Search Results (16)

Background/Objectives: Despite high recanalization rates associated with mechanical thrombectomy (MT), disability and death remain possible for many patients. Baseline stroke severity and reperfusion status predict outcomes; however, the influence of modifiable perioperative factors during general anesthesia (GA) remains unclear. We investigated actionable perioperative determinants of functional outcomes and 90-day mortality following MT under GA. Methods: We retrospectively analyzed 166 patients with acute ischemic stroke who underwent emergency MT with GA over 10 years (2014–2024). Poor functional outcomes were defined as a 90-day modified Rankin Scale score of 3–6, with all-cause 90-day mortality as the secondary endpoint. Independent predictors were identified using multivariable logistic regression, and discrimination was assessed using receiver operating characteristic analysis. Results: At 90 days, 56.6% of patients had poor functional outcomes, and mortality was 24.1%. Independent predictors of poor outcomes included preoperative hyperglycemia ≥ 140 mg/dL, vasopressor requirement, incomplete reperfusion, prolonged ventilator duration, and severe post-procedural neurological deficit. Optimal anesthetic induction dosing was strongly protective. Shorter groin puncture-to-recanalization time predicted better functional recovery. Mortality was associated with hyperglycemia, National Institutes of Health Stroke Scale ≥ 16, poor reperfusion, and prolonged ventilation. The models demonstrated excellent discrimination (area under the curve, 0.879 for poor outcomes; 0.923 for mortality). Perioperative physiological factors remained associated with outcomes independent of procedural success. Conclusions: Beyond technical success, perioperative physiological stability strongly influenced outcomes following MT under GA. Optimization of metabolic control, hemodynamic stability, procedural efficiency, and early ventilator liberation represents a clinically actionable strategy for improving neurological recovery and survival. Full article

Beach nourishment is a widely adopted nature-based solution for coastal erosion; however, its design efficacy and morphodynamic resilience under extreme wave conditions remain inadequately quantified, posing challenges for coastal hazard assessment. This study integrates physical-model experiments and XBeach numerical simulations to investigate the hydrodynamic and morphodynamic behavior of nourished beaches subjected to typhoon-driven extreme wave conditions at a headland-bay beach on Meizhou Island, China. Physical-model experiments were conducted to examine shoreline response and sediment redistribution under extreme waves for three nourishment tests. XBeach simulations resolved wave-induced currents, water-level variations, and sediment transport processes, enabling continuous tracking of nearshore hydrodynamics and beach profile evolution for three nourishment tests during Typhoon Doksuri. Results indicate that nourishment geometry and groin configuration play a dominant role in wave breaking patterns, sediment transport pathways and erosion–deposition distributions. Groin positions strongly influence alongshore sediment transport. Relocating the groin to an accretional zone reduces lee-side erosion and promotes a more stable shoreline. Steeper nourishment foreshore slopes promote offshore wave shoaling and breaking, enhancing fast wave-energy dissipation, shifting erosion seaward and limiting landward erosion extent. Consistent responses from both experimental and numerical results demonstrate that nourishment stability under extreme wave conditions is better characterized by the combined effects of erosion extent, erosion length, erosion depth, erosion volume, and alongshore and cross-shore sediment redistribution. The integrated physical–numerical approach provides a practical framework for assessing beach nourishment stability during coastal hazard events and offers guidance for the design and evaluation of resilient beach nourishment in wave-dominated, typhoon-prone coastal regions. Full article

