Search Results (156)

Spontaneous quadriceps tendon rupture is a very rare occurrence, notably for bilateral simultaneous ruptures. Its occurrence is commonly linked to an underlying condition that may weaken the tendons leading to rupture. We report the case of a 68-year-old Caucasian male afflicted with long-term gout who presented a bilateral simultaneous quadriceps tendon rupture (BSQTR). We showcase the clinical presentation, the surgical intervention, rehabilitation program, dynamic sonographic monitoring, and home-based rehabilitation techniques of this injury, which aimed to improve activities of daily living (ADL) and quality of life (QoL). The patient was included in a 9-week post-surgical rehabilitation program and a home-based rehabilitation program with subsequent pain management and gait reacquisition. The outcome measures included right and left knee active range of motion (AROM), pain intensity measured on Visual Analogue Scale (VAS), functioning measured through ADL score, and gait assessment on Functional Ambulation Categories (FAC). All endpoints were measured at different time points, scoring significant improvement at discharge compared to baseline (e.g., AROM increased from 0 degrees to 95 degrees, while VAS decreased from 7 to 1, ADL score increased from 6 to 10, and FAC increased from 1 to 5). Moreover, some of these outcomes continued to improve after discharge, and the effects of home-based rehabilitation program and a single hip joint manipulation were assessed at 6-month follow-up. Musculoskeletal ultrasound findings showed mature tendon structure, consistent dynamic glide, and no scarring. Full article

The strength parameters of fault gouge are critical factors that influence sealing capacity and fault reactivation in underground gas storage reservoirs. This study investigates the shear characteristics of remolded fault gouge under varying hydro-mechanical conditions, focusing on the coupled influence of water content and cementation. Sixty fault gouge samples are prepared using a mineral mixture of quartz, montmorillonite, and kaolinite, with five levels of water content (10–30%) and three cementation degrees (0%, 1%, 3%). Direct shear tests are conducted under four normal stress levels (100–400 kPa), and microstructural characteristics are examined using SEM. The results show that shear strength and cohesion exhibit a non-monotonic trend with water content, increasing initially and then decreasing, while the internal friction angle decreases continuously. Higher cementation degrees not only enhance shear strength and reduce the softening effect caused by water but also shift the failure mode from ductile sliding to brittle, cliff-type rupture. Moreover, clay content is found to modulate the degree—but not the trend—of strength parameter responses to water and cementation variations. Based on the observed mechanical behavior, a semi-empirical shear strength prediction model is developed by extending the classical Mohr–Coulomb criterion with water–cementation coupling terms. The model accurately predicts cohesion and internal friction angle as functions of water content and cementation degree, achieving strong agreement with experimental results (R² = 0.8309 for training and R² = 0.8172 for testing). These findings provide a practical and interpretable framework for predicting the mechanical response of fault gouge under complex geological conditions. Full article

This study explored mycelium-based composites (MBCs) as a sustainable alternative to conventional materials, focusing on the role of lignocellulosic substrates in optimizing their physical, mechanical, and biodegradability properties. It also addressed the valorization of agroforestry by-products, particularly European hazelnut shells (HZ) and radiata pine sawdust (SW), in an effort to reduce waste and minimize environmental impacts. The MBCs were obtained using two formulations (HZ100 and HZ75-SW25) of local agroforestry by-products bound together with natural growth of fungal mycelium from Ganoderma sp. We examined the physical and mechanical properties of these novel materials, including the density, shrinkage, water absorption, hydrophobicity, moduli of rupture and elasticity, and internal bond strength. Additionally, we assessed the biodegradability of the MBCs in soil to estimate the time required for complete degradation. The results clearly indicated differences in performance between the MBCs from HZ100 and HZ75-SW25. In general, HZ75-SW25 demonstrated superior mechanical performance compared to HZ100. Water absorption was low in both cases, suggesting a degree of hydrophobicity on the surface. The biodegradation results indicated that the fabricated MBCs could fully decompose in less than one year when buried in soil, confirming that these biocomposites are entirely biodegradable. Full article

