instability in naturally fractured formations,which can consider the discrete fracture network,mud intrusion,and associated weakening of fracture strength.The information provided by the numerical approach(e.g.displacement around the borehole,shear displacement on fracture,and fracture at shear limit)is helpful for managing wellbore stability and designing wellbore-strengthening operations.展开更多
Karst fracture-cavity carbonate reservoirs,in which natural cavities are connected by natural fractures to form cavity clusters in many circumstances,have become significant fields of oil and gas exploration and explo...Karst fracture-cavity carbonate reservoirs,in which natural cavities are connected by natural fractures to form cavity clusters in many circumstances,have become significant fields of oil and gas exploration and exploitation.Proppant fracturing is considered as the best method for exploiting carbonate reservoirs;however,previous studies primarily focused on the effects of individual types of geological formations,such as natural fractures or cavities,on fracture propagation.In this study,true-triaxial physical simulation experiments were systematically performed under four types of stress difference conditions after the accurate prefabrication of four types of different fracture-cavity distributions in artificial samples.Subsequently,the interaction mechanism between the hydraulic fractures and fracture-cavity structures was systematically analyzed in combination with the stress distribution,cross-sectional morphology of the main propagation path,and three-dimensional visualization of the overall fracture network.It was found that the propagation of hydraulic fractures near the cavity was inhibited by the stress concentration surrounding the cavity.In contrast,a natural fracture with a smaller approach angle(0°and 30°)around the cavity can alleviate the stress concentration and significantly facilitate the connection with the cavity.In addition,the hydraulic fracture crossed the natural fracture at the 45°approach angle and bypassed the cavity under higher stress difference conditions.A new stimulation effectiveness evaluation index was established based on the stimulated reservoir area(SRA),tortuosity of the hydraulic fractures(T),and connectivity index(CI)of the cavities.These findings provide new insights into the fracturing design of carbonate reservoirs.展开更多
Radial borehole fracturing that combines radial boreholes with hydraulic fracturing is anticipated to improve the output of tight oil and gas reservoirs.This paper aims to investigate fracture propagation and pressure...Radial borehole fracturing that combines radial boreholes with hydraulic fracturing is anticipated to improve the output of tight oil and gas reservoirs.This paper aims to investigate fracture propagation and pressure characteristics of radial borehole fracturing in multiple layers.A series of laboratory experiments with artificial rock samples(395 mm×395 mm×395 mm)was conducted using a true triaxial fracturing device.Three crucial factors corresponding to the vertical distance of adjacent radial borehole layers(vertical distance),the azimuth and diameter of the radial borehole are examined.Experimental results show that radial borehole fracturing in multiple layers generates diverse fracture geometries.Four types of fractures are identified based on the connectivity between hydraulic fractures and radial boreholes.The vertical distance significantly influences fracture propagation perpendicular to the radial borehole axis.An increase in the vertical distance impedes fracture connection across multiple radial borehole layers and reduces the fracture propagation distance along the radial borehole axis.The azimuth also influences fracture propagation along the radial borehole axis.Increasing the azimuth reduces the guiding ability of radial boreholes,which makes the fracture quickly curve to the maximum horizontal stress direction.The breakdown pressure correlates with diverse fracture geometries observed.When the fractures connect multi-layer radial boreholes,increasing the vertical distance decreases the breakdown pressure.Decreasing the azimuth and increasing the diameter also decrease the breakdown pressure.The extrusion force exists between the adjacent fractures generated in radial boreholes in multiple rows,which plays a crucial role in enhancing the guiding ability of radial boreholes and results in higher breakdown pressure.The research provides valuable theoretical insights for the field application of radial borehole fracturing technology in tight oil and gas reservoirs.展开更多
Acetabular fractures in the geriatric population are typically low-energy fractures resulting from a fall from standing height.Compromised bone quality in the elderly,as well as this population’s concomitant medical ...Acetabular fractures in the geriatric population are typically low-energy fractures resulting from a fall from standing height.Compromised bone quality in the elderly,as well as this population’s concomitant medical comorbidities,render the management of such fractures challenging and controversial.Non-operative management remains the mainstay of treatment,although such a choice is associated with numerous and serious complications related to both the hip joint as well as the general condition of the patient.On the other hand,operatively treating acetabular fractures(e.g.,with osteosynthesis or total hip arthroplasty)is gaining popularity.Osteosynthesis can be performed with open reduction and internal fixation or with minimally invasive techniques.Total hip arthroplasty could be performed either in the acute phase combined with osteosynthesis or as a delayed procedure after a period of non-operative management or after failed osteosynthesis of the acetabulum.Regardless of the implemented treatment,orthogeriatric co-management is considered extremely crucial,and it is currently one of the pillars of a successful outcome after an acetabular fracture.展开更多
When the geological environment of rock masses is disturbed,numerous non-persisting open joints can appear within it.It is crucial to investigate the effect of open joints on the mechanical properties of rock mass.How...When the geological environment of rock masses is disturbed,numerous non-persisting open joints can appear within it.It is crucial to investigate the effect of open joints on the mechanical properties of rock mass.However,it has been challenging to generate realistic open joints in traditional experimental tests and numerical simulations.This paper presents a novel solution to solve the problem.By utilizing the stochastic distribution of joints and an enhanced-fractal interpolation system(IFS)method,rough curves with any orientation can be generated.The Douglas-Peucker algorithm is then applied to simplify these curves by removing unnecessary points while preserving their fundamental shape.Subsequently,open joints are created by connecting points that move to both sides of rough curves based on the aperture distribution.Mesh modeling is performed to construct the final mesh model.Finally,the RB-DEM method is applied to transform the mesh model into a discrete element model containing geometric information about these open joints.Furthermore,this study explores the impacts of rough open joint orientation,aperture,and number on rock fracture mechanics.This method provides a realistic and effective approach for modeling and simulating these non-persisting open joints.展开更多
