Search Results (1,707)

Background/Objectives: Radial head arthroplasty (RHA) and open reduction and internal fixation (ORIF) have emerged as predominant methods of surgical management for radial head fractures. The objective of this study was to evaluate national trends in management of radial head fractures among ABOS oral examination candidates and to compare complication rates between RHA and ORIF. Methods: A search of the American Board of Orthopaedic Surgery (ABOS) oral examination database identified radial head fractures treated with RHA or ORIF between 2003 and 2021 in patients 18 years or older. Results: RHA cases increased significantly from 2003–2021 (p < 0.001). Patients undergoing RHA were older (52.4 years vs. 42.9 years, p < 0.001) and predominantly female (60.8% vs. 45.7%, p < 0.001). Medical and surgical complications within 60 days were higher after RHA (2.9% vs. 1.6%, p = 0.012; 24.9% vs. 20.4%, p = 0.001), most commonly stiffness (10.8% vs. 7.1%, p < 0.001), nerve injury (3.3% vs. 2.7%, p = 0.26), and implant failure (3.4% vs. 2.4%, p = 0.064). Non-union or delayed union (0.5% vs. 2.5%, p < 0.001) was significantly higher after ORIF, and fracture (1.1% vs. 0.3%, p = 0.008) was significantly higher after RHA. The highest proportion of RHA to ORIF was performed by surgeons with shoulder and elbow fellowship training (p < 0.001). Conclusions: Among ABOS Candidates, RHA volume surpassed ORIF for radial head fractures in 2010. Surgical complication rates for radial head fractures are high at 60 days follow-up for both procedures. RHA is associated with higher complication rates, especially stiffness; however, similar reoperation and readmission rates suggest that RHA may have been selected for more complex injuries. Full article

To investigate the impact of Integrated Mining-Backfill-Roof Contact (IMBR) synergy on strata subsidence in metallic deposits and analyze strata/surface movement patterns, this study enables safe, efficient, environmentally conscious, and sustainable mining development. Focusing on a representative metal mine, we integrated laboratory testing, theoretical analysis, and numerical modeling to determine experimental parameters. Utilizing MIDAS GTS NX, numerical models incorporated four orebody dip angles (30°, 50°, 70°, 90°), five stress release coefficients (20–100%), and contacted/uncontacted conditions to assess IMBR’s control efficacy on surrounding rock stability and surface subsidence. By examining strata/surface movement under variable dip angles and stress release coefficients, displacement control mechanisms were quantified, revealing strata movement evolution principles. Key findings indicate: (1) For all dip angles, the increase rate of displacement progressively intensifies as the excavation stress release coefficient decreases. Notably, at a 30° dipping angle, the most pronounced reduction occurs under declining stress release coefficients, with overall displacement reduction rates reaching 17% for ground surface and 18% for surrounding rock, respectively. (2) Surface displacement impacts intensify as dip angles flatten. (3) Shallower dips induce more pronounced stress disturbance, expanding overburden movement domains and exacerbating surface impacts. Finite element numerical modeling enables accurate and effective analysis of strata and ground movement patterns under varying orebody dipping angles and mining-backfill stress release coefficients. Findings demonstrate that IMBR technology, compared to conventional roof-contacted backfilling methods, achieves timely roof support through immediate backfill-roof contact, significantly reduces overburden fracture propagation depth, and offers valuable insights for controlling surface subsidence in complex mining conditions—particularly for mining under surface structures. Full article

Background/Objectives: Traumatic dislocation of the lumbosacral facet joints without associated fractures is exceedingly rare in the pediatric population. Due to the unique anatomical and biomechanical features of the pediatric spine, such injuries present diagnostic and therapeutic challenges. This study aims to describe a rare case of bilateral L5–S1 jumped facets without fracture in a 13-year-old boy and to review the existing literature on pediatric traumatic facet dislocations. Methods: We performed a systematic review according to PRISMA guidelines, searching PubMed, Embase, Scopus, and the Cochrane Library up to 16 January 2025. Keywords included “pediatric traumatic spondylolisthesis” and “pediatric traumatic facet joint”. Eligible studies reported traumatic lumbosacral or thoracolumbar facet dislocations in patients aged <18 years. In addition, we report the clinical course, surgical management, and outcome of a representative case from our institution. Results: The systematic review identified 14 pediatric cases across 11 studies. Most patients were male (71.4%), with high-energy trauma as the primary mechanism. The L5–S1 level was most frequently involved (57.1%). Neurological impairment was present in 57.1% of cases. All patients underwent surgical treatment, with posterior fixation being the most common approach. Our case involved bilateral L5–S1 jumped facets without fracture, successfully treated with open reduction and posterior fusion. Postoperative recovery was favorable, with neurological improvement. Conclusions: Traumatic bilateral facet dislocation without fracture is an extremely rare but serious condition in pediatric patients. Early recognition and surgical stabilization are essential to prevent permanent neurological damage. This study reinforces the importance of advanced imaging and prompt multidisciplinary management in optimizing outcomes. Full article