In the context of global energy scarcity, thermal insulation castables have garnered significant attention from the steel industry to reduce energy consumption. To optimize the performance of calcium hexaaluminate (CA₆)-based insulating castables, a systematic comparative study was conducted on the influence of varying amounts of calcium aluminate cement (CAC) incorporated into the castables. The results indicated that the addition of more CAC could increase the initial flowability of the castables with an air-entraining agent (AEA). Conversely, the flowability of the castables containing alumina bubbles continuously decreased after 30 min and 60 min. The apparent porosity of castables with only added AEA and alumina bubbles after being dried at 110 °C and treated at 1300 °C presented a decreasing trend as CAC content increased. Under the joint action of AEA and alumina bubbles, the amplification in porosity of castables treated at 1300 °C was positively correlated with the amount of CAC. The increase in CAC content could enhance the strength of samples, with a particularly notable improvement observed in castables prepared with the addition of AEA. For castables prepared with AEA and CAC contents of 9 wt.%, the cold modulus of rupture and cold crushing strength after heat treatment at 1300 °C were 17.5 MPa and 80.5 MPa, respectively. The thermal conductivity of castables presented non-monotonic change with the increase in CAC content. The effect of elevated CAC content on the pore fractal dimension of castables depended on the pore-forming methods. Grey correlation analysis (GCA) demonstrated that pore sizes in the range of 500–1000 nm, pore fractal dimensions, and pore sizes less than 500 nm had the highest degrees of correlation with CMOR, CCS, and thermal conductivity, respectively. Full article

Background/Objectives: Optimal activation of the quadriceps femoris, particularly the vastus medialis, while minimizing excessive activation of the vastus lateralis, is crucial for treating knee injuries like ACL ruptures and patellofemoral pain syndrome. Restoring proper muscle balance may enhance rehabilitation outcomes, but effective strategies for modulating muscle activity remain unclear. High-velocity low-amplitude hip manipulation has shown potential to influence neuromuscular function, yet its impact on quadriceps activation during knee extension has not been well studied. Therefore, the main aim of this study is to examine the effects of a single session of high-velocity low-amplitude hip manipulation on quadriceps femoris muscle activation and maximum voluntary contraction during knee extension. Methods: This study utilizes a randomized controlled design. Thirty physically active men and women (mean age: 21.9 ± 1.7 years) were randomly assigned to either an experimental group (n = 15; receiving hip joint manipulation) or a control group (n = 15; undergoing a sham intervention). Participants in the intervention group received a treatment involving hip manipulation and short-duration traction. Muscle activity of the rectus femoris, vastus lateralis, and vastus medialis was assessed using surface electromyography before and after the intervention, while muscle performance was measured by evaluating isometric knee extension strength in the lower limb. The isometric strength test was conducted in a seated position with the knee flexed at 60 degrees in Biodex System 4. Results: This study finds that the experimental group had significantly higher vastus lateralis mean amplitude (p = 0.020; effect size = 0.186) and vastus medialis mean amplitude (p < 0.001; effect size = 0.577) of electromyography root mean square electromyography compared to the control group. The experimental group also showed greater vastus medialis max amplitude (p < 0.001; effect size = 0.435). No significant differences were noted for rectus femoris mean amplitude (p = 0.078; effect size = 0.110), vastus lateralis max amplitude (p = 0.363; effect size = 0.031), rectus femoris max amplitude (p = 0.069; effect size = 0.117), or median frequency of the raw electromyography signal across muscle groups. Conclusions: In conclusion, high-velocity low-amplitude hip manipulation significantly enhances vastus medialis activation, highlighting its potential to improve quadriceps balance. These findings support the incorporation of hip manipulation into rehabilitation protocols. Full article

