Search Results (31)

Background: The management of lateral compression type 1 (LC-1) pelvic fractures remains controversial. Posterior fixation alone has traditionally been practiced without clearly defined indications for supplementary anterior stabilization. Direct comparative evidence between posterior-only and combined anterior–posterior fixation remains scarce. This study evaluated whether institutional criteria reliably identify patients who benefit from additional percutaneous anterior fixation. Methods: A retrospective cohort study was conducted at a level I trauma center and included adults with LC-1 fractures treated exclusively by percutaneous fixation. Combined anterior–posterior fixation was performed when predominant anterior pain and radiographic compromise indicated instability. Primary outcomes were pain trajectory (Numeric Rating Scale), inpatient opioid use, physiotherapy clearance, and ward mobility. Results: Thirty-seven patients were analyzed (combined = 14; posterior-only = 23). Preoperative pain was higher in the combined group (median 7 vs. 6; median difference 1 [95% CI 0 to 2]; p = 0.0036). Postoperatively, pain scores were lower in the combined group at 1–6 weeks (median difference −1 [95% CI −2 to 0]; p < 0.05). Opioid consumption was reduced (193 mg vs. 312 mg; median difference −200 mg [95% CI −280 to −120]; p < 0.001), and physiotherapy clearance occurred earlier (4 vs. 7 days; median difference −3 [95% CI −5 to −1]; p = 0.020). Conclusion: Our current indications to perform combined fixation were associated with favorable early outcomes in pain control and physiotherapy clearance among patients with LC-1 fractures showing anterior compromise. These results support a selective combined approach, though interpretation must remain cautious given the small retrospective cohort. Further prospective studies are warranted to validate these findings and refine patient selection. Full article

Schatzker type V bicondylar tibial plateau fractures present a major challenge due to the difficulty of achieving stable fixation with minimally invasive strategies. This study introduces a dual-thread lag and locking plate (DLLP) design that integrates lag screw compression with unilateral locking plate fixation. A custom-built compression evaluation platform and standardized 3D-printed fracture models were employed to assess biomechanical performance. DLLP produced measurable interfragmentary compression during screw insertion, with a mean displacement of 1.22 ± 0.11 mm compared with 0.02 ± 0.04 mm for conventional single lateral locking plates (SLLPs) (p < 0.05). In static testing, DLLP demonstrated a significantly greater maximum failure force (7801.51 ± 358.95 N) than SLLP (6224.84 ± 411.20 N, p < 0.05) and improved resistance to lateral displacement at 2 mm (3394.85 ± 392.81 N vs. 2766.36 ± 64.51 N, p = 0.03). Under dynamic fatigue loading simulating one year of functional use, all DLLP constructs survived 1 million cycles with <2 mm displacement, while all SLLP constructs failed prematurely (mean fatigue life: 408,679 ± 128,286 cycles). These findings highlight the critical role of lag screw compression in maintaining fracture stability and demonstrate that DLLP provides superior biomechanical performance compared with SLLP, supporting its potential as a less invasive alternative to dual plating in the treatment of complex tibial plateau fractures. Full article

