Search Results (1,613)

Background: Optimal timing for surgery following acute rotator cuff tears remains unclear. This study examines how the timing of arthroscopic rotator cuff repair (RCR) affects retear rates and functional outcomes. Methods: This PROSPERO-registered review (CRD42024528249) followed PRISMA guidelines and included randomized trials, and cohort, studies on adults with imaging-confirmed full-thickness rotator cuff tears. Studies lacking timing data or key outcomes were excluded. Risk of bias was assessed using ROBINS-I. Meta-analysis of retear rates was performed comparing surgical timing. Qualitative analysis was conducted classifying results as early-beneficial, delayed-detrimental, or neutral. Results: Our review included 13 studies and 871 patients with an average age of 57.9. Meta-analysis of eight studies comparing retear rates between early and delayed RCR demonstrated a significant benefit associated with early intervention risk ratio 0.60 (95% CI: 0.38–0.96). Functional outcomes also favored early intervention with four studies demonstrating significantly greater postoperative functional improvements in the early intervention group. Conclusions: Early arthroscopic RCR decreased the rate of retear and improved functional outcomes. No study found early intervention to be detrimental or delayed intervention to be superior. These findings support consideration of early repair when clinically appropriate. Future studies should determine more finite timing guidelines. Full article

In this study, a new type of novel demountable connector is proposed to enable complete dry connections between concrete beams and slabs, facilitating the full demountable design of these components. To analyze and evaluate the flexural performance of the concrete beams with the novel demountable connectors, a finite element model was developed, which was then validated by previous tests. The results indicate that bolt diameter, bolt strength, channel spacing, and concrete slab thickness have a significant impact on peak load, while concrete beam strength, concrete slab strength, and flange width have minimal influence. Similarly, flexural stiffness is strongly affected by bolt diameter, channel spacing, concrete slab strength, slab thickness, and flange width, whereas bolt strength and concrete beam strength play a lesser role. Notably, the finite element analysis confirms the absence of plastic deformation in most bolts and end plates, ensuring that the flexural components are designed for effective disassembly. A theoretical model for calculating the ultimate flexural moment of demountable concrete beams under different conditions is also proposed, and it agrees with the ultimate flexural moment from numerical analysis. Full article

The cornea, the transparent anterior window of the eye, critically refracts light and protects intraocular structures. Corneal pathologies, including trauma, infection, chemical injury, metabolic diseases, genetic conditions, and age-related degeneration, can lead to significant visual impairment. While penetrating keratoplasty or full-thickness corneal transplantation remains a standard and effective intervention for severe corneal dysfunction, limitations in donor tissue availability and the risk of immunogenic graft rejection necessitate alternative therapeutic strategies. Furthermore, for cases of isolated epithelial disfunction, a full-thickness cornea graft may not be required or effective. This review examines the potential of corneal epithelial constructs derived from autologous stem cells with functional barrier properties for corneal reconstruction and in vitro pharmacotoxicity testing. In this review, we delineate the current limitations of corneal transplantation, the advantages of stem cell-based approaches, and recent advances in generating engineered corneal epithelium. Finally, we address remaining technical challenges and propose future research directions aimed at clinical translation. Full article

We investigated the protective properties of ultrathin laminated coatings, comprising three pairs of Al₂O₃ and TiO₂ sublayers with coating thicknesses < 150 nm, deposited on AISI 310 stainless steel (SS) and Si (100) substrates at 80–500 °C by atomic layer deposition. The coatings were chemically etched and subjected to corrosion, ultrasound, and thermal shock tests. The coating etching resistance efficiency (R_e) was determined by measuring via XRF the change in the coating sublayer mass thickness after etching in hot 80% H₂SO₄. The maximum R_e values of ≥98% for both alumina and titania sublayers were obtained for the laminates deposited at 250–400 °C on both substrates. In these coatings, the titania sublayers were crystalline. The lowest R_e values of 15% and 50% for the alumina and titania sublayers, respectively, were measured for laminate grown at 80 °C on silicon. The coatings deposited at 160–200 °C demonstrated a delay in the increase of R_e values, attributed to the changes in the titania sublayers before full crystallization. Coatings grown at higher temperatures were also more resistant to ultrasound and liquid nitrogen treatments. In contrast, coatings deposited at 125 °C on SS had better corrosion protection, as demonstrated via electrochemical impedance spectroscopy and a standard immersion test in FeCl₃ solution. Full article

