Search Results (1,656)

Background/Objectives: Capsular contracture (CC) is the most frequent complication of breast implant surgery, affecting up to 20% of augmentation and up to 40% of post-mastectomy reconstruction patients. Diagnosis relies on the Baker classification with poor interobserver reliability (κ = 0.55). This study evaluated shear-wave elastography (SWE) as an objective diagnostic tool for CC via quantitative measurement of periprosthetic capsule stiffness. Methods: A prospective single-center comparative study (Romania) enrolled 26 augmentation patients (50 breasts) with asymptomatic Baker I/II CC as controls, and 25 breasts with confirmed Baker III/IV CC in post-mastectomy reconstruction patients as the study group. Stiffness was measured using the SuperSonic MACH 30 platform (mean, median, min, max, SD in kPa). Analysis included Mann-Whitney U tests, ROC curves with bootstrapped 95% CIs, and Youden’s J index. Confounder analyses (Spearman correlations, multivariable logistic regression, partial correlations) assessed the independence of SWE findings from implant depth, periprosthetic tissue thickness, region-of-interest (ROI) diameter, and body mass index (BMI). Results: All four primary stiffness parameters differed significantly between groups (p < 10⁻¹¹, r > 0.97). Control median stiffness was 32.6 kPa versus 138.0 kPa in the study group. All four parameters achieved outstanding discriminative performance (AUC 0.988–0.994); SWE median yielded the highest AUC (0.994; 95% CI 0.980–1.000). A threshold of 82 kPa provided 100% sensitivity, 98% specificity, and 100% NPV. Baker Grades III (~92 kPa) and IV (~147 kPa) also differed significantly (p = 0.0001). No covariate (implant depth, periprosthetic tissue thickness, ROI diameter, BMI) significantly influenced SWE values within either group (all intra-group Spearman ρ p > 0.05), and SWE median stiffness remained the sole significant predictor in the fully adjusted multivariable model (adjusted OR = 1.18, 95% CI 1.08–1.31, p < 0.001). Conclusions: SWE objectively differentiates normal periprosthetic capsules from clinically significant CC with outstanding accuracy. An 82 kPa median stiffness threshold offers a reproducible, non-invasive complement to the Baker classification and provides a foundation for elastography-based CC staging. Full article

Remote alpine lakes on the Xizang Plateau are important archives for tracing the long-range atmospheric transport (LRAT) of persistent organic pollutants, yet historical records of polybrominated diphenyl ethers (PBDEs) from this region remain scarce. The main objective of this study was to reconstruct the historical record of PBDEs in Yamzho Yumco sediments and to evaluate whether this record reflects source evolution, atmospheric transport, deposition, and post-emission environmental fractionation in a remote alpine receptor system. To achieve this objective, 17 PBDE congeners were determined in a ²¹⁰Pb- and ¹³⁷Cs-dated sediment core spanning 1930–2023. Σ₁₇PBDE concentrations ranged from 5.80 to 263.13 pg/g dw, and depositional fluxes ranged from 2.67 to 121.04 pg/cm²/yr, both showing a marked increase after the 1970s and remaining elevated after 2000. Lower-brominated congeners, especially BDE-47, dominated the core, whereas nona- and deca-BDEs appeared mainly in recent sediments, indicating progressive source evolution in recent decades. Tri- to penta-BDEs remained the dominant homologue fraction throughout the record, while elevated post-2000 BDE-47/BDE-99 ratios point to congener-selective environmental fractionation during atmospheric transport and deposition. Together, these results suggest that Yamzho Yumco sediments preserve not only the history of regional PBDE input, but also the coupled imprint of source evolution, transport-related fractionation, and delayed environmental response in a remote high-altitude receptor system. This study highlights the value of Xizang Plateau Lake sediments for process-based interpretation of POP fate in mountain environments. Full article

