Search Results (634)

Background/Objectives: The optimal surgical approach for Percutaneous KyphoPlasty (PKP) in patients with recent single-level Osteoporotic Vertebral Compression Fractures (OVCFs) remains controversial. Most available previous meta-analyses included studies with variable heterogeneity, often mixing unilateral and bilateral MIS approaches, differing surgical techniques, and various fracture patterns, which limited the reliability of their conclusions. This meta-analysis aimed to compare the efficacy and safety of unilateral versus bilateral PKP exclusively in patients with recent single-level OVCFs only. Methods: A systematic review was conducted according to the PRISMA 2020 guidelines. PubMed, Scopus, Cochrane Library, and ScienceDirect were searched for comparative studies published between 2000 and 2025. Randomized Controlled Trials (RCTs), prospective, and retrospective comparative studies comparing unilateral and bilateral PKP for recent single-level OVCFs were included. Clinical and radiological outcomes as well as perioperative complications and safety outcomes were analyzed using random-effects meta-analysis. Predefined subgroup analyses according to study design and sensitivity analyses were performed. Results: Eleven studies involving 1374 patients (705 unilateral and 669 bilateral PKP) met the inclusion criteria. No significant differences were observed between the two surgical approaches regarding short- or long-term pain relief, cement leakage, number of adjacent vertebral fractures, or overall clinical outcomes. Bilateral PKP demonstrated statistically significant, but clinically negligible, advantages in anterior vertebral body height restoration and kyphosis correction. Unilateral PKP required an insignificantly lower cement volume. For operative time, the overall pooled estimate favored unilateral PKP by approximately 10 min but showed extreme heterogeneity (I² = 98.5%). Importantly, the two RCTs showed no statistically significant between-group difference (MD = +1.2 min, 95% CI −4.5 to +6.8), indicating that the apparent overall effect was largely driven by observational evidence. Similar discrepancies between randomized and retrospective studies were observed for several other outcomes, underscoring the importance of considering study design when interpreting the results. Conclusions: Current evidence does not demonstrate clinically meaningful superiority of either unilateral or bilateral PKP for the treatment of recent single-level OVCFs. Bilateral PKP may provide small advantages in selected radiographic outcomes, whereas unilateral PKP uses modestly less bone cement; however, the relevance of these differences remains clinically uncertain. Surgical approach selection may therefore be individualized according to vertebral morphology, pedicle anatomy, fracture characteristics, surgeon experience, and technical feasibility rather than expectations of superior clinical outcomes. Further adequately powered randomized trials with standardized outcome reporting and long-term follow-up are warranted. Full article

Three-dimensional (3D) printing technology has become more and more popular in restorative dentistry; however, information regarding the mechanical properties of 3D-printed restorative materials remains limited. The aim of this study was to evaluate the behavior under compressive loading until fracture of occlusal veneers fabricated from two types of 3D-printed resin composites, Saremco Print Crowntec A2 and Voco V-Print C&B Temp A2, intended for permanent and temporary clinical restorations, respectively. The study design involved scanning a first upper premolar typodont tooth, previously prepared to receive an occlusal veneer restoration, followed by the computer-aided design of the occlusal veneers and resin dies and 3D printing, resulting in 20 samples. The cemented restorations were subjected to mechanical testing using a fracture-resistance test at a speed of 5 mm/min, applied until failure. The recorded failure forces ranged between 571 and 970 Newton (N), values that are comparable to physiological masticatory forces. The absorbed energy was calculated as the area under the force–displacement curve using the trapezoidal integration method. The mean energy at failure was 0.301 Joule (J) (Voco) and 0.244 Joule (J) (Saremco), with Voco demonstrating greater toughness. In terms of fracture pattern classification, the 3D-printed resin with a lower filler content presented a more catastrophic failure mode compared with the material with a higher filler content. Fractographic analysis revealed characteristic fracture patterns and failure-specific features. Higher predictability and greater fracture strength were observed for the low-filled material, as indicated by the Weibull analysis. Full article