The hydraulic testing of pre-existing fractures(HTPF)is one of the most promising in situ stress measurement methods,particularly for three-dimensional stress tensor determination.However,the stress tensor determinati...The hydraulic testing of pre-existing fractures(HTPF)is one of the most promising in situ stress measurement methods,particularly for three-dimensional stress tensor determination.However,the stress tensor determination based on the HTPF method requires at least six tests or a minimum of 14-15 tests(under different conditions)for reliable results.In this study,we modified the HTPF method by considering the shear stress on each pre-existing fracture,which increased the number of equations for the stress tensor determination and decreased the number of tests required.Different shear stresses were attributed to different fractures by random sampling;therefore,the stress tensors were obtained by searching for the optimal solution using the least squares criterion based on the Monte Carlo method.Thereafter,we constrained the stress tensor based on the tensile strength criterion,compressive strength criterion,and vertical stress constraints.The inverted stress tensors were presented and analyzed based on the tensorial nature of the stress using the Euclidean mean stress tensor.Two stress-measurement campaigns in Weifang(Shandong Province,China)and Mercantour road tunnel(France)were implemented to highlight the validity and efficiency of the modified HTPF(M-HTPF)method.The results showed that the M-HTPF method can be applied for stress tensor inversion using only three to four tests on pre-existing fractures,neglecting the stress gradient.The inversion results were confined to relatively small distribution dispersions and were significantly reliable and stable due to the shear stresses on the fractures and the stress constraints employed.The M-HTPF method is highly feasible and efficient for complete stress tensor determination in a single borehole.展开更多
The Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)satellite is a small magnetosphere–ionosphere link explorer developed cooperatively between China and Europe.It pioneers the use of X-ray imaging technology...The Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)satellite is a small magnetosphere–ionosphere link explorer developed cooperatively between China and Europe.It pioneers the use of X-ray imaging technology to perform large-scale imaging of the Earth’s magnetosheath and polar cusp regions.It uses a high-precision ultraviolet imager to image the overall configuration of the aurora and monitor changes in the source of solar wind in real time,using in situ detection instruments to improve human understanding of the relationship between solar activity and changes in the Earth’s magnetic field.The SMILE satellite is scheduled to launch in 2025.The European Incoherent Scatter Sciences Association(EISCAT)-3D radar is a new generation of European incoherent scatter radar constructed by EISCAT and is the most advanced ground-based ionospheric experimental device in the high-latitude polar region.It has multibeam and multidirectional quasi-real-time three-dimensional(3D)imaging capabilities,continuous monitoring and operation capabilities,and multiple-baseline interferometry capabilities.Joint detection by the SMILE satellite and the EISCAT-3D radar is of great significance for revealing the coupling process of the solar wind–magnetosphere–ionosphere.Therefore,we performed an analysis of the joint detection capability of the SMILE satellite and EISCAT-3D,analyzed the period during which the two can perform joint detection,and defined the key scientific problems that can be solved by joint detection.In addition,we developed Web-based software to search for and visualize the joint detection period of the SMILE satellite and EISCAT-3D radar,which lays the foundation for subsequent joint detection experiments and scientific research.展开更多
BACKGROUND Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types:Supracondylar(SC),lateral condyle(LC),and medial epicondyle(ME)fractu...BACKGROUND Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types:Supracondylar(SC),lateral condyle(LC),and medial epicondyle(ME)fractures.AIM To evaluate the epidemiology of pediatric distal humerus fractures(SC,LC,and ME)from an American insurance claims database.METHODS A retrospective review was performed on patients 17 years and younger with the ICD 9 and 10 codes for SC,LC and ME fractures based on the IBM Truven MarketScan®Commercial and IBM Truven MarketScan Medicare Supplemental databases.Patients from 2015 to 2020 were queried for treatments,patient age,sex,length of hospitalization,and comorbidities.RESULTS A total of 1133 SC,154 LC,and 124 ME fractures were identified.SC fractures had the highest percentage of operation at 83%,followed by LC(78%)and ME fractures(41%).Male patients were,on average,older than female patients for both SC and ME fractures.CONCLUSION In the insurance claims databases used,SC fractures were the most reported,followed by LC fractures,and finally ME fractures.Age was identified to be a factor for how a pediatric distal humerus fractures,with patients with SC and LC fractures being younger than those with ME fractures.The peak age per injury per sex was similar to reported historic central tendencies,despite reported trends for younger physiologic development.展开更多
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 p...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.展开更多
Conventional numerical solutions developed to describe the geomechanical behavior of rock interfaces subjected to differential load emphasize peak and residual shear strengths.The detailed analysis of preand post-peak...Conventional numerical solutions developed to describe the geomechanical behavior of rock interfaces subjected to differential load emphasize peak and residual shear strengths.The detailed analysis of preand post-peak shear stress-displacement behavior is central to various time-dependent and dynamic rock mechanic problems such as rockbursts and structural instabilities in highly stressed conditions.The complete stress-displacement surface(CSDS)model was developed to describe analytically the pre-and post-peak behavior of rock interfaces under differential loads.Original formulations of the CSDS model required extensive curve-fitting iterations which limited its practical applicability and transparent integration into engineering tools.The present work proposes modifications to the CSDS model aimed at developing a comprehensive and modern calibration protocol to describe the complete shear stressdisplacement behavior of rock interfaces under differential loads.The proposed update to the CSDS model incorporates the concept of mobilized shear strength to enhance the post-peak formulations.Barton’s concepts of joint roughness coefficient(JRC)and joint compressive strength(JCS)are incorporated to facilitate empirical estimations for peak shear stress and normal closure relations.Triaxial/uniaxial compression test and direct shear test results are used to validate the updated model and exemplify the proposed calibration method.The results illustrate that the revised model successfully predicts the post-peak and complete axial stressestrain and shear stressedisplacement curves for rock joints.展开更多
