Objectives Independent validation of risk scores after hip fracture is uncommon, particularly for evaluation of outcomes other than death. We aimed to assess the Nottingham Hip Fracture Score (NHFS) for prediction of mortality, physical function, length of stay and postoperative complications. Design Analysis of routinely collected prospective data partly collected by follow-up interviews. Setting and Participants Consecutive hip fracture patients were identified from the Northumbria hip fracture database between 2014-2018. Patients were excluded if they were not surgically managed or if scores for predictive variables were missing. Methods C-statistics were calculated to test the discriminant ability of the NHFS, Abbreviated Mental Test Score (AMTS), and ASA grade for in-hospital, 30- and 120-day mortality, functional independence at discharge, 30-days and 120-days, length of stay, and postoperative complications. Results We analysed data from 3208 individuals, mean age 82.6 (SD 8.6). 2192 (70.9%) were female. 194 (6.3%) died during the first 30-days, 1686 (54.5%) were discharged to their own home, 211 (6.8%) had no mobility at 120-days, 141 (4.6%) experienced a postoperative complication. The median length of stay was 18 days (IQR 8-28). For mortality, c-statistics for the NHFS ranged from 0.68-0.69, similar to ASA and AMTS. For postoperative mobility, the c-statistics for the NHFS ranged from 0.74-0.83, similar to AMTS (0.61-0.82) and better than the ASA grade (0.68-0.71). Length of stay was significantly correlated with each score (p<0.001 by Jonckheere-Terpstra test); NHFS and AMTS showed inverted U-shaped relationships with length of stay. For postoperative complications, c-statistics for NHFS (0.54-0.59) were similar to ASA grade (0.53-0.61) and AMTS (0.50-0.58). Conclusions and Implications The NHFS performed consistently well in predicting functional outcomes, moderately in predicting mortality, but less well in predicting length of stay and complications. There remains room for improvement by adding further predictors such as measures of physical performance in future analyses.

Background: Post-operative delirium in elderly with hip fracture is associated with various adverse clinical outcomes. Nevertheless, the pathophysiological processes underpinning delirium have remained elusive. The aim of this study is to explore the associations between delirium and its features and immune-inflammatory and blood gas biomarkers.Methods: In this prospective study we examined 65 patients who underwent a hip fracture surgery and assessed the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Richmond Agitation-Sedation Scale (RASS), and Delirium Rating Scale Revised-98 (DRS-R-98) before and during 4 days after the surgery. Complete Blood Count (CBC) and venous blood gas markers were obtained at the same time points.Results: Delirium was observed in 19 patients and was accompanied by significantly increased pO2, number of white blood cells, neutrophil percentage, and neutrophil/lymphocyte ratio, and lower mean platelet volume (MPV) (after adjusting for age, central nervous system (CNS) disease, blood loss during surgery, sleep disorders, and body mass index. The severity of delirium was associated with lowered number of platelets and MPV. Psychomotor disorders were associated with lower bicarbonate levels. The requirement of physical restraint of the patients was predicted by increased percentages of neutrophils and lymphocytes. Prior CNS disease was together with these biomarkers a significant predictor of delirium and severity of delirium. Conclusion: Delirium and psychomotor disorders following hip fracture and surgery may be caused by immune-inflammatory and oxidative stress pathways probably attributable to an aseptic inflammatory process. Oxygen administration may aggravate these pathways.

As exemplified by the global response to the SARS-CoV-2 pandemic, whole genome sequencing played an important role in monitoring the evolution of novel viral variants and provided guidance on potential antiviral treatments. The recent rapid and extensive introduction and spread of highly pathogenic avian influenza virus in Europe, North America and elsewhere raises the need for similarly rapid sequencing to aid in appropriate response and mitigation activities. To facilitate this objective, we investigated a next generation sequencing platform that uses a portable nanopore sequencing device to generate and present data in real time. This platform offers the potential to extend in-house sequencing capacities to laboratories that may otherwise lack resources to adopt sequencing technologies requiring large benchtop instruments. We evaluated this platform for routine use in a diagnostic laboratory. In this study we evaluated different primer sets for the whole genome amplification of influenza A virus and evaluated five different library preparation approaches for sequencing on the nanopore platform using the MinION flow-cell. A limited amplification procedure and a rapid procedure were found to be best among the approaches taken.

This research investigates the fatigue behaviour and fracture mechanics of high-performance concrete (HPC), including various compositions such as HPC with basalt aggregates (HPC-B), HPC with gravel (HPC-G), and high-strength coarse mortar (CM) static and cyclic tensile loading within the special priority program SPP 2020. The study aims to integrate fracture mechanics into structural analysis to enhance design guidelines for slender cross-sections and safety-related high-performance structural components. The experimental investigations reveal HPC-B's re-markable superiority, displaying higher compressive strength, modulus of elasticity, and tensile strength compared to HPC-G and CM. A modified disk-shaped compact tension (MDCT) based on ASTM standards, aided by digital image correlation (DIC) unveils fracture behaviour, empha-sizing fracture energy as a crucial parameter. HPC-B exhibits improved crack resistance and notch sensitivity reduction attributed to crushed basalt aggregates and enhanced interfacial transition zone (ITZ). The research scrutinizes factors like material characterization, aggregate morphology, stress levels, and displacement rate on crack formation. High-cycle fatigue tests show HPC-B's superior performance, and post-fatigue analysis reveals enhanced residual fracture toughness attributed to nano-level structural changes, stress redistribution and aggregate-matrix interac-tion. 3D image analysis via Computed Tomography (CT) scans captures mesostructural crack propagation and provide quantitative insights. This study advances the understanding of HPC fatigue behaviour, emphasizing the interplay of aggregate types, morphologies, and their dy-namic response to cyclic loading, offering valuable insights for optimizing design guidelines and fostering innovation in structural engineering.

The scratch test consists in pushing a tool across the surface of a material at a given penetration depth or applied load. It has several applications in Science and Engineering including strength testing, damage and quality control of thin films and coatings. Despite numerous attempts in scientific literature, the application of scratch test to characterizations of fracture properties remains a heavily controversial topic. Therefore, this investigation arises as an experimental study in order to assess the fracture toughness using scratch test. A study on the effect of cryogenic treatment, performed after tempering, on fracture toughness, via scratch test experiments, of different tool steels has been made. A laboratory investigation on AISI D2, AISI M2 and X105CrCoMo18 steel confirms the possibility of increasing the fracture toughness by carrying out the cryogenic treatment after the usual heat treatment

To determine the fracture rate of ceramic crowns and causes of ceramic crown failure, this study used keywords—namely “endocrown,” “veneered fixed dental prosthesis,” “monolithic lithium disilicate (LS2),” and “all-ceramic single crown”—to search for articles published in English from 2005 to 2023 in the PubMed electronic database. Rather than using the Boolean logic algorithm between MESH terms and keywords, we accurately calculated the numbers of final clinically tracked cases with crown fractures from the contents of articles. The titles and abstracts of many related articles focused on implant or abutment fracture, while crown fracture was investigated and mentioned only in the main texts of the articles. Our studies included those crowns as well as having more complete data collection. Our search yielded 228, 93, 404, and 358 articles for the keywords “endocrown,” “veneered fixed dental prosthesis,” “monolithic lithium disilicate (LS2),” and “all-ceramic single crown,” respectively. We used the Newcastle–Ottawa Scale (NOS) to assess article quality, and our inclusion criteria were randomized controlled trials (RCT) and cohort study articles involving more than 3 years of follow-up and more than 20 cases. After reviewing, 16 high-quality articles were selected for analysis. The 4.4% crown fracture rate recommended on the basis of most clinical results was achieved in only 6 of the 16 articles. In these 6 articles, the researchers concluded the following reasons that may cause the crown fractures: the thickness of the veneer ceramic material; the connector dimensions; pontic span of the fixed prosthesis; the type of cement; the treatment of the ceramic surface before luting. Other articles inferred that the computer-aided design libraries that were insufficient for the creation of appropriate anatomically supported frameworks for prostheses with ceramic veneers; the thermal expansion coefficient and fracture toughness of the framework material did not match those of the veneer ceramic, resulting in an insufficient area supporting the ceramic veneer then leads to premature crown failure after a long period chewing. The future prospective for material developing could focus on solving those problems and have better clinical results.

As one of the typical deposits in Sichuan-Yunnan-Guizhou Pb-Zn metallogenic province, the Daliangzi Pb-Zn deposit has a close genetic relation with the structural system of “black/fracture zone” formed under the action of NWW-approx. EW strike-slip structures in the metallogenic province, but the mechanism of rock and ore-controlling action of the structural system remains unclear. Based on detailed analysis of tectonite-mineralized alteration lithofacies of R1 “black/fracture zone”, the tectonite-mineralized alteration lithofacies zones can be divided into 4 types in succession outward from the Pb-Zn mineralization center, i.e., ① brecciated and stockwork-like Pb-Zn mineralization-complex breccia facies zone, ② stockwork-like Pb-Zn mineralization-simple breccia and cataclasite facies zone, ③ veined pyrite-sulfide-dolomitic cataclasite facies zone, and ④ fine-veined calcite-black carbonized dolomite facies zone; Cl- and SO42--rich high-temperature oxidizing ore-bearing fluid mixes with reducing fluid in Zone ① while migration and precipitation occur in Zone ④. With the evolution of ore-forming fluid, the homogenization temperature decreases from Zone ① to Zone ④, the salinity increases from Zone ① to Zone ② and then decreases to Zones ③ and ④, and the fluid density has little change on the whole; the contents of Zn, Pb, Cu, Ga, Ge, Cd, Ag, and other metallogenic elements, the Zn/Pb ratio, and the CaO/MgO mole ratio decrease gradually from Zone ① to Zone ④; and REE fractionation, calcilization, silicification, and pyritization enhance gradually from Zone ① to Zone ④. This series of changes are the product of diapirism (cryptoexplosion) of strike-slip structures and “black/fracture zone”, among which the second-order structures (F5, F100, and other faults) derived from NWW-approx. EW striking dextral shear-tension faults F1 and F15 control the brecciated and stockwork-like Pb-Zn mineralized complex breccia facies zones and the stockwork-like Pb-Zn mineralized simple breccia and cataclasite facies zones. Therefore, this paper establishes the zoning mode of tectonite-mineralized alteration lithofacies of “black/fracture zone” and proposes that Zones ① and ② are important prospecting criteria. conclusions.

There are no studies that have investigated the characteristics of car use across THA patients, including those who do not drive. This study aimed to evaluate, in THA patients, (1) postoperative car usage, (2) comfort while entering and exiting a car, and (3) whether lower limb muscle strength affects action comfort. One hundred seventy-two post-THA patients completed the questionnaire in 2020, along with assessments of hip abductor and knee extensor muscle strength before surgery and at discharge. Patients whose overall comfort level was judged as “comfortable” were defined as the “comfort” group; others were placed in the “discomfort” group. Of the 172 patients, 161 reported car usage at a mean of 5.6 years after THA. Of these, 114 and 47 patients were placed in the "comfort" and "discomfort" groups, respectively. Patients in the "discomfort" group were three times more likely to experience discomfort using the contralateral side door than the surgical side door, and about twice as many patients experienced discomfort when entering as when exiting. Lower preoperative contralateral hip abductor muscle strength was the only independent predictor for discomfort. The take-home messages were that prevention of contralateral-side weakness may improve comfort during the action after THA.

Hip joint surgeries, including total hip replacement or resurfacing, have increased tremendously in the last decades. Number of patients of all ages, replace their hip, due to severe injuries or trauma problems, so as to have a better life. According to these factors, new material and processes in implants manufacturing are imported to medicine, through research programs, every year. In the scope of one of these programs, that has to do with ceramic coatings on metallic resurfacing implants, a new 3axis Hip simulator was designed and manufactured in the Laboratory of Manufacturing Technology of the National Technical University of Athens. The scope of this paper is to present the main parts, materials and process used to manufacture the simulator as well as the way the simulator is working and how its movement in 3axis is accomplished. Furthermore, the evaluation of the machine and its use to examine resurfacing implants is presented.

Aluminum wire is a common material for wire bonding due to its resistance to oxidation and low price. It does not melt when becoming a free air ball (FAB) during the electronic flame-off (EFO) process with wettability, and is applied by wedge bonding. This study used 20μm Zn-Coated Al-0.5wt.%Si (ZAS) wires to improve the FAB shape after the EFO process, while maintaining stability of the mechanical properties, including the interface bonding strength and hardness. In order to test circuit stability after ball bonding, the current-tensile test was performed. During the experiment, it was found that 80nm ZAS with wire bonding has lower resistance and higher fusing current. For the bias tensile test, the thicker Zn film diffused into the Al-Si matrix easily, after which the strength was reduced. The ball-bond interfaces had no change in their condition before and after the bias. Accordingly, ZAS could be a promising candidate for ball bonding in the future.

Total hip arthroplasty (THA) is a preferred treatment for primary osteoarthritis (OA) or secondary due to developmental hip dysplasia (DDH). Gait analysis is considered a golden standard for evaluating post-arthroplasty walking patterns. This study compared post-THA spatiotemporal gait parameters (SGPs) between OA and DDH patients and explored correlations with demographic and clinical variables. Thirty patients (15 per group) were recorded during gait, and their SGPs were analyzed. Functionality was evaluated with the Oxford Hip Score (OHS). The OA patients were significantly older than DDH (pr< 0.51, all p< 0.05). The preoperative gait alterations associated with OA or DDH were improved to similar levels in both groups after THA. Post-arthroplasty SGPs and OHS correlations indicate limitations in certain activities. These find-ings must be correlated with kinetic gait analysis data to fully evaluate gait and functionality dif-ferences among patient groups.

