Search Results (653)

Background: Implant material may influence interfragmentary mechanics in medial malleolar (MM) fracture fixation. This study aimed to compare stainless steel, titanium, magnesium, and PLGA screws under identical conditions using finite element analysis (FEA). Methods: A CT-based ankle model with a unilateral oblique MM fracture (θ = 60° to the medial tibial plafond) was fixed with two parallel M4 × 35 mm screws placed perpendicular to the fracture plane (inter-axial distance 13 mm). Contacts were defined as nonlinear frictional, and each screw was assigned a pretension force of 2.5 N. Static single-leg stance was simulated with physiologic tibia/fibula load sharing. Four scenarios differed only by screw material. Primary outputs were interfragmentary micromotion (maximum sliding and gap). Secondary measures included fracture interface contact/frictional stresses, screw/bone von Mises stress, global construct displacement, and average tibiotalar cartilage contact pressure. Results: Interfragmentary micromotion increased as screw stiffness decreased. Maximum sliding was 32.2–33.8 µm with stainless steel/titanium, 40.4 µm with magnesium, and 65.0 µm with PLGA; corresponding gaps were 31.2–32.0 µm with stainless steel and titanium, 31.2 µm with magnesium, and 54.1 µm with PLGA, respectively. Interface stresses followed the same pattern: contact pressure (3.18–3.24 MPa for stainless steel/titanium/magnesium vs. 4.29 MPa for PLGA); frictional stress (1.46–1.49 MPa vs. 1.98 MPa). Peak screw von Mises stress was highest in stainless steel (104.1 MPa), then titanium (73.4 MPa), magnesium (47.4 MPa), and PLGA (17.9 MPa). Global axial displacement (0.26–0.27 mm) and average tibiotalar cartilage contact pressure (0.73–0.75 MPa) were essentially unchanged across materials. All conditions remained below commonly cited thresholds for primary bone healing (gap < 100 µm); however, PLGA exhibited a reduced safety margin. Conclusions: Under identical geometry and loading conditions, titanium and stainless steel yielded the most favorable interfragmentary mechanics for oblique MM fixation; magnesium showed intermediate performane, and PLGA produced substantially greater micromotion and interface stresses. These findings support the use of metallic screws when maximal initial stability is required and suggest that magnesium may be a selective alternative when reducing secondary implant removal is prioritized. Full article

Background/Objectives: The arrangement and positioning of genes on chromosomes are non-random in plant genomes. Adjacent gene pairs often exhibit similar co-expression patterns and regulatory mechanisms. However, the genomic and epigenetic features influencing such co-expression, particularly in perennial crops like tea (Camellia sinensis), remain largely uncharacterized. Methods: Firstly, we identified 771 specific neighboring gene pairs (SNGs) in C. sinensis (YK10) and investigated the contributions of intergenic distance and gene length to SNGs’ co-expression. Secondly, we integrated multi-omics data including transcriptome, ATAC-seq, Hi-C and histone modification data to explore the factors influencing their co-expression. Thirdly, we employed logistic regression models to individually assess the contributions of nine factors—ATAC-seq, H3K27ac, Hi-C, GO, distance, length, promoter, enhancer, and expression level—to the co-expression of SNGs. Finally, by integrating co-expression networks with metabolic profiles, several transcription factors potentially involved in the regulation of catechin metabolic pathways were identified. Results: Intergenic distance was significantly negatively correlated with co-expression strength, while gene length showed a positive correlation. Furthermore, these two features exerted synergistic effects with threshold characteristics and functional significance. SNGs marked by either ATAC-seq or H3K27ac peaks displayed significantly higher expression levels, suggesting that epigenetic regulation promotes co-expression. In addition, correlation analysis revealed that the expression of certain SNGs was closely associated with catechin accumulation, particularly epicatechin gallate (EGC) and epigallocatechin gallate (EGCG), highlighting their potential role in modulating tissue-specific catechin levels. Conclusions: Collectively, this study reveals a multilayered regulatory framework governing SNG co-expression and provides theoretical insights and candidate regulators for understanding metabolic regulation in tea plants. Full article