Background/Objectives: Groin pain syndrome (GPS) is a frequent and heterogeneous condition in athletes, often associated with persistent pain and functional limitation. Both focused extracorporeal shockwave therapy (f-ESWT) and exercise-based rehabilitation have been proposed as conservative treatment options, but evidence for their combined use in GPS remains limited. This prospective single-arm pilot study aimed to describe temporal changes in pain and function following a multimodal conservative program combining f-ESWT and structured rehabilitation in athletes with GPS, using validated groin-specific outcome measures. Methods: Thirty-one consecutive adult soccer players (mean age 28.4 ± 5.8 years; 77.4% male) with clinically and MRI-confirmed GPS underwent three weekly f-ESWT sessions (Duolith; 2400 pulses/session; 4 Hz; energy flux density 0.20 mJ/mm²) integrated within a supervised 16-week rehabilitation program (progressive adductor strengthening, core stabilization, and stretching). Outcomes were assessed at baseline (T0), 1 month (T1), and 4 months (T2): HAGOS (primary), VAS pain, and Roles and Maudsley (RM). Within-subject changes were analyzed using repeated-measures ANOVA with Bonferroni correction. Results: Statistically significant temporal changes were observed across all outcomes (all p < 0.001). HAGOSs changed from 47.23 ± 7.79 at T0 to 77.94 ± 16.18 at T1 and 90.00 ± 14.26 at T2 (partial η² = 0.89). VAS decreased from 6.81 ± 1.25 to 3.68 ± 1.11 and 1.90 ± 1.45 (partial η² = 0.91). RM decreased from 2.39 ± 0.50 to 1.52 ± 0.57 and 1.26 ± 0.63 (partial η² = 0.72). No adverse events were reported. Conclusions: In this single-arm pilot study, the multimodal program combining f-ESWT and structured rehabilitation was associated with temporal changes in groin-specific function and pain that exceeded established MCID thresholds. However, in the absence of a control group, these findings are purely descriptive and hypothesis-generating. The observed changes cannot be attributed to f-ESWT specifically, as the 16-week rehabilitation program likely contributed substantially to the outcomes. These preliminary observations require confirmation through adequately powered randomized controlled trials comparing the combined intervention to rehabilitation alone. Full article

The Damietta–Port Said coast, Nile Delta, has experienced extreme morphological change over the past four decades due to sediment reduction due to Aswan High Dam and continued anthropogenic pressures. Using multi-temporal Landsat (1985–2025) and high-resolution RapidEye and PlanetScope imagery with 50 m-spaced transects, the study documents major shoreline shifts: the Damietta sand spit retreated by >1 km at its proximal apex while its distal tip advanced by ≈3.1 km southeastward under persistent longshore drift. Sectoral analyses reveal typical structure-induced patterns of updrift accretion (+180 to +210 m) and downdrift erosion (−50 to −330 m). To improve predictive capability beyond linear DSAS extrapolation, Nonlinear Autoregressive Exogenous (NARX) and Bidirectional Long Short-Term Memory (BiLSTM) neural networks were applied to forecast the 2050 shoreline. BiLSTM demonstrated superior stability, capturing nonlinear sediment transport patterns where NARX produced unstable over-predictions. Furthermore, coupled wave–flow modeling validates a sustainable management strategy employing successive short groins (45–50 m length, 150 m spacing). Simulations indicate that this configuration reduces longshore current velocities by 40–60% and suppresses rip-current eddies, offering a sediment-compatible alternative to conventional breakwaters and seawalls. This integrated remote sensing, hydrodynamic, and AI-based framework provides a robust scientific basis for adaptive, sediment-compatible shoreline management, supporting the long-term resilience of one of Egypt’s most vulnerable deltaic coasts under accelerating climatic and anthropogenic pressures. Full article

Adductor-related groin pain (AGP) is a prevalent and frequently recurrent chronic injury among soccer players. This study investigated the impact of AGP history on kicking kinematics, kinetics, and patient-reported outcomes in regional-league soccer players using one-dimensional statistical parametric mapping (1D-SPM). Twenty male athletes were allocated to a group with prior AGP (GP group: n = 8) or without AGP (non-GP group, n = 12), and evaluated during maximal instep and inside-foot kicks using three-dimensional motion analysis and the Copenhagen Hip and Groin Outcome Score (HAGOS). The GP group reported significantly lower HAGOS for pain and quality of life. The 1D-SPM analysis revealed that the GP group employed a compensatory kinetic chain strategy, characterized by impaired trunk–pelvis rotation, increased reliance on the stance leg (SL) for stability, and altered kicking leg (KL) mechanics with reduced hip flexion power. These findings reveal that the underlying deficit in AGP is not isolated muscle weakness but a ‘lack of adaptability in motor control’, resulting in inefficient load distribution and contributing to the high recurrence rates in the adductors and SL. Rehabilitation should adopt a kinetic chain-oriented approach that also addresses stance limb function to mitigate recurrence and optimize performance. Full article