Total hip arthroplasty is a complex procedure. The achievements of implantology enabled the development of a faithful representation of hip joint physiology as well as the production of materials that can successfully replace damaged natural tissues. A very important issue is the correct selection of the geometry of the endoprosthesis adequate to the load of the joint. Materials used for endoprosthesis are a metal head and a polymer cup (e.g. PE-UHMW). The main interactions in the endoprosthesis are friction and surface pressure, which must be limited, exceeding them causes the destruction of the biomechanical system - plastic deformation of the polymer and the formation of too large and unacceptable radial clearances. Based on the author's developed calculation method of hip joint endoprosthesis contact parameters, the impact on maximum contact pressure and the angle of contact of the joint load was estimated depending on the diameter of the endoprosthesis and radial clearance. The correctness of changing the values of maximum contact pressure from the mentioned parameters was determined. Correspondingly: an increase in joint load causes a linear increase in the maximum contact pressure; increasing the diameter of the endoprosthesis head - their non-linear decrease, and increasing radial clearance - their increase

Osteoarthritis (OA) poses a growing challenge for the aging population, especially in hip and knee joints, contributing significantly to disability and societal costs. Conventional clinical evaluations, typically performed in controlled settings, face difficulties in capturing the dynamic characteristics of rehabilitation and functioning in real-life scenarios. The study assessed the use of automated unsupervised evaluations in the rehabilitation process for patients after hip and knee replacements. We analyzed data from 1144 individuals who used a digital application after surgery, activity data were collected using the Garmin Vivofit 4. Several parameters such as the Peak 6-Minute Consecutive Cadence (P6MC) and Peak 1-Minute Cadence (P1M) were computed and analyzed on a daily basis. The results indicated that cadence measurements, specifically, can effectively differ among individuals with hip and knee conditions as well as the recovery process. Moreover, these metrics demonstrated a high level of responsiveness in monitoring the progress of recovery, surpassing the effectiveness of simply measuring the total number of steps taken. The study highlighted the capacity of technology-driven, patient-centered rehabilitation to improve accuracy, tailor therapy to individual patients, and increased patient involvement. This research also highlighted the significance of automated, unsupervised assessments in enhancing rehabilitation results for OA patients following hip and knee replacement, as tele-rehabilitation becomes increasingly important.

Post-mortem characterisation is a pivotal tool to trace back to the origin of structural failures in modern engineering analyses. This work presents a comparison of both the crack propagation profiles and the rupture roughness profiles based on areal parameters for total fracture area. Notched and smooth samples made of weather-resistant structural steel (10HNAP), popular S355J2 structural steel and aluminium alloy AA2017A under bending, torsion, and combined bending-torsion are investigated. After the fatigue tests, fatigue fractures are measured with an optical profilometer, and the relevant surface parameters are critically compared. The results show a great impact of the loading scenario on both the local profiles and the total fracture areas. In this work, the results of both approaches (local and total fracture zones) for specimens with different geometries are investigated. For all specimens, measured texture parameters decreased in the following order: total area, rupture area, and propagation area.

In this paper, we propose a modeling method based on peridynamics for ductile fracture at high temperatures. A thermoelastic coupling model combining peridynamics and classical continuum mechanics is used to limit the peridynamics calculations to the failure region of a given structure, thereby reducing computational costs. Then, a plastic constitutive model of peridynamic bonds is developed to capture the ductile-fracture process of the structure. Furthermore, an iterative algorithm for ductile-fracture calculation is presented. Finally, several numerical examples are shown. Particularly, the fracture processes of a superalloy structure under 800℃ and 900℃ environments are simulated and compared with experimental results. Our comparisons show that the crack modes captured by the proposed model are similar to experimental observations, which verifies the validity of the proposed model.

Background: developmental dysplasia of the hip (DDH) is a condition characterized by abnormal hip development in infancy. Early diagnosis allows for effective treatment, while late presentation often necessitates complex surgical interventions. Current recommendations advise screening between the 6th and 8th week postnatal using ultrasound, typically employing the Graf method. However, there's no universal consensus on whether ultrasound screening significantly increases treatment compared to clinical examination-guided ultrasound. This study aims to explore the feasibility of prenatal ultrasound for early identification of DDH risk. Methods: This prospective observational study involved 100 pregnant women undergoing fetal hip ultrasound during the second and third trimesters. Using the modified Graf method, alpha and beta angles were calculated on the fetus. Postnatally, alpha and beta angles were compared with prenatal values. Results: Prenatal ultrasound at 24th week showed inconclusive results because of the difficulty in identification of Graf landmarks, while ultrasound at 34th week has proved to be a reliable and safe method for quantitative determination of alpha and beta angles. Significant correlations were found between prenatal and postnatal alpha and beta angles. Moreover, significant differences in prenatal alpha and beta values were observed in patients developing mature/immature hips postnatally. Conclusions: Prenatal diagnostics show promise for predicting infant hip development. Further research is warranted to validate correlation strength and clinical applicability.

Background: The incidence of fracture and surgery of the hip and lower extremities is still high. Long postoperative bed rest has the potential to increase the incidence of various complications that may increase the morbidity and mortality rate of patients after hip and lower extremities surgery. Aim: This literature review aimed to identify the effects of early mobilization in hip and lower extremity postoperative. Method: Search for articles on several databases such as ProQuest, ScienceDirect, CINAHL, Medline, Wiley Online and Scopus, using the Boolean operator by combining several keywords according to the literature review topic, with inclusion criteria are published in the last 3 years (2019-2021), used a quantitative design, written in English and full text articles. A total of 435 articles were obtained, then screened and reviewed, so that there were 16 (sixteen) eligible articles.Result: There were 11 (eleven) effects of early mobilization, i.e. reducing length of stay, reducing the risk of deep vein thrombosis (DVT), reducing pulmonary infections (pneumonia), reducing urinary tract infections, reducing the risk of wound infection, improving extremity function and ability to walk, reducing postoperative pain, reducing the risk of pressure sores, reducing postoperative delirium, reducing readmission and lowering hospitalization costs. Conclusion: This literature review showed that early mobilization is safe and effective in postoperative patients to reduce the risk of complications and adverse events. Nurses and health workers who care for patients could implement early mobilization and motivate patients to be cooperative in undergoing early mobilization.

Osteoporotic vertebral fracture is the most common fracture from osteoporosis, and are largely undiagnosed due to the mostly asymptomatic nature of the condition. It increases the risk of subsequent fractures and contributes to societal burden. Risk factors for osteoporotic fractures are found in the WHO fracture risk assessment model and used as a tool for monitoring bone health. Vertebral fractures are diagnosed from anteroposterior and lateral spine radiographs and are confirmed with an approximate loss of 20% vertebral height as compared to adjacent vertebrae. One of the most used grading for vertebral fractures is the SQ grading. Mild vertebral fractures could easily be misdiagnosed due to some peculiarities of the vertebral column. CT scan is useful for planning surgical intervention while an MRI scan can provide information about the recency of the fracture and rule out cancer-related fractures. Management depends on the severity of the fracture which could range from conservative management to surgical vertebral augmentation and decompression. Bisphosphonates are used to treat osteoporosis in acute and long-term management of fractures. Osteoimmunological therapies such as denosumab and romosozumab are new therapeutic interventions for osteoporosis while there are many other potential treatment options. Precision medicine provides an individualized treatment approach while regenerative medicine utilizes mesenchymal stem cells for fracture repair.

NASA/ESA/CSA joint venture James Webb Space Telescope is about to be launched. It is hypothesized to operate in near-infrared range. It is also hypothesized to unveil early star formation, galaxies, and universe due to its orbit, point in orbit and orbital motion. It has been under manufacturing for over 20 years at a staggering cost of 10 billion US dollars (most expensive scientific experiment in history). Beryllium (Be) is chosen to be element for construction of its main mirrors due to its high stiffness, low density, low linear coefficient of thermal expansion (α) in cryogenics and high thermal conductivity. It is followed by gold (Au) layer deposition on its (Be) surface to enhance its sensitivity towards infrared radiation as later is hypothesized to bear superior properties. However, serious mistakes have been made in selecting this material for this application. Owing to its crystal structure (hexagonal close packed (hcp)), slip planes (basal, prismatic and pyramidal) and mechanisms of their activation, Be necessitates easy fracture at cryogenic temperature. It has anisotropic properties and prone to transverse fracture under tensile loading. Furthermore, its ductile to brittle transition temperature is very low making it entirely unsuitable for such an application. It is one of most expensive metals on planet. This study constitutes revisiting these fundamental properties and mechanisms which were entirely ignored during materials selection thus rendering whole project useless.

Bioimpedance measurements are used increasingly in health applications because bioelectric parameters have been associated with anatomical and physiological properties, thus enabling to distinguish medical conditions. For bone fracture diagnostics, nevertheless, there is no established non-invasive method. Ex vivo studies and In vivo bioimpedance procedures, both invasive and non-invasive, on mammalians long bones are associated with promising results. In this work, out of a total of 568 papers, we reviewd 59 articles that mention long bone integrity by electric properties, be it Bioimpedance Analysis, Electrical Impedance Spectroscopy or Electrical Impedance Tomography. The papers are described in three sections, “Ex vivo measurements”, “In vivo invasive measurements” and “In vivo non-invasive measurements”. This review allows to establish the basics to planning the development of new technology to detect bone fracture via bioimpedance measurements.

This study evaluated the hip joints of the giant anteater (Myrmecophaga tridactyla) through imaging and macroscopic analyses and proposed a surgical approach for arthrotomy procedures in this species. The study used four samples fixed in 10% formaldehyde and six thawed carcasses. Radiographic and ultrasound examinations and anatomical dissection allowed the proposal of a surgical approach for the hip joint. The radiographic evaluation occurred with frog-legged ventrodorsal and lateral projections, and the ultrasound enabled joint soft tissue assessment. The articular elements represented similar characteristics to other domestic species. Some anatomical particularities of muscle groups were the intermuscular septum between the tensor fasciae latae and superficial gluteus muscles at the level of the greater trochanter of the femur, which provides lateral access to the femoral head and neck more conservatively. In conclusion, the anatomical particularities of radiographic positioning, the clinical applications of joint ultrasound, and the arrangement of muscle groups must be considered when evaluating and surgically accessing the hip joint of the giant anteater.

Background and Objectives:: Hip osteoarthritis is the main cause physical disability, also has a serious impact on the efficiency and independence of older people. The aim of the study was to analyze the relationship between hip osteoarthritis and the risk of sarcopenia. Our main hypothesis was whether the risk of sarcopenia, as measured by the SARC F questionnaire , is related to the physical fitness of older people with hip osteoarthritis. Materials and Methods: The study was conducted with the participation of 177 people of aged 65 or more, diagnosed hip osteoarthritis. The subjects were assessed using the SARC F questionnaire, the Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG) test. The subjects were divided into two groups depending on the result they obtained in the SARC F questionnaire (group 1- SARC F &lt;4, group 2 - SARC F ≥ 4). Results: There was a significant correlation between the results in the SARC F and the results of the TUG (p&lt;0.001) and the SPPB test, both the SPPB total score (p&lt;0.001)and its elements: SBBP chair stand test (p&lt;0.001), SPPB balance test (p&lt;0.001), SPPB gait speed test (p&lt;0.001). Logistic regression of the SPPB and TUG predictors showed that in SARC F more than 4 predicted worse SPPB and TUG outcomes. In the SARC group, F above 4 increases the odds of poorer scores in SPPB OR=1.097; CI 95% 1.053-1.146 and TUG, OR=1.096; CI 95% 1.104-1.266. Conclusion: The study showed that the results obtained in the SARC F questionnaire correlate with the possibilities of physical functioning in patients with hip osteoarthritis SARC F is an inexpensive method that can be used to assess the risk of sarcopenia. Healthcare professionals, especially in primary care, should consider assessing the risk of sarcopenia especially in people with hip osteoarthritis.

There are several causes of hypoxia during and after surgery, and atelectasis is a common symptom that occurs during surgery. In particular, elderly patients are more vulnerable to hypoxia due to their existing lung diseases or respiratory muscle weakness. This study presents the cases of two elderly patients who developed hypoxia during total hip arthroplasty under general anesthesia. Positive end expiratory pressure, recruitment maneuver, and increased fraction of inspired oxygen improved hypoxia only temporarily, and patients’ oxygen saturation level again dropped to 79%–80%. We suspected that hypoxia was caused by atelectasis and, therefore, re-sumed spontaneous respiration. Thereafter, both the patients showed an improvement in hypoxia. Intraopera-tive hypoxia that is suspected to be caused by atelectasis can be improved by securing sufficient lung volume for respiration through increased muscle tone with spontaneous respiration

This paper presents the results of experiments on the study of a hydraulic fracture interaction with a preliminary created fracture that simulates a natural fracture. A distinctive feature of the conducted experiments is the ability to use an ultrasonic sounding to measure the fracture propagation and opening simultaneously with the fluid pore pressure measurements at the several points of the porous saturated sample. It allows to obtain the pressure distributions at various experiment stages and to establish a relation between the pore pressure distribution and the hydraulic fracture propagation and its interaction with macroscopic natural fracture. The possibilities of active ultrasonic monitoring have been expanded due to preliminary calibration experiments, which make it possible to estimate the fracture opening value by attenuation of ultrasonic pulses. The experiments show that the fracture propagation is limited by the natural fracture. This is caused by the hydraulic fracturing fluid leaks into the natural fracture, so both hydraulic fracture and natural fracture compose united hydraulic system.

We investigated the micro-threaded stem taper surface and the impact on premature failures, aseptic loosening, and infection. We have focused on the fretting, and crevice corrosion of micro-threaded tapers, as well as the characterization of microstructure and surface properties of two new and three retrieved Zweymüller stem tapers of cementless hip endoprostheses selected from a set of 45 stems. The retrievals examined were those in which the sole source of modularity with a metallic component was the head-stem taper interface between the Ti alloy taper stem and the ceramic head. To determine the surface chemistry and microstructures of both new and retrieved hip endoprostheses stem taper titanium alloy, scanning electron microscopy (SEM) was employed for morphological and microstructural analyses. At the same time, energy dispersive spectroscopy (EDS) was utilized for characterizing chemical element distribution, and electron backscattered diffraction (EBSD) was used for phase analysis. The micro-threated stem taper’s roughness for different manufacturers was investigated using an optical profilometer. Standard roughness pa-rameters Ra (average surface roughness) and Rz (mean peak to valley height of the roughness pro-file) were used in this investigation.Additionally, profile depth and peak spacing for different samples were investigated. The surface roughness results indicate no significant difference in roughness associated with varying survivorship times, ranging from 3 to 239 months, and across different manufacturers. Electrochemical studies revealed no fretting corrosion in retrieved stem tapers (ceramic head) that prematurely failed due to aseptic loosening after 239 months, infection after 3 months, and low-grade infection after a 32-month lifetime. Therefore, three retrieved ta-pers and two new ones for comparison underwent potentiodynamic measurements in Hank’s so-lution to ascertain the corrosion rate of new and retrieved stem taper surfaces. The results show a low corrosion rate for both new and retrieved samples that failed prematurely due to aseptic loosening. However, the corrosion rate of infected and low-grade infected tapers was higher. In conclusion, our study aligns with existing literature, suggesting that the use of ceramic heads de-creases the problem of taper corrosion and subsequently reduces premature failures in total hip arthroplasty.