Introduction: Hereditary transthyretin amyloidosis (ATTRv) is a severe, multisystemic, autosomal dominant disease with variable penetrance caused by mutations in the TTR gene generating protein misfolding and accumulation of amyloid fibrils. The diagnosis is usually challenging because ATTRv may initially manifest with nonspecific multisystemic symptoms. Conversely, an early diagnosis is needed to start timely appropriate therapy. Hence, screening models have been proposed to improve ATTRv diagnosis. In this study, we propose a genetic screening model based on predefined “red flags” followed by “cascading screening” on first-degree relatives of patients who tested positive. Materials and methods: After obtaining written informed consent, genetic testing on salivary swabs was performed in individuals who met at least two major red flags for ATTRv (age > 65 years old, progressive sensory or sensorimotor neuropathy not responsive to steroids or immunomodulant therapies, recent and unexplained weight loss associated with gastrointestinal signs and symptoms, diagnosis of cardiac amyloidosis, bilateral or relapsing carpal tunnel syndrome, unexplained autonomic dysfunction) or one major flag and two minor flags (family history of neuropathy, ambulation disorders or cardiopathy, sudden cardiac death, a bedridden, wheelchaired patient without specific diagnosis excluding upper motor neuron diseases, infections, juvenile cardiac disease, ocular disorders, lumbar spine stenosis, biceps tendon rupture). Results: In the first screening phase, 29 suspected cases (individuals meeting at least two major red flags or one major red flag and two minor red flags) underwent genetic testing. One patient (3.5%) was diagnosed with hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN), carrying the Phe64Leu mutation. Then, cascade screening allowed for early recognition of two additional individuals (two pre-symptomatic carriers) among two first-degree relatives (100%). The identified patient was a 72-year-old man who had a family history of both cardiopathy, neuropathy, and a diagnosis of juvenile cardiac disease and progressive sensorimotor neuropathy unresponsive to steroids or immunomodulant therapies. Conclusions: ATTRv is a progressive and often fatal disease that should be promptly diagnosed and treated to stop progression and reduce mortality. Systematic screening for ATTRv yielded increased recognition of the disease in our neurological clinic. A focused approach for the screening of ATTRv-PN could lead to an earlier diagnosis and identification of asymptomatic carriers, enabling timely intervention through close clinical monitoring and early treatment initiation at symptom onset. Full article

Two large earthquakes with a series of aftershocks struck southeastern Türkiye within 9 h and had catastrophic consequences. Following the earthquake doublet, 11 provinces corresponding to approximately 1/7 of Türkiye were declared disaster zones. Even though the epicenters of the first event and second mainshocks were in Pazarcik and Elbistan with a magnitude ($M_w$) of 7.7 and 7.6 with over 500 km of multiple-fault ruptures, Hatay province was the most heavily damaged province and had the highest number of casualties and collapsed buildings. A densely deployed strong ground motion array of the Disaster and Emergency Management Presidency of Turkey (AFAD) recorded the earthquake doublet of the two consequent mainshocks, including ground motions exhibiting near-fault features. A suite of recorded ground motions in Hatay province is incorporated to examine the destructiveness of ground motions on reinforced concrete Moment-Resisting Frame buildings and the effectiveness of seismic isolation technology to reduce the observed damage. Moreover, Turkish Seismic Design Code-2018 code provisions are elaborated to determine the characteristics of the investigated structures. Nonlinear response history analyses were conducted for 24 types of structures by following the design provisions. The inelastic hysteretic response features in the fixed-base and isolation systems are represented through an inelastic Single-Degree-of-Freedom Bouc–Wen hysteretic model. Extreme characteristics of near-fault ground motions on RC structures and seismically isolated systems resulted in excessive drift and displacement demands. Roof drifts of reinforced concrete Moment-Resisting-Frame buildings exceeded 4% roof drift in mid-rise buildings, compatible with the field observations in Antakya city center, where the displacement demand and ultimate base shear coefficient of seismically isolated structures considered in this study exceeded the elastic spectral coefficient values of the design spectrum in the proximity of fault ruptures. Full article