Purpose: This study aims to investigate the predictive value of blood calcium in the prognosis of traumatic fracture. Methods: A retrospective experimental design was employed, 112 cases (52 non-fracture and 60 trauma...Purpose: This study aims to investigate the predictive value of blood calcium in the prognosis of traumatic fracture. Methods: A retrospective experimental design was employed, 112 cases (52 non-fracture and 60 traumatic fracture) were randomly selected. The type of fracture complies with WHO-recommended (2019) diagnostic criteria for osteoporosis combined with fracture. The blood pressure (BP) was measured by OMRON’s HEM-7136 model electronic blood pressure monitor. Blood calcium (Ca<sup>2+</sup>), and blood phosphorus (P) values were measured using Colorimetric Roche kits on a Roche/Hitachi fully automated biochemical analyzer. Data collection and analysis followed. Results: Higher levels of age, systolic and diastolic blood pressures were found in the traumatic fracture group compared to the control group, whereas weight, height, and blood phosphorus did not differ significantly (P adjusting for age, systolic blood pressure, diastolic blood pressure, and blood phosphorus, binary logistic regression analysis revealed that blood calcium was a protective factor against traumatic fracture (β = -26.85, OR = 0.00, 95% CI = 0.00 -0.02, P = 0.022). Conclusion: The findings suggest that high and low blood calcium levels may serve as useful indicators in predicting the prognosis of fractures resulting from trauma.展开更多
Stability analysis of underground constructions requires a model study of rock masses’ long-term performance. Creep tests under different stress conditions was conducted on intact granite and granite samples fracture...Stability analysis of underground constructions requires a model study of rock masses’ long-term performance. Creep tests under different stress conditions was conducted on intact granite and granite samples fractured at 30° and 45° angles. The experimental results indicate that the steady creep strain rates of intact and fractured rock present an exponential increase trend with the increase of stress level. A nonlinear creep model is developed based on the experimental results, in which the initial damage caused by fracture together with the damage caused by constant load have been taken into consideration. The fitting analysis results indicated that the model proposed is more accurate at identifying the full creep regions in fractured granite, especially the accelerated stage of creep deformation. The least-square fit error of the proposed creep model is significantly lower than that of Nishihara model by almost an order of magnitude. An analysis of the effects of elastic modulus, viscosity coefficient, and damage factors on fractured rock strain rate and creep strain is conducted. If no consideration is given to the effects of the damage, the proposed nonlinear creep model can degenerate into to the classical Nishihara model.展开更多
Horizontal well-stimulation is the key to unconventional resource exploration and development.The development mode of the well plant helps increase the stimulated reservoir volume.Nevertheless,fracture interference be...Horizontal well-stimulation is the key to unconventional resource exploration and development.The development mode of the well plant helps increase the stimulated reservoir volume.Nevertheless,fracture interference between wells reduces the fracturing effect.Here,a 2D hydro-mechanical coupling model describing hydraulic fracture(HF)propagation is established with the extended finite element method,and the effects of several factors on HF propagation during multiple wells fracturing are analyzed.The results show that with an increase in elastic modulus,horizontal principal stress difference and injection fluid displacement,the total fracture area and the reservoir stimulation efficiency are both improved in all three fracturing technologies.After a comparison of the three technologies,the method of improved zipper fracturing is proposed,which avoids mutual interference between HFs,and the reservoir stimulation effect is improved significantly.The study provides guidance for optimizing the fracturing technology of multiple horizontal wells.展开更多
Introduction: Forearm fractures involving both the radius and ulna, present distinctive challenges in orthopedic trauma management. This case report explores the complexities of a rare case of bilateral fractures, emp...Introduction: Forearm fractures involving both the radius and ulna, present distinctive challenges in orthopedic trauma management. This case report explores the complexities of a rare case of bilateral fractures, emphasizing the importance of a comprehensive approach for optimal outcomes. Case Presentation: This report presents the case of a 40-year-old motorcyclist who was involved in a road accident and arrived at the emergency department shortly after the incident. Clinical examination revealed closed fractures in both forearms with mild swelling and severe tenderness. Fortunately, no neurovascular issues or compartment syndrome were detected. The patient was administered intravenous fluids and effective pain relief. Forearm splints were applied and the arms were elevated using pillows. Radiographs showed fractures in the right distal radius and ulna, as well as the left mid-shaft radius and ulna. Under general anesthesia, open reduction and internal fixation were per-formed using plates and screws for all four fractures. Postoperatively, the patient’s arms were immobilized and elevated, with gradual recovery during follow-up appointments over six months, eventually achieving full function without complaints. Conclusion: This article highlights the possibility, although infrequent, of bilateral shaft fractures of the ulna and radius. With thorough clinical assessment and radiological investigation, such fractures can be well-defined. The required definitive treatment, which usually involves open reduction and internal fixation, can be performed.展开更多
Introduction: The commonest maxillofacial fractures involve the mandible. Age can be considered among influential factors. Aim of the Study: To compare mandibular fractures between children and adults from the beginni...Introduction: The commonest maxillofacial fractures involve the mandible. Age can be considered among influential factors. Aim of the Study: To compare mandibular fractures between children and adults from the beginning up to the treatment in Senegal. Patients and Method: A three-year retrospective study was conducted in a university hospital. The medical records of patients admitted for maxillofacial injuries were reviewed. Patient and injury-related variables including age, gender, etiology, average consultation delay, anatomic location of fracture and treatment were compared up to age of 15 and beyond that. Results: Considering 272 casualties, maxillofacial fractures were less frequent among children than adults (36.7% and 59.7%) and were mainly mandibular (90.1% and 91.4%). Male predilection (sex ratio of 2.4 and 4.9) was twice (2) as pronounced from the age of 16. The average consultation delay was two (2) times shorter for children. Road traffic accidents which predominated among children (33.9%) had comparable frequency (32.3%) although they were outnumbered by assault (37.6%) among adults. Fractures occurred mainly on the corpus (90.1% and 90.4%), particularly on parasymphysis (40.1%) up to the age of 15, whereas angle fractures increased (8.5% to 19.6%) and joint damage decreased afterwards. Intra-oral orthopedic procedures (91.2% and 92.6%) in which mandibular retention splints were more common (37.3%) up to the age of 15 then arch ligatures (49%) were then widely favored. Conclusion: Differences relating to the distribution of causes but also to the anatomic location on the corpus and to the choice of intra-oral orthopedic procedures within overall similarities between children and adults regarding the male predilection, the frequency of road traffic accidents, the mandibular injuries, but also the school therapeutic attitude consisting of favoring the orthopedic option.展开更多
基金Supported by Leading Talents Training Program of Pudong New Area Health Commission,No.PWR 12020-06and Shanghai Science and Technology Commission,No.20Y11901800.