Rapid urbanization across global South megacities has accelerated the overexploitation of urban aquifers, creating complex socio-hydrological crises that threaten long-term water resilience for a vast population. Conventional urban-water management frequently relies on uniform, city-wide regulatory mandates that fail to account for localized hydrogeological heterogeneities and the socio-economic drivers of private extraction. This study performed a seasonal assessment (post- and pre-monsoon) of groundwater levels (GWLs), across the National Capital Territory of Delhi, India, using a 13-year archival dataset (2010–2022) of 77 ‘common’ wells, with a sequential spatial–statistical framework. No statistically significant ‘seasonality’ was found in GWLs, except for isolated years. About 13% of the observations appeared as ‘deep outliers’, the call for more process-level hydrogeologic investigations. Spatial interpolation via the Inverse Distance Weighting (IDW) interpolation technique, alongside Global Moran’s I, Local Indicators of Spatial Association (LISA), and spatially Constrained Hierarchical Cluster Analysis (sHCA), revealed a recurrent spatial pattern: persistent, deep GWLs, within the fracture-dominated, low-yielding Alwar Quartzite (Delhi Ridge) of South and Southeast Delhi. The spatial clustering demonstrates the migration of the deep-GWL hotspots toward the unconfined alluvial aquifers of the Yamuna River floodplains to the east, threatening future baseflow stability. These spatial drawdown patterns represent a structural response to municipal Drinking Water Services Framework (DWSF) deficits, where intermittent supply and informal water markets incentivize the growth of more unregulated and unrestricted private pumping of groundwater. Achieving sustainable urban groundwater governance requires replacing blanket administrative mandates with a more data-driven, micro-zoned socio-hydrological framework across the city—combining area-specific extraction caps, economic instruments for geologically targeted aquifer storage and recovery, informal market regulation, and facilitating more participatory, community-based (Water users Associations, WUA) initiatives in the future to protect groundwater resources in Delhi. However, it requires specialized monitoring data, which is still largely lacking, and detailed investigations involving the aquifer hydrogeology and groundwater pumping patterns. Full article

Understanding the failure behavior of cylindrical-hole hard rocks is essential for rockburst prevention in deep underground engineering. In this study, fractal–statistical analysis was combined with true triaxial testing and discrete element modeling to quantify the rate-dependent failure and crack-network evolution of holed granodiorite. The results showed that, with an increasing loading rate, the peak axial stress increased from 143 to 190 MPa, the peak axial strain decreased from 1.24% to 0.86%, and the post-peak brittleness index increased from 0.83 to 1.19. The final failure pattern evolved from multi-crack tension–shear coupled failure to localized dominant fracture and intense hole-wall exfoliation. The mass fractal dimension of rockburst fragments increased with loading rate, reflecting a transition toward finer and more dispersed fragmentation. To extend the experimentally observed hole-wall failure mechanism to adjacent openings, a calibrated PFC3D double-hole model was further established. The numerical results revealed that crack interaction was governed by stress-concentration superposition and progressive rock-bridge damage, and the hole-spacing ratio controlled the connectivity and complexity of the crack network. As S/2R increased from 1.25 to 2.00, the dominant fracture-band inclination increased from 27° to 54°, reflecting a transition from steep inter-hole coalescence to more inclined and spatially dispersed fracture development. Full article

Rockbursts occur frequently in deep hard-rock tunnels, posing a major challenge to the safe and efficient construction of underground engineering. Engineering practice shows that in addition to high in-situ stress and hard brittle lithology, widely distributed structural planes in surrounding rock also significantly modify rockburst failure modes and intensity. This review systematically investigates structural-plane-controlled rockburst phenomena in deep hard-rock tunnels, based on 16 published field cases and more than 40 laboratory studies. First, we summarize the influence mechanisms of structural planes on tunnel rockbursts at the engineering scale through statistical analysis of case data. We then integrate existing experimental findings to analyze how the geometric and physical properties of structural planes alter rockburst behavior, from four perspectives: location (concealed/exposed), attitude (dip angle, strike, length), filling state, and multi-plane combination. We further synthesize multi-physical field response characteristics (acoustic emission, infrared thermal radiation, and surface strain field) from laboratory tests, and compare crack propagation and energy evolution patterns dominated by structural planes. The scale dependence of structural plane effects is discussed, highlighting consistencies and discrepancies between laboratory-scale mechanisms and field-scale engineering phenomena. Finally, we analyze rockburst mechanisms under the coupled action of structural planes and dynamic disturbances, and propose targeted engineering control strategies for different structural plane conditions. The purpose of this review is to integrate a set of analysis frameworks to establish the relationship between structural plane characteristics (location, attitude, filling state, and multi-plane combination) and multi-physical field responses, fracture evolution and energy evolution laws, as well as engineering-scale rockburst behavior. It is noteworthy that the engineering cases compiled in this review predominantly originate from deep hard-rock tunnels in China. The universality of the impact of structural planes on rockbursts still needs to be further verified by combining cases from different structural settings and engineering backgrounds. Full article