This study examined muscle coordination during cutting movements in athletes with a history of groin pain. A total of 15 athletes who had experienced groin pain in the past two years (GP) and 14 healthy controls (CON) participated. Electromyography (EMG) and ground reaction force (GRF) data were collected, and EMG was analyzed using non-negative matrix factorization to extract muscle synergies. Three synergies were identified in both groups: Synergy 1 (landing), Synergy 2 (deceleration), and Synergy 3 (acceleration). No group differences were observed in GRF. However, compared with the CON, the GP demonstrated a 58.1% greater contribution of the latissimus dorsi and a 31.5% greater contribution of the erector spinae (SES) in Synergy 1, suggesting excessive trunk involvement during landing. In Synergy 2, SES contribution was 97.0% lower in the GP. In Synergy 3, the external oblique contribution decreased by 118.4%, while rectus abdominis contribution increased by 54.3%. These muscles are critical for pelvic stability, and their altered contributions indicate disrupted neuromuscular coordination in athletes with GP. Full article

Introduction: Overuse injuries are a growing concern among adolescent soccer players, with the repetitive nature of the sport placing significant physical demands on young athletes. These injuries can have long-term implications for physical development, performance, and overall well-being. This narrative synthesis aimed to evaluate the existing literature on the epidemiology, risk factors, and management strategies for overuse injuries in adolescent soccer players. Methods: A comprehensive literature search was conducted using PubMed and Embase. A total of 123 articles were identified, 27 of which met the inclusion criteria after screening. Studies focusing on overuse injuries in adolescent soccer players aged 10–18 years were included, while those addressing acute injuries, non-soccer populations, or adult athletes were excluded. Relevant quantitative and qualitative data were extracted and evaluated. Due to heterogeneity in study designs and outcomes, findings were narratively synthesized rather than meta-analyzed. Results: The period around peak height velocity (PHV: 11.5 years in girls, 13.5 years in boys) was consistently identified as a high-risk window, with seven studies demonstrating a significantly increased incidence of overuse injuries. Additional risk factors included leg length asymmetry, truncal weakness, early sport specialization, high ratios of organized-to-free play, and increased body size. Injury burden was greatest for hamstring and groin injuries, often leading to prolonged time lost from play. Preventive interventions such as plyometric training, trunk stabilization, and structured load monitoring demonstrated reductions in injury incidence in several prospective studies, though protocols varied widely. Conclusion: This narrative synthesis highlights PHV as the most consistent risk factor for overuse injuries in adolescent soccer players, alongside modifiable contributors such as training load, sport specialization, and free play balance. Evidence supports neuromuscular training and structured monitoring as promising preventive strategies, but there remains a lack of standardized, evidence-based protocols. Future research should focus on optimizing and validating interventions, integrating growth and load monitoring, and leveraging emerging approaches such as machine learning-based risk prediction. Full article

Coastal defense has traditionally relied on hard infrastructures like breakwaters, dykes, and groins to protect harbors, settlements, and beaches from the impacts of longshore drift and storm waves. The prolonged exposure to wave erosion and dynamic loads of different nature can result in damage, deformation, and eventual failure of these infrastructures, entailing severe economic and environmental losses. Periodic post-construction monitoring is crucial to identify shape changes, ensure the structure’s stability, and implement maintenance works as required. This paper evaluates the performance and quality of the restitution products obtained from the application of UAV photogrammetry to the longest breakwater in the province of Cádiz, southern Spain. The photogrammetric outputs, an orthomosaic and a Digital Surface Model (DSM), were validated with in situ RTK-GPS measurements, displaying excellent planimetric accuracy (RMSE 0.043 m and 0.023 m in X and Y, respectively) and adequate altimetric accuracy (0.100 m in Z). In addition, the average enveloping surface inferred from the DSM allowed quantification of the deformation of the breakwater and defining of the deformation mechanisms. UAV photogrammetry has proved to be a suitable and efficient technique to complement traditional monitoring surveys and to provide insights into the deformation mechanisms of coastal structures. Full article