Accurate broiler weight estimation in commercial farms is hindered by noisy scale data and multi-broiler occupancy. To address this challenge, we propose a KDE-based framework enhanced with systematic preprocessing, including coefficient of variation (CV), relative change (ROC), and absolute change (AC). In this study, kernel density estimation (KDE) is employed not as a predictive model, but as a distributional tool to robustly extract representative flock weight from noisy, high-frequency scale measurements under commercial farm conditions. In the absence of physical ground-truth, our evaluation focused on the framework’s ability to consistently detect the single, representative peak in the KDE distribution. Weekly thresholds were empirically optimized for the preprocessing filters. Results show that the combined ROC + AC method consistently produced unimodal peak distributions and improved the Peak Detection Rate (PDR) from 91.2% (raw data) to 97.9%. Single-Entity Filtering, assisted by cameras, further mitigated density distortions caused by prolonged occupancy, while CV-only and ROC-only filtering yielded less stable representative values. These findings demonstrate that rigorous preprocessing is essential for reliable KDE-based weight estimation under real-world farm conditions. The proposed framework not only improves data quality and stabilizes distributions but also provides a practical foundation for real-time monitoring and AI-driven precision livestock farming models. Full article

Background: Microsaccades are small fixational eye movements tightly linked to attention and oculomotor control. Although diabetes mellitus is associated with retinal and neural alterations that may impair visuomotor function, the influence of physical activity on microsaccade behaviour in individuals with type 2 diabetes mellitus (T2DM) remains unknown. This study investigated whether habitual physical activity modulates microsaccade characteristics during fixation under different optic flow stimuli. Given that optic flow engages motion processing and gaze stabilisation pathways that may be affected by diabetes-related microvascular/neural changes, it can reveal subtle visuomotor alterations during fixation. Methods: Twenty-eight adults with T2DM and no diagnosed retinopathy performed a fixation task while viewing optic flow stimuli made of moving dots. Eye movements were recorded using an EyeLink system. Physical activity behaviour was assessed at baseline and at a 6-month follow-up after a low-threshold aerobic circuit training programme. Classification as physically active (≥600 MET-min/week) or inactive (<600 MET-min/week) was based on the 6-month assessment. Microsaccade characteristics were analysed by repeated-measures ANOVA. Results: Microsaccade rate was modulated by optic flow (p = 0.044, η²p = 0.106) and showed a significant stimulus × group × sex interaction (p = 0.005, η²p = 0.163), indicating sex-dependent differences in how optic flow modulated microsaccade rate across physically active and inactive participants. A time × stimulus interaction effect was found in peak velocity (p = 0.03, η²p = 0.114) and amplitude (p = 0.02, η²p = 0.127), consistent with modest context-dependent changes over time. Conclusions: These findings suggest that physical activity modulates microsaccade generation and supports the potential of microsaccade metrics as sensitive indicators of oculomotor function in diabetes. Full article

Objectives: The purpose of this study was to determine whether hamstrings’ passive and active shear moduli measured before and after a fatigue task are correlated. Studying the correlation between passive and active shear moduli is important because, if correlated, passive SWE could provide a quicker assessment without requiring fatigue-inducing voluntary contractions. Methods: Forty-seven football players with no history of hamstring strain injury participated. Muscle shear modulus was assessed only in the dominant lower-limb (dominance defined as the preferred kicking limb) using ultrasound-based shear wave elastography at rest and during isometric contractions at 20% of maximal voluntary isometric effort before and immediately after a 10 × 30 m repeated sprint protocol. Results: Regarding sprint performance, a significant decrease of 8.3% was seen between the first and the last sprints (first: 7.14 ± 0.27 m/s; last: 6.60 ± 0.31 m/s; p < 0.001; dz = 1.88 [1.40–2.35]). In relation to the peak torque normalized to bodyweight, a significant decrease of 9.2% was seen between pre and post (pre: 1.98 ± 0.30 Nm/kg; post: 1.83 ± 0.31 Nm/kg; p < 0.001; dz = 0.89 [0.78–0.95]). Regarding the correlation analysis, none of the passive and active shear moduli measures was significantly correlated in any condition (Bonferroni correction for multiple comparisons, significance threshold set at p < 0.004). Conclusions: The results suggest that the hamstrings’ passive and active shear moduli are not correlated after a fatigue task. Full article