Background and Clinical Significance: The coexistence of synchronous urologic malignancies may present diagnostic and therapeutic challenges, particularly when symptoms are minimal or nonspecific. This case illustrates the role of multimodal diagnostic correlation in identifying a second primary urologic malignancy during the evaluation of incidental PSA elevation. Case presentation: Case Presentation: We report the case of a 56-year-old male presenting with minimal lower urinary tract symptoms who underwent stepwise diagnostic evaluation including PSA (prostate specific antigen), free PSA, urinary SelectMDx RT-PCR testing (reverse transcription polymerase chain reaction), multiparametric MRI (magnetic resonance imaging), transrectal biopsy and inflammatory biomarker assessment. PSA was 17.69 ng/mL with a free PSA ratio of 6.56%. SelectMDx indicated a 90% probability of prostate cancer and a 65% risk of Gleason ≥ 7 disease. mpMRI demonstrated two suspicious lesions without extracapsular extension. Biopsy confirmed acinar adenocarcinoma Gleason 7 (3 + 4), Grade Group 2. Persistent post-biopsy hematuria led to additional imaging that revealed bladder wall thickening, and cystoscopy confirmed multifocal carcinoma in situ. Radical cystoprostatectomy with orthotopic ileal neobladder reconstruction was performed. Conclusions: This case illustrates the importance of diagnostic vigilance and multimodal correlation in a minimally symptomatic patient, particularly when persistent clinical findings are not fully explained by the initial diagnosis. The findings should be interpreted as illustrative and cannot be generalized beyond the single-case context. Full article

Post-disaster reconstruction programmes create an irreversible window for embedding or foreclosing residential energy efficiency at scale. This study examines the structural determinants of per capita residential electricity consumption (K_MES) across all 81 provinces of Türkiye over 2013–2022 using a balanced province-year panel. We develop two complementary panel models, both estimated by two-way fixed effects (province + year) with cluster-robust standard errors, and supported by GLS-AR(1) and random-effects GLS robustness checks. Note that K_MES measures the electricity component of residential energy use only; we, therefore, also estimate the building-stock model with a constructed total-energy dependent variable that combines residential electricity (H_MES) and natural-gas consumption (X_DG) in kWh-equivalent units. Model 1 isolates the macroeconomic transmission channel through which exchange-rate volatility shapes residential electricity demand. Because the USD/TRY rate has no cross-sectional variation, its identifying power in two-way fixed effects comes from its interaction with province-level natural-gas-heating exposure (sh_gas × EV_DA). The interaction is robustly negative across all full-sample specifications (β ≈ −0.022, p < 0.01), indicating that provinces with greater gas-heating penetration are buffered against currency-depreciation pass-through into electricity demand. Provincial GDP carries the dominant direct macro coefficient (β ≈ 0.27–0.29, p < 0.01), establishing income elasticity rather than the exchange rate as the headline aggregate driver. Model 2 decomposes the building stock by structural system, filler material, heating system, and heating fuel. The dominant predictors are the share of electric heating (β ≈ 1.16–1.27, p < 0.01) and the share of AC-only heating (β ≈ −1.0 to −1.13, p < 0.05), with a total-energy specification reaching R² = 0.92. In the comparative subsample of the eleven Kahramanmaraş-affected provinces, masonry construction emerges as the dominant pre-disaster predictor of per capita electricity consumption (β = 14.04, p < 0.05), revealing structurally distinct stock characteristics that pre-date the February 2023 earthquake. Two re-framings are required. First, since the panel covers 2013–2022, the disaster-province estimates capture pre-disaster structural heterogeneity rather than post-disaster market rupture. Second, the macroeconomic mechanism that prior work attributed to the exchange-rate level is more accurately understood as a fuel-mix-mediated exposure channel. The combined evidence implies that mandatory building-code enforcement and natural-gas grid extension are complementary policy levers in the 488,000-unit Turkish Housing Development Administration reconstruction programme: gas grid expansion reduces the macroeconomic vulnerability of residential energy demand, while masonry-replacement construction standards address the largest pre-disaster structural determinant of energy intensity in the affected region. Full article