With the deepening implementation of the coordinated development strategy for energy exploitation and ecological conservation, green coal mining technology has become a critical pathway to achieve balanced resource development and environmental protection. This study investigates the stress field evolution and dynamic fracture propagation mechanisms in overlying strata during shallow coal seam mining in the Shenfu mining area. By employing a multidisciplinary approach combining triaxial compression tests (0–15 MPa confining pressure), scanning electron microscopy (SEM) microstructural characterization, elastoplastic theoretical modeling, and FLAC3D numerical simulations, the synergistic failure mechanisms of overlying strata were systematically revealed. Gradient-controlled triaxial tests demonstrated significant variations in stress-strain responses across lithological types. Notably, Class IV sandstone exhibited exceptional uniaxial compressive strength of 106.7 MPa under zero confining pressure, surpassing the average strength of Class I–III sandstones (86.2 MPa) by 23.6%, attributable to its highly compacted grain structure. A nonlinear regression-derived linear strengthening model quantified that each 1 MPa increase in confining pressure enhanced axial peak stress by 4.2%. SEM microstructural analysis established critical linkages between microcrack networks/grain-boundary slippage at the mesoscale and macroscopic brittle failure patterns. Numerical simulations demonstrated that strata failure manifests as tensile-shear composite fractures, with lateral crack propagation inducing bed separation spaces. The stress field exhibited spatiotemporal heterogeneity, with maximum principal stress concentrating near the initial mining cut during early excavation. Fractures propagated obliquely at angles of 55–65° to the horizontal plane in an ‘inverted V’ pattern from the goaf boundaries, extending vertically 12–18 m before transitioning to the bent zone, ultimately forming a characteristic three-zone structure. Experimental and simulated vertical stress distributions showed minimal deviation (≤2.8%), confirming constitutive model reliability. This research quantitatively characterizes the spatiotemporal synergy of strata failure mechanisms in ecologically vulnerable northwestern China, proposing a confining pressure-effect quantification model for support parameter optimization. The revealed fracture dynamics provide critical insights for determining ecological restoration timelines, while establishing a novel theoretical framework for optimizing green mining systems and mitigating ecological damage in the Shenfu mining area. Full article

Pedicle screw fixation is a common spinal surgery technique, but concerns remain about stability when screws are malpositioned. Traditional in vitro pull-out tests assess anchorage but lack physiological accuracy. This study examined the stability of correctly placed and intentionally malpositioned pedicle screws on forty vertebrae from five cadavers. Optimal screw paths were planned via CT scans and applied using 3D-printed guides. Four malposition types—medial, lateral, superior, and superior-lateral—were created by shifting the original trajectory. A custom setup applied three consecutive cycles of tensile and compressive load from 50 N to 200 N. Screw inclination under load was measured with a 3D optical system. The results showed increasing screw inclination with higher forces, reaching about 1° at 50 N and 2° at 100 N, similar in both load directions. Significant differences in inclination were only found at 100 N tensile load, where malpositioned screws showed a lower inclination. Overall, malpositioning had no major effect on screw loosening. These findings suggest that minor deviations in screw placement do not significantly compromise mechanical stability. Clinically, the main concern with malpositioning lies in the potential for injury to nearby structures rather than reduced screw fixation strength. Full article

Excess-sulfate phosphogypsum slag cement (EPSC), offering the potential for large-scale phosphogypsum (PG) utilization, has drawn significant attention. However, its susceptibility to salt erosion in marine/saline environments remains unquantified, hindering engineering applications. This study, therefore, systematically investigates the effect of various salts (NaCl, MgCl₂, KCl, and Na₂SO₄) at different concentrations (0.5–1.5%) on the hydration mechanism and performance of EPSC using rheometry, strength tests, and microstructural characterization (XRD/SEM-EDS). The findings reveal that EPSC exhibits low initial yield stress and plastic viscosity, both of which increase over time. The addition of Na⁺, Cl⁻, and SO₄²⁻ ions promotes hydration and flocculent structure formation in the EPSC paste, thereby enhancing the yield stress and plastic viscosity. In contrast, Mg²⁺ and K⁺ ions inhibit the hydration reaction, although Mg²⁺ temporarily increases the plastic viscosity by forming Mg(OH)₂ during the initial stage of the reaction. Both Na₂SO₄ and NaCl improve mechanical properties when their concentrations are within the 0.5–1.0% range; however, excessive amounts (>1%) negatively impact these properties. Significantly, adding 0.5% NaCl significantly improves the mechanical properties of EPSC, achieving a 28-day compressive strength of 51.06 MPa—a 9.5% increase compared to the control group. XRD and SEM-EDX analyses reveal that NaCl enhances pore structure via Friedel’s salt formation, while Na₂SO₄ promotes the early nucleation of ettringite. However, excessive ettringite formation in the later stages of the hydration reaction due to Na₂SO₄ may negatively affect compressive strength due to the inherent abundance of SO₄²⁻ in the EPSC system. Therefore, attention should be paid to the effect of excessive SO₄²⁻ on the system. These results establish salt-type/dosage thresholds for EPSC design, enabling its rational use in coastal infrastructure where salt resistance is critical. Full article