In this study, we aimed to address the lack of systematic research on key collision dynamics parameters (elastic restitution coefficient) in the full mechanization of rapeseed operations, which hinders the development of precision agriculture. In this present work, the restitution coefficient of rapeseed was systematically investigated, and a predictive model (R² = 0.959) was also established by using Box–Behnken design response surface methodology (BBD-RSM). The results show that the collision restitution coefficient varies in the range of 0.539–0.649, with the key influencing factors ranked as follows: moisture content (M_c) > material layer thickness (L) > drop height (H). The EDEM simulation methodology was adopted to validate the experimental results, and the results show that there is a minimal relative error (−1% < δ < 1%) between the measured and simulated rebound heights, indicating that the established model shows a reliable prediction performance. Moreover, by comprehensively analyzing stress, strain, and energy during the collision process between rapeseed and Q235 steel, it can be concluded that the process can be divided into five stages—free fall, collision compression, collision recovery, rebound oscillation, and rebound stabilization. The maximum stress (1.19 × 10⁻² MPa) and strain (6.43 × 10⁻⁶ mm) were observed at the beginning of the collision recovery stage, which can provide some theoretical and practical basis for optimizing and designing rapeseed machines, thus achieving the goals of precise control, harvest loss reduction, and increased yields. Full article

Refractory full-thickness macular holes (rFTMHs) present a significant challenge in vitreoretinal surgery, with reported incidence rates of 4.2–11.2% following standard vitrectomy with internal limiting membrane (ILM) peeling and gas tamponade. Risk factors include large hole size (>400 µm), chronicity (>6 months), high myopia, incomplete ILM peeling, and post-operative noncompliance. Multiple surgical techniques exist, though comparative evidence remains limited. Current options include the inverted ILM flap technique, autologous ILM transplantation (free flap or plug), lens capsular flap transplantation (autologous or allogenic), preserved human amniotic membrane transplantation, macular subretinal fluid injection, macular fibrin plug with autologous platelet concentrates, and autologous retinal transplantation. Closure rates range from 57.1% to 100%, with selection depending on hole size, residual ILM, patient posturing ability, etc. For non-posturing patients, fibrin plugs are preferred. Residual ILM cases may benefit from extended peeling or flap techniques, while large holes often require scaffold-based (lens capsule, amniotic membrane) or fibrin plug approaches. Pseudophakic patients should avoid posterior capsular flaps due to lower success rates. Despite promising outcomes, the lack of randomized trials necessitates further research to establish evidence-based guidelines. Personalized surgical planning, considering anatomical and functional goals, remains crucial in optimizing visual recovery in rFTMHs. Full article

Background: Surgical management of large full-thickness macular holes (MHs) remains challenging, particularly when aiming for both rapid visual recovery and consistent anatomical closure without inducing retinal trauma. This retrospective single-center study evaluated the efficacy of activated conditioned plasma (ACP) as an intraoperative coadjuvant supporting ILM (internal limiting membrane) peeling and air tamponade in the treatment of idiopathic MHs measuring 400–800 µm, under real-time intraoperative optical coherence tomography (i-OCT) guidance. Methods: Seventy eyes from fifty patients underwent pars plana vitrectomy with intraoperative ACP application. ACP, a leukocyte-poor autologous platelet concentrate, was used intraoperatively as a coadjuvant to ILM peeling and air tamponade. It facilitated the formation of a transparent fibrin membrane over the retinal surface, supporting edge approximation and promoting retinal healing. Results: The primary outcome was complete MH closure confirmed by OCT; the secondary outcome was improvement in BCVA on postoperative day 7 and during a 12-month follow-up. Anatomical closure was achieved in 98.6% of cases. On day 7, 78.6% of eyes showed a ≥ three-line BCVA improvement, with mean BCVA increasing from 0.25 ± 0.21 to 0.69 ± 0.20 (p < 0.001). These outcomes remained stable throughout the follow-up. No significant intraoperative or postoperative complications were observed. Conclusions: The combination of ACP and i-OCT appears to be a safe and effective strategy for anatomical foveolar reconstruction, enabling early visual recovery while minimizing inflammation and fibrotic scarring associated with conventional techniques. Full article