Landslides cause significant casualties and economic losses worldwide each year, creating an urgent demand for rapid and reliable volume estimation during emergency response. Conventional approaches often involve trade-offs among accuracy, efficiency, and data availability, particularly when pre-event topographic data are unavailable. This study proposes a novel GIS-based method for rapid landslide volume estimation through sliding surface reconstruction. By integrating open-source geospatial data (post-landslide Digital Elevation Model and landslide boundary KML) with spline interpolation and spatial analysis, the method reconstructs the subsurface sliding surface and calculates volume by comparing this surface with the post-landslide DEM. Applied to the 2019 Shuicheng landslide (Guizhou Province, China), the method yielded a volume estimate of 1.58 × 10⁶ m³, which deviates by only ~5% from official survey data. The entire workflow can be completed within approximately one hour, demonstrating high efficiency, low operational cost, and acceptable accuracy for rapid post-disaster assessment during the critical “golden 72 h”. Full article

Orbital fractures account for up to 16% of all facial fractures. Surgical intervention for these fractures depends on several factors, including globe displacement. This case-control study aimed to quantify the effects of orbital reconstruction on the three-dimensional globe position after orbital trauma. Pre- and post-operative radiological data of 29 cases (27 patients, with two patients requiring reintervention) with an orbital fracture were analyzed. The contralateral, unaffected orbits of the same patients served as the control group. This study used a recently validated method employing semi-automatic registration algorithms to measure globe displacement after trauma and its post-operative change. The statistical analysis, performed using the Mann–Whitney U test, showed significant globe position restoration in the anterior–posterior (2.15 mm, p ≤ 0.001) and medial–lateral (1.34 mm, p ≤ 0.001) directions, as well as in overall three-dimensional Euclidean distance (3.04 mm, p = 0.014) after surgery. The repositioning was clinically relevant in 62% of the cases, indicating that the three-dimensional globe repositioning was 2 mm or more with a positive clinical impact. Additionally, it was important to note that both the number of fractured walls and fractures of the inferomedial strut significantly affected globe repositioning after trauma. This finding highlights the importance of accurately considering the fracture pattern in surgical planning, as a better understanding of globe displacement following orbital trauma could enhance patient selection, surgical planning, and clinical outcomes. Full article

Tribocorrosion is one of the main degradation mechanisms affecting metallic components exposed simultaneously to mechanical wear and electrochemical corrosion. In this work, the influence of the Nb/Ti ratio on the tribocorrosion behavior of Fe–Cr–Mo–Nb–Ti multicomponent alloys produced by vacuum arc melting was investigated. The alloys were designed through systematic variations in the relative contents of niobium and titanium to assess their effect on electrochemical stability, wear resistance, and surface degradation. Electrochemical behavior was evaluated by potentiodynamic polarization in a 3.5 wt.% NaCl solution, while tribological and tribocorrosion tests were conducted using a ball-on-disk configuration under controlled conditions. Post-test surface analysis was performed using stereomicroscopy combined with digital image processing, enabling three-dimensional topographical reconstruction of the wear tracks and extraction of quantitative parameters including groove depth, pile-up height, wear track width, and surface roughness. The results demonstrate that the Nb/Ti ratio significantly influences both electrochemical and tribological responses. The alloy with the highest Nb/Ti ratio exhibited the best overall performance, showing the lowest corrosion current density (5.37 × 10⁻⁸ A/cm²) under static conditions and the lowest wear rate (1.32 mm³/mm²·year), together with the least severe surface degradation, characterized by a groove depth of approximately 7.8 µm and minimal pile-up formation. A progressive deterioration in performance was observed as the Nb/Ti ratio decreased, with the lowest-ratio compositions presenting higher wear severity and surface instability. The AISI 316L reference material exhibited intermediate performance across all evaluated parameters. Overall, increasing the Nb/Ti ratio enhances passive film stability, reduces plastic deformation, and mitigates material removal under tribocorrosion conditions. The incorporation of three-dimensional surface analysis provides a more robust evaluation of wear mechanisms, supporting the design of multicomponent alloys with improved resistance to combined mechanical and electrochemical degradation in aggressive environments. Full article

