Search Results (345)

Three-dimensional printing (3DP) has gained increasing attention in construction as a means of addressing labor shortages and improving efficiency. Various studies have investigated fiber-reinforced mortars for 3DP. However, only a few studies have examined mixture design strategies aimed at controlling early structural build-up, and the relationships between early structural build-up, printability, and interlayer stability remain largely unexplored. This study aimed to establish a practical method for evaluating the static yield stress and early buildability of 3DP mortars under construction-site conditions. Vane shear and 15-stroke flow tests were conducted to assess the static and dynamic behavior of mortars incorporating polyvinyl alcohol (PVA) fibers, and their compressive and flexural strengths were also evaluated. According to the results, the vane shear test sensitively captured the rheological changes associated with variations in fiber content and superplasticizer dosage. The addition of PVA fibers increased the maximum shear stress of the mortar, resulting in atypical static yield stress development compared to fiber-free mortars. While the 15-stroke flow test further elucidated flowability, the vane shear test revealed a stronger correlation between mechanical properties and overall buildability. Thus, vane shear testing can be reliably used to assess early-age structural build-up and interlayer stability in 3DP mortars for optimizing print performance. Full article

Background/Objectives: Demineralization around orthodontic brackets may compromise enamel integrity and alter the mechanical stability of the bracket–adhesive–enamel interface, thereby influencing bond performance and clinical outcomes. This study aimed to evaluate the effect of enamel demineralization on the fatigue-based shear bond strength (SBS) of different orthodontic brackets. Methods: Seventy-five extracted maxillary premolars subjected to demineralization were allocated into five groups (n = 15 per group). Victory metal (Group 1), APC Clarity Advanced ceramic (Group 2), Clarity Self-ligating ceramic (Group 3), Gemini metal (Group 4), and Clarity Advanced ceramic (Group 5) brackets were bonded to the tooth surfaces using Transbond XT (3M Unitek, Monrovia, CA, USA). The mean demineralization values of the specimens were recorded before demineralization (T0) and after exposure to an artificial cariogenic environment (T1). Fatigue-based SBS was evaluated under cyclic loading (10 N, 0.5 Hz) at a crosshead speed of 300 mm/min using a closed-loop controlled, low-cycle fatigue testing machine and expressed as the number of shear strokes to failure. The level of statistical significance was set at p < 0.05. Results: No significant differences in demineralization were observed among the groups at T0 (p > 0.05); however, all groups showed significant increases at T1 (p < 0.05), with Group 1 demonstrating significantly lower demineralization than the other groups (p < 0.05). Fatigue-based SBS was higher in Groups 1, 3, and 5 than in Groups 2 and 4, as indicated by a greater number of shear strokes to failure (p < 0.05). In Groups 2 and 4, a statistically significant negative correlation was observed between changes in enamel demineralization and the number of shear strokes to failure (p < 0.05). No hard tissue damage was observed in Group 5 during fatigue testing. Conclusions: Increased demineralization may adversely affect fatigue-based SBS and increase the risk of hard tissue damage. Under plaque-related demineralization conditions, Victory metal and Clarity Advanced ceramic brackets may demonstrate more favorable fatigue bond behavior; however, further in vitro and in vivo studies are required to confirm these findings. Full article

Stroke and brain cancer are severe disorders of the central nervous system (CNS) associated with high morbidity and mortality. Although each condition has been extensively studied individually, growing evidence suggests that cerebrovascular injury may influence the development of brain malignancies. This narrative review synthesizes current experimental, clinical, and epidemiological data supporting a mechanistic link between stroke and brain cancer, with a particular focus on blood–brain barrier (BBB) dysfunction. We discuss how stroke-induced hypoxia, oxidative stress, and neuroinflammation disrupt BBB integrity, promote endothelial activation, and induce the expression of adhesion molecules that facilitate arrest, extravasation, and survival of circulating tumor cells within the CNS. Additionally, post-stroke regenerative signaling, angiogenesis, and immune modulation may contribute to the formation of a permissive microenvironment that supports tumor initiation and metastatic growth. Available epidemiological studies, clinical observations, and case reports are reviewed to evaluate the strength and limitations of the association between cerebrovascular events and subsequent brain cancer. Although the co-occurrence of stroke and brain cancer remains relatively uncommon, elucidating the shared molecular and cellular mechanisms underlying this relationship can improve risk stratification and allow the development of diagnostic and therapeutic strategies aimed at preserving BBB integrity and reducing long-term oncological complications after stroke. Full article