This research examines the mechanical properties of fiber-reinforced modified high-water content materials intended for mining backfill applications. Conventional high-water content materials encounter several challenges, including brittleness, inadequate crack resistance, and insufficient later-stage strength. Basalt fiber (BF) and polypropylene fiber (PP) were integrated into the material system to establish a reinforcing network through interfacial bonding and bridging mechanisms to mitigate these issues. A total of nine specimen groups were developed to assess the influence of fiber type (BF/PP), fiber content (ranging from 0.5% to 2.0%), and water cement ratio (from 1.25 to 1.75) on compressive, tensile, and shear strengths. The findings indicated that basalt fiber exhibited superior performance compared to polypropylene fiber, with a 1% BF admixture yielding the highest compressive strength of 5.08 MPa and notable tensile enhancement attributed to effective pore-filling and three-dimensional reinforcement. Conversely, higher ratios (e.g., 1.75) resulted in diminished strength due to increased porosity, while a ratio of 1.25 effectively balanced matrix integrity and fiber reinforcement. Improvements in shear strength were less significant, as excessive fiber content disrupted interfacial friction, leading to a propensity for brittle failure. In conclusion, basalt fiber-modified high water content materials (with a 1% admixture and a ratio of 1.25) demonstrate enhanced ductility and mechanical performance, rendering them suitable for mining backfill applications. Future investigations should focus on optimizing the fiber matrix interface, exploring hybrid fiber systems, and conducting field-scale validations to promote sustainable mining practices. Full article

We describe a new genus and species of the tribe Ichthyomyini (Rodentia: Sigmodontinae) based on three specimens collected in Machupicchu, Cusco, in the southern Peruvian Andes. Our study includes a comprehensive morphological analysis of 201 specimens representing all recognized species, employing multivariate statistics (principal component analysis) of external and cranial measurements, as well as phylogenetic methods. We used maximum parsimony for morphological data and concatenated molecular datasets (Cytochrome b [17 species], IRBP [15 species], and RAG1 [11 species]) analyzed via maximum likelihood and Bayesian inference. The new genus and species exhibit an allopatric distribution relative to other Ichthyomyini and are distinguished by the following combination of traits: dull slate-gray dorsal fur, lighter ventrally without contrast to the dorsum; incomplete philtrum; vestigial pinna concealed within head fur; long, broad hindfeet with a well-developed fringe of stiff hairs and brown soles; laterally compressed tail exceeding head-body length; type 1 carotid circulation pattern; absence of the orbicular apophysis of the malleus; presence of posteroloph and posterolophid in M1, M2, m1, and m2; unilocular hemiglandular stomach (non-reduced). Full article

Background/Objectives: Surgery for adolescent idiopathic deformities is often aimed at improving aesthetic appearance, striving for the best possible correction. However, severe and rigid scoliotic curves not only present aesthetic issues but can also compromise cardiopulmonary health and cause early neurological impairment due to spinal cord compression, posing significant risks of morbidity and mortality if untreated. Conservative treatments are ineffective for severe curves, defined by scoliotic angles over 70° and flexibility below 30% on lateral bending X-rays. Treatment often requires invasive interventions, such as osteotomies and vertebral resections. In particular, posterior vertebral column resection (PVCR) has shown effectiveness in realigning vertebral structures in complex cases. This study describes the efficacy and risks of PVCR through a series of cases treated at our institution. Methods: This case series was conducted at the Rizzoli Orthopedic Institute in Bologna, involving eight pediatric patients with severe, rigid spinal deformities, operated upon between 2018 and 2023. The underlying pathologies included idiopathic kyphoscoliosis, neurofibromatosis type 1, Pott’s disease, and other congenital anomalies. Preoperative assessment included standard radiographs, magnetic resonance imaging, and computed tomography. During PVCR, motor and sensory evoked potentials were monitored to minimize neurological injury risk. Postoperative management included blood transfusions, antibiotic support, and early physiotherapy. Results: PVCR resulted in an average reduction in the Cobb angle from 86.3° preoperatively to 22.4° postoperatively, with a mean correction of 64%. The mean duration of the procedures was 337.4 min. Three patients had an uneventful postoperative course, while five developed complications, including infections and temporary neurological deficits, which were successfully managed. One patient developed an epidural hemorrhage that required emergency surgery for hematoma evacuation, with partial recovery. This study demonstrates the potential of PVCR for correcting rigid spinal deformities, highlighting the importance of postoperative management to minimize the associated risks. Conclusions: Posterior vertebral resection techniques offer significant promise in the correction of pediatric spinal deformities. Although ours is a small case series, it can provide important data for such treatment. Long-term monitoring is needed to fully understand the impact of these procedures and to further refine surgical techniques. Full article