The purpose of the study was to analyze the effect of feeding type on selected quality parameters and the nutritional characteristics of pork fat. Fats were extracted by using the modified Folch method from the groin, jowl and trimming shoulder of pigs fed two types of diets: liquid and dry. The peroxide values and fatty acid profiles, as well as their distribution, in the triacylglycerol molecules were determined. Additionally, nutritional indexes and thermal properties, including the oxidative stability of pork fat, were assessed. Among the tested fats, the groin fat was characterized by the best oxidative stability which did not depend on the diet type used. In the case of jowl and trimming shoulder, a higher share of monounsaturated fatty acids was determined in fats of pigs fed a liquid diet, whereas in the groin, jowl and trimming shoulder fats of pigs fed dry feed, a higher share of polyunsaturated fatty acids was found. Fats extracted from the groin, jowl and trimming shoulder of pigs fed a liquid diet showed a more favorable ratio of n-6 to n-3 acids. Despite the different feeding systems used, tested fats were characterized by a similar distribution of fatty acids in triacylglycerol molecules with a positive effect on fat digestibility. It is worth emphasizing that especially in the case of trimming shoulder fat, the influence of a diet used in pigs’ nutrition on quality parameters was noticeable. The trimming shoulder fat of pigs fed a liquid diet was characterized by a longer induction time of oxidation, contained less saturated fatty acids and presented a more favorable fatty acid profile with a beneficial distribution of fatty acids in triacylglycerol molecules. Full article

During the cofferdam construction of the toe reinforcement project at the Qiantang River Estuary, the scouring of the riverbed at the groin head often led to the collapse of geotube groins due to strong tidal currents. Based on field experience, employing a combination of clay and geotubes proved to be a more effective solution to this problem. This study adopted a flume model experiment to investigate the scouring and deposition around geotube groins and mixed clay–geotube groins. The results indicated that the influence of tidal surges on geomorphic changes surrounding the groins was more pronounced during spring tides than during neap tides. Under the same flow conditions, the scour depth at the head of the geotube groin was notably deeper than that of the mixed clay–geotube groin. Additionally, sediment silting behind the mixed clay–geotube groin was significantly greater than that behind the geotube groin. The clay component of the mixed clay–geotube groin served to mitigate the head scour, enhancing the overall structural stability to a certain extent. The geotube groin, with its surrounding scour pits expanding over time, experienced increasing tensile strain. This resulted in the rupture of the geotextile material, the loss of internal sand and, ultimately, groin collapse. It was found that mixed clay–geotube groins were better suited for cofferdam construction in strong tidal estuaries compared to geotube groin alternatives. Full article

Our research introduces the river regulation effects on three sections of the upper and middle Odra River (south-western Poland), with differently channelized parts. In the upper and lower reaches, the river was straightened, narrowed, and trained with groins, whereas in the middle section, it was also impounded by numerous barrages. The discharge duration (DD) and water stage duration (WSD) curves for water-gauge stations from these river sections were analyzed to recognize changes in river flows and channel morphology since the mid-20th century. This analysis is supplemented by an examination of repeated surveys of the gauge cross sections of the river, annual precipitation totals in its catchment, and their relationship to the variation of the North Atlantic Oscillation (NAO) index. Our findings provide new hydrological insights for the region. The three river sections exhibited different patterns of the adjustment of the channel morphology to the river channelization: upper section was typified by channel incision, middle section by channel stability, and lower section by channel incision in its upper part and vertical stability of the channel bed in the lower part. Barrages in the middle section stabilized water stages in a wide range of hydrological conditions. Annual precipitation totals and river run-off did not change systematically over the study period. The variation in precipitation totals was inversely related to annual values of the NAO index. The study confirms the usefulness of DD/WSD curves to analyze changes in river run-off and the vertical position of the channel bed. Full article