The morphological evolution of mineral-filled fractures in low-clay shale during water exposure remains poorly understood, particularly regarding how infilling mineralogy, fracture geometry, and fluid accessibility control the response. In this study, fixed-field scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM–EDS) was used to track selected fracture regions in Longmaxi Formation shale recovered from a depth of approximately 4072 m in the southern Sichuan Basin, China. The same regions were examined before immersion and after 3 and 6 days of static immersion in deionized water (18.2 MΩ·cm; essentially zero initial ionic strength). Changes in fracture trace length, apparent aperture, area fraction, and box-counting fractal dimension were quantified using a consistent image-analysis procedure and interpreted together with elemental distributions. Three fracture-evolution patterns were identified: sustained enlargement, initial enlargement followed by partial reduction, and moderate aperture increase accompanied by pronounced trace-length extension. Calcium-sulfate-rich fractures exhibited the first two patterns. Their initial enlargement was associated with dissolution of the mineral infilling, whereas the contrasting later-stage responses appeared to be influenced by fracture geometry and fluid accessibility. Relatively open fractures continued to enlarge, while more confined fractures showed partial loss of the initial enlargement and local accumulation of crystalline material. However, the composition and origin of this material (including possible drying-induced crystallization) remain uncertain. Clay-rich fractures showed modest aperture enlargement and continued trace-length extension, consistent with clay–water interaction, although the underlying mechanism could not be resolved conclusively. These results demonstrate that fractures with similar mineral infillings can follow different temporal evolution paths during water exposure. The fixed-field SEM–EDS workflow provides a reproducible method for quantitatively tracking microscale fracture evolution and improves understanding of mineral- and geometry-dependent fracture responses in low-clay shale, though the results are derived from a single specimen and should be interpreted as illustrative observations rather than population-level statistics. Full article

Material extrusion (MEX) enables rapid fabrication of single-use polymer casting patterns for foundry and mechanical engineering applications, where handling strength and surface texture are critical. This study examines how infill pattern, density, and orientation affect the mechanical and surface properties of samples printed from ELEGOO PLA on a Bambu Lab A1 using Bambu Studio 2.5.0. Two infill types (triangle, grid), two densities (50%, 70%), and five orientations were evaluated via uniaxial tension, fixed-deflection three-point bending, line-profile and areal surface texture measurements, and SEM fracture analysis. Tensile strength ranged from 23.60 to 29.19 MPa. Raising infill density from 50% to 70% increased mean tensile strength from 24.62 to 27.65 MPa. The highest tensile strength, 29.19 MPa, occurred for a 70% grid infill at 75° orientation; the highest bending load at 4 mm midspan deflection, 107.97 N, occurred for a 70% grid infill at 15°. Across the descriptive surface dataset, differences among the top, side, and bottom surfaces were greater than the variations associated with infill orientation. Top, side, and bottom surfaces formed via different mechanisms; the relatively high bottom-surface roughness arose from replication of the textured PEI build plate. The selected lower-density fracture surfaces exhibited more pronounced visible gaps and inter-bead discontinuities in the SEM images. Within the tested range, the 70% grid infill produced the best overall mechanical performance. These findings are specific to the ELEGOO PLA–Bambu Lab A1–Bambu Studio 2.5.0 system and should not be interpreted as intrinsic PLA properties, used for direct cross-material benchmarking, or assumed to represent behavior under industrial foundry conditions. Instead, they provide system-specific screening data for selecting candidate infill configurations and for the subsequent evaluation of this commercial MEX printing platform for producing single-use polymer casting patterns for complex-geometry components in mechanical engineering under representative foundry conditions. Full article