文摘BACKGROUND Excellent hip joint function facilitates limb recovery and improves the quality of survival.This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and outcomes in elderly hip fractures patients and to provide evidence for patient rehabilitation and clinical management.AIM To explore the relationship between inflammatory factors and hip function and the interaction between inflammation and health after hip fracture in elderly patients.METHODS The elderly patients who had hip fracture surgery at our hospital between January 1,2021,and December 31,2022 were chosen for this retrospective clinical investigation.Patients with excellent and fair postoperative hip function had their clinical information and characteristics gathered and compared.Age,gender,fracture site,surgical technique,laboratory indices,and other variables that could have an impact on postoperative joint function were all included in a univariate study.To further identify independent risk factors affecting postoperative joint function in hip fractures,risk factors that showed statistical significance in the univariate analysis were then included in a multiple logistic regression analysis.In addition to this,we also compared other outcome variables such as visual analogue scale and length of hospital stay between the two groups.RESULTS A total of 119 elderly patients with hip fractures were included in this study,of whom 37 were male and 82 were female.The results of univariate logistic regression analysis after excluding the interaction of various factors showed that there was a statistically significant difference in interleukin(IL)-6,IL-8,IL-10,C-reactive protein(CRP),and complement C1q(C1q)between the fair and excellent joint function groups(P<0.05).The results of multiple logistic regression analysis showed that IL-6>20 pg/mL[Odds ratio(OR)3.070,95%CI:1.243-7.579],IL-8>21.4 pg/mL(OR 3.827,95%CI:1.498-9.773),CRP>10 mg/L(OR 2.142,95%CI:1.020-4.498)and C1q>233 mg/L(OR 2.339,95%CI:1.094-5.004)were independent risk factors for poor joint function after hip fracture surgery(all P<0.05).CONCLUSION After hip fractures in older patients,inflammatory variables are risk factors for fair joint function;therefore,early intervention to address these markers is essential to enhance joint function and avoid consequences.
基金funding support from National Natural Science Foundation of China(Grant No.41831278).
文摘For a special geological structure of columnar jointed rock mass(CJRM),its mechanical properties are strongly affected by the columnar joints.To describe the fracture behaviors of CJRM using the basic theories of interface mechanics for composite materials,the interface stresses of the vertical and horizontal joints,which are the two primary joints in the CJRM under triaxial compression,are studied,and their mathematical expressions are derived based on the superposition principle.Based on the obtained interface stresses of the vertical and horizontal joints in the CJRM,the crack initiation of the joint interface in the CJRM is studied using the maximum circumferential stress theory in fracture mechanics.Moreover,based on this investigation,the fracture behaviors of CJRM are analyzed.According to the results of similar material physical model tests for the CJRM,the theoretical study is verified.Finally,the influence of the mechanical parameters of the CJRM on the joint interface stress is discussed comprehensively.
基金financial supports received from the National Natural Science Foundation of China(42174136,41821002 and 41874151)the Shandong Provincial Natural Science Foundation,China(ZR2021JQ14).
文摘Fractured hydrate-bearing reservoirs show significantly anisotropic geophysical properties. The joint application of seismic and electromagnetic explorations is expected to accurately assess hydrate resources in the fractured reservoirs. However, the anisotropic joint elastic-electrical properties in such reservoirs that are the key to the successful application of the joint explorations, remain poorly understood. To obtain such knowledge, we designed and implemented dedicated laboratory experiments to study the anisotropic joint elastic-electrical properties in fractured artificial silica sandstones (with fracture density of about 6.2%, porosity of approximately 25.7%, and mean grainsize of 0.089 mm) with evolving methane hydrate. The experimental results showed that the anisotropic compressional wave velocities respectively increased and decreased with the forming and dissociating hydrate, and the variation in the increasing trend and the decreasing extent of the velocity perpendicular to the fractures were more significant than that parallel to the fractures, respectively. The experimental results also showed that the overall decreasing trend of the electrical conductivity parallel to the fractures was steeper than that perpendicular to the fractures during hydrate formation, and the general variations of the two conductivities with complex trend were similar during hydrate dissociation. The variations in the elastic and electrical anisotropic parameters with forming and dissociating hydrate were also found to be distinct. Interpretation of the experimental results suggested that the hydrate binding to the grains evolved to bridge the surfaces of fractures when saturation exceeded 10% during hydrate formation, and the bridging hydrate gradually evolved to floating in fractures during dissociation. The experimental results further showed that the anisotropic velocities and electrical conductivities were correlated with approximately consistent trends of different slopes during hydrate formation, and the joint elastic-electrical anisotropic parameters exhibited a sharp peak at the hydrate saturation of about 10%. The results suggested that the anisotropic joint properties can be employed not only to accurately estimate hydrate saturation but also possibly to identify hydrate distribution in the fractures.