Background: Plasma fibrinogen (FIB) levels exhibit a significant elevation during the acute phase of ischemic stroke (IS), and their dynamic fluctuations serve as important biomarkers for stroke onset, disease progression, and long-term prognosis. Tong-Qiao-Huo-Xue Decoction (TQHXD) is highly effective in treating blood stasis syndromes affecting the head and face. Nevertheless, the association between TQHXD and FIB in the underlying mechanism of treating IS warrants further investigation. Methods: Proteomics analysis predicted the potential therapeutic targets of TQHXD for IS. An in vivo model of middle cerebral artery occlusion followed by reperfusion (MCAO/R) was created in mice. To explore the interaction between FIB and NLRP3, as well as to verify the particular healing outcomes of TQHXD. Results: An increased blood–brain barrier (BBB) permeability was observed after MCAO/R, accompanied by substantial accumulation of FIB in the brain. In vivo experiments demonstrated that FIB triggered the activation of the NLRP3 inflammasome in microglia. Proteomic analysis revealed a significant increase in FIB levels following model induction, which were markedly reduced after treatment with TQHXD; KEGG pathway enrichment analysis indicated that these changes were primarily associated with the NOD-like receptor signaling pathway. Laser speckle contrast imaging showed that TQHXD treatment significantly improved cerebral blood flow and attenuated brain injury in mice. Fluorescence imaging, ELISA, and Western blotting results collectively demonstrated that TQHXD effectively reduced FIB accumulation and suppressed NLRP3 inflammasome activation. MD and pull-down experiments further demonstrated a strong interaction strength between FIB and NLRP3. Conclusions: FIB accumulates in the ischemic penumbra following CIRI, while TQHXD can effectively down-regulate FIB expression and inhibit NLRP3 inflammasome activation to mitigate CIRI. These findings provide a novel theoretical foundation and treatment direction for stroke management in clinical settings. Full article

Background/Objectives: The impact of stroke on upper extremity function in the older adult population underscores the need for accurate recovery prediction. Motor evoked potential (MEP) has been explored as a predictor of upper extremity function recovery in patients with stroke. However, research specifically targeting the geriatric population remains limited. Therefore, this study focused specifically on patients aged 65 years and older to investigate correlations between MEP parameters and upper extremity function. This study investigates correlations between MEP parameters (amplitude and latency) and upper extremity function-related measures, including Medical Research Council (MRC) scale, the Korean version of the Modified Barthel Index (K-MBI), and the Hand Function Test (HFT), including grip strength, pinch strength, the Box and Block Test, and the 9-Hole Peg Test, in older adults with stroke. Methods: A multiple linear regression model predicts upper extremity outcomes using initial MEP parameters, time, and function. The dataset includes 90 patients with stroke categorized by timing of the first MEP assessment: ≤3 months (n = 42) or >3 months (n = 48). Results: MEP amplitude and latency were significantly correlated with upper extremity function in both groups. No significant correlations were found between MEP amplitude or latency and outcome measures. Regression analysis showed that initial MEP amplitude had a limited association with outcomes, whereas latency was significantly associated with grip strength (β: −10.205, 95% CI: −19.374~−1.036) and the Box and Block Test (β: −10.204, 95% CI: −20.254~−0.154). Initial upper extremity parameters were significantly associated with K-MBI and HFT follow-up results (p < 0.05). Conclusions: Larger MEP amplitude and faster initial MEP latency were associated with improved upper extremity function in patients with stroke. In older patients, MEP latency, rather than amplitude, demonstrated greater predictive value for upper extremity function recovery, possibly due to age-related muscle atrophy, a factor not fully addressed in existing prognostic frameworks such as PREP2. These findings support the integration of MEP latency assessment into geriatric stroke prognostication, complementing existing frameworks such as PREP2, and may guide personalized rehabilitation planning to optimize functional recovery and independence. Full article