Osteoporosis is a common problem in orthopedic medicine, and it has become an important medical issue in orthopedics as Taiwan is gradually becoming an aging society. In the diagnosis of osteoporosis, the bone mineral density (BMD) derived from dual-energy X-ray absorptiometry (DXA) is the main criterion for orthopedic diagnosis of osteoporosis, but due to the high cost of this equipment and the lower penetration rate of the equipment compared to the X-ray images, the problem of osteoporosis has not been effectively solved for many people who suffer from osteoporosis, however, at present, in clinical diagnosis, doctors are not yet able to accurately interpret X-ray images for osteoporosis manually, and must rely on the data obtained from DXA. In recent years, with the continuous development of artificial intelligence, especially in machine learning and deep learning, significant progress has been made in image recognition. Therefore, it is worthwhile to revisit whether it is possible to use a convolutional neural network model to read a hip X-ray image and then predict the patient's BMD. In this study, we proposed a hip X-ray image segmentation model and a hip X-ray image recognition classification model. First, we used the U-Net model as a framework to segment the femoral neck, greater trochanter, wards triangle, and the total hip in the hip X-ray images. We then performed image matting and data augmentation. Finally, we constructed a predictive model for osteoporosis using deep learning algorithms. In the segmentation experiments, we used intersection over union (IoU) as the evaluation metric for image segmentation, and both the U-Net and U-Net++ models achieved segmentation results greater than or equal to 0.5. In the classification experiments, using the T-score as the classification basis, the total hip using the DenseNet121 model has the highest accuracy of 74%.

Fracture and failure performance of foamed concrete materials were conducted using three methods, i.e., inverse analysis, digital image correlation (DIC) and finite element modelling (FEM) from tested normalized notched beams under three-point bending. From this study, several characteristics both experimental and FEM are discussed. However inverse analysis is only well applicable for series GF-30. The bilinear softening of the testing beam was estimated to identify fracture energy (GF), critical crack length (ac) and elastic modulus (E) with values of 0.015 N/mm, 54.5 mm, and 13 GPa, respectively. Additionally, fracture toughness was calculated by adopting double-K (initiation fracture of 6.907 MPa.mm0.5, unstable fracture of 23.186 MPa.mm0.5 and cohesive fracture of 16.278 MPa.mm0.5). Two-dimensional FEA Modelling of fracture was carried out using a Traction Separation Law (TSL), incorporating extended finite element method (XFEM) and cohesive zone (CZM) techniques. A sensitivity study was carried out, global mesh size of two and damage stabilization cohesive with the value of 1 × 10-5 showed good convergence and were used in other models. Furthermore, by comparing experimental observation using DIC, reliability FEM was validated and showed good acceptance to simulating the crack propagation.

Geological structures such as joints and faults in rock mass have significant influence on open pit mining. Hence, it is critical to develop a understanding of dynamic joint behaviour under blasting loading. This in turn can provide both theoretical and practical guidance to improve blasting rock fragmentation and associated bucket excavating efficiency. In this paper, delayed blasting on the highwall bench at Baiyunebo open-pit mine was used as an example, a nonlinear joint blasting model was also constructed. By simplifying the blasting wave propagation velocity, the P-wave normal incidence to the joint was obtained. The peak vibration velocity was 0.33m/s at 3.0s. The S-wave reflected by the joint interface was first reflected backward and then forward, which the peak vibration velocity was 0.027 m/s. By combining the relevant stress and displacement theories of type I and II cracks, the equipotential diagrams of the stress and displacement field with the vibration velocity of the particle were obtained. σx was positive in the direction of 0~330° and subjected to tensile stress, whereas σy was positive in the direction of 0~180° and under tensile stress. The longitudinal σy along joint was low in compressive stress distribution area and did not affect surrounding rock at the time. The stress concentration appeared in the lower right corner. Based on the continuous behavior of stress wave in joints, the asymmetry and continuous changes reflected in the whole process could not be analysed by the contour diagram. Hence, ANSYS used to analyse distribution of the stress field. The intensity of the shock wave after detonation was greater than that of the rock strength. Subsequently, the sub-layer shock wave supplemented the shock wave energy that was not enough to break the rock and induced further cracking. This was able to be visualized by the degree of color change post-processing. It was concluded that with the attenuation of the detonation wave energy, the stress exhibited a decreasing trend in this process. According to distribution of the peak effective stress, it was found that the peak value first increased to 10-12 MPa and then showed a downward trend. Overall, the results were validated against the finite element simulation and mathematical analysis.

Introduction: Bone fractures may be the result of high force impact or stress, or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, osteopenia, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture. Bone cancer can be primarily or secondary to metastasis. Case presentation: We report a rare case of left humerus fracture in a 59-year-old male patient due to metastatic renal cell carcinoma. Our patient had no important past medical history. He suffered from two months of left arm pain, moderate disability and fever at night. Analgesics consumption resulted in minimal relieve. Trauma history was negative. X-ray of the left arm showed an osteolytic lesion with humerus fracture. Abdominal computed tomography with contrast showed right renal mass.Radical right nephrectomy was performed in addition to alignment nailing of the left humerus fracture with biopsy. Pathology report documented clear cell carcinoma with metastatic bone. The treatment was completed by chemotherapyDiscussion: Secondary bone tumors are metastatic lesions which have spread from other organs, most commonly carcinomas of the breast, lung, and prostate, and rarely from kidney. In some cases, bone metastasis could be the first symptoms of renal cell carcinoma. Conclusion: suspected pathological bone fractures should be investigated completely. It may hide a tumor as a cause.

The paper describes the Field Boundary Element Method applied to the fracture analysis of a 2D rectangular plate made of Functionally Graded Material to calculate Mode I Stress Intensity Factor. The object of the Field Boundary Element Method is the transversely isotropic plane plate. Its material presents an exponential variation of the elasticity tensor depending on a scalar function of position, i.e., the elastic tensor results from multiplying a scalar function by a constant taken as a reference. Several examples using a parametric representation of the structural response show the suitability of the method that constitutes a sight of Stress Intensity Factor evaluation of Functionally Graded Materials plane plates even in the case of more complex geometries.

Abstract: This study was aimed to determine the influence of the volume fraction of steel fibers and on fracture parameters of concrete. Fifty notched steel fiber reinforced concrete (SFRC) beams and ordinary concrete beams with dimensions of 100mm×100mm×515mm were cast and tested via three-point bending test. Among them, the type of steel fiber is milling type (MF), and the volume fraction of steel fiber added is 0%, 0.5%, 0.5%, 1.5%, 1.5%, 2%, respectively. The effects of the steel fiber volume fraction (VF) on the critical stress intensity factor (KIC), fracture energy (GF), the deflection at failure(δ0), the critical crack mouth opening displacement (CMODC) and the critical crack tip opening displacement (CTODC)were studied. Through the analysis of test phenomena and test data such as load-deflection (P-δ) curve, load-crack mouth opening displacement (P-CMOD) curve and load-crack tip opening displacement (P-CTOD) curve following conclusions are drawn: With the increase of steel fiber volume fraction, some fracture parameters increase gradually and maintain a certain linear growth. The gain ratio of fracture parameters increases significantly, and the gain effect is obvious. Through this law of growth, the experimental statistical formulas of fracture energy and critical stress intensity factor are summarized.

Pre-existing fracture and secondary cracks in rock mass are formed by natural power, such as magma condensed to igneous rocks and tectonic movement. The orientation and inclination of these fractures obey certain laws relating to the stress, temperature, minerals, water and so on. Therefore, cracks react differently under the same external loading on the condition of various inclination, fissure apertures, stiffness and joint roughness. To simulate the crack propagation, experiments on hollow cylinder cut by one oblique interface mimicking single fracture accumulated numerous data discovering the failure criterion in accordance with the Mohr-Coulomb criterion. And theory on the Terzaghi’s effective principle take an essential role in controlling the behavior of triggering fault. This paper introduced a series of oblique plane cutting the cylinder regarded as fractures at different inclination to concentrate on how the fracture characteristics effect the stress and strain distribution inside the specimen, especially, the relationship between displacement and water head. The key point of this numerical simulation is coupling the solid phase and the fluid phase, specifically, the mechanic and seepage field. According to the statics, curves referring to deformation and water head could be described as increasing lines. Besides, simulation on coupling solid phase and fluid phase can supply crucial evaluation on activating existing fault, and thus predicting induced seismicity in reservoirs or estimating damage in shale gas exploration.

The present study investigates the failure mechanisms of industrial fiber materials, using a custom designed fiber cutting performance test bench. The fracture morphologies of single PA6 fibers are examined by scanning electron microscopy. The analysis reveals that fiber cutting can be distinguished according to four distinct stages of fiber failure represented by shearing, cutting, brittle fracture, and tensile failure, which are the result of different mechanisms active during the processes of crack initiation, extension and fracture. The results of fractographic analysis are further verified by an analysis of the blade assembly speed with respect to time over the entire fracture failure process based on high-speed camera data. The results of fractographic analysis and blade assembly speed are fully consistent.

The ultrasound guided viscosupplementation of the hip joint with hyaluronic acid(HA)is considered a standard procedure among the conservative treatments for hip arthritis.The aim of the study was to evaluate the clinical benefit and the incidence of adverse events of the technique in a obseravtional study at one year follow up. We evaluated a consecutive series of 85 patients with a diagnosis of symptomatic arthritis that performed intra-articular ultrasound-guided hyaluronic acid injections. The scales used for evaluation were modified Harris Hip Score(mHHS),WOMAC (Western Ontario and McMaster University),Hip Outcome Score (HOOS) with subscale Sport (HOOSs), for pain the Visual Analogic Scale (VAS).The patients were classified according to Tonnis’ radiological classification of arthrosis (range 0-3):20 patients(grade 0),32(grade 1),18(grade 2),15(grade 3).At last follow up all the scales increased:mHHS from 59.35 to 82.1,HOOS from 69.45 to 78.53,HOS Sport from 47.4 to 58.11,VAS from 6.09 to 3.97,WOMAC from 33.2 to 31.5 (p<0.05 for all the parameters);13/85 requested arthroplasty. Based on our findings, indication for use of hyaluronic acid is limited to patients with mild to moderate arthritis.Patients in advanced arthritis refusing replacement surgery and asking for this treatment should be informed about the poor results of the technique even in the short term follow up.

The purpose of this case study was to evaluate the benefits that evidence-based nutritional and training recommendations could have on the time course of reconditioning following hip arthroplasty in a competitive master triathlete. Methods: During 38 weeks (from 6 weeks prior to surgery through to the return to competition), the athlete was provided with detailed training and nutritional recommendations based on the latest research evidence. Dietary intake (via the remote food photographic method), body composition (via DXA), peak oxygen uptake (VO2peak), peak power output (PPO) and cycling efficiency (GE) were assessed 6 weeks pre- and 8, 12, 18, 21 and 25-weeks post-surgery. Training load was quantified (TRIMP score) daily during the retraining. Results: Total body mass increased by 8.2 kg (attributable to a 3.5 and 4.6 kg increase in fat mass and lean mass, respectively) between week -6 and week 8 despite a reduction in carbohydrate (CHO) intake post-surgery (<3.0g/kg/day). This was accompanied with a decrease in VO2peak, PPO, and GE due to a drop in training load. From week 7, the athlete resumed training and was advised to gradually increase CHO intake according to the demands of training. Conclusions: Eventually the athlete was able to return to competition in week 32 with a higher PPO, improved VO2peak and GE. Throughout retraining, energy availability was maintained around 30 kcal/kg LBM/day, protein intake was high while CHO intake was periodised. Such dietary conditions allowed the athlete to maintain and even increase lean mass, which represents a major challenge with ageing.

Our daily activities hinge on the flexibility of our fingers, and a fractured finger can significantly disrupt these routines. The finger bones enable us to bend and fold the fingers and thumb to pick up or grasp objects and do all of our daily activities. A broken finger can cause adverse effects on our daily life activities. It is important to treat broken finger as soon as possible. Swift and precise treatment begins with capturing multiple X-rays, followed by the critical step of fracture detection in these images. Relying on the naked eye for this task carries the risk of overlooking small fractures. To address this issue an automated diagnoses of fractured fingers from images is required for which the current research employs advanced deep learning models—ResNet34, ResNet50, ResNet101, ResNet152, VGG-16, and VGG-19—to classify finger images from the Musculoskeletal Radiographs (MURA) dataset as either fractured or non-fractured. The results emphasize the consistently strong performance of ResNet models, attaining an impressive accuracy of 81.9%. This surpasses VGG models by 3.4% and establishes ResNet as the new benchmark for state-of-the-art accuracy.

Hydraulic fracturing is an efficient method to develop oil/gas resources economically. Temporary plugging and diverting fracturing (TPDF) can generate diversion fractures perpendicular to the initial fractures and enhance the stimulated area. The aperture of the diversion fractures determines its conductivity and the oil/gas production. This work established a fluid-solid fully coupled simulation model to investigate the fracture aperture influenced by various factors during TPDF. The factors include the permeability of the tight plug, the length of the tight plug, Young’s modulus, rock tensile strength, in-situ stress contrast, the leak-off coefficient of the fracture surface, and fluid injection rate. Results show that the aperture of the previous fracture can be enlarged, and the aperture of the diversion fracture can be decreased by the tight plug. The aperture at the diversion fracture mouth is much smaller than that along the diversion fracture. Reservoirs with low Young’s modulus and high rock tensile strength can generate the diversion fracture with a wider aperture. Moreover, increasing the fluid injection rate can effectively increase the fracture mouth aperture. In this way, the risk of screenout can be lowered. This work is beneficial for the design of the TPDF and ensures safe construction.