Accurate detection and efficient loss assessment serve as critical technical foundations for disaster evaluation by agricultural insurance providers. However, existing detection methods often face limitations such as low detection accuracy and high missed detection rates when dealing with small-scale sunburn lesions in the trellis cultivation environment of kiwifruit, due to unclear texture features and severe canopy obstruction. This study proposes the YOLO-ST-OD model, an improved version of YOLOv11s, for detecting sunburned kiwifruit fruits with small targets in different complex environments. By dynamically adjusting the receptive field via the LSKNet module to achieve the precise detection of key features and suppression of background noise, and by coordinating with the multi-branch spatial and channel enhancement mechanism of the MCSEAM module to effectively compensate for feature loss caused by overlapping leaves or fruits, the system utilizes the RFAMPS module to fuse sub-pixel convolution with dynamic attention for high-fidelity spatial reconstruction. The experimental results show that the precision rate (P) of the YOLO-ST-OD model reaches 0.862, the mean average precision (mAP) reaches 0.837, and the recall rate reaches 0.818. Compared with mainstream models such as YOLOv5s, YOLOv7, YOLOv8s, YOLOv9, YOLOv10s and Faster CNN, it has better comprehensive performance in terms of precision, mAP and floating-point computation. Compared with the baseline model YOLOv11s, which achieved accuracy of 0.813, mAP of 0.752 and recall of 0.792, the YOLO-ST-OD model saw improvements of 6.03%, 8.78% and 5.68% in average accuracy, recall and mAP, respectively. The experimental results also demonstrated the robust performance of YOLO-ST-OD across varying levels of occlusion, fruit densities and imaging altitudes. This research can provide technical support for the rapid assessment of sunscald damage to kiwifruit, enabling faster post-disaster assessments and reducing costs for insurers. Full article

Although heritage reconstruction can effectively restore physical form, the regeneration of living cultural experience remains theoretically underexplored in heritage tourism scholarship. This study introduces the concept of post-reconstruction experiential disjunction (PRED)—the structural misalignment among reconstructed material form, historically embedded cultural scripts, and the embodied practices of contemporary visitors—and develops the Material–Script–Practice (MSP) framework around it. Taking Yuyuan Garden (愚园) in Nanjing as an empirical case, a mixed-methods design combines online discourse analysis, field observation, and a questionnaire survey (N = 300). Findings reveal that Cultural Script most strongly predicts disjunction mitigation—a four-item scale capturing visitors’ holistic sense of experiential connectivity (α = 0.832), followed by Material Form; Embodied Practice contributes comparatively little. Photographers show significantly lower mitigation levels than other groups, owing to structural conflicts between professional visual practice and the cultural logic of classical garden space. The MSP framework reveals a weighted hierarchy among its three dimensions: a finding that extends and empirically specifies the theoretical insights of Lefebvre’s spatial triad and Edensor’s heritage performance theory, neither of which typically foregrounds differential explanatory weight among their constituent elements. When cultural scripts offer accessible meaning pathways for visitors of diverse backgrounds, heritage spaces can move beyond formal reconstruction toward experiential reconstitution, sustaining the conditions for long-term heritage preservation. Full article