Background and Objectives: Three-dimensional printing is increasingly used to fabricate dental restorations; however, limited evidence is available on the mechanical performance and fracture behavior of printable resin materials used for endocrown restorations. Fracture load alone may not fully describe material performance, particularly when brittle or defect-sensitive failure occurs. This in vitro study aimed to compare the fracture resistance, Weibull parameters, experimental Mode I fracture toughness parameter, and failure patterns of three 3D-printed resin materials used for endocrown restorations. Materials and Methods: Thirty anatomically identical molar replicas were produced from a single prepared tooth model and restored with endocrowns fabricated from NextDent C&B MFH (NextDent B.V., Soesterberg, The Netherlands), SprintRay Crown (SprintRay Inc., Los Angeles, CA, USA), and BEGO VarseoSmile Crown Plus (BEGO GmbH & Co. KG, Bremen, Germany) (n = 10/group). The restorations were cemented and subjected to compressive loading until fracture. Maximum fracture force values were analyzed using Welch’s ANOVA and Weibull statistics. In parallel, single-edge-notched bend (SENB) specimens were fabricated from the same materials and tested using an ASTM D5045-based configuration to calculate an experimental Mode I fracture toughness parameter. Representative fractured crowns and standardized specimens were examined using stereomicroscopy to assess visible failure morphology. Results: No statistically significant difference in maximum fracture force was found among the three materials (Welch’s ANOVA, p = 0.217). The mean fracture force values were 862.37 N for NextDent C&B MFH, 804.37 N for SprintRay Crown, and 699.43 N for BEGO VarseoSmile Crown Plus. In the complementary analyses, BEGO VarseoSmile Crown Plus showed the highest Weibull modulus (m = 9.36), indicating a narrower distribution of fracture values, and the highest mean experimental Mode I fracture toughness parameter (5.250 MPa·m^0.5) under the present experimental conditions. Qualitative stereomicroscopic analysis revealed material-dependent visible failure patterns: SprintRay Crown exhibited more extensive fragmentation, whereas BEGO VarseoSmile Crown Plus showed a more defined visible fracture pattern with less secondary fragmentation. Conclusions: Fracture load alone was insufficient to characterize the mechanical behavior of the tested materials fully. Weibull parameters, the experimental fracture toughness parameter, and failure morphology provided complementary information and should be considered when evaluating 3D-printed resin materials for endocrown restorations. Full article