Background: Calcaneal fractures are the most frequent traumatic injuries of the hindfoot and can cause severe disability with social and economic sequelae; since 1980 an increasing number of studies and new technologies have led to an improvement in their management and complications but treatment is still controversial. The purpose of the study to review the secondary scientific literature looking for the optimal management of calcaneal fracture; Methods: through the PubMed MEDLINE database, 4856 articles were identified; only meta-analyses and systematic reviews were included in the study. Results: 59 reviews with more than 10,000 calcaneus fractures were examined and results were divided into various topics; the majority of articles agree on the superiority of surgical versus conservative treatment; minimally invasive access to the sinus tarsi shows better results and fewer complications than traditional extended lateral access; reduction and osteosynthesis with percutaneous and/or minimally invasive techniques seem to provide better outcomes if compared to open treatments. Conclusions: The management of calcaneus fractures requires an individualized planning based on the functional demands of the patient, the type of fracture and associated injuries. New technologies and further studies may still improve the management of these lesions.

Nonlinear rheological properties of chiral crystal cholesteryl oleyl carbonate (COC) in blue phase III are investigated under different shear deformations; large amplitude oscillatory shear, step shear deformation, and continuous shear flow. Rheology of the liquid crystal is significantly affected by structural rearrangement of defects under shear flow. One of the examples on the defect-mediated rheology is the blue phase rheology. Blue phase is characterized by three dimensional network structure of the disclination lines. It has been numerically studied that the rheological behavior of the blue phase is dominated by destruction and creation of the disclination networks. In this study, we find that the nonlinear viscoelasticity of BPIII is characterized by the fracture of the disclination networks. Depending on the degree of the fracture, the nonlinear viscoelasticity is divided into two regimes; the weak nonlinear regime where the disclination network locally fractures but still show elastic response, and the strong nonlinear regime where the shear deformation breaks up the networks, which results in a loss of the elasticity. Continuous shear deformation reveals that a series of the fracture process delays with shear rate. The shear rate dependence suggests that force balance between the elastic force acting on the disclination lines and the viscous force determines the fracture behavior.

A new mathematical model is presented to study the effects of macrophages on the bone fracture healing process. The model consists of a system of nonlinear ordinary differential equations that represents the interactions among classically and alternatively activated macrophages, mesenchymal stem cells, osteoblasts, and pro- and anti-inflammatory cytokines. A qualitative analysis of the model is performed to determine the equilibria and their corresponding stability properties. Numerical simulations are also presented to support the theoretical results and to monitor the evolution of a broken bone for different types of fractures under various medical interventions. The model can be used to guide clinical experiments and to explore possible medical treatments that accelerate the bone fracture healing process either by surgical interventions or drug administrations.

This contribution attempts to provide a state-of-the-art account on the physicochemical and biomedical properties of plasma-sprayed hydroxylapatite (HAp) coatings that are routinely applied to the surfaces of metallic endoprosthetic and dental root implants, designed to replace or restore lost functions of diseased or damaged tissues of the human body. Even though the residence time of powder particles of HAp in the plasma jet is extremely short, the high temperature applied introduces compositional and structural changes of the precursor hydroxylapatite that severely affect its chemical and physical properties and in turn, its biomedical performance. These changes are based on the incongruent melting behaviour of HAp and can be traced, among many other analytical techniques, by high-resolution synchrotron X-ray diffraction, vibrational (Raman), and nuclear magnetic resonance (NMR) spectroscopies. In vivo reactions of the plasma-sprayed coatings with extracellular fluid (ECF) can be assessed and predicted by in vitro testing using simulated body fluids as proxy agents. Ways are being discussed to safeguard appropriate biological performance of hydroxylapatite coatings in long-term service by controlling their phase content, porosity, surface roughness, residual stress distribution, and adhesion to the implant surface.

In response to a threefold increase in osteoporotic vertebral fractures (OVF) at our institution over the past decade and the subsequent development of new fractures within a year in a third of cases, we evaluated the effectiveness of STIR MRI scans in conjunction with CT scans for initial OVF diagnosis. This study, conducted over five months, involved full spine sagittal STIR MRI scans alongside CT scans for patients over 50 with minor injury-related vertebral fractures. The independent assessments by radiologists and neurosurgeons of 64 patients revealed that while CT scans identified 161 fresh fractures, of which only 68 were previously reported, MRI detected 266 fractures, 1.65 times more than CT. CT scans showed single fractures in 27% of patients and multiple fractures in 73%, whereas MRI identified single fractures in 9% and multiple fractures in 91% of patients. Additionally, MRI demonstrated a 1.5-fold increase in adjacent fracture detection. The use of MRI influenced treatment plans in 67% of cases. Given these findings, we advocate for including a STIR MRI of the entire spine alongside CT scans in OVF cases, as it significantly enhances fracture detection and can alter treatment strategies.

The integration of three-dimensional (3D) printed resin denture teeth represents a significant ad-vancement in digital dentistry. This study aimed to assess their ability to withstand chipping and indirect tensile fractures, comparing them with conventionally manufactured resin denture teeth. Four groups, each comprising 30 specimens, were examined: Group 1 featured 3D printed denture teeth (NextDent, 3D Systems, Soesterberg, The Netherlands), while the others included commer-cially obtained Ivostar Shade, SpofaDent Plus, and Major Super Lux teeth. Stereolithography 3D printing was utilized to produce methacrylate-based photopolymerized resin teeth models for Group 1, while the remaining groups were commercially sourced. Chipping and indirect tensile fracture tests were performed at a speed of 1 mm/min until fracture occurred. Statistical analysis was conducted using one-way analysis of variance (ANOVA) with Tukey's honestly significant difference multiple comparisons test (p < 0.05). Results indicated that 3D-printed teeth exhibited higher indirect tensile fracture resistance than Major Super Lux and Ivostar Shade but lower than SpofaDent Plus. Additionally, in the chipping test, buccal chipping occurred in 3D-printed resin teeth without distortion. In the indirect tensile test, the fracture line emerged near the loading point, extending cervically from the inner incline of both cusps. Overall, denture teeth produced via 3D printing with printable resin materials demonstrated sufficient fracture resistance, making them suitable for prosthetic applications.

The nature of the fracture and fragmentation process of concrete medium under blast loading is the transformation process of the medium from continuum to discontinuity, coupled with the significant rate correlation of concrete medium, its mechanical behavior presents a high degree of complexity. Problems such as grid distortion and even negative volume are often encountered in the finite element method and others when solving this problem, while the material point method can effectively avoid these problems. In addition, the widely used HJC concrete constitutive model does not take into account the segmented characteristics of the calculation function for dynamic increasing factor. Therefore, in this paper, firstly, the calculation function for dynamic increasing factor in the HJC concrete model is modified by SHPB experiment, and the improved HJC concrete model is proposed; secondly, the material point method simulation program is developed, and the improved HJC concrete model is embedded into the simulation program; finally, the simulation program is verified by numerical examples, and the results show that the developed simulation program can better simulate the fracture and fragmentation process of concrete medium under blast loading, especially the pulverization characteristics of the medium in the near zone of the load.

The purpose of this work is to compare two fracture prediction models with real-world data. The pure Artificial Neural Network (ANN) model emphasizes regression analysis, while the hybrid model (SVM-ANN) focuses on the combination of regression and classification analysis or Support Vector Machine. The results were subsequently tested against logging data by combining the Machine Learning approach with advanced logging tools. In this context, we used electrical image logs and the dipole acoustic tool which together allowed the distinction of 404 open fractures and 231 closed fractures and, consequently the estimation of fracture porosity. The results are then fed into two machine-learning algorithms. Pure Artificial Neural Networks and hybrid models are used to establish comprehensive results, which are subsequently tested to check the accuracy of the models. The outputs obtained from the two methods demonstrate that the hybridized model has a lower Root Mean Square Error (RMSE) than pure ANN. The results of our approach strongly suggest that incorporating hybridized machine learning algorithms in fracture porosity estimations can contribute to the development of more trustworthy static reservoir models in simulation programs. Finally, the combination of Machine Learning (ML) and well-log analysis do permit reliable estimation of fracture porosity in the Ahnet field in Algeria, where, in many places, advanced logging data is absent and costly.

Gaucher Disease's (GD) pathophysiology generates anesthetic concerns in Total Hip joint Arthroplasty (THA), and due to its rareness, data on perioperative risks is scarce. This 22-year study at a large reference center addresses anesthetic management and perioperative outcomes in GD. This retrospective-cohort study assessed anesthetic success and safety in 30 THA patients, comparing them with a control-matched group. Data on clinical characteristics, perioperative events, and outcomes were collected. The primary outcome was difficult anesthesia-initiation incidence. Secondary outcomes were difficult intraoperative course and hemodynamic management, and the development of postoperative-complications. The age, sex, weight, body mass index, primary-to-revision hip arthroplasty ratio were similar in both groups. The mean age was 48±13 years. Ten arthroplasties were revision while twenty were primary. There was no significant difference at all-type anesthesia first initiation attempt success. No particular preference by staff anesthetists for general anesthesia or neuraxial procedures was observed. The GD group showed significantly higher mean intraoperative packed red blood cell units administered (0.73 vs 0.18);(p= 0.038)), higher intraoperative and postoperative platelet transfusion incidence (5/30 [16.7%] vs. 0/56 [0.00%];p=0.004) and (3/30 [10%] vs 0/56 [0%];p=0.040) and longer mean recovery-room length-of-stay (426±412 vs 175±140;p=0.004). Postoperative complications were not significantly different.

The paper analyses the national DK-model Hydrological Information and Prediction (HIP) system and HIP portal viewed as a ‘Digital Twin’ and how the introduction of real-time dynamic updating of the DK-model HIP simulations can give room for plug-in sub-models with real-time boundary conditions made available from a HIP portal. The possible feedback to a national real-time risk knowledge base during extreme events (flooding and drought) is also discussed. Under climate change conditions, Denmark is likely to experience more rain in winter, more evapotranspiration in summer, intensified cloudbursts, drought, and sea level rise. These challenges have been addressed as part of the Joint Governmental Digitalization Strategy 2016-2020 for better use and sharing of public data about the terrain, water, and climate to support climate adaptation, water management, and disaster risk reduction. This initiative included the development of a new web-based data portal (HIP portal) developed by the Danish Agency for Data Supply and Infrastructure (SDFI). GEUS delivered 5 terra-byte of hydrological model data to the portal with robust calibration methods and hybrid Machine Learning (ML) being key parts of the deliverables. The paper discusses the challenges and potentials of further developing the HIP Digital Twin with ‘plug-in Digital Twins’ for local river basins including feedback to the national level.

The paper aims in assessing risks of mandible fractures consequent to impacts or sport accidents. The role of the structural stiffness of mandible, related to disocclusion state, is evaluated through numerical simulations using the finite element method (FEM). It has been assumed that the quasi-static stress field, due to distributed forces developed during accidents, could explain the common types of mandibular fractures. Geometric model of adolescent mandible was built, upon the basis of medical imaging, in CAD software with distinction between cortical layer and inner spongy bone. The finite element model of disoccluded mandible was next created. Mandibular condyles were supposed jammed in the maxillary fossae. The total force of 700 N, simulating an impact on mandible, has been sequentially applied in three distinct areas: centrally, at canine zone and at the mandibular angle. Clinically most frequent fractures of mandible were recognized through the analysis of maximal principal stress and maximal principal strain fields. Mandibular fracture during accidents can be analyzed at satisfactory level using linear quasi-static FE models for designing protections in sport and transport. The proposed approach can be improved by introducing more realistic interactions between condylar processes and fossae.

Plasma treatment of soft polymers is the promising technique to improve biomedical properties. The response to the deformation of such materials is not yet clear. Soft elastic polyurethane treated with plasma immersion ion implantation is subjected to fatigue uniaxial loading (50000 cycles, frequency – 1 Hz, strain amplitude – 10, 20, 40%). The influence of the strain amplitude and the plasma treatment regime on damage character is discussed. Surface defects are studied in unloaded and stretched states of the material. As a result of fatigue loading, transverse cracks (with closed overlapping edges as well as with open edges deeply propagating into the polymer) and longitudinal folds which are break and bend inward, appear on the surface. Hard edges of cracks cut the soft polymer which is squeezed from the bulk to the surface.

Bone/fracture healing is a complex process with different steps and four basic tissue layers being affected: cortical bone, periosteum, fascial tissue surrounding the fracture, and bone marrow. Stem cells and their derivatives, including embryonic stem cells, induced pluripotent stem cells, mesenchymal stem cells, hematopoietic stem cells, skeletal stem cells, and multipotent stem cells, can function to artificially introduce highly regenerative cells into decrepit biological tissues and augment the healing process at the tissue level. Stem cells are molecularly and functionally indistinguishable from standard human tissues. The widespread appeal of stem cell therapy lies in its potential benefits as a therapeutic technology that, if harnessed, can be applied in clinical settings. This review aims to establish the molecular pathophysiology of bone healing, the current stem cell interventions that disrupt or augment the bone healing process, and finally, consider the future direction/therapeutic options related to stem cells and bone healing.

The formation and propagation of cracks occurs through irreversible dislocation movements at notches, material defects and grain boundaries. Since this process is partly thermally controlled, the resistance to dislocation movements at low temperatures increases. This slows both fatigue initiation and fatigue crack propagation. From recent experimental data, it can be seen that fatigue crack growth is accelerated below the fatigue transition temperature (FTT) that correlates with the ductile-brittle transition temperature (DBTT) found by well-known fracture mechanics tests, i.e., Charpy impact, fracture toughness, and CTOD. Hence, this study investigates the relation between FTT and DBTT in S500 high-strength steel base material and welded joints at low temperatures using fatigue crack growth, fracture toughness tests as well as scanning electron microscopy. From the tests, an almost constant decrease in fatigue crack propagation rate is determined with decreasing test temperature even below the DBTT.