Background: Repetitive peripheral magnetic stimulation (rPMS) has emerged as a promising non-invasive treatment modality for reducing muscle hypertonus and spasticity. However, standardized protocols regarding stimulation parameters, particularly the number of stimuli required to achieve therapeutic effects, remain largely undefined. Methods: In an exploratory study, seventeen healthy participants (15 male, 2 female) underwent progressive rPMS treatments at 5 Hz frequency with incrementally increasing stimulus counts (105, 210, 315, 420, and 840 stimuli). Seventeen participants served as controls (11 male, 6 female) receiving sham stimulation. Achilles tendon reflexes were elicited using a computer-controlled reflex hammer, and compound muscle action potential (CMAP) peak-to-peak amplitudes were recorded via surface electromyography before and immediately after each stimulation session. Results: The overall repeated-measures ANOVA indicated a significant main effect (F(5, 80) = 4.98, p = 0.001, η²_p = 0.237). All rPMS treatments produced significant reductions in CMAP amplitudes compared to baseline (p < 0.05). No progressive dose-dependent relationship was observed between stimulus count and response magnitude, suggesting a threshold effect rather than progressive inhibition. Control group showed no significant changes (p ≤ 0.56). Conclusions: Low-frequency (5 Hz) rPMS produces rapid inhibitory effects on spinal reflex circuits with onset after as few as 105 stimuli. These findings indicate that treatment effects can be achieved with substantially fewer stimuli than previously assumed. Further research is needed to identify parameters capable of achieving greater reflex suppression. Full article

This study aims to investigate the tip resistance mechanism of open-ended steel pipe piles under partially plugged conditions by decomposing the load-sharing contribution of the ring zone and the internal soil core. A virtual static loading test was performed using the two-dimensional discrete element method (2D-DEM). Note that the findings of this study were obtained within the range of the 2D-DEM analysis conditions and do not intend to directly reproduce the three-dimensional arching mechanism or to establish equivalence between 2D and 3D responses. Quasi-static conditions were ensured by identifying loading parameters such that the energy residual remained ≤5% during driving, rest, and static loading phases, and the sensitivity criterion |Δq_b|/q_b ≤ 3% was satisfied when the loading rate was halved or doubled. The primary evaluation range of static loading was set to s/D = 0.1 (10% D), corresponding to the displacement criterion for confirming the tip resistance in the Japanese design specifications for highway bridges. For reference, the post-peak mechanism was additionally tracked up to s/D = 0.2 (20% D). Within a fixed evaluation window located immediately beneath the pile tip, high-contact-force (HCF) points were binarized using the threshold τ = μ + σ, and their occupancy ratio φ and normalized force intensity I* were calculated separately for the ring and core regions. A density-based contribution index (“K_{-density share}”) was defined by combining “strength × area” and normalizing by the geometric width. The results suggest that, for the sand conditions and particle-scale ratios examined (D/d_50 = 25–100), the ring zone tends to carry on the order of 85–90% of the tip resistance within the observed cases up to the ultimate state. Even at high plugging ratios (CRs), the internal soil core gradually increases its occupancy and intensity with settlement; however, high-contact-force struts beneath the ring remain active, and it is suggested that the ring-dominant load-transfer mechanism is generally preserved. In the post-peak plastic regime, the K_{-density share} remains around 60%, indicating that the internal core plays a secondary, confining role rather than becoming dominant. These findings suggest that the conventional plug/unplug classification based on PLR can be supplemented by a combined use of plugging ratio CR (a kinematic indicator) and the ring contribution index (K_{-density share}), potentially enabling a continuous interpretation of plugged and unplugged behaviors and contributing to the establishment of a design backbone for tip resistance evaluation. Calibration of design coefficients, scale regression, and mapping to practical indices such as N-values will be addressed in part II of this study. (Note: “Contribution” in this study refers to the HCF-based density contribution index K_{-density share}, not the reaction–force ratio.) Full article