Concrete 3D printing technology is emerging as a new way to transform the construction industry in the future. However, the existing concrete 3D printing technology still has different degrees of defects in the print molding process. The existing concrete 3D nozzles need to undergo a long motion trajectory when printing complex curved components, which leads to lower geometric accuracy of curved structures, as well as poorer overall molding quality of the printed components. The aim of this study is to design a reducer nozzle to effectively shorten the printing stroke and thus improve the printing accuracy. A reducing nozzle is proposed with multi-gear internal meshing and a rotating blade structure nozzle with an adjustable outlet caliber. The mechanical strength of the rotating blade of the nozzle and the distribution characteristics of the flow field inside the nozzle are verified through fluid–solid coupling analysis. Experimental comparison shows that compared with the existing concrete 3D printing nozzle, the variable-caliber nozzle significantly improves the surface quality of the specimen, which strongly promotes the practical application and development of concrete 3D printing technology in the engineering field. Full article

Background: This systematic review aims to identify modifiable and non-modifiable predictors of exercise capacity (VO₂peak level or change) in stroke survivors. These insights may further optimize rehabilitation treatment and improve long-term health outcomes. Methods: PubMed (PubMed.gov), EMBASE (Elsevier), CINAHL (EBSCO), and Web of Science (Clarivate) were searched (last search on 7 October 2025). Inclusion criteria were: (1) adults (>18 years) who survived a stroke (ischemic and hemorrhagic), (2) outcome was a measurement of maximum exercise capacity (VO₂peak) measured with CPET (or equivalent), (3) predictors of exercise capacity were measured (e.g., personal factors, disease-related factors, components of rehabilitation), (4) predictors of exercise capacity were analyzed in multivariate regression models, (5) primary research, and (6) full-text available. During the data extraction phase, predictors were categorized into modifiable and non-modifiable predictors. Risk of bias was assessed with the McMaster Critical Review Form for Quantitative Studies. Results: Of 919 unique articles, seventeen were included. Modifiable factors such as BMI (4/8 articles) and fat mass (1/1), lower limb strength (3/3), cardiorespiratory fitness (e.g., baseline VO₂peak (2/4)), training intensity (2/2) and perceived fatigue (1/1) significantly predicted VO₂peak (level or change). Significant non-modifiable predictors were age (3/11), sex (1/8), diabetes (1/2), and stroke-specific (4/8) factors. Conclusions: This systematic review highlights the significant role of modifiable and non-modifiable predictors in optimizing exercise capacity (VO₂peak) for stroke survivors. In addition, considering modifiable and non-modifiable predictors allows for more personalized treatment planning. The findings can guide healthcare professionals in tailoring rehabilitation programs, though further research is needed to develop a comprehensive prediction model. Full article

Stroke often results in impaired hand motor function, making effective hand rehabilitation essential for restoring activities of daily living (ADLs). Motor rehabilitation and neurorehabilitation are two major pathways to functional recovery. Rehabilitation gloves have proven to be effective tools for motor rehabilitation, and among them, soft robotic gloves (SRGs) have emerged as a research focus due to their lightweight design and inherent safety. Functional electrical stimulation (FES), which applies electrical currents to muscles and nerves, shows promise in promoting motor neural reorganization and restoring muscle strength in the hands of stroke survivors. The technologies applied to hand rehabilitation must possess the characteristics of safety, comfort, and practicality, while overcoming critical challenges such as portability, user-friendliness, and wearability. Motivated by the rehabilitation needs of post-stroke patients, this paper reviews recent advances in SRGs, FES, and hybrid hand rehabilitation systems (HHRSs) for hand rehabilitation, systematically examining progress in actuation strategies, intention sensing, and control algorithms across these three technologies. Furthermore, the limitations and technical challenges of current HHRSs are analyzed and four key future research directions are identified to pave the way for further development in this field. Full article