Study design: Retrospective cohort study. Objectives: To investigate the outcomes of early ballon kyphoplasty (BKP) intervention compared with late intervention for osteoporotic vertebral fracture. Background: Osteoporotic vertebral fractures, can lead to kyphotic deformity, severe back pain, depression, and disturbances in activities of daily living (ADL). BKP has been widely utilized to treat symptomatic OVFs and has proven to be a very effective surgical option for this condition. BKP is relatively a safe and effective method due to less acrylic cement leakage and greater kyphosis correction. Materials and Methods: A retrospective comparative study was conducted at our hospital for patients who underwent BKP for osteoporotic vertebral fractures in the time frame between January 2020 and December 2022. Ninety-nine patients were included in this study, patients were classified into two groups: 36 patients underwent early BKP intervention (EI)

Cervical injuries from athletic activities are rare; they can have severe consequences if not diagnosed and managed promptly. The choice of diagnostic imaging modality is pivotal in ensuring timely and accurate diagnosis. We detail the case of a 19-year-old female athlete who sustained a C2 Durel Type II Subclass C fracture during a short-track speed skating championship. Initial evaluation using X-ray imaging at the athletic center medical facility did not detect the injury, allowing her to continue competing. Persistent pain led to further evaluation at our institution, where MRI and CT scans confirmed the fracture. Approximately 45 days post-injury, the patient underwent a successful surgical intervention utilizing O-arm CBCT navigation for C1-C2 dorsal fusion. Post-surgery, she embarked on a comprehensive rehabilitation program and fully recovered within 12 weeks. This case underscores the limitations of relying solely on X-ray imaging for diagnosing cervical fractures post-trauma. Our findings advocate prioritizing CT scans as a primary diagnostic tool in such scenarios, emphasizing the need for a robust diagnostic approach to ensure athlete safety and well.

A single fracture is the basic unit of fracture medium, and the roughness of fracture wall surface is an important factor influencing hydraulic characteristics of the flow in bedrock fracture. However, effects of the shape and density of roughness elements (various bulges/pits on rough fracture wall surfaces) on water flow in a single rough fracture have not been thoroughly discovered. Thus the water flow in single fracture with different shapes and densities of roughness elements was simulated by using Fluent software in this study. The results show that in wider fractures the flow rate mainly depends on fracture aperture, while in narrow and close fracture medium the surface roughness of fracture wall is the main factor of head loss of seepage; there is a negative power exponential relation between the hydraulic gradient index and the average fracture aperture, i.e. with the increase of fracture aperture, the relative roughness of fracture and the influence weight of hydraulic gradient both decrease; and in symmetrical-uncoupled fractures there is a super-cubic relation between the discharge per unit width and average aperture. Above results would help to deepen the understanding of rough fracture seepage.

The problem of filling the bone cavity remains relevant in maxillofacial and oral surgery. There is a large selection of osteotropic materials of various natures for filling of bone defects of different etiology. The aim of our research was to improve the result of surgical treatment in a patient with a complicated mandibular fracture with the use of collagenic xenograft during osteosynthesis. In this article, we introduce our experience in the treatment of a patient with a complicated mandibular angle fracture in a combination with the follicular cyst. The obligate steps of treatment included stabilization of the bony fragments, a decrease of risk in fracture line malposition along with titan mini- plates, and shortening in the time of bone regeneration due to a filling of bone defect with the osteotropic material. This approach allowed us to reduce the rehabilitation period and further prosthetic treatment after 4-5 months without additional bone grafting manipulations. Though, the use of collagen osteotropic material, possessing osteoconductive properties, can improve the treatment of patients with mandibular fractures.

Acid fracturing simulation is used widely to optimize carbonate reservoirs and improve acid fracturing treatment performance. In this study, a method was used to minimize the risk of the acid fracturing treatment. First, optimal fracture geometry parameters with UFD methods are calculated. After that, design components change as long as fracture geometry parameters reach their optimal values. The results showed a high flow rate needed to achieve optimal fracture geometry parameters with increasing acid volume. Sensitivity analysis was performed on controllable and reservoir parameters. It observed that a high flow rate should be applied for a low fluid viscosity to achieve the optimization goals. Straight acid reaches optimal conditions at a high flow rate and low volume. These conditions for retarded acids appear only at a low flow rate and high volume. The study of the acid concentration for gelled acid showed that as it increased, the flow rate and volume increased. Besides, for low permeability formation, a large fracture half-length and small fracture width are desirable. In this case, a higher flow rate will be required. The sensitivity analysis showed that the optimum flow rate and acid volume increase and decrease for the high Young's modulus. The effect of closure stress was also investigated and observed for a sample with high closure stress, low flow rate, and high acid volume are required.

Total Hip Arthroplasty is one of the most successful surgery. However, due to the worldwide growing population life expectancy and the related incidence of age-dependent bone diseases, a growing number of cases of intra-operative fractures lead to revision surgery with high rates of morbidity and mortality. Surgeons choose the type of the implant, either cemented or cementless prosthesis, on the basis of the age, the quality of the bone and the general medical conditions of the patients. Generally, no quantitative measures are available to assess the intra-operative fracture risk. Consequently, the decision-making process is mainly based on medical operators’ expertise and qualitative information obtained by imaging. Motivated by this scenario, we here propose a mechanical-supported strategy to assist surgeons in their decisions, by giving intelligible maps of the risk fracture which take into account the interplay between actual strength distribution inside the bone tissue and its response to the forces exerted by the implant. To this end, we produce charts and patient-specific synthetic “traffic-light” indicators of fracture risk, by making use of ad hoc analytical solutions to predict the stress levels in the bone by means of CT-based mechanical and geometrical parameters of the patient. We felt that, if implemented in a friendly software or proposed as an app, the strategy could constitute a practical tool to help the medical decision-making process, in particular with respect to the choice of adopting cemented or cementless implant

Modeling fluid flow in three-dimensional (3D) Discrete Fracture Networks (DFNs) is of relevance in many engineering applications, such as hydraulic fracturing, oil/gas production, geothermal energy extraction, nuclear waste disposal and CO₂ sequestration. A new Boundary Element Method (BEM) technique with discontinuous quadratic elements and a parallel Domain Decomposition Method (DDM) is presented herein for the simulation of the steady-state fluid flow in 3D DFN systems with wellbores, consisting of planar fractures having arbitrary properties and wellbore trajectories. Numerical examples characterized by DFNs of increasing complexity are investigated to evaluate the accuracy and efficiency of the presented technique. The results show that accurate solutions can be obtained with less nodes than with mesh-based methods (e.g. Finite Element Method). In addition, the DDM algorithm used provides a quite fast convergence. The simulation results of the fluid flow around intersections among traces (linear intersections between fractures), intersections between traces and a fracture boundaries, and wellbore intersections is accurate. Source code is available at : https://github.com/BinWang0213/PyDFN3D.

The reinforcement of concrete by using polyolefin fibres may be considered in structural design to meet the requirements of the applicable code rules. In order to achieve a reliable use of such a composite material, use of full-scale real structures is needed. The conversion of lab testing data into real practice properties is challenging and significantly influenced by various aspects, among which the size effect is a key one. Given that the available literature does not report coinciding conclusions about such an effect on quasi-brittle materials reinforced with fibres, further research is justified. Therefore, this work studies the behaviour of notched beams with three proportional sizes by using self-compacting polyolefin reinforced concrete with a fibre volume fraction of 1.1%. Flexural testing was carried out according to the standard EN-14651, with the results revealing the existence of the size effect. In addition, a reduction of the residual strength identified in the larger specimens was observed in fracture surfaces with equal fibre content.

Fracture grouting has been a widely used mitigation measure against seepage in the Yellow River Embankment. However, there is currently a lack of systematic investigation for evaluating the anti-seepage effectiveness of fracture grouting employed in this longest river embankment in China. Therefore, in this work, laboratory and in-situ experiments are carried out for investigating the reinforcement effect of fracture grouting in the Jinan Section of the Yellow River Embankment. In particular, firstly, the laboratory tests concentrate on studying the optimum strength improvement for cement-silicate grout by varying the content of backfilled fly ash and bentonite as admixtures. Flexural strength and Scanning Electron Microscope photographs are investigated for assessing the strength and compactness improvement. Subsequently, based on the obtained optimum admixtures content, in-situ grouting tests are carried out in the Jinan Section of the Yellow River Embankment to evaluate the anti-seepage effectiveness of fracture grouting, where geophysical prospecting and pit prospecting methods are employed. Laboratory results show that, compared with pure cement-silicate grouts, the gelation time of the improved slurry is longer and gelation time increases as fly ash content increases. The optimum mixing proportion of the compound cement-silicate grout is 70% cement, 25% fly ash and 5% bentonite, and the best volume ratio is 2 for the investigated cases. Geophysical prospecting using the Ground Penetrating Radar and High Density Resistivity methods can reflect the anti-seepage effectiveness of fracture grouting on site. It shows that the grouting material mainly flows along the axial direction of the embankment. The treatment that is used to generate directional fracture is proved to be effective. The injection hole interval distance is suggested to be 1.2 m, where the lapping effect of the grouting veins is relatively significant. For the investigated cases, the average thickness of the grouting veins is approximately 6.0 cm and the corresponding permeability coefficient is averagely 1.6 × 10⁻⁶ cm/s, which meets the anti-seepage criterion in practice.

Abstract Introduction: Although ankle fractures and Achilles tendon injuries are among the most common traumatic presentations when they occur individually, concomitant Achilles tendon rupture and ipsilateral ankle fractures are quite unusual. To our knowledge this is the first report of acute Achilles tendon rupture associated with missed ipsilateral closed bimalleolar ankle fracture. Case Presentation: A 34 years old male patient presented with a traumatic right Achilles tendon rupture after sustaining road traffic accident one day prior. There was an open wound over the tendon substance with absent active plantaflexion of the involved leg. After confirming complete Achilles tendon rupture with positive Thompson test, the patient was prepared for emergency debridement and possible tendon repair differing imaging studies, which missed ipsilateral closed bimalleolar ankle fracture. Conclusion: Routine anteroposterior and lateral X-rays should be used in conjunction with a complete history and physical examination to detect any concomitant fracture with open Achilles tendon rupture.

In this paper, through high-temperature tensile tests of 55NiCrMoV7 steel, the high-temperature fracture behavior, microstructure evolution and carbide distribution characteristics of both thermal-mechanical coupling zone (fracture zone) and thermal stress zone (clamping zone) at different temperatures were studied. Intrinsic relationship between high temperature fracture and carbides types, distribution and size were revealed and evolution mechanism of microstructure near cracks in 55NiCrMoV7 hot-working die steel during high temperature deformation was clarified. Samples were stretched at different temperatures from 25 °C to 700 °C, and microscopic examinations were carried out by using SEM and TEM. The results showed that: With the increase of temperature, tensile strength and yield strength decreased, elongation and reduction of area increased, and fracture mode changed from brittle fracture to ductile fracture by transition temperature at about 400℃. During high temperature deformation, the grain dislocation density decreased, the tempered martensite decomposed, recovered, recrystallized, and then grain grew. M7C3 and M23C6 carbides precipitated and grew along the grain boundary, and a small amount of fine granular MC carbides were dispersed in the grain. The work done by the external force on the deformation zone would cause the temperature of it to be higher than tensile temperature, which provides thermodynamic conditions for the re-dissolution of small carbides near the fracture zone and the grain growth of large carbides, resulting in the decrease of small carbides and increase of large carbides in thermal-mechanical coupling zone.

Linear elastic fracture modeling coupled with empirical material tension data result in good quantitative agreement with experimental measurements of fracture failure for both brittle and tough epoxy nanocomposites. The nanocomposites comprise diglycidyl ethers of bisphenol A cured with O,O’ bis (2-aminopropylpropylene glycol) (Jeffamine D230) and doped with rubber nanoparticles of varying concentrations. Toughness, critical load, and critical displacement in quasi-static single edge-notched three-point bending are predicted accurately using both surface-based cohesive zone (CZS) and extended finite element (XFEM) methods implemented in Abaqus software. Fracture initiation within a crack is taken at the yield stress from uniaxial tension data. Prediction of fracture processes using a generalized truncated linear traction-separation law was significantly improved by considering the case of a linear softening function. There are no adjustable parameters in the XFEM model. The CZS model requires only optimization of the element displacement at fracture parameter. Thus, these continuum methods describe these materials in mode I fracture with a minimum number of independent parameters.

The carbonized elastomer-based composites (CECs) possess a number of attractive features in terms of thermomechanical and electromechanical performance, durability in aggressive media and facile net-shape formability, but their relatively low ductility and strength limit their suitability for structural engineering applications. Prospective applications such as structural elements of MEMS can be envisaged, since smaller principal dimensions reduce the susceptibility of components to residual stress accumulation during carbonization, and to brittle fracture in general. We report the results of operando in-SEM study of micro-deformation and fracture behavior of CECs based on NBR elastomeric matrices filled with carbon and silicon carbide. Nanostructured carbon composite materials were manufactured via compounding of elastomeric substance with carbon and SiC fillers using mixing rolling mill, vulcanization, and low-temperature carbonization. Double Edge Notched Tensile (DENT) specimens of vulcanized and carbonized elastomeric composites were subjected to in situ tensile testing in the chamber of the scanning electron microscope (SEM) Tescan Vega 3 using Deben Microtest 1 kN Tensile Stage. The series of acquired SEM images were analyzed by means of Digital Image Correlation (DIC) using Ncorr open source software to map the spatial distribution of strain. These maps were correlated with Finite Element Modelling (FEM) simulations to refine the values of elastic moduli. Besides, the elastic moduli were derived from unloading curve nanoindentation hardness measurements carried out using NanoScan-4D tester and interpreted using the Oliver-Pharr method. Carbonization causes significant increase of elastic moduli from 0.86 ± 0.07 to 14.12 ± 1.20 GPa for the composite with graphite and carbon black fillers. Nanoindentation measurements yield somewhat lower values, namely, 0.25 ± 0.02 GPa and 9.83 ± 1.10 GPa before and after carbonization respectively. The analysis of fractography images suggests that crack initiation, growth and propagation may occur both at the notch stress concentrator and relatively far from the notch. Possible causes of such response are discussed, namely, (1) residual stresses introduced by processing; (2) shape and size of fillers; and (3) the emanation and accumulation of gases in composites during carbonization.