Background: Mechanical loading is a fundamental regulator of bone remodelling; however, the mechanotransduction mechanisms governing alveolar bone adaptation under tensile-dominant orthodontic loading remain insufficiently defined. In particular, the molecular pathways associated with tension-driven cortical modelling in the periodontal ligament (PDL)–bone complex have not been systematically interpreted in the context of advanced biomechanical simulations. Methods: A nonlinear finite element model of the alveolar bone–PDL–tooth complex was developed using patient-specific CBCT data. Three loading configurations were analysed: (i) conventional orthodontic loading, (ii) loading combined with corticotomy alone, and (iii) a translation-dominant configuration generated by the Bone Protection System (BPS). Pressure distribution, displacement vectors, and stress polarity within the PDL and cortical plate were quantified across different bone density conditions. The mechanical outputs were subsequently interpreted in relation to established mechanotransductive molecular pathways involved in osteogenesis and angiogenesis. Results: Conventional loading generated compression-dominant stress fields within the marginal PDL, frequently exceeding physiological thresholds and producing moment-driven root displacement. Corticotomy alone reduced local stiffness but did not substantially alter stress polarity. The BPS configuration redirected loads toward a tensile-favourable mechanical environment characterised by reduced peak compressive pressures and parallel (translation-dominant) displacement vectors. The predicted tensile stress distribution is compatible with activation profiles of key mechanosensitive pathways, including integrin–FAK signalling, Wnt/β-catenin–mediated osteogenic differentiation and HIF-1α/VEGF-driven angiogenic coupling, suggesting a microenvironment that may be more conducive to cortical apposition than to resorption. Conclusions: This study presents a computational–molecular framework linking finite element–derived tensile stress patterns with osteogenic and angiogenic signalling pathways relevant to alveolar bone remodelling. The findings suggestthat controlled redirection of orthodontic loading toward tensile domains may shift the mechanical environment of the PDL–bone complex toward conditions associated with osteogenic than resorptive responses providing a mechanistic basis for tension-induced cortical modelling. This mechanobiological paradigm advances the understanding of load-guided alveolar bone adaptation at both the tissue and molecular levels. Full article

Cavitation in aircraft hydraulic systems continues to pose a serious problem for the aviation industry. This paper presents a new study on cavitation in aviation hydraulic fluid AMG-10 at its inception condition, corresponding to a relative pressure drop of Δp = 0.58, within a small-scale rectangular throttle channel of specified dimensions. Numerical simulations were performed in a quasi-steady-state framework using the realizable k–ε turbulence model combined with the Enhanced Wall Treatment approach, and the results were validated against time-integrated experimental data obtained via the shadowgraphy method. Cavitation was modeled using the Zwart–Gerber–Belamri model. The validated numerical model, which showed a pressure deviation of less than 10% from experimental data on the upper and lower walls, also demonstrated good agreement in the dimensions of the cavitation regions, confirming that the upper region is consistently larger than the lower one. Quantitative analysis demonstrated that regions with high vapor concentration are highly localized, representing only 0.048% of the channel volume at a 0.8 vapor fraction threshold. The analysis reveals that the cavitation regions spatially coincide with local pressure drops to values as low as 214 and 236 Pa near the upper and lower walls. These regions are also associated with wall jets, accelerated by the flow constriction to velocities up to 41.98 m/s. Furthermore, the cavitation region corresponds to a distinct peak in the mean turbulent kinetic energy field, reaching 164.5 m²/s², which decays downstream. Full article

This numerical study demonstrates the existence of a critical injection momentum threshold necessary for stable liquid film formation, highlighting that either excessive or insufficient momentum degrades cooling performance. This optimization is critical for maximizing cooling effectiveness from short injection holes in high-performance propulsion systems. By comparing Smoothed Particle Hydrodynamics (SPH) and Volume of Fluid (VOF) methods, we find that the SPH method predicts a thicker, more continuous coolant film due to its superior mass conservation during interface breakup. A key design insight emerges: cooling performance peaks at a distinct, critical coolant momentum. Insufficient momentum leads to poor coverage, while excess momentum causes film separation and is counter-productive. The identified configuration—defined by a precise combination of flow rate, pressure, and geometry—promotes immediate and stable film formation. The robustness of this finding is confirmed by the agreement between the two numerical methods on film thickness and the captured physical evolution of the film from a pronounced wave to a damped state. Full article