Over recent decades, phase-change materials (PCMs) have gained prominence as latent-heat thermal energy storage systems in building envelopes because of their high energy density. However, only PCMs that complete a full daily charge–discharge cycle can deliver meaningful energy and carbon-emission savings. This simulation study introduces a methodology that simultaneously optimizes PCM integration for storage efficiency, indoor thermal comfort, and energy savings. Two new indicators are proposed: overall storage efficiency (EC_n), which consolidates heating and cooling-efficiency ratios into a single value, and the performance factor (PF), which quantifies the PCM’s effectiveness in maintaining thermal comfort. Using EnergyPlus v8.9 coupled with DesignBuilder, a residential ASHRAE 90.1 mid-rise apartment was modeled in six warm-temperate (Cfb) European cities for the summer period from June 1 to August 31. Four paraffin PCMs (RT-22/25/28/31 HC, 20 mm thickness) were tested under natural and controlled ventilation strategies, with windows opening 50% when outdoor air was at least 2 °C cooler than indoors. Simulation outputs were validated against experimental cubicle data, yielding a mean absolute indoor temperature error ≤ 4.5%, well within the ±5% tolerance commonly accepted for building thermal simulations. The optimum configuration—RT-25 HC with temperature-controlled ventilation—achieved PF = 1.0 (100% comfort compliance) in all six cities and delivered summer cooling-energy savings of up to 3376 kWh in Paris, the highest among the locations studied. Carbon-emission reductions reached 2254 kg CO₂-e year⁻¹, and static payback periods remained below the assumed 50-year building life at a per kg PCM cost of USD 1. The EC_n–PF framework, therefore, provides a transparent basis for selecting cost-effective, energy-efficient, and low-carbon PCM solutions in warm-temperate buildings. Full article

Bcakground: The deepithelialized free gingival graft (DGG) technique provides high-quality connective tissue grafts (CTGs) with predictable outcomes for recession coverage. This study evaluates a novel method of free gingival graft (FGG) deepithelialization using an Er,Cr:YSGG laser (LDEE) for treating multiple gingival recessions. Methods: A split-mouth study was conducted on 46 (n = 46) recessions in nine patients (23 per test and control group). Sites were randomized. Full-thickness palatal grafts were harvested with a scalpel. In the test group (LDEE), deepithelialization was performed extraorally using an Er,Cr:YSGG laser (2780 nm; 2.5 W, 83.3 mJ, 30 Hz, 600 µm tip). In the control group (DEE), a 15c scalpel was used. All CTGs were applied using the modified coronally advanced tunnel (TUN) technique. Clinical parameters—recession depth (RD), keratinized tissue width (KT), gingival thickness (GT), pocket depth (PD), clinical attachment loss (CAL), pink esthetic score (PES), approximal plaque index (API), mean root coverage (MRC), and complete root coverage (CRC)—were assessed at baseline (T0), 3 months (T1), and 6 months (T2). Results: Both LDEE and DEE groups showed significant improvements in RD, KT, GT, PD, and CAL over time (p < 0.001). At T1 and T2, KT was significantly higher in the LDEE group (T1: 3.73 ± 0.72 mm; T2: 3.98 ± 0.76 mm) compared to the DEE group (T1: 3.21 ± 0.61 mm; T2: 3.44 ± 0.74 mm; p < 0.05). Other parameters (RD, GT, PD, CAL) showed no statistically significant intergroup differences at any time point (p > 0.05). After 6 months, MRC was 95% and CRC 82.6% for LDEE, compared to 94.8% and 82.6% for DEE (p > 0.05). PES scores were similar between groups at all time points (p > 0.05). Conclusions: Both laser- and scalpel-deepithelialized grafts effectively treated gingival recessions. LDEE combined with TUN resulted in significantly greater KT width compared to DEE + TUN. Full article