With the increasing intensity of resource development in alpine regions, numerous geotechnical engineering problems in cold regions have become increasingly prominent. In order to explore the damage and deterioration laws of rocks caused by freeze–thaw action, this paper takes the biotite granulite on the eastern slope of Yanshan Iron Mine as the research object. By analyzing the changes in mechanical and acoustic emission parameters of rock samples after freeze–thaw, and combining with existing freeze–thaw damage theories, the suitable freeze–thaw damage mechanism for this rock is further explored, and a freeze–thaw damage model for biotite granulite with low and high freeze–thaw cycles is established. The results of this study demonstrate that biotite granulite subjected to a lower number of freeze–thaw cycles exhibits significantly greater reductions in peak strength, elastic modulus, acoustic emission (AE) hit counts, cumulative ringing counts, and cumulative energy compared with specimens exposed to a higher number of cycles. As the freeze–thaw cycles increase, the formation of newly generated large-scale fractures during failure becomes progressively less pronounced, leading to a diminished resistance to deformation and a gradual increase in plastic deformation during loading. A coupled damage variable relationship was established for biotite granulite under both low and high freeze–thaw regimes based on cumulative AE ringing counts. In the early three stress stages, specimens subjected to fewer cycles exhibited fewer microcracks, with no clear spatial correlation between their distribution and the eventual fracture coalescence zones, whereas specimens exposed to a higher number of cycles showed a distinct sequential relationship between microcrack initiation sites and subsequent crack coalescence. Building upon existing freeze–thaw damage theories, the freeze–thaw damage mechanism specific to biotite granulite was further elucidated. Accordingly, a freeze–thaw damage model for low- and high-cycle conditions was developed and preliminarily validated. Full article

In probabilistic risk assessment (PRA), the fracture limit of fuel cladding tubes under loss-of-coolant accident conditions plays a critical role in determining the core damage, highlighting the need for accurate modeling of cladding tube fracture behavior. However, for high-burnup cladding tubes, it is often infeasible to conduct extensive experiments due to limited material availability, high costs, and technical constraints. These limitations make it difficult to acquire sufficient data, leading to substantial epistemic uncertainty in fracture modeling. To enhance the realism of PRA results under such constraints, it is essential to develop methods that can effectively reduce epistemic uncertainty using limited experimental data. In this study, we propose a Bayesian approach for designing experimental conditions based on a widely applicable information criterion (WAIC) in order to effectively reduce the uncertainty in the prediction of fuel cladding tube fracture with limited data. We conduct numerical experiments to evaluate the effectiveness of the proposed method in comparison with conventional approaches based on empirical loss and functional variance. Two cases are considered: one where the true and predictive models share the same mathematical structure (Case 1) and one where they differ (Case 2). In Case 1, the empirical loss-based design performs best when the number of added data points is fewer than approximately 10. In Case 2, the WAIC-based design consistently achieves the lowest Bayes generalization loss, demonstrating superior robustness in situations where the true model is unknown. These results indicate that the proposed method enables more informative experimental designs on average and contributes to the effective reduction in epistemic uncertainty in practical applications. Full article

During the service life of steel bridges, the structural stress histories display combined cyclic characteristics due to the superposition of low-frequency thermal loading and high-frequency vehicle loading. To investigate the fatigue performance under such loading patterns, a series of constant-amplitude and high-low frequency superimposed loading fatigue (HLSF) tests were conducted on notched specimens fabricated from Q355D bridge steel. The influence of HLSF waveform parameters on fatigue life was systematically investigated. Based on the fracture evolution mechanism, a concept of low-frequency periodic damage acceleration factor was proposed to effectively model the block nonlinear damage effects, and the applicability of existing fatigue life prediction models was discussed. The results show that the effect of average stress on the fatigue life under HLSF can be effectively considered by Walker’s formula. Low-amplitude ratios and low-frequency ratios indicate unfavorable loading conditions that may accelerate the Q355D fatigue damage accumulation, and these conditions are not adequately accounted for in current life prediction models. Compared to constant amplitude loading, HLSF can lead to a 66% and 46% reduction in high-frequency life when the amplitude ratio reaches 0.12 and the frequency ratio reaches 100. Compared to Miner’s rule, the proposed damage correction method reduces the life prediction error for HLSF by 11%. These findings provide valuable references for the fatigue assessment of bridge steel structures under the coupled effects of temperature and vehicle loading. Full article