Radiotherapy simulation is essential for accurately targeting tumors while preserving healthy tissue, ensuring treatment precision and safety. This study aimed to develop an integrated radiotherapy simulation system capable of automated segmentation, dose estimation, and collision detection within a virtual planning environment to enhance efficiency and reduce costs in radiotherapy treatment planning. The Point Transformer model was applied to organ point cloud data derived from CT medical imaging for automated segmentation. Farthest point sampling (FPS) was employed to downsample the data before training. To enhance the accuracy and anatomical fidelity of the AI-generated segmentation results, reconstruction and refinement algorithms, including k-d tree, outlier removal, marching cubes, and surface smoothing, were implemented. Beam penetration simulation with the ray casting algorithm was employed for correction-based dose estimation. A collision detection module was incorporated to identify potential machine–machine or machine–patient interactions. The entire workflow was executed within a Unity 3D-based virtual simulation environment. As a result, the Point Transformer model demonstrated high segmentation accuracy, achieving Dice scores of 93.86 $\pm$ 1.50% for single-organ and 91.86 $\pm$ 3.25% for multi-organ cases, surpassing the performance of PointNet++. Applying ray casting for the refined surface meshes generated through post-processing enabled accurate dose estimation with discrepancies of 3.5% (brain), 5.9% (liver), and 13.8% (lung) compared to a Pinnacle TPS. The proposed method provides a low-cost and adaptable solution that enables easy modification and further development, making it particularly suitable for widespread applications in radiotherapy research, education, and clinical workflow optimization. Full article

This paper argues that the central thesis of Wael Hallaq’s The Impossible State is that traditional Islamic cultures as shaped by Sharīʿa did not abide by a fact-value distinction. Hallaq’s incisive account of traditional Islamic socio-political culture has relevant repercussions beyond the Islamic context from which he draws his conclusions. The importance of Hallaq’s project stems from how it reconstructs a specific tradition—Islam—to contest logics presented as modern and universal. His central argument, that the modern (Western) state is ultimately organized around a fact-value distinction, bears crucially on analyses of the historical Chinese state and its “modernization.” As this paper shows, the Chinese were the first to invent the modern bureaucratic state that Hallaq problematizes in his account of post-feudal European “modernity.” The critique that Hallaq makes of this modern bureaucratic state finds resonance throughout the millennia of Chinese history. Historically, the Confucians argued against the proponents of a similar fact-value distinction in political life—the “legalist” (fajia, 法家). Philosophically, the Confucians had conclusively won the debate against the legalists in dynastic China and the historic Chinese state and its political culture disavowed of the kind of fact-value distinction championed by the legalists. However, in contemporary times, due to the attempt by Western knowledge production to globalize the “modern” state, there has been a revival of legalism by Western scholars. This paper situates the revival within the context of Hallaq’s powerful critique, which frames the West’s attempt to globalize its political models as a form of epistemic colonization. Full article

Electric vehicles introduce new considerations for pedestrian safety because their lower operating noise at low speeds may reduce pedestrian detectability in urban traffic environments. This study proposes a simulation-based integrated active–passive pedestrian protection framework for electric vehicles by linking automatic emergency braking, active hood deployment, and post-crash head injury assessment. A total of 688 valid pedestrian–vehicle crash records from the National Highway Traffic Safety Administration database were analyzed, and 5 representative pedestrian crash scenarios were constructed through clustering-informed scenario screening and a benchmark pedestrian AEB scenario. The scenarios were reconstructed in a PreScan–Simulink co-simulation environment to evaluate a time-to-collision-based AEB strategy, while the active hood system was assessed using multi-body dynamics simulation and finite element head impact analysis. The AEB results showed that three scenarios were avoided before pedestrian contact, whereas two remained unavoidable, with residual impact speeds of approximately 31.5 km/h and 46 km/h. The hood reached a stable deployed posture within approximately 0.1 s under the modeled conditions. The HIC₁₅ results at eight selected impact points showed that speed reduction and hood deployment generally reduced head injury metrics, but full compliance with the reference HIC₁₅ threshold of 1000 was not achieved at all points. These findings suggest that the proposed strategy can improve simulated pedestrian head protection performance under selected electric vehicle crash scenarios, while further structural optimization, experimental validation, and cost–benefit assessments are still required. Full article