This pilot in vitro study explored the tensile retention of lithium disilicate and monolithic zirconia crowns cemented onto zirconia one-piece implants using two resin cements and two cementation protocols. In addition, the relationship between micro-computed tomography (micro-CT)-derived cement layer characteristics and retention was explored for lithium disilicate crowns. Thirty-two implant–crown assemblies were prepared using 16 lithium disilicate and 16 zirconia crowns. Specimens were cemented with either an adhesive resin cement (Panavia V5) or a self-adhesive resin cement (SpeedCem Plus) using two protocols: conventional apical-half cementation (AH) and an abutment-assisted apical-half protocol (A-AH). Cement thickness and porosity for lithium disilicate crowns were obtained from a previously published micro-CT analysis of the same specimens; no micro-CT measurements were available for the zirconia specimens. Tensile pull-out testing was performed using a universal testing machine. The primary outcome was the maximum recorded force at the first observed mechanical failure, irrespective of the mode of that failure, so that all 32 specimens contributed a value. Failure occurred by crown debonding in 27 specimens, by crown fracture in 4 and by implant fracture in 1. For the primary outcome, the maximum recorded force was lower for lithium disilicate than for zirconia crowns (medians 347.20 versus 596.05 N; exact Mann–Whitney p = 0.017) and lower with the A-AH than with the AH protocol (medians 304.24 versus 614.38 N; p < 0.001), whereas the difference between the two resin cements was not statistically significant (medians 438.88 versus 550.83 N; p = 0.210). The highest observed mean maximum load was recorded for zirconia crowns cemented with Panavia V5 using the AH protocol (729.9 ± 237.7 N), whereas the lowest observed mean maximum load was recorded for lithium disilicate crowns cemented with Panavia V5 using the A-AH protocol (219.7 ± 105.1 N). In a secondary, cause-specific exploratory analysis restricted to crown debonding (27 events, 5 specimens censored at fracture), Cox proportional hazards regression on the applied-force scale gave hazard ratios of 3.75 (95% CI 1.40–10.01) for lithium disilicate versus zirconia, 6.47 (2.39–17.53) for A-AH versus AH and 1.82 (0.76–4.39) for Panavia V5 versus SpeedCem Plus. For lithium disilicate crowns, exploratory factorial ANOVA indicated that cementation protocol was associated with differences in cement thickness (p = 0.035), while cement type was associated with differences in porosity (p < 0.001). All 16 lithium disilicate cement thickness observations lay between 253.29 and 254.96 µm, a total span of 1.67 µm. Within that extremely restricted range, a univariable exploratory Cox model expressed per 0.1 µm gave a hazard ratio for debonding of 1.24 (95% CI 1.03–1.48; p = 0.024); this is an unadjusted association across a range that is itself associated with cementation protocol, and it does not demonstrate a clinically meaningful or independent effect of cement thickness. No association was detected for total porosity (0.959 per percentage point, 0.717–1.283); that interval is wide and indicates absence of evidence rather than evidence of no association. Within the limitations of this pilot in vitro study—four specimens per subgroup, wide confidence intervals and no adjustment for multiplicity—the findings suggest that crown material and cementation protocol may be associated with retention patterns. They are exploratory and hypothesis-generating and require confirmation in larger, independently powered studies. Full article

Deep shale reservoirs in the tectonically complex margin of the southern Sichuan Basin have experienced multistage deformation, resulting in strong spatial heterogeneity of the present-day geostress field. However, the influence of stress heterogeneity on multiscale pore structure evolution and reservoir quality remains poorly constrained. Here, we integrate in-situ stress measurements, overburden porosity and permeability experiments, CO₂/N₂ adsorption, high-pressure mercury intrusion, SEM-MAPS (Scanning Electron Microscopy-MAPS) pore imaging, stress well profile interpretation, and multifractal analysis to quantify the controls of present-day geostress heterogeneity on pore structure evolution in deep Longmaxi Formation shale. The results show that the present-day stress regime is characterized by a strike-slip pattern (σ_H > σ_v > σ_h), with significant variations among different structural deformation zones. Increasing structural deformation results in enhanced differential stress, increasing by 30–80% from gentle structures to tight folds and fault-affected zones, accompanied by a 60–70° rotation of the maximum principal stress orientation. Differential stress, effective stress, differential stress coefficient, and stress structure index exhibit strong negative correlations with porosity, whereas permeability decreases nonlinearly with increasing stress, indicating progressive pore-throat compression and connectivity degradation under heterogeneous stress conditions. Multifractal analysis reveals that pore-size domains exhibit different sensitivities to stress heterogeneity. The macropore fractal dimension (DN3) shows the strongest response, followed by mesopores (DN2), whereas micropores (DN1) exhibit relatively limited variations. Fault-affected zones and strongly deformed regions display higher DN3 values (>2.8), reflecting enhanced complexity of macropore and fracture networks. In contrast, gentle structural zones characterized by curvature values <0.10 km⁻¹ and distances >500 m from faults exhibit relatively low and stable fractal dimensions (<2.73), indicating more homogeneous pore structures. Increasing stress heterogeneity induces the transformation of organic matter pores from regular subcircular shapes to flattened and slit-like morphologies, accompanied by pore-size migration toward smaller scales (<15 nm) and enhanced pore heterogeneity (Df > 1.35). These findings reveal that present-day geostress heterogeneity governs shale pore fractal evolution and promotes the transition from micropore-dominated to heterogeneous macropore–fracture systems. This study provides quantitative insights into stress-controlled pore evolution and reservoir quality evaluation in deep shale reservoirs under complex tectonic settings. Full article