Background: Chronic post-stroke spasticity often limits gait despite best-practice botulinum-toxin intramuscular injections (BTIs), whose benefit is constrained by short duration, dose ceilings, and tachyphylaxis. Cryoneurolysis (CNL) induces a reversible axonotmesis with preserved endoneurium, potentially providing longer tone reduction with fewer adverse effects, but its impact on whole-gait quality and its compatibility with implanted functional electrical stimulation (FES) remain poorly documented. Case presentation: A 43-year-old man, 12 years after right middle cerebral artery stroke, walked independently with an implanted common peroneal FES system but complained of effortful gait with left-knee “locking” and drop foot without FES. Multiple BTI series to triceps surae and quadriceps yielded only transient benefit. Two ultrasound-guided CNL sessions targeted tibial (soleus, medial gastrocnemius) and femoral (rectus femoris, vastus intermedius) motor branches. Quantitative gait analysis and fine-wire electromyography (EMG) were performed at baseline, 6 weeks after each CNL, and at 6 months, with and without FES. CNL produced immediate and sustained reductions in triceps surae and quadriceps overactivity, resolution of genu recurvatum, normalization of stiff-knee gait, improved ankle dorsiflexion, and increased swing phase knee flexion (>50°). Gait Deviation Index rose from 69 to 80 and Gillette Gait Index decreased by more than 50%, with preserved strength and without adverse events. Conclusions: Targeted, sequential CNL of tibial and femoral motor branches can safely deliver durable, clinically meaningful gait improvements when BTI has reached its ceiling and can act synergistically with implanted FES. Quantitative gait analysis and EMG sharpen clinical decision-making in spasticity management. Full article

The selection of a final operating point from a Pareto front set of marine diesel engine configurations relies on the critical task of translating operator priorities into quantitative criterion weights. This study isolates this pivotal weighting step and introduces an operator-defined fuzzy weighting module that maps linguistic importance ratings to normalized weights. This module systematically maps important ratings for Specific Fuel Consumption (SFC), Nitrogen Oxides (NOx), and Particulate Matter (PM) into a set of normalized weights for the Multi-Criteria Decision-Making method. The module’s core is a Mamdani-type fuzzy logic module that utilizes triangular membership functions and centroid defuzzification. These fuzzy weights are integrated with the TriMetric Fusion algorithm to generate a robust consensus ranking. Validation on a Pareto front from a two-stroke diesel engine demonstrates the framework’s efficacy: a Fuel-Economy priority selected a configuration with SFC advantage, while a Strict Environmental Compliance priority correctly identified dual emissions strengths. Furthermore, the system effectively mediated trade-offs in a high-competition scenario. Rank correlation analysis confirmed that while the Pareto front nature of the alternatives leads to inherent similarities in rankings, the fuzzy weights induce significant and logical divergences. Future work will focus on validation with real operator feedback and comparative studies with traditional weighting methods. Full article

Background: Stroke is the leading cause of physical disability in adults in Catalonia. Despite this, there is a lack of evidence of physiotherapy interventions on functional capacity during the chronic phase of the pathology. This multicenter clinical trial will be conducted with a sample size of 75 participants. Objectives: The objective of the study is to evaluate the effectiveness of a therapeutic exercise program in physiotherapy using telerehabilitation to optimize functional recovery and quality of life in people with chronic stroke, and to determine its impact on adherence to the exercise program. Methods: This is a multicenter randomized controlled trial. Three parallel groups will be compared, and two will undergo the same type of therapy. A control group (CG) will perform conventional intervention in primary care. There will be two experimental groups; (EG1) will perform document-guided therapeutic exercises at home and (EG2) will perform therapeutic exercises at home guided by a telerehabilitation program. The outcomes to be measured are degree of independence of a person in their activities of daily living, assessed by the Barthel Index, motor function, muscle tone of the affected limbs, muscle strength of the affected limbs, balance, gait efficiency, perception of musculoskeletal pain, perception of fatigue, risk of falls, perception of quality of life, and the perception of perceived subjective change after treatment. These outcomes will be evaluated at baseline (T0), at ten weeks (T1) (end of the intervention), and at 18 weeks (T2). The study duration per patient will be 18 weeks (a ten-week intervention, followed by an eight-week intervention follow-up). The analysis will be performed using a mixed linear model (ANOVA 3X3) and significance level p < 0.05. Full article