基金supported by the National Natural Science Foundation of China(NSFC)(41941018).
文摘2G-NPR bolt (the 2nd generation Negative Poisson’s Ratio bolt) is a new type of bolt with high strength, high toughness and no yield platform. It has signifcant efects on improving the shear strength of jointed rock mass and controlling the stability of surrounding rock. To achieve an accurate simulation of bolted joint shear tests, we have studied a numerical simulation method that takes into account the 2G-NPR bolt's tensile–shear fracture criterion. Firstly, the indoor experimental study on the tensile–shear mechanical properties of 2G-NPR bolt is carried out to explore its mechanical properties under diferent tensile–shear angles, and the fracture criterion of 2G-NPR bolt considering the tensile–shear angle is established. Then, a three-dimensional numerical simulation method considering the tensile–shear mechanical constitutive and fracture criterion of 2G-NPR bolt, the elastoplastic mechanical behavior of surrounding rock and the damage and deterioration of grouting body is proposed. The feasibility and accuracy of the method are verifed by comparing with the indoor shear test results of 2G-NPR bolt anchorage joints. Finally, based on the numerical simulation results, the deformation and stress of the bolt, the distribution of the plastic zone of the rock mass, the stress distribution and the damage of the grouting body are analyzed in detail. The research results can provide a good reference value for the practical engineering application and shear mechanical performance analysis of 2G-NPR bolt.
文摘This paper describes numerical simulation of hydraulic fracturing using fracture-based continuum modeling(FBCM)of coupled geomechanical-hydrological processes to evaluate a technique for high-density fracturing and fracture caging.The simulations are innovative because of modeling discrete fractures explicitly in continuum analysis.A key advantage of FBCM is that fracture initiation and propagation are modeled explicitly without changing the domain grid(i.e.no re-meshing).Further,multiple realizations of a preexisting fracture distribution can be analyzed using the same domain grid.The simulated hydraulic fracturing technique consists of pressurizing multiple wells simultaneously:initially without permeating fluids into the rock,to seed fractures uniformly and at high density in the wall rock of the wells;followed by fluid injection to propagate the seeded fracture density hydraulically.FBCM combines the ease of continuum modeling with the potential accuracy of modeling discrete fractures and fracturing explicitly.Fractures are modeled as piecewise planar based on intersections with domain elements;fracture geometry stored as continuum properties is used to calculate parameters needed to model individual fractures;and rock behavior is modeled through tensorial aggregation of the behavior of discrete fractures and unfractured rock.Simulations are presented for previously unfractured rock and for rock with preexisting fractures of horizontal,shallow-dipping,steeply dipping,or vertical orientation.Simulations of a single-well model are used to determine the pattern and spacing for a multiple-well design.The results illustrate high-density fracturing and fracture caging through simultaneous fluid injection in multiple wells:for previously unfractured rock or rock with preexisting shallow-dipping or horizontal fractures,and in situ vertical compressive stress greater than horizontal.If preexisting fractures are steeply dipping or vertical,and considering the same in situ stress condition,well pressurization without fluid permeation appears to be the only practical way to induce new fractures and contain fracturing within the target domain.
基金financially supported by National Natural Science Foundation of China(Grant Nos.52074312 and 52211530097)CNPC Science and Technology Innovation Foundation(Grant No.2021DQ02-0505).
文摘Borehole instability in naturally fractured rocks poses significant challenges to drilling.Drilling mud invades the surrounding formations through natural fractures under the difference between the wellbore pressure(P w)and pore pressure(P p)during drilling,which may cause wellbore instability.However,the weakening of fracture strength due to mud intrusion is not considered in most existing borehole stability analyses,which may yield significant errors and misleading predictions.In addition,only limited factors were analyzed,and the fracture distribution was oversimplified.In this paper,the impacts of mud intrusion and associated fracture strength weakening on borehole stability in fractured rocks under both isotropic and anisotropic stress states are investigated using a coupled DEM(distinct element method)and DFN(discrete fracture network)method.It provides estimates of the effect of fracture strength weakening,wellbore pressure,in situ stresses,and sealing efficiency on borehole stability.The results show that mud intrusion and weakening of fracture strength can damage the borehole.This is demonstrated by the large displacement around the borehole,shear displacement on natural fractures,and the generation of fracture at shear limit.Mud intrusion reduces the shear strength of the fracture surface and leads to shear failure,which explains that the increase in mud weight may worsen borehole stability during overbalanced drilling in fractured formations.A higher in situ stress anisotropy exerts a significant influence on the mechanism of shear failure distribution around the wellbore.Moreover,the effect of sealing natural fractures on maintaining borehole stability is verified in this study,and the increase in sealing efficiency reduces the radial invasion distance of drilling mud.This study provides a directly quantitative prediction method of borehole instability in naturally fractured formations,which can consider the discrete fracture network,mud intrusion,and associated weakening of fracture strength.The information provided by the numerical approach(e.g.displacement around the borehole,shear displacement on fracture,and fracture at shear limit)is helpful for managing wellbore stability and designing wellbore-strengthening operations.
基金sponsored by the National Natural Science Foundation of China(Grants Nos.52104046 and 52104010).