Background: atrial fibrillation (AF) patients with obesity and high thromboembolic risk need oral anticoagulant therapy. Limited data are available on direct oral anticoagulants (DOACs) in this population, and a point-of-care method has been validated to support rapid clinical decisions and to identify on-off plasma concentration thresholds. Methods: This is a monocentric, cross-sectional diagnostic accuracy study on obese AF outpatients referred to Policlinico Umberto I of Rome. Urinary Dipsticks were assessed with separate pads for factor Xa (FXA-i) and thrombin inhibitor (THR-i) and compared to the reference standard of trough and peak plasma concentrations with chromogenic assays/dTT and prespecified plasma thresholds for each DOAC. Study endpoints were the sensitivity, specificity, positive and negative predictive values (PPV and NPV) of DOACs Dipstick compared to plasma concentrations. Sub-analyses according to obesity severity and type of DOAC were performed. Results: 320 paired plasma and urine samples were available from 160 enrolled patients (mean age 73.2 ± 9.1 years). Compared to trough plasma concentrations, DOACs Dipstick showed a sensitivity of 99.24% (mean, 95% confidence interval, CI 95.82–99.98), specificity of 6.89% (0.85–22.76), PPV 82.80% (81.32–84.18), NPV 66.67% (15.79–95.52). On the other hand, compared to peak plasma concentrations, DOACs Dipstick showed a sensitivity of 97.8% (93.7–99.5), specificity of 0% (0.0–15.4), and PPV of 85.9% (85.6–86.2). Urinary Dipstick showed a sensitivity of 99.10% (95.4–100.0), specificity of 4.70% (0.60–16.20) and a PPV and NPV of 74.50% (73.2–75.8) and 66.70 (15.7–95.6), compared to plasma thresholds > 30 ng/mL of FXA-I and THR-I. Sub-analyses showed similar results between FXA-i and THR-i. Conclusions: The urine point-of-care has high sensitivity, acceptable PPV, but low specificity and NPV in AF obese patients and may be useful only in selected clinical scenarios. Full article

Background: This study aimed to provide reference values for estimating training intensities in long-distance runners based on progressive incremental tests, considering differences related to sex and performance level. Methods: A total of 1411 endurance-trained runners (819 men and 592 women) completed a standardized treadmill protocol with gas exchange analysis to determine ventilatory thresholds and peak oxygen consumption (VO_2peak). Heart rate (HR) and running speed at each threshold were expressed relative to their peak values. Results: HR at second ventilatory threshold (VT2) occurred at 93.5 ± 2.5% of HR peak, and HR at first ventilatory threshold at 85.1 ± 4.6%. The relative running speeds at VT2 and VT1 corresponded to 87.6 ± 3.9% and 73.9 ± 5.5% of the speed at VO_2peak, respectively. In men, beginners exhibited higher relative HR and VO₂ values at the ventilatory thresholds than elite runners. In contrast, women displayed higher and more stable relative values across performance levels. Conclusions: These findings establish precise, evidence-based reference ranges derived from a large cohort of runners and highlight the need to consider sex and performance level when estimating exercise intensities. Individualized physiological assessment remains essential for accurate training prescription and performance optimization. Full article

Wind-induced response poses a significant challenge to the stability of extra-large-span heavy steel box girders during synchronous lifting operations. This study adopted a method combining numerical simulation with on-site monitoring to investigate the aerodynamic characteristics the beam during the overall hoisting process of the Xiaotun Bridge. A high-fidelity finite element model was established using Midas NFX 2024 R1, and fluid–structure interaction (FSI) analysis was conducted, utilizing the RANS k-ε turbulence model to simulate stochastic wind fields. The results show that during the lifting stage from 3 m to 25 m, the maximum horizontal displacement of the steel box girder rapidly increases at wind angles of 90° and 60°, and the peak displacement is reached at 25 m. Under a strong breeze at a 90° wind angle and 25 m lifting height, the maximum lateral displacement was 42.88 mm based on FSI analysis, which is approximately 50% higher than the 28.58 mm obtained from linear static analysis. Subsequently, during the 25 m to 45 m lifting stage, the displacement gradually decreases and exhibits a linear correlation with lifting height. Concurrently, the maximum stress of the lifting lug of the steel box girder increases rapidly in the 3–25 m lifting stage, reaches the maximum at 25 m, and gradually stabilizes in the 25–45 m lifting stage. The lug stress under the same critical condition reached 190.80 MPa in FSI analysis, compared with 123.83 MPa in static analysis, highlighting a significant dynamic amplification. Furthermore, the detrimental coupling effect between mechanical vibrations from the lifting platform and wind loads was quantified; the anti-overturning stability coefficient was reduced by 10.48% under longitudinal vibration compared with lateral vibration, and a further reduction of up to 39.33% was caused by their synergy with wind excitation. Field monitoring validated the numerical model, with stress discrepancies below 9.7%. Based on these findings, a critical on-site wind speed threshold of 9.38 m/s was proposed, and integrated control methods were implemented to ensure construction safety. During on-site lifting, lifting lug stresses were monitored in real time, and if the predefined threshold was exceeded, contingency measures were immediately activated to ensure a controlled termination. Full article