This paper presents the history and evolution of the different projects carried out from 1999 to 2008 at Cavo beach in the Elba Island, Italy. The village of Cavo almost completely lost its beach in the 1970s due to the reduction of sedimentary input, and the backing coastal road was defended by a revetment and two detached breakwaters. Such severe erosion processes continued in the following years and impeded any possibility of beach tourist development. In 1999, a project based on the removal of existing breakwaters and beach nourishment works based on the use of gravel as borrow sediment and the construction of two short groins to maintain nourished sediment, raised environmental concern and did not find the approval of the stakeholders. They were worried about the characteristics of the sediments, i.e., waste materials from iron mining rich in red silt and clay. Such sediment fractions made the sea red during the nourishment and deposited on the Posidonia oceanica meadow in front of the beach, with a potential environmental impact. Furthermore, they cemented the gravel fraction forming a beach rock. Between 2006 and 2008, these materials were covered with better quality gravel, extending and raising the beach profile, which required the elevation and lengthening of the two existing groins. Beach evolution monitoring following the second project, based on morphological and sedimentological data acquired before, during and after the works, demonstrated the great stability of the newly created beach. The wider beach has allowed the construction of a promenade and the positioning, in summer, of small structures useful for seaside tourism, increasing the appeal of this village. Data presented in this paper shows an interesting study case, since few examples exist in international literature regarding gravel nourishment projects monitoring and evolution. Full article

This paper presents a parametric stability study of groin, or cross vaults, a structural element widely used in old masonry construction, particularly in Gothic architecture. The vaults’ stability is measured using the geometric safety factor (GSF), computed by evaluating the structure’s minimum thickness through a thrust network analysis (TNA). This minimum thickness is obtained by formulating and solving a specific constrained nonlinear optimisation problem. The constraints of this optimisation enforce the limit analysis’s admissibility criteria, and the equilibrium is calculated using independent force densities on a fixed horizontal projection of the thrust network. The parametric description of the vault’s geometry is defined with respect to the radius of curvature of the vault and its springing angle. This detailed parametric study allows identifying optimal parameters which improve the vaults’ stability, and a comprehensive comparison of these results was performed with known results available for two-dimensional pointed arches. Moreover, an investigation of different force flows represented by different form diagrams was performed, providing a better understanding of the vaults’ structural behaviour, and possible collapse mechanisms were studied by observing the points where the thrust network touches the structural envelope in the limit states. Beyond evaluating the GSF, the groin vault’s stability domain was described to give additional insights into the structural robustness. Finally, this paper shows how advances in equilibrium methods can be useful to understand and assess masonry groin vaults. Full article

This paper shows coastal evolution along the Andalusia Region (Spain) and the impacts on it of coastal structures. The study area was divided into 47 units to calculate the erosion/accretion/stability (or evolution) rates by using the DSAS extension of ArcGIS software. Evolution rates were divided into different classes from “Very high accretion” to “Very high erosion”. As a result, 9 units recorded accretion, 19 stability and 19 erosion. Further, 17 units presented a positive balance and 28 units a negative one, showing a negative net balance of 29,738.4 m²/year corresponding to the loss of 1784.30 km² of beach surface in the 1956–2016 period. The distribution of evolution areas along the studied coast was carried out by means of the “R” project for statistical computing. The analysis evidenced the impact of rigid structures: accretion was essentially observed up-drift of ports and groins and in correspondence of protection structures, especially of breakwaters. Erosion classes were observed down-drift of ports and groins and in correspondence of revetments/seawalls, and at largest river deltas, and “stability” was observed at pocket beaches and coastal areas locally stabilized by protection structures. Last, results were used to determine the distribution of swash- and drift-aligned coastal sectors and main direction of sedimentary transport. Full article

Analysis of written documents, projects and historical cartography of the 17th and 18th centuries allows reconstruction of the shore protection works performed at Callao (Peru) to defend the settlements and its boundary wall from storm waves and tsunamis. Groins appeared for the first time in early 18th century maps, together with gently sloping revetments in an unrealized project of the same period. Comparisons between Callao projects and those performed in Europe in the same centuries show a uniformity in design and construction materials that overpasses the environmental differences of the sites. Successes and failures followed each other and, although an understanding of coastal dynamics and the positive and negative effects of the various works were known, it was not possible to guarantee the stability of the walls and consequently the safety of the city from sea attack. A strategic retreat was even considered. Full article