文摘Karst fracture-cavity carbonate reservoirs,in which natural cavities are connected by natural fractures to form cavity clusters in many circumstances,have become significant fields of oil and gas exploration and exploitation.Proppant fracturing is considered as the best method for exploiting carbonate reservoirs;however,previous studies primarily focused on the effects of individual types of geological formations,such as natural fractures or cavities,on fracture propagation.In this study,true-triaxial physical simulation experiments were systematically performed under four types of stress difference conditions after the accurate prefabrication of four types of different fracture-cavity distributions in artificial samples.Subsequently,the interaction mechanism between the hydraulic fractures and fracture-cavity structures was systematically analyzed in combination with the stress distribution,cross-sectional morphology of the main propagation path,and three-dimensional visualization of the overall fracture network.It was found that the propagation of hydraulic fractures near the cavity was inhibited by the stress concentration surrounding the cavity.In contrast,a natural fracture with a smaller approach angle(0°and 30°)around the cavity can alleviate the stress concentration and significantly facilitate the connection with the cavity.In addition,the hydraulic fracture crossed the natural fracture at the 45°approach angle and bypassed the cavity under higher stress difference conditions.A new stimulation effectiveness evaluation index was established based on the stimulated reservoir area(SRA),tortuosity of the hydraulic fractures(T),and connectivity index(CI)of the cavities.These findings provide new insights into the fracturing design of carbonate reservoirs.
基金The authors gratefully acknowledge the financial support received from the Strategic Cooperation Technology Projects of CNPC and CUPB(No.ZLZX2020-01)the National Key Scientific Research Instrument Research Project of NSFC(No.51827804).
文摘Radial borehole fracturing that combines radial boreholes with hydraulic fracturing is anticipated to improve the output of tight oil and gas reservoirs.This paper aims to investigate fracture propagation and pressure characteristics of radial borehole fracturing in multiple layers.A series of laboratory experiments with artificial rock samples(395 mm×395 mm×395 mm)was conducted using a true triaxial fracturing device.Three crucial factors corresponding to the vertical distance of adjacent radial borehole layers(vertical distance),the azimuth and diameter of the radial borehole are examined.Experimental results show that radial borehole fracturing in multiple layers generates diverse fracture geometries.Four types of fractures are identified based on the connectivity between hydraulic fractures and radial boreholes.The vertical distance significantly influences fracture propagation perpendicular to the radial borehole axis.An increase in the vertical distance impedes fracture connection across multiple radial borehole layers and reduces the fracture propagation distance along the radial borehole axis.The azimuth also influences fracture propagation along the radial borehole axis.Increasing the azimuth reduces the guiding ability of radial boreholes,which makes the fracture quickly curve to the maximum horizontal stress direction.The breakdown pressure correlates with diverse fracture geometries observed.When the fractures connect multi-layer radial boreholes,increasing the vertical distance decreases the breakdown pressure.Decreasing the azimuth and increasing the diameter also decrease the breakdown pressure.The extrusion force exists between the adjacent fractures generated in radial boreholes in multiple rows,which plays a crucial role in enhancing the guiding ability of radial boreholes and results in higher breakdown pressure.The research provides valuable theoretical insights for the field application of radial borehole fracturing technology in tight oil and gas reservoirs.
文摘Acetabular fractures in the geriatric population are typically low-energy fractures resulting from a fall from standing height.Compromised bone quality in the elderly,as well as this population’s concomitant medical comorbidities,render the management of such fractures challenging and controversial.Non-operative management remains the mainstay of treatment,although such a choice is associated with numerous and serious complications related to both the hip joint as well as the general condition of the patient.On the other hand,operatively treating acetabular fractures(e.g.,with osteosynthesis or total hip arthroplasty)is gaining popularity.Osteosynthesis can be performed with open reduction and internal fixation or with minimally invasive techniques.Total hip arthroplasty could be performed either in the acute phase combined with osteosynthesis or as a delayed procedure after a period of non-operative management or after failed osteosynthesis of the acetabulum.Regardless of the implemented treatment,orthogeriatric co-management is considered extremely crucial,and it is currently one of the pillars of a successful outcome after an acetabular fracture.
基金supported by the National Key R&D Program of China (2018YFC0407004)the Fundamental Research Funds for the Central Universities (Nos.B200201059,2021FZZX001-14)the National Natural Science Foundation of China (Grant No.51709089)and 111 Project.
文摘When the geological environment of rock masses is disturbed,numerous non-persisting open joints can appear within it.It is crucial to investigate the effect of open joints on the mechanical properties of rock mass.However,it has been challenging to generate realistic open joints in traditional experimental tests and numerical simulations.This paper presents a novel solution to solve the problem.By utilizing the stochastic distribution of joints and an enhanced-fractal interpolation system(IFS)method,rough curves with any orientation can be generated.The Douglas-Peucker algorithm is then applied to simplify these curves by removing unnecessary points while preserving their fundamental shape.Subsequently,open joints are created by connecting points that move to both sides of rough curves based on the aperture distribution.Mesh modeling is performed to construct the final mesh model.Finally,the RB-DEM method is applied to transform the mesh model into a discrete element model containing geometric information about these open joints.Furthermore,this study explores the impacts of rough open joint orientation,aperture,and number on rock fracture mechanics.This method provides a realistic and effective approach for modeling and simulating these non-persisting open joints.
基金supported by the National Natural Science Foundation of China(Grant No.42174118)a research grant(Grant No.ZDJ 2020-7)from the National Institute of Natural Hazards,Ministry of Emergency Management of China.
文摘The hydraulic testing of pre-existing fractures(HTPF)is one of the most promising in situ stress measurement methods,particularly for three-dimensional stress tensor determination.However,the stress tensor determination based on the HTPF method requires at least six tests or a minimum of 14-15 tests(under different conditions)for reliable results.In this study,we modified the HTPF method by considering the shear stress on each pre-existing fracture,which increased the number of equations for the stress tensor determination and decreased the number of tests required.Different shear stresses were attributed to different fractures by random sampling;therefore,the stress tensors were obtained by searching for the optimal solution using the least squares criterion based on the Monte Carlo method.Thereafter,we constrained the stress tensor based on the tensile strength criterion,compressive strength criterion,and vertical stress constraints.The inverted stress tensors were presented and analyzed based on the tensorial nature of the stress using the Euclidean mean stress tensor.Two stress-measurement campaigns in Weifang(Shandong Province,China)and Mercantour road tunnel(France)were implemented to highlight the validity and efficiency of the modified HTPF(M-HTPF)method.The results showed that the M-HTPF method can be applied for stress tensor inversion using only three to four tests on pre-existing fractures,neglecting the stress gradient.The inversion results were confined to relatively small distribution dispersions and were significantly reliable and stable due to the shear stresses on the fractures and the stress constraints employed.The M-HTPF method is highly feasible and efficient for complete stress tensor determination in a single borehole.