Proton pump inhibitors (PPIs) are among the most prescribed drugs worldwide owing to their proven efficacy in symptom control and mucosal healing for acid-related disorders including gastroesophageal reflux disease (GORD), peptic ulcer disease, Helicobacter pylori eradication, functional dyspepsia, and gastroprotection in high-risk patients. However, long-term use beyond approved indications is increasingly common and has raised safety concerns. Observational studies link chronic PPI use to a myriad of adverse outcomes such as enteric infections (e.g., Clostridioides difficile), nutrient deficiencies (magnesium, vitamin B12), osteoporotic fractures, chronic kidney disease, dementia, and gastric and colorectal cancer. While causality is not always established, these associations warrant cautious risk–benefit assessment in patients receiving prolonged therapy. Current guidelines advocate periodic review of ongoing PPI use and emphasise deprescribing where appropriate. Strategies include dose reduction, on-demand or intermittent use, and switching to H2-receptor antagonists, particularly in patients with non-erosive reflux disease or functional dyspepsia. Tools from the National Institute for Health and Clinical Excellence, American College of Gastroenterology, and the Canadian Deprescribing Network assist clinicians in identifying candidates for tapering or discontinuation. This narrative review focuses on the concept of “PPI stewardship” by providing an evidence-based overview of PPI indications, risks, and deprescribing strategies to promote appropriate, safer, and patient-centred use of acid-suppressive therapy. Full article

Foodborne pathogenic biofilms pose significant challenges to food safety due to their enhanced resistance to conventional antimicrobial agents. In this study, we evaluated the synergistic antibiofilm activity of oregano essential oil (OEO) from Lippia graveolens and the lytic bacteriophage phiLLS against six foodborne bacteria. GC–MS analysis achieved a 100% identification ratio, revealing that OEO was mainly composed of carvacrol (58.9%), p-cymene (28.6%), γ-terpinene (2.9%), and caryophyllene (2.6%). The MIC and MBC of OEO were 1 and 2 mg/mL, respectively, for all strains except E. coli BALL1119 (MIC = 2 mg/mL). We assessed biofilm biomass by crystal violet (CV) staining and metabolic activity using the TTC assay under both individual and combined treatments, monitored 9-hour planktonic growth kinetics to calculate Bliss and HSA synergy indexes, and employed atomic force microscopy (AFM) to visualize nanoscale alterations in Staphylococcus aureus and Escherichia coli BALL1119 biofilms. Combined OEO (2 mg/mL) and phiLLS (MOI 1) treatments achieved significantly greater biofilm biomass reduction than single agents, notably yielding >70% inhibition of S. aureus biofilms (p < 0.05) and a Bliss synergy index of 10.8% in E. coli BALL1119 growth kinetics, whereas other strains were additive. In biofilm assays, S. aureus and Salmonella spp. showed the highest reductions in biomass (CV) (71.0% and 67.8%, ΔHSA = 27.0% and 17.4%; ΔBliss = 21.1% and 13.8%) and metabolic activity (TTC) (68.6% and 48.5%). AFM revealed that OEO alone smoothed the extracellular matrix (averaging a 35% reduction in roughness), whereas the combined treatment caused fracturing (≈68 nm roughness) and prominent lytic pits. Although variability in S. aureus biofilm architecture precluded statistically significant pairwise comparisons, AFM topography and consistent trends in Ra/Rz parameters provided clear visual corroboration of the significant reductions detected by CV and TTC assays. These complementary data indicate that OEO primes the biofilm matrix for enhanced phage-mediated collapse, offering a green, two-step strategy for controlling resilient foodborne biofilms. Full article