Creating a comfortable microclimate in the premises of buildings is currently becoming one of the priorities in the field of architecture, construction and engineering systems. The increased attention from the scientific community to this topic is due not only to the desire to ensure healthy and favorable conditions for human life but also to the need for the rational use of energy resources. This area is becoming particularly relevant in the context of global challenges related to climate change, rising energy costs and increased environmental requirements. Practice shows that any technical solutions to ensure comfortable temperature, humidity and air exchange in rooms should be closely linked to the concept of energy efficiency. This allows one not only to reduce operating costs but also to significantly reduce greenhouse gas emissions, thereby contributing to sustainable development and environmental safety. In this connection, this study presents a parametric assessment of the influence of climatic and geometric factors on the aerodynamic characteristics of the air cavity, which affect the heat exchange process in the ventilated layer of curtain wall systems. The assessment was carried out using a combined analytical calculation method that provides averaged thermophysical parameters, such as mean air velocity ($V_s$), average internal surface temperature ($t_{in.s}^{av}$), and convective heat transfer coefficient (${\alpha }_s$) within the air cavity. This study resulted in empirical average values, demonstrating that the air velocity within the cavity significantly depends on atmospheric pressure and façade height difference. For instance, a 10-fold increase in façade height leads to a 4.4-fold increase in air velocity. Furthermore, a three-fold variation in local resistance coefficients results in up to a two-fold change in airflow velocity. The cavity thickness, depending on atmospheric pressure, was also found to affect airflow velocity by up to 25%. Similar patterns were observed under ambient temperatures of +20 °C, +30 °C, and +40 °C. The analysis confirmed that airflow velocity is directly affected by cavity height, while the impact of solar radiation is negligible. However, based on the outcomes of the analytical model, it was concluded that the method does not adequately account for the effects of solar radiation and vertical temperature gradients on airflow within ventilated façades. This highlights the need for further full-scale experimental investigations under hot climate conditions in South Kazakhstan. The findings are expected to be applicable internationally to regions with comparable climatic characteristics. Ultimately, a correct understanding of thermophysical processes in such structures will support the advancement of trends such as Lightweight Design, Functionally Graded Design, and Value Engineering in the development of curtain wall systems, through the optimized selection of façade configurations, accounting for temperature loads under specific climatic and design conditions. Full article

The uniform distribution of APIs is essential in tablet formulations, particularly in direct compression, where powder blending is the only means of ensuring dose homogeneity. This study evaluated the influence of three mixing techniques—V-type mixer, planetary ball mill, and vibratory ball mill—on the physical properties and content uniformity of naproxen sodium tablets. Blends consisting of naproxen sodium, cellulose, PVP, calcium carbonate, and magnesium stearate were prepared under varied mixing intensities and characterized in terms of flowability, compressibility, and particle size distribution. The resulting tablets were analyzed for weight, thickness, hardness, friability, and API content using a simplified bypass HPLC method. The V-type mixer yielded tablets with the most consistent weight and thickness, despite the poorest blend flow properties. Vibratory milling produced the hardest tablets and best API content uniformity, although high-energy processing introduced variability at longer mixing times. The analytical method proved fast and robust, allowing for reliable API quantification without full chromatographic separation. These findings underscore the need to balance mechanical blending energy with formulation properties and support the use of streamlined analytical strategies in pharmaceutical development. Full article

Background: Post-traumatic corneal wounds that require suturing are quite common; they reduce corneal transparency and cause corneal distortion, leading to corneal astigmatism and higher-order aberrations. Excimer laser treatment can be a potentially beneficial intervention for such wounds. The observation aimed to evaluate the effectiveness of topography-guided custom ablation treatment (TCAT) in patients with corneal injuries. Methods: This observation included three patients with corneal penetrating trauma (full-thickness corneal scar) and one patient with corneal blunt trauma, i.e., a non-penetrating injury with corneal laceration (partial-thickness corneal scar). This cohort study was conducted from July 2021 to August 2023. After first-stage treatment (stabilization of the post-traumatic visual defect confirmed by refraction and topography examination, corneal healing, and improvement of the corneal scar), the patients underwent the second-stage treatment, i.e., TCAT with a 20 to 45 s application of mitomycin C solution to avoid haze induction. After TCAT, the uncorrected distance visual acuity (UDVA) and best-corrected distance visual acuity (BCVA) were measured. Refractive astigmatism was assessed using autorefractometry. Topographic astigmatism was analyzed using corneal topography and pachymetry. The root mean square (RMS) of the higher-order aberration was calculated using Zernike coefficients. The patients’ corneal healing and refractive changes were monitored. Results: All patients were monitored for corneal healing and refractive changes and underwent the same second-stage treatment, which utilized TCAT to regularize the corneal surface and reduce higher-order aberrations (HOAs). The UDVA of patients 1, 2, 3 and 4 improved by 3, 7.5, 4 and 6 rows (Snellen chart), respectively. The resultant UDVA was 1.0, 0.9, 0.7 and 1.2, while BCVA was 1.0, 1.2, 1.0, and 1.5, respectively. Conclusions: TCAT regularized the patients’ corneal surfaces and reduced HOAs. We, therefore, conclude that TCAT may be a beneficial second-stage treatment for corneal trauma-induced astigmatism. Full article