基金supported by the Stable-Support Scientific Project of the China Research Institute of Radio-wave Propagation(Grant No.A13XXXXWXX)the National Natural Science Foundation of China(Grant Nos.42174210,4207202,and 42188101)the Strategic Pioneer Program on Space Science,Chinese Academy of Sciences(Grant No.XDA15014800)。
文摘The Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)satellite is a small magnetosphere–ionosphere link explorer developed cooperatively between China and Europe.It pioneers the use of X-ray imaging technology to perform large-scale imaging of the Earth’s magnetosheath and polar cusp regions.It uses a high-precision ultraviolet imager to image the overall configuration of the aurora and monitor changes in the source of solar wind in real time,using in situ detection instruments to improve human understanding of the relationship between solar activity and changes in the Earth’s magnetic field.The SMILE satellite is scheduled to launch in 2025.The European Incoherent Scatter Sciences Association(EISCAT)-3D radar is a new generation of European incoherent scatter radar constructed by EISCAT and is the most advanced ground-based ionospheric experimental device in the high-latitude polar region.It has multibeam and multidirectional quasi-real-time three-dimensional(3D)imaging capabilities,continuous monitoring and operation capabilities,and multiple-baseline interferometry capabilities.Joint detection by the SMILE satellite and the EISCAT-3D radar is of great significance for revealing the coupling process of the solar wind–magnetosphere–ionosphere.Therefore,we performed an analysis of the joint detection capability of the SMILE satellite and EISCAT-3D,analyzed the period during which the two can perform joint detection,and defined the key scientific problems that can be solved by joint detection.In addition,we developed Web-based software to search for and visualize the joint detection period of the SMILE satellite and EISCAT-3D radar,which lays the foundation for subsequent joint detection experiments and scientific research.
文摘BACKGROUND Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types:Supracondylar(SC),lateral condyle(LC),and medial epicondyle(ME)fractures.AIM To evaluate the epidemiology of pediatric distal humerus fractures(SC,LC,and ME)from an American insurance claims database.METHODS A retrospective review was performed on patients 17 years and younger with the ICD 9 and 10 codes for SC,LC and ME fractures based on the IBM Truven MarketScan®Commercial and IBM Truven MarketScan Medicare Supplemental databases.Patients from 2015 to 2020 were queried for treatments,patient age,sex,length of hospitalization,and comorbidities.RESULTS A total of 1133 SC,154 LC,and 124 ME fractures were identified.SC fractures had the highest percentage of operation at 83%,followed by LC(78%)and ME fractures(41%).Male patients were,on average,older than female patients for both SC and ME fractures.CONCLUSION In the insurance claims databases used,SC fractures were the most reported,followed by LC fractures,and finally ME fractures.Age was identified to be a factor for how a pediatric distal humerus fractures,with patients with SC and LC fractures being younger than those with ME fractures.The peak age per injury per sex was similar to reported historic central tendencies,despite reported trends for younger physiologic development.
文摘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.
基金The authors acknowledge the financial support from Natural Sciences and Engineering Research Council of Canada through its Discovery Grant program(RGPIN-2022-03893)École de Technologie Supérieure(ÉTS)construction engineering research funding.
文摘Conventional numerical solutions developed to describe the geomechanical behavior of rock interfaces subjected to differential load emphasize peak and residual shear strengths.The detailed analysis of preand post-peak shear stress-displacement behavior is central to various time-dependent and dynamic rock mechanic problems such as rockbursts and structural instabilities in highly stressed conditions.The complete stress-displacement surface(CSDS)model was developed to describe analytically the pre-and post-peak behavior of rock interfaces under differential loads.Original formulations of the CSDS model required extensive curve-fitting iterations which limited its practical applicability and transparent integration into engineering tools.The present work proposes modifications to the CSDS model aimed at developing a comprehensive and modern calibration protocol to describe the complete shear stressdisplacement behavior of rock interfaces under differential loads.The proposed update to the CSDS model incorporates the concept of mobilized shear strength to enhance the post-peak formulations.Barton’s concepts of joint roughness coefficient(JRC)and joint compressive strength(JCS)are incorporated to facilitate empirical estimations for peak shear stress and normal closure relations.Triaxial/uniaxial compression test and direct shear test results are used to validate the updated model and exemplify the proposed calibration method.The results illustrate that the revised model successfully predicts the post-peak and complete axial stressestrain and shear stressedisplacement curves for rock joints.
文摘Purpose: This study aims to investigate the predictive value of blood calcium in the prognosis of traumatic fracture. Methods: A retrospective experimental design was employed, 112 cases (52 non-fracture and 60 traumatic fracture) were randomly selected. The type of fracture complies with WHO-recommended (2019) diagnostic criteria for osteoporosis combined with fracture. The blood pressure (BP) was measured by OMRON’s HEM-7136 model electronic blood pressure monitor. Blood calcium (Ca<sup>2+</sup>), and blood phosphorus (P) values were measured using Colorimetric Roche kits on a Roche/Hitachi fully automated biochemical analyzer. Data collection and analysis followed. Results: Higher levels of age, systolic and diastolic blood pressures were found in the traumatic fracture group compared to the control group, whereas weight, height, and blood phosphorus did not differ significantly (P adjusting for age, systolic blood pressure, diastolic blood pressure, and blood phosphorus, binary logistic regression analysis revealed that blood calcium was a protective factor against traumatic fracture (β = -26.85, OR = 0.00, 95% CI = 0.00 -0.02, P = 0.022). Conclusion: The findings suggest that high and low blood calcium levels may serve as useful indicators in predicting the prognosis of fractures resulting from trauma.