Reactivation of pre-existing weaknesses in the upper crust can be documented using surface features, and has occurred throughout time and space, particularly in regions where the basement material dates from the Precambrian and has undergone successive deformation events. This study aims to use surface features such as fracture patterns to document evidence of such reactivation in the Paleozoic and Cenozoic of Nebraska and Kansas (units separated by an unconformity in the study area). The most prominent basement features in southeast Nebraska and northeast Kansas are oriented NE-SW, likely related to the midcontinent rift, and oriented NW-SE, likely related to fabrics from the Central Plains Orogen. These features are well defined in the potential fields data. Fracture patterns in the study area show an E-W oriented trend, as well as clearly discernable NE-SW and subsidiary N-S and NW-SE trends. The E-W trend is interpreted to be related to far-field stresses from Laramide and Ancestral Rocky Mountain orogenic events, whilst the NE-SW trend is interpreted to be related to subtle reactivation on the Mid-continent rift and related faults, observed in basement data. These movements produced stresses of sufficient magnitude to produce extensional fractures in the overlying rock units, but not sufficient to generate shear. Similarly, the ~N-S and NW-SE fracture trends are taken as evidence of subtle reactivation on the Nemaha Uplift and Central Plains Orogen systems, generating fractures but not shear movement. This contribution therefore provides a convincing case-study of the value of fracture orientations (that is, surface morphodynamics) in discerning buried tectonic trends and subtle reactivation thereon.

The natural distribution of stress in the femur is altered when total hip arthroplasty (THA) is performed. In fact, when a stem is inserted inside the femur, there is a variation in stress due to the difference in rigidity between the material with which the stem is made and the femur. This generates the phenomenon of stress-shielding. The aim of this study is to design an optimized prosthesis that guarantees excellent rotational stability and re-duced stress shielding. Methods: through the finite element method (FEM) the mechanical behavior of the stem subjected to the loads described by ISO 7206-4: 2010 is studied. Re-sults: Through topological optimization, there is a reduction in stress shielding in the proximal zone of 31.46%. The addition of ridges on the dorsal side of the stem also im-proves rotational stability by 27.82%. Conclusions: The decrease in stiffness that is rec-orded with the optimized stem, guarantees a greater distribution of stress on the bone. The presence of dorsal ridges also favors the corticalization of the bone as it loads the bone near the dorsal ensuring further stability. The perforated prosthesis presented in this study, shows an increase in primary stability and an improvement in rotational stability. As there is also a bone regrowth inside the prosthesis.

Low back pain (LBP) is a health problem that affects 70-80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of the study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from PubMed, PEDro, and Scopus databases published up to September 2022. Based on Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASpe and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as “good”. In conclusion, the addition of hip muscle strengthening exercises iterating LBP effectively improving pain and disability.

Pedigree data of 13 339 border collie dog was collected along with hip and elbow dysplasia records (1352 CHD and 524 CED), and an inbreeding-purging (IP) model was created to detect possible purging. Ancestral inbreeding coefficients were calculated by gene dropping simulation method (Ballou, 1997; Kalinowski, 2000) with GRain 2.0 (Baumung et al., 2015) software. GLMM models were created to the examined traits fitted with a log-link Poisson distribution, added to the estimated values of classical inbreeding coefficient (F_W), and the ancestral inbreeding (F_BAL, F_KAL, F_KAL_NEW) as covariates. The effective population size decreased in the examined period along with the increase of F_W however, slight differences were found as a consequence of breeding dog imports. CHD values were getting lower by the expansion of F_BAL as the alleles were inbred in the past. For CHD signs of purging were obtained. There was a positive trend regarding the breeding activity (both sire and dam of the future litters should be screened and certified free from CHD and CED), as years of selection increased the frequency of alleles with favorable hip and elbow conformation. Division of the ancestral inbreeding coefficient shows that alleles IBD for the first time (F_KAL_NEW) had a negative effect on both traits, while F_KAL shows favorable results for alleles IBD in the past generations. Some authors had proven this phenomenon in captive populations or experimental conditions however, no evidence of inbreeding purge has ever been described in dog populations. Despite the various breeding practices, it seems, that alleles of these polygenic disorders could be successfully purged out of the population with long term selection.

As the oil industry increasingly turns to unconventional low-permeability and low-porosity reservoirs, precise post-fracture production prediction is a pivotal instrument in investment de-cision-making, formulation of energy policies, and promotion of environmental assessments. Nevertheless, despite extensive research spanning decades, the precise post-fracture production prediction based on logging parameters remains an intricate task. In this study, we gathered ex-tensive logging data and segmented the post-frac gas production during well testing on the first day to enrich the dataset. Nine pipelines were then architected using various techniques of data preprocessing, feature extraction, and advanced machine learning models. Hyperparameter op-timization was executed via the GridsearchCV. To assess the efficacy of diverse models, metrics including the coefficient of determination (R2), standard deviation (SD), and root mean square error (RMSE) were invoked. Among the several pipelines explored, the PS-NN exhibited excellent predictive capability in specific reservoir contexts (an R2 value of 0.94 and an RMSE of 48.15). In essence, integrating machine learning with logging parameters effectively assesses reservoir productivity at multi-meter formation scales. This strategy not only mitigates uncertainties en-demic to reservoir exploration but also equips petroleum engineers with monitoring on reservoir dynamics, thereby facilitating reservoir development. Additionally, this approach provides res-ervoir engineers with an efficient way of reservoir performance oversight.

This study is focused on the mechanical properties of WC-Co composites obtained via Selective Laser Sintering using PA12 as a binder. The as-printed samples were thermally debonded, and sintered, first in vacuum, and then sinter-HIPed at 1400oC, using 50 bar Ar, which has led to relative densities up to 66 %. Optical metallographic images show a microstructure consisting of WC, with an average grain size in the range of 1.4 – 2.0 µm, with isolated large grains, in a well-distributed Co matrix. The shrinkage of the samples was 43 %, with no significant shape distortion. The printing direction of the samples has a great impact on the transversal rupture strength (TRS). Nevertheless, the bending strength was low, with a measured maximum of 612 MPa. SEM images of the fracture surface of TRS samples show the presence of defects that constitute the cause of the low measured values. The hardness values position the obtained composites in the range of medium coarse classical cemented carbides. The results were also related to the amount of free Co after sintering, close to the initial one, as assessed by magnetic measurements, indicating a low degree of interaction with PA12 decomposition products.

Background and objectives: Thoracolumbar fracture – dislocations (AO type C) are rare injuries that occur due to very high-energy trauma, and the result is transitional and rotational instability of the spinal column and neurological impairment. Several reduction maneuvers have thus far been published, each of which can be of use in certain specific situations. We developed a novel modification to the previously described reduction technique. Materials and methods: This is a retrospective review of the management of thoracic AO type C fracture-dislocations managed with a modified novel reduction technique. The success of the reduction and intraoperative iatro-genic complications such as dural tear and screw pull out were the outcomes analyzed. Results: A total of 4 cases were successfully reduced with this novel reduction technique. We did not note any complications such as a dural tear or screw failure with this modified novel reduction tech-nique. Conclusion: The novel modification to the reduction technique employed in the management of thoracic fracture-dislocations resulted in a successful reduction without the risk of iatrogenic complications due to the reduction maneuver.

Hydraulic fracturing for oil-gas and geothermal reservoir stimulation is closely related to the generation and propagation of Mode I crack. Nonlinear deformation due to rock heterogeneity occurs at such crack tip, which causes the fracture process zone (FPZ) to form before the crack propagates unsteadily. However, the relationship between the FPZ characteristics and rock heterogeneity still remain elusive. We used three rock types common in reservoir for experimental investigation, and each of them includes two subtypes with different heterogeneity due to grain size or microstructural characteristics. Drawing on the experiment results, we calculated the FPZ size in each cracked chevron notched Brazilian disk, and we reproduced the formation process of the FPZ in marble by discrete element method. We showed that strong heterogeneity is favorable to large FPZ size, can enhance the ability of crack generation and complicate crack morphology. Coupling the Weibull distribution with fracture mechanics, the dependence of the FPZ size on heterogeneity degree can be theoretically explained, which suggests that inherent heterogeneity of rocks set physical foundation for formation of FPZ. These findings can improve our recognition to formation mechanism of the Mode I crack and provide useful guidelines for evaluating reservoir fracability.

This paper concerns the effect of proppant embedment related with hydraulic fracturing treatment. This phenomenon occurs if the strength of the reservoir rock is lower than proppant grains. The aim of the research is laboratory determining the loss of width of the proppant pack built of light ceramic grains. The laboratory simulation of the embedment phenomenon was carried out for a shale rock on a hydraulic press, in a specially prepared for this purpose a heated embedment chamber. Tests were conducted at high temperature and axial compressive stress conditions. The surfaces of the cylindrical core plugs (fracture faces) were imaged under an optical microscope equipped with 3D software. The fracture faces were examined and compared before and after the embedment phenomenon. The analysis of the obtained images of the fracture face were made based on the research method of the embedment phenomenon developed at Oil and Gas Institute-NRI. On the basis of laboratory tests, the parameters characterizing the embedment phenomenon were collected and discussed. In addition, the percentage reduction in the width of the proppant pack was determined.

The success of total hip arthroplasty depends on the experience of the surgeon, and one of the ways the surgeon currently determines the final implant insertion depth is to listen to the change in audible pitch of the hammering sound. We investigated the use of acoustic vibration emissions as a novel method for insertion quality assessment. A non-invasive contact microphone-based measurement system for insertion depth estimation, fixation and fracture detection was developed using a simplified in vitro bone/implant (n=5). 2583 audio recordings were analysed in vitro to obtain energy spectral density functions. Out of the four main resonant peaks under in vitro conditions, broach insertion depth statistically correlates to increasing 3rd and 4th peak frequencies. Degree of fixation was also observed as higher goodness of fit (0.26-0.78 vs. 0.12-0.51 between two broach sizes, the latter undersized). Finally, however, the moment of fracture could not be predicted. A cadaver in situ pilot study suggests comparable resonant frequencies in the same order of magnitudes with the bone model. Further understanding of the signal patterns are needed for an early warning system diagnostic system for imminent fractures, bone damage, improving accuracy and quality of future procedures.

In recent years, the biomimetic potential of lignified or partially lignified fruit pericarps has moved into focus. For the transfer of functional principles into biomimetic applications, a profound understanding of the structural composition of the role models is important. The aim of this study was to qualitatively analyse and visualize the functional morphology of the coconut endocarp on several hierarchical levels, and to use these findings for a more precise evaluation of the toughening mechanisms in the endocarp. Eight hierarchical levels of the ripe coconut fruit were identified using different imaging techniques, including light and scanning electron microscopy as well as micro-computer-tomography. These range from the organ level of the fruit (H0) to the molecular composition (H7) of the endocarp components. A special focus was laid on the hierarchical levels of the endocarp (H3-H6). This investigation confirmed that all hierarchical levels influence the crack development in different ways and thus contribute to the pronounced fracture toughness of the coconut endocarp. By providing relevant morphological parameters at each hierarchical level with the associated toughening mechanisms, this lays the basis for transferring those properties into biomimetic technical applications.

Polyolefin fibre reinforced concrete (PFRC) has become an attractive alternative to steel for the reinforcement of concrete elements mainly due to its chemical stability and the residual strengths that can be reached with lower weights. The use of polyolefin fibres can meet the requirements in the standards, although the main constitutive relations are based on the experience with steel fibres. Therefore, the structural contributions of the fibres should be assessed by inverse analysis. In this study, the fibre dosage has been fixed at 6kg/m³ and both self-compacting concrete and conventional concrete have been used to compare the influence of the positioning of the fibres. An idealized homogeneous distribution of the fibres with such fibres crossing from side to side of the specimen has been added to self-compacting concrete. The experimental results of three-point bending tests on notched specimens have been reproduced by using the cohesive crack approach. Hence, the constitutive relations were found. The significance of this research relies on the verification of the formulations found to build the constitutive relations. Moreover, with these results it is possible to establish the higher threshold of the performance of PFRC and the difficulties of limiting the first unloading branch typical of fracture tests of PFRC.

Background: Periprosthetic joint infection (PJI) following total hip and knee arthroplasty remains an extremely challenging and relatively high complication. This study aims to develop, validate and evaluate the use of machine learning (ML) algorithm to predict PJI in patients undergoing revision arthroplasties. Methods: A comprehensive review of patients undergoing hip or knee revision arthroplasty from 1 January 2015 to 31 March 2021 was conducted. Clinical data coming from preoperative patients history, laboratory analysis and demographic characteristics of patients were screened. Final data have been used to train a Logistic Regression model with the aim of predicting PJI preoperatively. Results: 1360 patients were enrolled, 1141 in the aseptic cohort and 219 in the infected cohort were included. ML demonstrated good discriminatory performance in predicting PJI in the selected patients (area under the curve 0.770 ± 0.006 in the training set and 0.720 ± 0.057 in the test set), and identified 3 significant predictors of PJI. Conclusion: ML algorithm trained using preoperative clinical data accurately predicted PJI. The incorporation of ML models into preoperative assessment of patients undergoing prosthetic revision procedures are useful in providing specific risk assessment to aid individualised counselling, shared decision making and presurgical optimization.

Purpose: Proximal Femur Fractures (PFFs) in elder patients lead to decreased productivity. Skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs) are non-home destinations for post-discharge disposition. This study aims to evaluate the loss of independence (LOI) following PFFs and examine the economic impact it entails. Method: Literature from various databases was collected and analyzed retrospectively. The inclusion criteria included patients age >18 years and articles published after 1990. All studies were screened and a PRISMA chart was used to demonstrate the search process. 24 studies were finally used for review. Results: LOI following PFFs significantly increases with age. Fractures in geriatrics avail a significant amount of post-care resources and had longer lengths of stay. Furthermore, six pre-operative risk factors were identified for non-home disposition including age >75, female, non-Caucasian race, Medicare status, prior depression, Charlson Comorbidity Index. Patients discharged directly to home have lower total cost compared to those discharged to rehabilitation units. Loss of independence increases with advancing age. Discussion: PFFs can lead to serious loss of independence among elderly patients with direct impact on economic, social, psychological aspects and the healthcare system.