Introduction: Aneurysms of brain vessels are life-threatening conditions with various adverse outcomes, some stemming from microsurgical intervention, particularly when major vessel perforators are inadequately protected. The use of endoscopes enhances the approach to aneurysms by providing closer visualization (180–360 degrees) of the local anatomy, potentially reducing accidental damage. To improve visualization and efficiency, a microscope-integrated 45-degree angled microinspection endoscopic tool (QEVO^®, Carl Zeiss, Oberkochen^TM) has been developed and employed in various neurosurgical procedures. Methods: Between 2021 and 2025, 27 brain aneurysms were treated with QEVO^® assistance at the Department of Neurosurgery, Clinical Center of the University of Sarajevo. The choice of the videos corresponds to the best image quality in videos and on the microscopic determination of adjacent vessel perforators, which were not adequately seen purely by the surgical microscope in specific cases. Exclusion criteria included cases without a need for QEVO^® assistance in perforator visualization, severe brain edema, intraoperative aneurysm rupture, posterior circulation, or low video quality. Results: Case 1 demonstrates an anterior choroidal artery (AchA) aneurysm; Case 2 presents an anterior communicating artery (AcommA) aneurysm; and Case 3 features contralateral middle cerebral artery (MCA) microsurgical clipping with QEVO^® assistance. Conclusions: The QEVO^® tool significantly improves the visualization of aneurysm–perforator relationships, increasing the likelihood of preserving perforators during standard microsurgical clipping. This innovative approach may reduce surgical complications and enhance patient outcomes, highlighting the tool’s potential as an adjunct in aneurysm microsurgery. Full article

The application of light-emitting diode (LED)-dependent photobiomodulation (PBM) in promoting post-tendon injury healing has been recently reported. Despite establishing a theoretical basis for ligament restoration through PBM, identifying effective LED wavelength combinations and ensuring safety in animal models remain unresolved challenges. In our previous study, we demonstrated that combined irradiation at 630 nm and 880 nm promotes cell proliferation and migration, which are critical processes during the early stage of tendon healing in human-derived tendon fibroblasts. Based on this, we hypothesized that 630/880 nm LED-based PBM might promote rapid healing during the initial phase of tendon healing, and we aimed to analyze the results after PBM treatment in a murine model. Migration kinetics were analyzed at two specific wavelengths: 630 and 880 nm. The Achilles tendon in the hind limbs of Balb/c mice was severed by Achilles tendon transection. Subsequently, the mice were randomized into LED non-irradiation and LED irradiation groups. Mice with intact tendons were employed as healthy controls. The total number of mice was 13 for the healthy and injured groups and 14 for the LED-irradiated injured group, and the data presented in this manuscript were obtained from one representative experiment (n = 4–5 per group). The wounds were LED-irradiated for 20 min daily for two days. Histological properties, tendon healing mediators, and inflammatory mediators were screened on day 14. The roundness of the nuclei and fiber structure, indicating the degree of infiltrated inflammatory cells and severity of fiber fragmentation, respectively, were lower in the LED irradiation group than in the LED non-irradiation group. Immunohistochemical analysis depicted an increase in tenocytes (SCX⁺ cells) and recovery of wounds with reduced fibrosis (lower collagen 3 and TGF-β1) in the LED irradiation group during healing; conversely, the LED non-irradiation group exhibited tissue fibrosis. Overall, the ratio of M2 macrophages to total macrophages in the LED irradiation group was higher than that in the injured group. LED-based PBM in the Achilles tendon rupture murine model facilitated a rapid restoration of histological and immunochemical outcomes. These findings suggest that LED-based PBM presents remarkable potential as an adjunct therapeutic approach for tendon healing and warrants further research to standardize various parameters to advance and establish it as a reliable treatment regimen. Full article