Lightning strikes are a major cause of wind turbine (WT) damage, with approximately 80% of cloud-to-ground lightning strikes exhibiting a multi-stroke characteristic. Therefore, studying the transient overvoltages induced by multiple lightning strokes is essential for the effective lightning protection of offshore WTs. Firstly, a multiple-stroke lightning current model representative of Guangdong Province, China, is established based on data from the lightning location system and rocket-triggered lightning experiments. Simulations are then employed to analyze the transient overvoltage of a Guangdong offshore wind farm under multiple lightning strikes. Simulation results indicate that when a WT is subjected to a two-stroke lightning flash, with current amplitudes corresponding to a cumulative probability density of approximately 1%, the surge arrester A1 must be configured with four parallel columns to ensure the insulation safety of the equipment without sustaining damage. Additionally, adequate electrical clearance must be maintained between the power cable and the tower wall, or alternatively, a high-strength insulating material may be applied over the cable armor to prevent flashover. Moreover, it is observed that the front time of the impulse current flowing through the surge arrester is approximately 2 μs, significantly shorter than the front time specified in IEC 60099-4 for the repetitive charge transfer capability test of ZnO varistors. Hence, it is essential to consider local lightning intensity and distribution characteristics when studying the transient overvoltages in offshore wind farms, optimizing surge arrester configurations, and assessing the impulse withstand performance of ZnO varistors, in order to ensure the safe and stable operation of offshore WTs. Full article

Elite 50 m freestyle performance demands targeted interventions for events that may be decided by hundredths of a second. This case study assesses the effectiveness of an individualised in-water resistance training intervention informed by load–velocity (LV) profiling in both profiling metrics and competitive performance, while documenting the training characteristics of an elite 50 m freestyle swimmer (male, 24.8 years) over the 18 months culminating in the Paris 2024 Olympic Games. A coach-led, six-week resisted-swim intervention involved three sessions per week with prescribed velocity-decrement zones targeting technical development, speed-strength, and power while preserving the swimmer’s race stroke rate. Post-intervention LV outputs showed likely improvements in maximal swim speed, of +3.4% and theoretical maximal load, of +13.6%, and competition time improved by 1.3% with a 3.5% improvement in free swimming time (15–45 m). Although limited to a single-athlete design, the observed improvements suggest that individualised, LV-informed resisted swimming using accessible equipment may contribute to enhancements in sprint swimming performance. Full article

Background/Objectives: While strength training interventions improve walking performance in stroke survivors, the underlying neuromuscular mechanisms remain poorly understood. This study investigated muscle-level adaptations following a 12-week moderate-to-high-intensity strength training program in ten chronic stroke survivors using comprehensive musculoskeletal modeling analysis. Methods: Three-dimensional gait analysis was performed pre- and post-intervention, with subject-specific OpenSim models estimating individual muscle forces, powers, and work capacities throughout stance phase. Results: Non-paretic hip flexor negative work capacity increased significantly (0.033 to 0.042 J/kg, p = 0.033, Cohen’s d = 0.47), driven by enhanced rectus femoris power absorption during late stance that mechanistically facilitated trunk acceleration through leg deceleration. Knee extensor force generation showed increasing trends during loading response in both limbs. During push-off, ankle plantar flexor force generation showed trends toward bilateral improvements, primarily through paretic soleus and gastrocnemius contributions, though power output remained unchanged, indicating persistent velocity-dependent muscular deficits. Conclusions: Improved gait performance in both limbs demonstrates that strength training produces functionally beneficial bilateral muscle-level reorganization. The absence of a control group limits causal inference, though the observed biomechanical adaptations align with functional improvements, supporting the integration of strength training into comprehensive stroke rehabilitation protocols targeting locomotor recovery. Full article

(1) Background: Post-stroke spasticity limits motor recovery and independence. Combining botulinum toxin type-A (BoNT-A) injection with intensive, task-specific robot-assisted therapy (RAT) might enhance neuroplasticity and functional gains, but its additive effect and optimal timing are uncertain. (2) Methods: We systematically searched major medical databases and trial registries up to April 2025 for randomized controlled trials in adults with post-stroke spasticity comparing botulinum toxin type-A injection plus RAT with toxin injection plus conventional therapy, or RAT alone with RAT combined with toxin injection. Risk of bias was assessed using the RoB 2 tool, and findings were synthesized narratively. (3) Results: Seven trials (n = 229) were included. Across all studies, toxin treatment reduced spasticity within groups, whereas additional spasticity reduction with RAT versus conventional rehabilitation was inconsistent. In contrast, several lower-limb trials reported greater improvements in walking capacity and balance when RAT was added, while upper-limb trials showed comparable motor recovery across treatment arms with occasional advantages in strength and movement quality. A pilot four-arm study suggested that starting RAT around four weeks after injection may maximize upper-limb motor gains. (4) Conclusions: The combination of BoNT-A with RAT appears safe and is particularly promising for gait rehabilitation, but further research is needed to define optimal timing and protocols. Full article