Ion beam figuring (IBF) is an ultra-high-precision surface finishing technology characterized by a distinct trade-off between the spot size of the removal function and its corresponding figuring capabilities. A larger spot size for the removal function leads to higher processing efficiency but lower figuring ability. Conversely, a smaller spot size results in higher figuring ability but lower efficiency. Adjusting the spot size of the removal function using tools with an aperture is a possible approach. However, existing variable-aperture tools have certain limitations in IBF processing. To leverage the advantages of both large and small spot sizes for the removal function during IBF processing, an in situ dynamic beam variable-aperture device has been designed. This device optimizes the parameters of diaphragm sheets and employs FOC for dynamic aperture adjustment. Simulations show that 12 numbers of 0.1 mm-thick sheets minimize removal function distortion, with the thermal strain-induced area variation being <5%. FOC enables rapid (≤0.45 s full range) and precise aperture control. Experiments confirm adjustable spot sizes (FWHM 0.7–17.2 mm) with Gaussian distribution (correlation >96.7%), operational parameter stability (relative change rate ≤5%), and high repeatable positioning precision (relative change rate ≤3.2% in repeated adjustments). The design enhances IBF efficiency, flexibility, and accuracy by enabling in situ spot size optimization, overcoming conventional limitations. Full article

Background/Objectives: Oral cavity wound recovery presents unique challenges due to constant moisture exposure and functional mechanical stresses. Nanoscale extracellular vesicles (exosomes) with regenerative properties offer promising therapeutic potential for tissue regeneration, contributing to improved health outcomes. This study evaluated human exosomal preparations in promoting oral mucosal regeneration. Methods: We established standardized full-thickness wounds in the buccal mucosa of SD rats and divided subjects into experimental (receiving 50 billion human exosomes) and control (receiving carrier solution only) groups. Comprehensive wound assessment occurred at predetermined intervals (days 0, 3, 7, and 10) through photographic documentation, histological examination, and quantitative measurement. Results: Exosomal-treated tissues demonstrated statistically significant acceleration in closure rates (p < 0.05), achieving 87.3% reduction by day 10 versus 64.1% in the controls. Microscopic analysis revealed superior epithelial development, reduced inflammatory infiltration, and enhanced collagen architectural organization in exosomal-treated specimens. Semi-quantitative evaluation confirmed consistently superior healing metrics in the experimental group across all assessment timepoints. Conclusions: These findings demonstrate that human exosome preparations significantly enhance oral mucosal regeneration in SD rats, suggesting potential clinical applications for accelerating recovery following oral surgical procedures. Full article

Accurate identification of active-layer compositions in organic photovoltaic (OPV) devices often relies on invasive techniques such as electrical measurements or material extraction, which risk damaging the device. In this study, we propose a non-invasive classification approach based on simulated full-device absorption spectra. To account for fabrication-related variability, the active-layer thickness varied by over ±15% around the optimal value, creating a realistic and diverse training dataset. A multilayer perceptron (MLP) neural network was applied with various activation functions, optimization algorithms, and data split ratios. The optimized model achieved classification accuracies exceeding 99% on both training and testing sets, with minimal sensitivity to random initialization or data partitioning. These results demonstrate the potential of applying deep learning to spectral data for reliable, non-destructive OPV composition classification, paving the way for integration into automated manufacturing diagnostics and quality control workflows. Full article