Background and objectives: The incidence of hip fractures in advanced age is increasing due to the aging society. In trochanteric region fractures of the femur, patient positioning can be performed various ways. The aim of this study is to clinically and radiologically compare the use of the supine hemilithotomy position, the lateral decubitus position, and the traction table when performing PFN surgery for femoral intertrochanteric fractures in the geriatric age group.Materials and Methods: A total of 170 older patients with femoral intertrochanteric fractures were included in this cross-sectional study. The patients were divided into three groups the supine hemilithotomy group, lateral decubitus group and fracture table. For the postoperative period, complications, length of stay in the intensive care unit, and length of stay in hospital were examined, while in postoperative radiographs, tip-apex distance (TAD), collodiaphyseal angle (CDA), and Cleveland-Bosworth quadrants were examined to evaluate the placement of the lag screw in the femoral head. Quality of fracture reduction was evaluated according to the modified Baumgaertner criteria.Results: The mean age of the patients was 77.77±8.8; 57.6% of patients were female. According to the modified Baumgaertner criteria, it was determined that patients with ‘poor’ reduction quality had an approximately ten times higher risk of cut-out than those with ‘good’ reduction quality. (OR = 10.111, p = 0.002, 95% confidence interval; 2.313-44.207). The duration of surgery of patient in the fracture table group was found to be higher than in the other groups, the CDA in the supine position group were found lower than in the other groups, and the TAD in the supine position group was found higher than in the other groups. Complications were mostly detected in patients who underwent surgery in the lateral decubitus position. (p<0,05) Conclusion: We believe that it is necessary to be familiar with all methods, since it is very difficult to choose the most appropriate method according to the surgeon’s experience, the hospital’s facilities and conditions, and the patient’s clinical status.

Using numerical software to establish a three-dimensional geological model of shield tunneling through fault fracture zones, considering the synchronous grouting effect at the shield tail, the disturbance of various geotechnical structures in the fault fracture zone under deep burial and high water pressure conditions is studied. According to the comparison between the numerical model analysis results and the on-site inspection results of the entire process of Shiziyang B3 section, synchronous grouting at the shield tail is the main reason for the changes in soil and water pressure in the fault fracture zone area. The soil and water pressure changes strongly during shield tunneling, and the maximum excess pore pressure value occurs when the shield tail passes. When the shield tunneling machine is far away, the soil and water stress shows a downward trend. The impact of synchronous grouting decreases with the increase of tunneling distance. Due to the difference in permeability, the variation law of pore pressure in the fault fracture zone is significantly different from the original rock, leading to a faster increase in pore pressure in the fracture zone area and a wider range of influence.

Numerous reservoirs that play a significant role in worldwide petroleum production and reserves contain fractures. Typically, the fractures must form a connected network for a reservoir to be classified as naturally fractured. Characterizing the reservoir with a focus on its fracture network is crucial for modeling and predicting production performance. To simplify the solution, dual continuum modeling techniques are commonly employed. However, to use continuum-scale approaches, properties such as average aperture, permeability, and matrix fracture interaction parameters must be assigned, making it necessary to improve fracture depiction and modeling methods. This study investigates a fractured reservoir with a low matrix permeability and a well-connected fracture network. The focus is on the impact of the hyrachical fracture network on the production performance of gas-based enhanced oil recovery methods. The Discrete Fracture Model (DFN) was utilized to create comprehensive two-dimensional models for three processes: Gas Injection (GI), Water Alternating Gas (WAG), and Foam Assisted Water Alternating Gas (FAWAG). Moreover, dimensionless numbers were employed to establish connections between properties across the entire fracture hierarchy, spanning from minor to major fractures and encompassing the fracture intensity. The results indicate that the FAWAG is more sensitive to fracture types and networks than the WAG and GI processes. Hence, the sensitivity of the individual EOR method to the fracture network requires a respective depth of description of the fracture network. However, other factors, such as reservoir fluids properties and fracture properties, might influence the recovery when the minor fracture networks are excluded. This study has determined that, among the enhanced oil recovery (EOR) techniques examined, the significance of the hyrachical depth of fracture networks diminishes as the ratio of major (primary fracture) aperture to the aperture of medium and minor fractures increases. Additionally, the impact of the assisted-gravity drainage method was greater with increased reservoir height; however, as the intensity ratio increased, the relative importance of medium and minor fracture networks decreased.

Concrete has become the most common construction material showing among other advantages good behaviour when subjected to high temperatures. Nevertheless, concrete is usually reinforced with elements of other materials such as steel in the form of rebars or fibres. Thus, the behaviour under high temperatures of these other materials can be critical for structural elements. In addition, concrete spalling occurs when concrete is subjected to high temperature due to internal pressures. Micro polypropylene fibres (PP) have shown to be effective for reducing such spalling although this type of fibres barely improve any of the mechanical properties of the element. Hence, a combination of PP with steel rebars or fibres can be effective for the structural design of elements exposed to high temperatures. New polyolefin fibres (PF) have become an alternative to steel fibres. PF meet the requirements of the standards to consider the contributions of the fibres in the structural design. However, there is a lack of evidence about the behaviour of PF and elements made of polyolefin fibre reinforced concrete (PFRC) subjected to high temperatures. Given that these polymer fibres would be melt above 250 °C, the behaviour in the intermediate temperatures was assessed in this study. Uni-axial tests on individual fibres and three-point bending tests of PFRC specimens were performed. The results have shown that the residual load-bearing capacity of the material is gradually lost up to 200 °C, though the PFRC showed structural performance up to 185°C.

The formation of rock fractures in nature has a certain relationship with water seepage. In order to analyze the shape of rock fracture, we propose a rock deformation theoretical model in three-dimensional space considering with the condition of seepage water pressure, and establish the mass conservation equation, seepage equation, surrounding rock displacement equation, so as to deduce the rock deformation control equation under seepage pressure action. The numerical analysis of the nonlinear quadratic partial differential equation obtains the fracture deformation distribution in the example, and verifies with the calculated fracture morphology. And we further use this principle to analyze the fracture morphology in nature and prove the rationality of the theory.

Fracture density, a critical parameter of unconventional reservoirs, can be used to evaluate potential of unconventional reservoirs and location of production wells. Many technologies, such as amplitude variation with offset and azimuth (AVOA) technology, vertical seismic profiling (VSP) technology, and multicomponent seismic technology, are generally used to predict fracture of reservoirs. they can qualitatively predict fracture by analyzing seismic attributes, including seismic wave amplitudes, seismic wave velocities, which are sensitive to fracture. However, it is important to quantitatively describe fracture of reservoirs. In this study, based on a double-layer model, the relationships between fracture density and the double-layer model’s physical parameters, such as velocity of fast shear-wave, velocity of slow shear-wave, and density, were established, and then a powerful quantitative prediction method for fracture density was proposed dramatically. Afterwards, the Hudson model for crack was used to test the applicability of the method. The result shown that the quantitative prediction method for fracture density can be applied suitable to the Hudson model for crack. Finally, the result of validation models indicated that the method can predict fracture density effective, in which absolute relative deviation (ARD) were less than 5% and root-mean-square error (RMSE) was 4.88×10-3.

Objective The aim of this study was to examine the impact of a modern lifestyle on college female students' health, specifically focusing on their hip and knee joint mobility. The objective of this study was to assess the influence of hydraulic resistance training with the self-myofascial release technique on improving joint mobility in female college students. The training also aimed to compare the effectiveness of hydraulic resistance exercise with and without the self-myofascial release technique on hip and knee joint mobility.Methods The study used a randomized controlled trial design to recruit 30 female college students aged 18-25 through campus advertisements and announcements. Medical conditions or injuries that might have affected participation was screened. Participants were indiscriminately allocated to Group A (Hydraulic Resistance Training with Self-Myofascial Technique) or Group B (Hydraulic Resistance Training without Self-Myofascial Technique). The baseline assessments included joint range of motion (ROM) measurements using a goniometer. Certified trainers supervised the training sessions, and the data were analyzed using SD and mean using SPSS. ResultsThis study aimed to evaluate the impact of hydraulic resistance training with self-myofascial release on hip and knee joint mobility in female college students. The results showed that both groups showed improved hip and knee flexion with and without the self-myofascial release technique. However, the Group A using the self-myofascial release technique (Group A) showed a more significant enhancement, as indicated by the smaller p value compared to Group B. It has been suggested that the self-myofascial release technique may improve hip and knee joint mobility. ConclusionThis study concluded that Hydraulic Resistance Training with Self-Myofascial Release (HSMR) could improve hip and knee joint mobility among female college students. These findings suggest that integrating the self-myofascial release technique into training regimens can improve joint mobility. However, further research with larger sample sizes and extended intervention periods was needed to understand the long-term effects and sustainability of these improvements.

Although lithium-ion batteries have extensively been used in various applications because of their high energy capacity, fracture and failure, the by-products of large strains and stresses caused by fast charging and discharging need yet to be addressed. The size effects on the mechanical behavior of the nano-sized structures are significant; however, the classical elasticity theory may not consider such effects. On the other hand, surface stress theory, as a robust and potential theory, is suitable in considering size effects in nano-scale structures. Therefore, in this paper, in order to involve the surface stress effects on the fracture behavior of Li-ion batteries, the following steps are taken. Firstly, a phase-field model is used to determine the evolution of the concentration profile. Subsequently, the stress distribution is obtained by using the surface stress theory combined with chemical equations for a planar electrode. Afterward, by using the weight function method for an edge crack in the plate, the stress intensity factor is derived for all time steps and possible crack lengths during the process. It is found that with increasing phase boundary thickness parameter or decreasing phase-separation phenomenon, the surface mechanics parameters become more influential. Furthermore, in the presence of positive surface stress, the diffusion-induced stress distribution decreases, which in turn reduces the stress intensity factor. In addition, in this paper, the two states of surface stress are compared either for elastic or total strain. Concerning stresses and concentrations, the results indicate a big difference at the beginning of the deintercalation process showing, in particular, 2% for stresses, but the differences diminish gradually.

Size effect on plain concrete specimens is well known and can be correctly captured when performing numerical simulations by using a well characterised softening function, but in the case of fibre reinforced concrete this is not directly applicable, since an only diagram cannot capture the material behaviour on elements with different size due to dependence of the orientation factor of the fibres with the size of the specimen. In previous works, the use of a trilinear softening diagram proved to be very convenient for reproducing fracture of polyolefin fibre reinforced concrete elements, but only if it is previously adapted for each specimen size. In this work, a predictive methodology is used to reproduce fracture of polyolefin fibre reinforced concrete specimens of different sizes under three-point bending. Fracture is reproduced by means of a well known embedded cohesive model, with a trilinear softening function that is defined specifically for each specimen size. The fundamental points of these softening functions are defined a priori by using empirical expressions proposed in past works, based on an extensive experimental background. Therefore, the numerical results are obtained in a predictive manner, and then compared with a previous experimental campaign, showing that this approach properly captures the size effect, although some values of the fundamental points in the trilinear diagram could be defined more accurately.

Abstract: Comparing outcrop data to laboratory results is important to verify and validate experiments of analogue and reservoir materials especially regarding conditions for deformation experiments. This is important better understand highly complex carbonate reservoir strata and their response to changes in subsurface conditions, reducing subsurface uncertainty. This study develops methods to allow for a more straightforward comparison of outcrop data (m-scale) with experimentally created fracture arrays developed in cylindrical samples (cm-scale). The main objective is to assess usefulness of experimentally-produced fracture networks as analogues for subsurface structures, typically at the meter and above scale by developing new techniques to use the lab deformation. It analyses key characteristics of laboratory-induced fracture networks by adapting scanline methods to use with x-ray tomography (XRT) images to allow for comparison with outcrop and field data. To test and verify these new methods two low permeability carbonate samples were used for deformation testing and analysis. Applying the different scanline methods we show that they can be used to analyse lab induced fractures (mm to cm-scale) identified in XRT images for comparison with outcrop data (m-scale). In addition, these methods also allow for quantification of fracture network attributes e.g. fracture spacing, fracture apertures, orientation. This new data bridges the gap between micro-scanlines using thin sections and outcrop scanlines.

Preliminary clinical data suggest pain reduction through fasting in different diagnoses. This uncontrolled observational clinical study examined the effects of prolonged modified fasting on pain and functional parameters in hip and knee osteoarthritis. Patients admitted to the inpatient department of Internal Medicine and Nature-based Therapies of the Immanuel Hospital Berlin between February 2018 and March 2020, answered questionnaires at the beginning and end of inpatient treatment, as well as 3, 6 and 12 months after discharge. Additionally, selected blood and anthropometric parameters were routinely assessed during the inpatient stay. Fasting was performed as part of a multimodal integrative treatment program, with daily caloric intake of <600 kcal for 7.7 ± 1.7 days. N=125 consecutive patients were included. Results revealed an amelioration of overall symptomatology (WOMAC Index score: -14.8±13.31; p<0.001; d=0.78), and pain alleviation (NRS Pain: -2.7±1.98, p<0.001, d=1.48). Pain medication was reduced, stopped, or replaced by herbal remedies in 36% of patients. Improvements were also observed in secondary outcome parameters, including increased quality of life (WHO-5: +4.5±4.94, p<0.001, d=0.94), reduced anxiety (HADS-A: -2.1±2.91, p<0001, d=0.55) and depression (HADS-D: -2.3±3.01, p<0.001, d=0.65), decreases in body weight (-3.6 kg ± 1.65, p< 0.001, d=0.21), and blood pressure (systolic: -6.2±15.93, p<0.001, d= 0.43; diastolic: -3.7±10.55, p<0.001, d=0.43). Results suggest that patients with osteoarthritis of the lower extremities may profit from a prolonged fast embedded in a multimodal integrative treatment regarding quality of life, pain, and disease-specific functional parameters. Confirmatory RCTs are warranted to further investigate these hypotheses.