Background and Objectives: Healthcare-associated infections (HAIs) significantly increase morbidity and mortality in critically ill patients, and their burden became more pronounced during the COVID-19 pandemic. However, data describing the temporal evolution of HAIs, pathogen distribution, and associated risk factors across consecutive pandemic waves remain limited. This study aimed to characterize the epidemiology, microbiology, and outcomes of HAIs in COVID-19 intensive care units (ICU) patients and to identify clinical and laboratory predictors of mortality. Materials and Methods: This retrospective observational study included adult patients with RT-PCR–confirmed COVID-19 who developed at least one HAI ≥ 48 h after ICU admission between March 2020 and December 2020, encompassing the first three pandemic waves in Türkiye, in a tertiary-care ICU. Demographic, clinical, laboratory, and microbiological data were collected. Inflammatory markers and severity scores (SAPS-II, MCCI, and NLR) were analyzed. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values for mortality prediction. Results: Among the 1656 ICU admissions, 145 patients (8.7%) developed HAIs; after exclusions, 136 patients were included in the final analysis. Bloodstream infections were the most frequent HAI (57%), followed by urinary tract infections (31%), ventilator-associated pneumonia (9%), and surgical site infections (1%). Klebsiella pneumoniae was the predominant pathogen, followed by Candida albicans and Acinetobacter baumannii. Multidrug-resistant organisms, including MRSA and VRE, showed variable distribution across pandemic periods. Overall in-hospital mortality was 74.3%. Non-survivors had significantly higher SAPS-II, MCCI, and NLR values. ROC analysis identified NLR > 38.8 and SAPS-II > 35.5 as mortality-predictive thresholds. Dynamic inflammatory marker patterns correlated with infection timing, and early peaks of CRP, WBC, and IL-6 were associated with worse outcomes. Conclusions: HAIs imposed a substantial clinical burden on critically ill COVID-19 patients, with high mortality driven predominantly by multidrug-resistant bloodstream infections. Severity indices and inflammation-based biomarkers demonstrated strong prognostic value. Temporal shifts in pathogen ecology across pandemic waves underscore the need for adaptive infection-prevention strategies, continuous microbiological surveillance, and strengthened antimicrobial stewardship in critical care settings. Full article

This research explores the application of extreme value theory in modelling and quantifying tail risks across different economic equity markets, with focus on the Nairobi Securities Exchange (NSE20), the South African Equity Market (FTSE/JSE Top40) and the US Equity Index (S&P500). The study aims to recommend the most suitable probability distribution between the Generalised Extreme Value Distribution (GEVD) and the Generalised Pareto Distribution (GPD) and to assess the associated tail risk using the value-at-risk and expected shortfall. To address volatility clustering, four generalised autoregressive conditional heteroscedasticity (GARCH) models (standard GARCH, exponential GARCH, threshold-GARCH and APARCH (asymmetric power ARCH)) are first applied to returns before implementing the peaks-over-threshold and block maxima methods on standardised residuals. For each equity index, the probability models were ranked based on goodness-of-fit and accuracy using a combination of graphical and numerical methods as well as the comparison of empirical and theoretical risk measures. Beyond its technical contributions, this study has broader implications for building sustainable and resilient financial systems. The results indicate that, for the GEVD, the maxima and minima returns of block size 21 yield the best fit for all indices. For GPD, Hill’s plot is the preferred threshold selection method across all indices due to higher exceedances. A final comparison between GEVD and GPD is conducted to estimate tail risk for each index, and it is observed that GPD consistently outperforms GEVD regardless of market classification. Full article