Background and Objectives: Anterior sacroiliac fracture dislocation (ASFD), also known as locked pelvis, is a rarely reported diagnosis. The types of ASFDs are often misdiagnosed as lateral compression fractures due to the presence of crescent fractures. In this study, we distinguished ASFD from lateral compression fractures (LC 2) and studied their characteristics. Materials and Methods: This is a retrospective study involving patients from a Level 1 trauma center. Fifty-nine patients under the age of 65 years with crescent fractures caused by a high-energy mechanism were investigated. Results: The incidence of ASFD was 25% (15 of 59) in patients with crescent fractures. Among the 15 patients, 6 had override of the ilium over the sacrum, inhibiting reduction in the sacroiliac joint. Pre-operative radiographic evaluations revealed that vertical displacement of the ASFD was larger than that of lateral compression fracture (LC 2) in the outlet view (mean 9.5 vs. 1.9 mm, p = 0.013), and the pelvic asymmetry ratio was larger in ASFD (mean 7.8 vs. 4.1, p = 0.006) in the pelvis AP view. All patients achieved union after surgery. Post-operative radiography showed no significant vertical displacement difference. There was no difference in vascular injury or hemodynamic instability requiring embolization or preperitoneal pelvic packing (PPP) between the two groups. Conclusions: Patients with ASFD have greater vertical displacement and asymmetry compared to patients with LC 2 fractures. These fractures must be distinguished for appropriate reduction and anterior plate fixation. Full article

As a special type of clay, expansive clay is widely distributed in China. Its characteristics of swelling and softening when meeting water and shrinking and cracking when losing water bring many hidden dangers to engineering construction. Expansive clay is known as “engineering cancer”, and in-depth research on the unloading mechanical response characteristics and the unloading constitutive relationships of expansive clay is a prerequisite for conducting geotechnical engineering design and safety analysis in expansive-soil areas. In order to obtain the unloading mechanical response characteristics and the expression of the unloading tangent modulus of expansive clay, typical expansive clay in the Hefei area was taken as the research object, and triaxial unloading stress path tests were conducted. The stress–strain properties, microstructures, macro failure modes, and strength indexes of the expansive clay were analyzed under unloading stress paths. Through an applicability analysis of several classical soil strength criteria, an unloading constitutive model and the unloading tangent modulus expression of the expansive clay were constructed based on the Mohr–Coulomb (hereinafter referred to as “M-C”) criterion, the Drucker–Prager (hereinafter referred to as “D-P”) criterion, and the extended Spatial Mobilized Plane (hereinafter referred to as “SMP”) criterion theoretical frameworks. The following research results were obtained: (1) The stress–strain curves of the three stress paths of the expansive clay were hyperbolic. The expansive clay showed typical strain-hardening characteristics and belonged to work-hardening soil. (2) Under the unloading stress paths, the soil particles were involved in the unloading process of stress release, and the failure samples showed obvious stretching, curling, and slipping phenomena in their soil sheet elements. (3) Under both unloading stress paths, the strength of the expansive clay was significantly weakened and reduced. Under the lateral unloading paths, the cohesive force (c) of the expansive clay was reduced by 32.7% and the internal friction angle (φ) was increased by 19% compared with those under conventional loading, while under the axial unloading path, c was reduced by 63.5% and φ was reduced by 28.7%. (4) For typical expansive clay in Hefei, the conventional triaxial compression (hereinafter referred to as “CTC”) test, the reduced triaxial compression (hereinafter referred to as “RTC”) test, and the reduced triaxial extension (hereinafter referred to as “RTE”) test stress paths were suitable for characterization and deformation prediction using the M-C strength criterion, D-P strength criterion, and extended SMP strength criterion, respectively. (5) The derived unloading constitutive model and the unified tangent modulus formula of the expansive clay could accurately predict the deformation characteristics of the unloading stress path of the expansive clay. These research results will provide an important reference for future engineering construction in expansive-clay areas. Full article