This study investigates the dynamic amplification effect of the main girder of cable-stayed bridges after cable rupture. The expression for the dynamic amplification effect is derived using the modal superposition method, and the influence of the duration of cable rupture on the dynamic amplification effect is investigated. The results indicate that, for a single-degree-of-freedom (SDOF) system without damping, the displacement dynamic amplification factor (DAF) can reach a maximum of 2.0. For the main girder of cable-stayed bridges, the dynamic amplification factor can exceed 2.0 and is related to the weight of the projection components of the response on the mode shapes. Using the modal superposition method of calculation, the higher-order modes have the greatest influence on shear force, followed by the bending moment, while they have the least influence on displacement. The theoretical derivation is validated using a simplified model, and it is shown that the commonly used equivalent static load calculation method with a factor of 2.0 for the static cable force poses potential safety risks. Furthermore, this study shows that the shorter the duration of cable rupture, the more pronounced the dynamic amplification effect. It is recommended that the duration of the cable rupture should not exceed 0.01 times the fundamental period of the structure when the maximum impact effect is calculated to ensure the rationality of the calculation results. Full article

Tunnels crossing active faults frequently experience simultaneous exposure to fault dislocation and seismic action during operation. To study the damage behavior of tunnels under the combined effects of fault dislocation and seismic action, a three-dimensional nonlinear finite element model was established. This model simulates fault dislocation superimposed on seismic action in the context of tunnel engineering through active faults. The main conclusions are as follows: (1) The acceleration amplification phenomenon occurs in the tunnels after the superposition of seismic action; at the same time, the degree and scope of tunnel damage increase significantly, in which the increase in tensile damage is more significant. (2) The initial damage from fault dislocation worsens tunnel damage under seismic action, as evidenced by the energy dissipation characteristics. (3) As the initial fault displacement and peak seismic acceleration increase, the extent of lining damage also increases. Notably, compressive damage to the lining is symmetrically distributed along the fault plane, whereas tensile damage is significantly more severe within the fault rupture zone. (4) Even moderate earthquakes can cause severe damage to tunnels crossing active faults. Therefore, tunnel construction in these areas must include disaster prevention and mitigation strategies. Full article

Background/Objectives: While neonatal morbidities associated with early preterm birth are known, the risks of maternal morbidities in these births remain unclear. Thus, we set out to assess the risk of maternal morbidities associated with early preterm births. Methods: Retrospective cohort study utilizing the United States (US) Natality Live Birth database from the Centers for Disease Control and Prevention (2016–2021). Low-risk singleton pregnancies were included. High-risk conditions such as out-of-hospital births, fetal anomalies, pregestational and gestational diabetes, and hypertensive disorders of pregnancy were excluded. The rates of several maternal morbidities were compared among three gestational age at birth groups: 23 0/7–27 6/7 (i.e., extreme preterm), 28 0/7–33 6/7 (i.e., early preterm), and 37 0/7–41 6/7 (i.e., term, reference group) weeks. Multivariable logistic regression was used to adjust outcomes for potential confounders. Data were presented as adjusted odds ratios (aORs) with a 95% confidence interval (CI). Results: 18,797,394 live births were analyzed. Extreme and early preterm birth were associated with increased odds of maternal transfusion (aOR 3.32, 95% CI 3.13–3.53 and aOR 2.96, 95% CI 2.86–3.07), uterine rupture (aOR 3.75, 95% CI 3.14–4.48 and aOR 4.13, 95% CI 3.76–4.54), unplanned hysterectomy (aOR 5.60, 95% CI 4.85–6.48 and aOR 5.92, 95% CI 5.47–6.40), and maternal admission to the intensive care unit (ICU, aOR 10.58, 95% CI 9.97–11.54 and aOR 10.13, 95% CI 9.77–10.50) compared to term birth. The odds of third- or fourth-degree perineal lacerations were decreased in both preterm birth groups compared to term birth. Conclusions: In addition to the known prematurity-related neonatal morbidities, extreme and early preterm births also impose a risk for maternal morbidities. Higher odds of maternal transfusion, uterine rupture, unplanned hysterectomy, and maternal admission to the ICU were detected in our cohort. These data should be taken into consideration when caring for patients with preterm births. Full article