基金supported by the National Natural Science Foundation of China(No.42307258)the technological research projects in Sichuan Province(No.2022YFSY0007)the China Atomic Energy Authority(CAEA)through the Geological Disposal Program.
文摘Stability analysis of underground constructions requires a model study of rock masses’ long-term performance. Creep tests under different stress conditions was conducted on intact granite and granite samples fractured at 30° and 45° angles. The experimental results indicate that the steady creep strain rates of intact and fractured rock present an exponential increase trend with the increase of stress level. A nonlinear creep model is developed based on the experimental results, in which the initial damage caused by fracture together with the damage caused by constant load have been taken into consideration. The fitting analysis results indicated that the model proposed is more accurate at identifying the full creep regions in fractured granite, especially the accelerated stage of creep deformation. The least-square fit error of the proposed creep model is significantly lower than that of Nishihara model by almost an order of magnitude. An analysis of the effects of elastic modulus, viscosity coefficient, and damage factors on fractured rock strain rate and creep strain is conducted. If no consideration is given to the effects of the damage, the proposed nonlinear creep model can degenerate into to the classical Nishihara model.
基金funded by Shaanxi Natural Science Basic Research Program Project Study on Liquid Propellant High Energy Gas Fracturing Mechanism in Radial Well Based on Phase Field Method(No.2019JQ-824)NSFC Projects Evolution Mechanism and Effectiveness Evaluation of Fracture Network Produced by Volume Fracturing with Tighter Clusters in Continental Shale Oil Reservoir(No.52274040)+1 种基金Study on Thermal Secondary Pore Evolution and Salt Precipitation Regulation Mechanism in Fire Flooding Reservoirs Based on Multi-field Coupling of Thermal-Flow-Solid-Chemical(No.52274039)Xi’an Shiyou University Youth Scientific Research and Innovation Team Operation Funds in 2018 Flow Mechanism of Complex Reservoirs and High Efficiency Development and Oil Production Technology(No.115080020).
文摘Horizontal well-stimulation is the key to unconventional resource exploration and development.The development mode of the well plant helps increase the stimulated reservoir volume.Nevertheless,fracture interference between wells reduces the fracturing effect.Here,a 2D hydro-mechanical coupling model describing hydraulic fracture(HF)propagation is established with the extended finite element method,and the effects of several factors on HF propagation during multiple wells fracturing are analyzed.The results show that with an increase in elastic modulus,horizontal principal stress difference and injection fluid displacement,the total fracture area and the reservoir stimulation efficiency are both improved in all three fracturing technologies.After a comparison of the three technologies,the method of improved zipper fracturing is proposed,which avoids mutual interference between HFs,and the reservoir stimulation effect is improved significantly.The study provides guidance for optimizing the fracturing technology of multiple horizontal wells.
文摘Introduction: Forearm fractures involving both the radius and ulna, present distinctive challenges in orthopedic trauma management. This case report explores the complexities of a rare case of bilateral fractures, emphasizing the importance of a comprehensive approach for optimal outcomes. Case Presentation: This report presents the case of a 40-year-old motorcyclist who was involved in a road accident and arrived at the emergency department shortly after the incident. Clinical examination revealed closed fractures in both forearms with mild swelling and severe tenderness. Fortunately, no neurovascular issues or compartment syndrome were detected. The patient was administered intravenous fluids and effective pain relief. Forearm splints were applied and the arms were elevated using pillows. Radiographs showed fractures in the right distal radius and ulna, as well as the left mid-shaft radius and ulna. Under general anesthesia, open reduction and internal fixation were per-formed using plates and screws for all four fractures. Postoperatively, the patient’s arms were immobilized and elevated, with gradual recovery during follow-up appointments over six months, eventually achieving full function without complaints. Conclusion: This article highlights the possibility, although infrequent, of bilateral shaft fractures of the ulna and radius. With thorough clinical assessment and radiological investigation, such fractures can be well-defined. The required definitive treatment, which usually involves open reduction and internal fixation, can be performed.
文摘Introduction: The commonest maxillofacial fractures involve the mandible. Age can be considered among influential factors. Aim of the Study: To compare mandibular fractures between children and adults from the beginning up to the treatment in Senegal. Patients and Method: A three-year retrospective study was conducted in a university hospital. The medical records of patients admitted for maxillofacial injuries were reviewed. Patient and injury-related variables including age, gender, etiology, average consultation delay, anatomic location of fracture and treatment were compared up to age of 15 and beyond that. Results: Considering 272 casualties, maxillofacial fractures were less frequent among children than adults (36.7% and 59.7%) and were mainly mandibular (90.1% and 91.4%). Male predilection (sex ratio of 2.4 and 4.9) was twice (2) as pronounced from the age of 16. The average consultation delay was two (2) times shorter for children. Road traffic accidents which predominated among children (33.9%) had comparable frequency (32.3%) although they were outnumbered by assault (37.6%) among adults. Fractures occurred mainly on the corpus (90.1% and 90.4%), particularly on parasymphysis (40.1%) up to the age of 15, whereas angle fractures increased (8.5% to 19.6%) and joint damage decreased afterwards. Intra-oral orthopedic procedures (91.2% and 92.6%) in which mandibular retention splints were more common (37.3%) up to the age of 15 then arch ligatures (49%) were then widely favored. Conclusion: Differences relating to the distribution of causes but also to the anatomic location on the corpus and to the choice of intra-oral orthopedic procedures within overall similarities between children and adults regarding the male predilection, the frequency of road traffic accidents, the mandibular injuries, but also the school therapeutic attitude consisting of favoring the orthopedic option.