The wound healing mechanism is dynamic and well-orchestrated; yet, it is a complicated process. The hallmark of wound healing is to promote wound regeneration in less time without invading skin pathogens at the injury site. This study developed a sodium–carboxymethylcellulose (Na-CMC) bilayer scaffold that was later integrated with silver nanoparticles/graphene quantum dot nanoparticles (AgNPs/GQDs) as an acellular skin substitute for future use in diabetic wounds. The bilayer scaffold was prepared by layering the Na-CMC gauze onto the ovine tendon collagen type 1 (OTC-1). The bilayer scaffold was post-crosslinked with 0.1% (w/v) genipin (GNP) as a natural crosslinking agent. The physical and chemical characteristics of the bilayer scaffold were evaluated. The results demonstrate that crosslinked (CL) groups exhibited a high-water absorption capacity (>1000%) and an ideal water vapour evaporation rate (2000 g/m² h) with a lower biodegradation rate and good hydrophilicity, compression, resilience, and porosity than the non-crosslinked (NC) groups. The minimum inhibitory concentration (MIC) of AgNPs/GQDs presented some bactericidal effects against Gram-positive and Gram-negative bacteria. The cytotoxicity tests on bilayer scaffolds demonstrated good cell viability for human epidermal keratinocytes (HEKs) and human dermal fibroblasts (HDFs). Therefore, the Na-CMC bilayer scaffold could be a potential candidate for future diabetic wound care. Full article

Well structures with ultra-long sections have become one of the most applied technologies in the field of shale gas development. While there have been many technical challenges, enhancing the breaking efficiency and stability of polycrystalline diamond compact (PDC) bits has become an essential issue of focus. Since 2013, the well structure in the Duvernay area has been optimized multiple times, and the rate of penetration (ROP) of the entire wellbore has nearly doubled. However, there are significant differences in terms of the performances of different PDC bits, and there is still room for improvement to optimize these drill bits. For this reason, a confined compressive strength test was conducted to obtain the rock mechanical parameters from shale cores extracted from the long horizontal section. Using these data, a finite element model (FEM) was developed with a corresponding scale. A calibration of the elastic-plastic damage constitutive models was then performed using the FEM. The breaking mechanism of three different PDC bits was examined using a “PDC bit-bottom hole” interaction FEM model, facilitating guidance for bit selection and design optimization: (1) The type B PDC bit, which has four blades and 20 cutters, exhibited the highest mechanical specific energy (MSE) and the lowest vibration across three directional mechanical characteristics. This design is recommended for engineering applications. (2) Lower axial vibrations were produced when the CDE was used as the rear element when compared to those when using the BHE. However, an increase within an acceptable range was observed in the TOB and circumferential vibrations. Thus, for redesigning work on the type B bit, the assembly of the CDE is suggested. (3) A decrease in the MSE and vibration in three directional mechanical characteristics was observed when the depth of cut (DOC) was varied between 1.5 and 2.0 mm. A broadening in the range of lateral forces was noted when a DOC of 2.0 mm was used. Therefore, for the redesign of the type B bit, the assembly of CDEs as rear elements at a DOC of 1.5 mm is recommended. In conclusion, a new practical method for the selection and optimization of PDC bit design, based on rock mechanics and the FEM theory, is proposed. Full article