Cyclic superelasticity in laser powder bed fusion (LPBF)-fabricated NiTi alloys is strongly influenced by the scale of structural regulation. While conventional post-processing strategies are typically interpreted from a microstructural perspective, the distinct roles of bulk and surface regulation in governing cyclic functional response remain unclear. In this study, heat treatment and laser shock peening (LSP) are employed as representative bulk and surface regulation routes, respectively, to systematically investigate their effects on phase transformation and cyclic superelasticity. The results reveal that heat treatment and LSP operate through fundamentally different regulation modes. Heat treatment acts as a bulk regulation route, reconstructing the overall microstructure, promoting precipitation (NiTi₂ and Ni₄Ti₃), and modifying transformation pathways, which enhances recovery ratio but reduces recoverable strain. In contrast, LSP acts as a surface/subsurface regulation route, inducing gradient grain refinement and near-surface hardening while maintaining a B2-dominated matrix. As a result, the LSP-treated sample exhibits superior cyclic stability, with a stable recoverable strain of 9.93% and a superelastic strain of 5.10% after 10 cycles. These findings demonstrate that cyclic superelasticity is governed not only by phase constitution but also critically by the scale of structural regulation. This work provides a practical framework for selecting post-processing strategies to optimize functional performance in LPBF NiTi alloys. Full article

In 2023, Tropical Cyclone Freddy caused severe damage in southern Malawi, flooding much of the lowland area near Lake Chilwa and displacing many residents. This study evaluates long-term, region-specific mitigation strategies to lessen future risks, using a novel approach that combines drone and satellite data, building footprints, and 3D simulations to analyze how building elevation affects flood damage and assess Property-Level Flood Risk Adaptation measures. Results show a significant difference in ground elevation between affected and unaffected buildings, with damaged structures generally at lower levels. The 3D simulation confirmed a water-level rise of approximately 3.0 m caused by Freddy. Scenario analysis indicates that elevating buildings by 2.0, 2.5, and 3.0 m could reduce direct flood exposure and 64%, 76%, and 91% of damage, respectively. These insights can inform the development of targeted regional risk-mitigation strategies through Property-Level Flood Risk Adaptation in high-risk areas. Full article

Background: Rehabilitation of edentulous mandibles in a post-oncologic setting remains a major clinical challenge. In such situations, placement of conventional endosseous implants may be compromised by severe bone deficiency, a history of peri-implant infection, and constraints related to reconstructive soft tissues. Customized titanium subperiosteal implants, made possible by three-dimensional imaging, computer-aided design, and additive manufacturing, represent a potential alternative when conventional options are unfavorable. This case report describes a full-arch fixed rehabilitation of an edentulous mandible in a patient previously treated for squamous cell carcinoma of the floor of the mouth. Methods: A patient-specific titanium additively manufactured subperiosteal jaw implant (AMSJI) made of biocompatible titanium was designed using a digital planning workflow. Implant placement was performed in a single surgical session under general anesthesia, with fixation using osteosynthesis screws. A screw-retained full-arch provisional prosthesis was delivered intraoperatively, allowing immediate loading with adjustments aimed at avoiding compression of the healing soft tissues. Results: The patient achieved satisfactory functional and esthetic rehabilitation. Postoperative follow-up showed overall favorable mucosal tolerance; an early, limited peri-abutment mucosal dehiscence was observed and managed with suturing under local anesthesia, without compromising implant stability. Conclusions: This case highlights the clinical interest of patient-specific titanium subperiosteal implants as a fixed rehabilitation option in post-oncologic patients with major osseous and mucosal constraints and a history of reconstructive procedures. The combination of accurate digital planning and custom-made manufacturing may avoid the need for extensive bone grafting. However, these findings should be interpreted with caution due to the short-term follow-up and the inherent limitations of a single-case report, which limit the level of evidence and generalizability. Full article