To address the challenge of surrounding rock control in deep gob-side entry driving, the return airway of the 20203 working face of the Dahaize Coal Mine was taken as the engineering background. The stress, deformation and plastic zone evolution characteristics of the surrounding rock of the gob-side entry were studied through theoretical analysis, numerical simulation and field tests, and the surrounding rock control mechanism and the double-layer flexible thick anchor control technology were proposed. The results show that under the influence of the adjacent gob, the peak compressive stress of the gob-side entry is transferred to the solid coal side, and tensile stress areas are generated on the roof; shear failure is the main failure pattern of the surrounding rock in the gob-side entry, which is characterized by significantly asymmetric deformation. Based on the displacement failure characteristics of the surrounding rock zones, a double-layer flexible thick anchorage structure was constructed. The anchorage depth of the first basic support exceeds the critical thickness of the shallow fractured surrounding rock zone, forming a thick load-bearing layer for the roadway surrounding rock; the anchorage depth of the secondary reinforced support extends into the stable rock mass, enhancing the bearing capacity of the anchored body and the roadway surrounding rock. The results of numerical simulation show that after adopting a double-layer flexible thick anchor support, the average deformation of the roof decreases by 48.81%, and the range of the tensile stress zone and plastic zone is significantly reduced. In engineering applications, the average deformation of the roadway roof was 42.58 mm, the two-end convergence was 0–2 mm, the roof separation value was controlled within 0–30 mm, and the rock strata within 0–5.0 m remained intact. This technology effectively suppresses the large deformation of the surrounding rock in deep gob-side entry, providing an innovative strategy for roadway stability control under comparable geological and mining conditions. Full article

Background/Objectives: Ankle fracture–dislocation is associated with prolonged recovery, posttraumatic osteoarthritis, and poor functional outcomes. However, the structural factors responsible for ankle fracture–dislocation remain incompletely understood. This study aimed to identify the injury characteristics associated with ankle fracture–dislocation and compare radiographic outcomes between patients with and without dislocation. Methods: A retrospective review was performed on 130 patients who underwent operative treatment for ankle fractures. Patients were divided into dislocation (n = 26) and non-dislocation (n = 104) groups. Demographic characteristics, injury mechanism, trauma energy, fracture morphology, posterior malleolar fracture classification, syndesmotic injury, and deltoid ligament injury were evaluated. Independent risk factors were identified using multivariate logistic regression analysis. Bone union time and postoperative osteoarthritis were also compared. Results: Haraguchi type II posterior malleolar fracture (p < 0.001) and syndesmotic injury (p = 0.017) were independently associated with ankle fracture–dislocation. Bone union took significantly longer in the dislocation group than in the non-dislocation group (7.04 ± 3.75 vs. 5.29 ± 3.48 months; p = 0.026). Postoperative osteoarthritis occurred more frequently in the dislocation group (42.3% vs. 24.0%), although the difference was not statistically significant (p = 0.063). Conclusions: Haraguchi type II posterior malleolar fracture morphology and syndesmotic injury were associated with ankle fracture–dislocation. These findings suggest that posteromedial structural disruption and syndesmotic instability play important roles in ankle fracture–dislocation. Furthermore, ankle fracture–dislocation was associated with delayed bone union, indicating a more severe injury pattern. Full article

The variation features of metallic element grades can reflect the enrichment level of mineral deposits. Thus, quantitative characterization of the spatial patterns of metallogenic elements is fundamental to studying ore-forming processes and implementing mineral exploration. This study applies fractal theory and self-developed MATLAB computational scripts to process Cu grade datasets from 28 drillholes within the Pulang porphyry copper deposit, Yunnan Province. Both rescaled range (R/S) analysis and correlation integral methods were applied to clarify the spatial patterns of Cu grades in drill-cores. The calculated Hurst exponents ranged from 0.510 to 0.636, which demonstrated the persistent variation of Cu grades along the vertical direction of drillholes. This work further explored the correlation between Cu mineralization and fluctuations in correlation dimension (D_C), with D_C values spanning 0.011–2.873. Results indicate steep fractal gradient zones host high-grade copper ore bodies, and fractal dimension is a robust indicator to trace the migration of hydrothermal fluids. The Hurst exponents of Cu grade sequences correlate strongly with mineralization intensity, and ore-bearing veins extend continuously throughout all sampled drillholes. Accordingly, fractal gradients can be utilized to depict prospective zones for favorable mineralization in uncharted regions. This methodology may be applicable to other structurally controlled mineral deposits where similar fracture-controlled mineralization occurs, though further testing on different deposit types is needed. Full article