Using experimental methods to study the influence of hole and cracks on the mechanical properties and fracture characteristics of rock-like mortar materials under biaxial compression conditions. The double crack specimens with hole depths from 0–100 mm are prefabricated to study the strength and deformation characteristics of the specimens under different lateral loads σ₂ = 0–6 MPa. The evolution process of secondary crack initiation, development, and connection of the hole-crack specimens are recorded. The results show that: (1) One type of rock mortar test material is prepared, and its main physical and mechanical parameters are all within the range of sandstone, which can effectively simulate the stress deformation characteristics of sandstone. (2) When the depth of the holes in cracked samples exceeds 50% of the length, the strength and deformation of the samples undergo a sudden change. When the depth of the hole in the crack specimen increases from 40 mm to 60 mm, the peak stress decreases most significantly. Moreover, the maximum values of the strain value at peak strength and lateral strain both occur at a hole depth of 60 mm. (3) When the cracked specimen contains through-holes, the failure mode is composite fracture and shear composite fracture. When the depth of the hole is different, the fracture forms include tension composite fracture, shear composite fracture, and composite fracture. Full article

Under uniaxial compression, the soil mass may be subjected to transverse tensile splitting or swelling failure. This failure is caused by the tensile stress in the soil; that is, part of the vertical stress is converted into lateral stress. In order to investigate the factors that influence the stress transfer phenomenon, the failure mode of the soil mass can be predicted more accurately, and the internal force of the soil mass can be analyzed. This paper begins with the definition of the stress conversion coefficient and measures it by combining macroscopic mechanical properties with microscopic structure analyses. By carrying out a uniaxial compression test on a large soil sample, an equivalent tensile test was carried out according to the equivalent transverse displacement measured using the S-type tension sensor in order to explore the change law of the stress conversion coefficient. The arrangement and distribution of pores and particles at different positions in the samples before and after compression were further observed and analyzed using the SEM test to explore the formation mechanism of the stress transition phenomenon, and the following research results were obtained: (1) The stress conversion coefficient of the soil under compression is not invariable. An increase in the loading rate and a decrease in water content cause brittleness, and the stress conversion coefficient of the soil decreases. (2) Shear failure is more likely to occur in large samples of brittle soils under uniaxial compression. (3) The tensile stress in the compressed soil is caused by the invasion and extrusion of soil particles. Full article

Chiari 1 Malformation (CM1) is classically defined as a caudal displacement of the cerebellar tonsils through the foramen magnum into the spinal cord. Modern imaging techniques and experimental studies disclose a different etiology for the development of CM1, but the main etiology factor is a structural defect in the skull as a deformity or partial reduction, which push down the lower part of the brain and cause the cerebellum to compress into the spinal canal. CM1 is classified as a rare disease. CM1 can present with a wide variety of symptoms, also non-specific, with consequent controversies on diagnosis and surgical decision-making, particularly in asymptomatic or minimally symptomatic. Other disorders, such as syringomyelia (Syr), hydrocephalus, and craniocervical instability can be associated at the time of the diagnosis or appear secondarily. Therefore, CM1-related Syr is defined as a single or multiple fluid-filled cavities within the spinal cord and/or the bulb. A rare CM1-related disorder is syndrome of lateral amyotrophic sclerosis (ALS mimic syndrome). We present a unique clinical case of ALS mimic syndrome in a young man with CM1 and a huge singular syringomyelic cyst with a length from segment C2 to Th12. At the same time, the clinical picture showed upper hypotonic-atrophic paraparesis in the absence of motor disorders in the lower extremities. Interestingly, this patient did not have a disorder of superficial and deep types of sensitivity. This made it difficult to diagnose CM1. For a long time, the patient’s symptoms were regarded as a manifestation of ALS, as an independent neurological disease, and not as a related disorder of CM1. Surgical treatment for CM1 was not effective, but it allowed to stabilize the course of CM1-related ALS mimic syndrome over the next two years. Full article