Seismic risk expresses the expected degree of damage and loss following a catastrophic event. An efficient tool for assessing the seismic risk of embankments is fragility curves. This research investigates the influence of embankment’s geometry, the depth of rupture occurrence, and the underlying sandy soil’s conditions on the embankment’s fragility. To achieve this, the response of three highway embankments resting on sandy soil was examined through quasi-static parametric numerical analyses. For the establishment of fragility curves, a cumulative lognormal probability distribution function was used. The maximum vertical displacement of the embankments’ external surface and the fault displacement were considered as the damage indicator and the intensity measure, respectively. Damage levels were categorized into three qualitative thresholds: minor, moderate, and extensive. All fragility curves were generated for normal and reverse faults, as well as the combination of those fault types (dip-slip fault). Finally, the proposed curves were verified via their comparison with those provided by HAZUS. It was concluded that embankment geometry and depth of fault rupture appearance do not significantly affect fragility, as exceedance probabilities show minimal differences (<4%). However, an embankment founded on dense sandy soil reveals slightly higher fragility compared to the one founded on loose sand. Differences regarding the probability of exceedance of a certain damage level are restricted by a maximum of 7%. Full article

Background: Cranial cruciate ligament rupture is a common orthopedic condition in dogs. Tibial plateau leveling osteotomy (TPLO) is a widely accepted method due to its success in stabilizing the stifle joint. This study aims to investigate the changes in the TPA over a 12-month follow-up period in dogs undergoing TPLO. Methods: An analysis of medical records from 60 dogs, aged 2 to 8 years and weighing between 7 and 59 kg, who underwent the TPLO procedure was conducted. TPA measurements were recorded before surgery, immediately after surgery, and during follow-up periods at 8 weeks, 6 months, and 12 months post-operation. Results: Results showed a consistent increase in TPA over time, with the mean TPA rising from 4.98 degrees immediately post-surgery to 9.02 degrees at the 12-month follow-up. No patients exhibited a decrease in TPA during the study period. The mean difference between the final and initial TPA was 4.045 degrees, with patients exhibiting smaller initial TPAs showing less variation over time; Conclusions: This is the first report on long-term TPA changes following TPLO, offering essential insights into tibial remodeling and the potential for optimizing surgical outcomes. Based on the results, achieving a lower initial TPA (1–2 degrees) may reduce postoperative TPA changes, supporting more stable stifle function. Full article

A simple and innovative method was introduced for the production of green and recoverable flame-retardant cotton fabrics, where sulfonated cotton fabric (COT-SC) was synthesized by oxidizing cotton fabric with sodium periodate, followed by a sulfonation step with sodium bisulfite to provide active sites, which further chelated barium ions (Ba²⁺) to achieve flame retardancy. The morphological and structural characterizations of the fabricated cotton fabrics (COT-SC-Ba) demonstrated that the cleavage of C₂-C₃ free hydroxy groups within the cellulose macromolecule was chemically modified for grafting a considerable number of sulfonic acid groups, and Ba²⁺ ions were effectively immobilized on the macromolecule of the cotton fabric through a chelation effect. Results from cone calorimeter tests (CCTs) revealed that COT-SC-Ba became nonflammable, displayed a delayed ignition time, and decreased the values of the heat release rate (HRR), total smoke release (TSR), effective heat of combustion (EHC), and CO/CO₂ ratio. TG/DTG analysis demonstrated that COT-SC-Ba possessed greater thermal stability, fewer flammable volatiles, and more of a char layer during burning than that of the original cotton fabric. Its residual mass was increased from 0.02% to 26.9% in air and from 8.05% to 26.76% in N₂, respectively. The COT-SC-Ba not only possessed a limiting oxygen index (LOI) of up to 34.4% but could also undergo vertical burning tests evidenced by results such as the non-afterflame, non-afterglow, and a mere 75 mm char length. Those results demonstrated that the combination of SO₃⁻ and Ba²⁺ promoted the formation of a char layer. Moreover, cotton fabric regained its superior flame retardancy after being washed and re-chelated with Ba²⁺. Additional characteristics of the cotton fabric, such as the rupture strength, white degree, and hygroscopicity, were maintained at an acceptable level. In conclusion, this research can offer a fresh perspective on the design and development of straightforward, efficient, eco-friendly, and recoverable fire-retardant fabrics. Full article