Most common classifications for acetabular bone defects are based on radiographic two-dimension imaging, with low reliability and reproducibility. With the rise of modern processing techniques based on 3D modelling, methodologies for volumetric quantification of acetabular bone loss are available. Our study aims to describe a new methodology for quantitative assess-ment of acetabular defects, based on 3D modelling, focused on the surface analysis of the integrity of the main anatomical structures of the acetabulum represented by four corresponding sectors (posterior, superior, anterior, and medial). The defect entity is measured as the Area Increase Ra-tio (AIR) detected in all the sectors analyzed on three planes of view (frontal, sagittal and axial) compared to healthy hemipelvises. The analysis was performed on 3D-models from the CT-scan of six exemplary specimens with a unilateral pathological hemipelvis. AIR between the native and the pathological hemipelvis was calculated for each sector, for a total of 48 analysis (range, +0.93% - +171.35%). AIR of >50% were found in 22/48(45.8%) sectors and affected mostly the posterior, medial and superior sectors (20/22, 90.9%). Qualitative analysis showed consistency of the data with the morphological features of the defects. Further studies with larger samples are needed to validate the methodology and potentially develop a new classification scheme.

Hip replacement has significantly improved the quality of life of patients with symptomatic hip osteoarthritis. Metal-on-metal (MoM) bearings have been used with conventional total hip re-placement (THR) for several decades with promising results from early applications. Wear and corrosion of these implants may lead to a release of metal products into surrounding tissue and body fluids. From the 1980s onwards, the search for increasingly better coupling materials with low levels of wear led to the rise of hard-on-hard couplings such as ceramic-on-ceramic (CoC). The latter is currently the coupling with the longest known duration and with a wear rate close to zero. MoM coupling has been for a long time the most significative alternative, but systemic and local complications linked to the release of chromium and cobalt ions, determine the withdrawn from the market. One other alternative proposed over the time has been Ceramic-on-Metal (CoM) bearing. Preliminary results have been described as favourable, but due to the failures of metal on metal it has been withdrawn from the market, without causing significant clinical complications. In this narrative review, we analysed risks and benefits associated with the implantation of hybrid hard-on-hard bearings, such as CoM.

In the history of high-performance polymer composite parts with continuous in-plane fibre reinforcement, the comparatively moderate structural-mechanical properties in their out-of- plane-z-direction and the limited load carrying capability between individual reinforcement layers within the laminated structures have always been one of the greatest challenges. Plenty of research work has been carried out to improve load transfer capability as well as fracture toughness for crack opening events between the reinforcement layers by means of out-of-plane fibre reinforcement implementation, for example by sewing or z-pinning technologies. However, the results have not become established across a wide range of applications so far, because the technologies used have led to considerable losses of in-plane strength properties. In this paper first results are presented for a new method of a low fraction z-fibre reinforcement by means of very thin diameter laser drilled holes filled with short carbon fibres, demonstrating potential to improve Mode II fracture toughness.

Study design: Technical note. Objectives: To present a new technique of treatment for a patient with thoracolumbar focal kyphosis due to osteoporotic verte-bral fracture (OVFs). Background : OVFs are common among the elderly population. Following a severe wedged fracture, patients often experience low back pain and disruptions in activities of daily living. Reconstruction surgeries, such as corpectomy, are among the treatment options for this condition. However, corpectomy requires longer surgical times and involves a significant amount of blood loss. Materials and Methods : An 80-year-old woman presented to our hospital with severe low back pain and gait disturbance. She had experienced an L2 OVF six years prior. Although she had no neurological deficit, she could not walk more than 200m due to pain. Preoperative spinal radiographs revealed severe sagittal malalignment, with the L2 vertebra collapsed and focal kyphosis of L1-3 measuring 34 degrees. Results: The patient underwent anterior and posterior surgery in the right decubitus position using a C-arm free technique. The surgical time was 133 minutes with an estimated blood loss of 100 ml. Hyperlordotic cages were inserted in the upper and lower disc space via a lateral approach, while percutaneous pedicle screws (PPS) were inserted from a posterior approach. These procedures were performed simultaneously under navigation guidance only. Post-operative images showed excellent spinal alignment, with local kyphosis reduced from 34 to 14 degrees, and no major or severe complications occurred. At one-year follow-up, the patient was able to walk smoothly, with her visual analogue scale for low back pain improving from 73mm to 13mm, and her Oswestry Disability Index improving from 53.3% to 13.3%. Conclusions/Level of Evidence : The simultaneous use of hyperlordotic cages and PPS is an effective and innovative navigation technique that yields promising outcomes for thoracolumbar focal kyphosis resulting from OVFs. This approach not only reduces surgical time but also minimizes intraoperative blood loss. Level V.

The management of blunt abdominopelvic trauma with combined hemoperitoneum and pelvic fractures is challenging for trauma surgeons. Although angioembolization can achieve hemostasis in most visceral organ injuries and pelvic fractures after blunt abdominal trauma, it cannot effectively control hemorrhage in patients with blunt bowel mesenteric injury (BBMI). This study aimed to determine the risk factors associated with hemodynamically unstable patients with BBMI and to test the hypothesis that pelvic fracture is an independent risk factor for patients with unstable BBMI and concomitant pelvic fracture to guide the therapeutic sequence for difficult-to-manage patients. This retrospective study reviewed the data of hospitalized patients with trauma between 2009 and 2021 and included 158 adult patients with surgically proven BBMI. The patients were divided on the basis of the presence of a shock episode before emergency laparotomy. The shock group included 44.3% of all patients in the study (n = 70). Clinical injury severity and prognosis for patients in the shock group were poorer than those for patients in the non-shock group, and more invasive treatments and transfusions were performed for patients in the shock group than for those in the non-shock group. Pelvic fractures were more frequently associated in the shock group than in the non-shock group (21.4% vs. 5.7%; p = 0.003). In multivariate analysis, the presence of intracerebral hemorrhage (odds ratio [OR] = 10.87, 95% confidence intervals [CIs]: 1.70–69.75) and rib fracture (OR = 5.94, 95% CIs = 1.06–33.45) were identified as independent predictors of shock, whereas the effect of pelvic fracture did not achieve statistical significance (OR = 2.94, 95% CIs = 0.66–13.13) after adjusting for confounding factors. For patients with BBMI, outcomes need to be improved during early diagnosis and treatments should be expeditiously performed on the basis of the rapid identification of unstable hemodynamic status. In unstable patients with concomitant pelvic fractures, we support the current management algorithm that recommends performing laparotomy first.

The 1060 aluminium alloy is widely applied to electronic industry, construction area, aerospace field, traffic engineering, decoration and consumption goods market for its good chemical, physical and mechanical properties. In general, excellent processing property is necessary and important for manufacturing of complicated panels. In this paper, a special 2D ultrasonic vibration incremental forming method is designed to improve its plasticity and mechanical properties. Three kind of processing methods including traditional single point incremental forming, longitudinal ultrasonic vibration incremental forming and 2D ultrasonic vibration incremental forming are conducted for flexible manufacture of conical parts of 1060 aluminium alloy sheet. Then micro-hardness tests, residual stress tests and scanning electron microscopy tests are carried out to probe its revolution of micro-structure and mechanical properties and to analysis the effects of different types of ultrasonic vibration on plasticity and fracture characteristic of 1060 aluminium alloy. It is proved that 2D ultrasonic vibration is facilitated to improvement of plasticity and surface qualities of 1060 aluminium alloy than the other two processing methods. So, the novel 2D ultrasonic vibration incremental forming possesses substantial application values on flexible and rapid manufacturing of complicated thin-walled component of aluminium alloy.

Background: GaitSmart (GS) is a sensor-based digital medical device that can be used with the integrated app vGym to provide a personalised rehabilitation programme for older people undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). This study aimed to determine whether the GS intervention used in the rehabilitation of older people undergoing THA or TKA is potentially cost-effective compared to the current standard of care (SoC). Methods: Decision-analytic modelling was conducted to estimate cost-effectiveness over a seventeen- week time horizon, from an NHS perspective. UK clinical and cost data from the GaitSmart randomised clinical trial was used to obtain input parameters, and sensitivity analysis was performed to address uncertainty. Results: Over a seventeen-week time horizon, GS incurred cost savings of £450.56 and a 0.02 gain in quality-adjusted life years (QALYs) compared to the SoC. These results indicate that GS is the dominant intervention because the device demonstrated greater effectiveness and lower costs. Probabilistic sensitivity analyses confirm the robustness of our results. Conclusion: GS appears to offer short-term efficiency benefits and demonstrates cost-effectiveness for the improvement of gait in people undergoing THA or TKA, compared to the SoC. These findings provided new evidence to inform policymakers.

Compared to the southern Tibetan Plateau, the northern part has been regarded as relatively lacking geothermal resources. However, there is no lack of natural hot springs exposed in beads along large-scale fracture systems, and research on them is currently limited to individual hot springs or geothermal systems. This paper focuses on the Wahongshan-Wenquan Fracture Zone (WWFZ), analyzes the formation of five hydrothermal activity zones along the fracture zone in terms of differences in the hydrochemical and isotopic composition of the hot water, and then explores the hydrothermal control of hot springs in the zone by the fracture. The results show that the main Fractures of WWFZ is the regional heat-control structures, and the fracture system formed by a small number of near-north-south and near-east-west fractures transversal to it provides a favorable channel for deep hydrothermal convective circulation. Ice and snow melt water from the Ngola Shan Mountains, with an average elevation of more than 4,500 meters above sea level, infiltrates along the fractures and is heated by deep circulation to form deep geothermal reservoirs. There is no detectable contribution of mantle source heat to the hot spring gases, and the heat source is mainly natural heat conduction warming, but the "Low-Velocity body (LVB)" in the middle and lower crust of the area may be the primary heat source of the high geothermal background in the area. The hydrochemical components of the hot springs in the area show a certain regularity, and the main ionic components, TDS and water temperature, tend to increase away from the main rupture, reflecting the controlling effect of the WWF on the hydrothermal transport in the area. In the future, the geothermal work in this area should focus on the hydrothermal control properties of different levels, the nature of fractures in the area, and the thermal contribution of LVB in the middle and lower crust.

700 MPa grade Ti and Nb-Ti microalloyed steels produced by thermo-mechanical control rolled processes (TMCP) were studied to elucidate texture that contributes to delamination and consequent impact toughness. The microstructure of Ti and Nb-Ti steels consisted of ferrite and bainite. Compared with Ti steel, Nb-Ti steel was characterized by a microstructure with finer ferrite and more bainite. The results from tensile and impact tests indicated that there is insignificant change in tensile properties, but toughness was greater in Nb-Ti steel compared with Ti steel. More severe delamination in Nb-Ti steel is attributed to stronger α-fiber (RD ||<110>) texture than Ti steel, especially {100}<110>, {113}<110> and {112}<110> texture. Typical cleavage river patterns were not observed on delaminated fracture surface, instead the cleavage fracture surface indicated some dimples. Interestingly, the impact energy of samples with delamination was greater than samples without delamination in the ductile–brittle transition region. The study suggests that delamination in the ductile–brittle transition zone may also be representative of high toughness.

The aim of this study was to evaluate and compare the fracture resistance of definitive zirconia dioxide restorations obtained using a computer-aided design and manufacturing (CAD/CAM) system. Methods: Two groups of ten samples were analyzed for each material (n: 20), the first group was Zolid Gen X Amann Girrbach (ZGX) and the second group was Cercon HT Dentsply Sirona (CDS). The restorations were designed with identical parameters and milled with a CAD/CAM system. Each specimen was load tested at a speed of 0.5 mm/min with a direction parallel to the major axis of the tooth and with an initial preload of 10N until fracture using a universal testing machine (Universal/Tensile Testing Machine, Autograph AGS-X Series) equipped with a 20 kN load cell. The results obtained were recorded in Newtons (N), using software connected to the testing machine. Results: Statistically significant differences were found, and the fracture toughness of the monolithic zirconia crowns was lower in the CDS group (1744.84 ± 172.8 N), compared to the ZGX group (2387.41 ± 516 N). Conclusions: The monolithic zirconia CAD-CAM zirconia crowns showed sufficient fracture strength to be used in posterior molar and premolar zones with either material as they withstood fracture loads greater than the maximum masticatory force.

Background Bone fracture fixation surgery is one of the most commonly performed surgical procedures in the orthopedic field. However, fracture healing complications occur frequently, and the choice of the most optimal surgical approach often remains challenging. In the last years, computational tools have been developed with the aim to assist preoperative planning procedures of bone fracture fixation surgery. Objectives The aims of this review are (1) to provide a comprehensive overview of the state-of-the-art in computer-assisted preoperative planning of bone fracture fixation surgery, (2) to assess the clinical feasibility of the existing virtual planning approaches, and (3) to assess their clinical efficacy in terms of clinical outcomes as compared to conventional planning methods. Methods A literature search was performed in the MEDLINE-PubMed, Ovid-EMBASE, Ovid-EMCARE, Web of Science, and Cochrane libraries to identify articles reporting on the clinical use of computer-assisted preoperative planning of bone fracture fixation. Results 79 articles were included to provide an overview of the state-of-the art in virtual planning. While patient-specific geometrical model construction, virtual bone fracture reduction, and virtual fixation planning are routinely applied in virtual planning, biomechanical analysis is rarely included in the planning framework. 21 of the included studies were used to assess the feasibility and efficacy of computer-assisted planning methods. The reported total mean planning duration ranged from 22 to 258 minutes in different studies. Computer-assisted planning resulted in reduced operation time (Standardized Mean Difference (SMD): -2.19; 95% Confidence Interval (CI): -2.87, -1.50), less blood loss (SMD: -1.99; 95% CI: -2.75, -1.24), decreased frequency of fluoroscopy (SMD: -2.18; 95% CI: -2.74, -1.61), shortened fracture healing times (SMD:-0.51; 95% CI: -0.97, -0.05) and less postoperative complications (Risk Ratio (RR): 0.64, 95% CI: 0.46, 0.90). No significant differences were found in hospitalization duration. Some studies reported improvements in reduction quality and functional outcomes but these results were not pooled for meta-analysis, since the reported outcome measures were too heterogeneous. Conclusions Current computer-assisted planning approaches are feasible to be used in clinical practice and have been shown to improve clinical outcomes. Including biomechanical analysis into the framework has the potential to further improve clinical outcome.