This study systematically investigates the influence of varying corrosion severity on the bearing capacity of K-shaped circular-section joints, with explicit consideration of weld line positioning. Four full-scale circular-section joint specimens with clearance gaps were designed to simulate localized corrosion through artificially introduced perforations, and axial static loading tests were performed to assess the degradation of structural performance. Experimental results indicate that the predominant failure mode of corroded K-joints manifests as brittle fracture in the weld-affected zone, attributable to the combined effects of material weakening and stress concentration. The enlargement of corrosion pit dimensions induces progressive deterioration in joint stiffness and ultimate bearing capacity, accompanied by increased displacement at failure. A refined finite element model was established using ABAQUS. The obtained load–displacement curve from the simulation was compared with the experimental data to verify the validity of the model. Subsequently, a parametric analysis was conducted to investigate the influence of multiple variables on the residual bearing capacity of the nodes. Numerical investigations indicate that the severity of corrosion exhibits a positive correlation with the reduction in bearing capacity, whereas web-chord members with smaller inclination angles demonstrate enhanced corrosion resistance, when θ is equal to 30 degrees, K_s decreases from approximately 0.983 to around 0.894. Thin-walled joints exhibit accelerated performance deterioration compared to thick-walled configurations under equivalent corrosion conditions. Furthermore, increased pipe diameter ratios exacerbate corrosion-induced reductions in structural efficiency, when the corrosion rate is 0.10, β = 0.4 corresponds to K_s = 0.98, and when β = 0.7, it is approximately 0.965. and distributed micro-pitting results in less severe capacity degradation than concentrated macro-pitting over the same corrosion areas. Full article

This study investigates the fracture behavior of recycled aggregate concrete by integrating fractal theory and empirical modeling to quantify how recycled coarse aggregates (RCAs) and recycled fine aggregates (RFAs) influence crack complexity and maximum crack width under varying content and loads. The results reveal distinct scale-dependent behaviors between RCA and RFA. For RCA, moderate dosages enhance fractal complexity (a measure of surface roughness) by promoting micro-crack proliferation, while excessive RCA reduces complexity due to matrix homogenization. In contrast, RFA significantly increases both fractal complexity and crack width under equivalent loads, reflecting its susceptibility to micro-scale interfacial transition zone (ITZ) degradation. Non-linear thresholds are identified: RCA’s fractal complexity plateaus at high loads as cracks coalesce into fewer dominant paths, while RFA’s crack width growth decelerates at extreme dosages due to balancing effects like particle packing. Empirical models link aggregate dosage and load to fractal dimension and crack width with high predictive accuracy (R² > 0.85), capturing interaction effects such as RCA’s load-induced complexity reduction and RFA’s load-driven crack width amplification. Secondary analyses further demonstrate that fractal dimension correlates with crack width through non-linear relationships, emphasizing the coupled nature of micro- and macro-scale damage. These findings challenge conventional design assumptions by differentiating the impacts of RCA (macro-crack coalescence) and RFA (micro-crack proliferation), providing actionable thresholds for optimizing mix designs. The study also advances sustainable material design by offering a scientific basis for updating standards to accommodate higher recycled aggregate percentages, supporting circular economy goals through reduced carbon emissions and waste diversion, and laying the groundwork for resilient, low-carbon infrastructure. Full article

The aim of this study article is to better understand patient outcomes following simple nasal fracture realignment, comparing outcomes when performed under LA versus GA. A systematic search of the evidence base is conducted. Data extraction and documentation are performed in keeping with PRISMA guidance. Critical appraisal tools are applied to aid quality assessment and assessment of bias. Twelve articles were selected for inclusion in this review, accumulating 2405 participants in total. No significant difference in patient outcomes between the LA and GA groups was observed. There was high variation in article quality, with some assessed as having a high risk of bias. Although some methodological limitations and outcome heterogeneity between studies hamper our ability for direct comparison, it seems likely that patient outcomes after nasal fracture correction under LA versus GA are comparable. Further large-scale studies with an agreed set of outcome measures are required to understand this relationship more fully. Full article

Background/Objectives: Femoral neck and proximal femur fractures in the elderly can result from low-energy trauma due to osteoporotic changes and contribute significantly to increased morbidity and mortality. Despite various treatment options, closed reduction and internal fixation (CRIF) with intramedullary nails has become the predominant approach. While a minimally invasive approach reduces complications and speeds recovery, this outcome is not always feasible in practice. The primary surgical goal remains achieving a stable and precise fracture reduction, favoring CRIF when possible. Our study aims to evaluate the clinical, radiological, and functional outcomes of patients operated on using the Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique. Methods: Patients who underwent surgery for intertrochanteric femur fractures between June 2019 and June 2021 were analyzed. Patients who were between 75 and 90 years old and had undergone surgery with a proximal femoral nail (PFN) were included in the study. Patients were excluded if they required general anesthesia, if an acceptable reduction could not be achieved with the PFN, if they did not attend the last follow-up examination, or if the follow-up period was <4 years. Patients were functionally assessed using the Harris hip score at the 6th month and at the last follow-up and using the visual analog scale at the surgery, at the 4th hour after surgery, and at the time of discharge. For radiological assessment, the classification of reduction quality and the measurement of the tip–apex distance were used. Results: Forty patients (22F/18M) were included in the study. Their mean age was 83.0 ± 2.9 years. The mean time from trauma to surgery was 6.8 ± 2.3 h. Patients were mobilized on average 1.53 ± 0.8 h after surgery, and the mean hospitalization time was 27.4 ± 8.1 h. No statistically significant decrease in hemoglobin value was observed before or after surgery (p = 0.476). The Harris hip score was 73.3 ± 3.2 at the 6th month postoperatively and 74.9 ± 2.5 at the last follow-up (p = 0.296). The reduction quality was found to be poor in only two patients. Conclusions: The WALANT technique’s promising results in terms of pain management, blood loss control, and early mobilization show that it is a viable alternative to conventional anesthesia methods in geriatric hip fractures. Full article