Background/Objectives: Plain radiography is the first-line imaging modality for acute foot and ankle trauma; however, computed tomography (CT) may provide additional information in selected patients with persistent clinical suspicion, equivocal radiographic findings, or a need for detailed fracture characterization. We hypothesized that the CT-confirmed fracture proportion would be higher among patients with suspicious radiographs than among those with normal radiographs and that CT would identify additional fractures in a clinically selected cohort. Methods: This retrospective single-center selected-cohort study included 1000 adult patients with isolated foot and/or ankle trauma who underwent both plain radiography and CT during the same clinical encounter. Plain radiographs were categorized as normal, suspicious for fracture, or definite fracture on the basis of original radiology reports and available imaging records. A CT-confirmed fracture was defined as the presence of an acute fracture on CT. Analyses focused primarily on CT-confirmed fracture proportions and conditional diagnostic yield within the selected CT cohort. Conditional apparent diagnostic performance was evaluated as a supplementary sensitivity analysis and was not intended to estimate population-level diagnostic accuracy. Results: Plain radiographs were categorized as normal in 628 patients, suspicious in 283, and definite fracture in 89. CT detected acute fractures in 386 patients (38.6%). The CT-confirmed fracture proportions were 14.8% in the normal radiograph group, 72.1% in the suspicious radiograph group, and 100.0% in the definite fracture group. The proportion of patients without a definite fracture on plain radiography but with an acute fracture on CT was 29.7%. Fracture-pattern classification was unavailable in 85 of 386 cases with CT-confirmed fractures (22.0%); therefore, fracture-pattern analyses were considered exploratory. Conclusions: In this selected CT cohort, CT identified additional acute fractures in a subset of adult isolated foot and ankle trauma cases that could not be definitively classified as fractures on plain radiography. Because CT was not systematically performed in all trauma patients, the findings represent selected-cohort CT yield rather than true population-level diagnostic accuracy. Full article

Azimuthal traveltime analysis provides comparatively stable fracture-orientation estimates but limited information on fracture-related elastic changes, whereas amplitude variation with offset (AVO) inversion is sensitive to residual azimuthal moveout. We propose a sequential offset vector tile (OVT)-domain azimuthal traveltime-constrained AVO inversion workflow for reservoir-scale fracture characterization. Traveltime responses are first used to estimate the locally dominant fracture orientation and reduce azimuth-dependent event misalignment. Prestack AVO inversion is then applied separately to representative fracture-parallel and fracture-perpendicular gathers to obtain two sets of apparent elastic parameters, from which a relative tangential-weakness attribute ($\Delta e$) and Poisson’s ratio ratio ($R_{\nu }$) are derived. Synthetic tests show that the mean fracture-orientation error is no greater than 1.1° for prescribed noise levels of 0–50%, and that varying the maximum incidence angle from 20° to 40° causes no systematic deterioration in the recovered attributes. In the field application, the predicted dominant orientation of N 45° E–N 60° E agrees with the approximately N 50° E fracture trend identified from an independent structure-tensor-based seismic interpretation near ZT3. Compared with the uncorrected results, the corrected $\Delta e$ and $R_{\nu }$ maps exhibit improved continuity and better spatial correspondence with the independently interpreted fracture pattern. These results demonstrate that the proposed workflow effectively integrates the stable directional constraint provided by azimuthal traveltime analysis with the fracture-related elastic information obtained from directional AVO inversion, enabling reservoir-scale characterization of the dominant fracture orientation, relative fracture-related weakness variation, and possible fluid sensitivity. Within the stated assumptions and applicability conditions, the method provides a practical seismic framework for fractured-reservoir characterization and evaluation. Full article