The ECAP (equal channel angular pressing) technique plays a crucial role in enhancing the overall performance of aluminum alloys. In this study, ECAP was applied to a self-developed micro-alloyed Al-0.7Fe-0.4Mg-0.1Si-0.5Er aluminum alloy to investigate the strengthening effects of varying numbers of passes. The results show that after four ECAP passes, the alloy achieved a high tensile strength (208 MPa), yield strength (175.4 MPa), elongation after fracture (10.8%), and a relatively high electrical conductivity (57.1%IACS). The enhanced strength is primarily attributed to precipitation strengthening (${\sigma }_p$), grain refinement strengthening (${\sigma }_{gbs}$), and dislocation strengthening (${\sigma }_{dis}$). The grain refinement is a result of dynamic recrystallization (DRX) induced by severe plastic deformation. This study demonstrates that ECAP enables a significant improvement in the mechanical properties (82.3%) of the alloy while causing only a marginal reduction (2.9%) in electrical conductivity. These findings provide both technological and theoretical support for the manufacturing of high-performance conductors and other lightweight electrical structural components. Full article

Background: Wrist arthritis significantly impacts the quality of life in elderly populations. While total wrist arthroplasty and wrist arthrodesis are established treatments, partial resurfacing procedures are emerging as a solution offering advantages for patients over 70 years of age. Objective: To systematically evaluate the efficacy, safety, and functional outcomes of radial versus carpal resurfacing procedures for the management of wrist arthritis in patients over 70 years of age. Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted for studies published from these databases’ inception to May 2025. Studies reporting the outcomes of either radial or carpal resurfacing in patients ≥70 years of age with wrist arthritis were included. Primary outcomes were pain reduction, functional improvement, and complication rates. Results: Twenty studies met the inclusion criteria. Both carpal and radial resurfacing provided pain relief, with mean VAS scores ranging from 0 to 3.8 across studies and DASH scores ranging from 13 to 59 points, while carpal resurfacing showed better preservation of range of motion, with flexion/extension arcs of 27–65° compared to 22–46° for radial implants. Complication rates were comparable, though implant loosening was uncommon with both radial and carpal resurfacing. Both procedures demonstrated satisfactory patient-reported outcomes at midterm follow-up (median: 32 months; range: 6–84 months). Conclusion: In patients over 70 years of age with wrist arthritis, both radial and carpal resurfacing appear to be viable options with distinct advantages. Radial resurfacing may be preferred for patients with previous distal radius fractures, while carpal resurfacing offers better motion preservation and is indicated in SLAC and SNAC wrists. Patient selection should consider specific arthritis patterns, activity requirements, and comorbidities. Long-term studies are needed to evaluate durability beyond 5–10 years in this population. Full article

Control valves are the main throttling resistance components in industries such as chemical engineering, nuclear power, aerospace, hydrogen energy, natural gas transportation, marine engineering, and energy systems. Flow-induced vibration fatigue failure is a common failure mode. To provide engineers and researchers with a reference for reliable design analysis of control valves and to predict and prevent potential failures, this article reviews and categorizes vibration-induced failure in control valves by integrating numerous engineering cases and research articles. The vibration failures of control valves are mainly divided into categories such as jet flow, vortex flow, cavitation, and acoustic cavity resonance. This paper reviews control valve vibration research from three aspects: theoretical models, numerical simulations, and experimental methods. It highlights the mechanisms by which internal unstable flow, jet flow, vortex shedding, cavitation, and acoustic resonance lead to vibration-induced fractures in valve components. Additionally, it examines the influence of valve geometry, component constraints, and damping on flow-induced valve failures and summarizes research on vibration and noise reduction in control valves. This paper aims to serve as a reference for the analysis of vibration-induced failures in control valves, helping identify failure mechanisms under different operating conditions and proposing effective solutions to enhance structural reliability and reduce the occurrence of vibration failures. Full article