Search Results (469)

Background and Objectives: Intertrochanteric hip fractures (ITFs) are common in older adults and frequently coexist with knee osteoarthritis (KOA). Although both conditions share key biomechanical risk factors, the specific relationship between KOA severity and ITF stability has not been well defined. Recent evidence suggests that degenerative knee changes may alter lower-limb load distribution and increase susceptibility to unstable fracture patterns. This study evaluated whether KOA severity, graded using the Kellgren–Lawrence (KL) system, is associated with ITF stability according to the 2018 AO/OTA classification. Materials and Methods: A retrospective observational study was conducted on 138 patients with IHFs treated between 2018 and 2023. KOA severity was assessed using KL grades I–IV on non-weight-bearing anteroposterior knee radiographs. Lateral wall thickness (LWT) was measured using the Hsu method, with <20.5 mm indicating fracture instability. Statistical analyses included correlation, linear regression, logistic regression, and receiver operating characteristic (ROC) curve analysis to examine the association between KL grade and fracture stability. Results: Among 138 patients, 98 (71.0%) had unstable ITFs. Advanced KOA was significantly more common in the unstable group (KL III 45.9%, KL IV 48.0%; p < 0.001). KL grade showed a significant inverse correlation with LWT (Pearson’s r = −0.394, p < 0.001). Each one-grade increase in KL severity was associated with a 3.8 mm reduction in LWT (p < 0.001). In multivariable logistic regression, KL grade remained an independent predictor of fracture instability (adjusted OR = 4.9, 95% CI: 2.8–8.8, p < 0.001), whereas age and comorbidities were not significant. ROC analysis demonstrated good discriminatory power (AUC = 0.79). A KL ≥ III threshold achieved 95% sensitivity and 56% specificity for predicting instability. Conclusions: Higher KOA severity is strongly associated with unstable ITF patterns. KL grade independently predicts instability and may serve as a simple, accessible radiographic indicator of biomechanical vulnerability and fracture risk in older adults. Incorporating KOA severity into the preoperative evaluation may enhance risk stratification, guide selection of fixation strategy, and support individualized rehabilitation planning. Full article

Accurate assessment of gingival thickness is essential for clinical decision-making in implant dentistry, periodontology, and orthodontics. Qualitative phenotype assessment using color-coded periodontal probes is commonly applied as a rapid screening tool, whereas ultrasonography provides quantitative, non-invasive measurements expressed in millimeters. The relationship between these two approaches, however, remains insufficiently defined. The aim of this study was to evaluate the correspondence between qualitative gingival phenotype classification using a color-coded probe and quantitative soft tissue thickness measured with an ultrasound-based system. In this observational diagnostic substudy, the gingival phenotype was categorized as thin, medium, thick, or very thick based on probe translucency and compared with ultrasound-derived thickness values obtained at standardized sites. Qualitative phenotype categories showed a consistent association with quantitative measurements, supporting the role of color-coded probes as screening tools within a complementary diagnostic framework. Ultrasonography provided objective data suitable for detailed assessment and monitoring. These findings support a complementary diagnostic approach combining qualitative screening with quantitative measurement. Full article

Surge-like glacier instabilities in Central Asia remain underexplored, particularly in regions of mild instability or smaller glaciers. In 1980, two leading Soviet glaciologists proposed a classification method (GS1980) to calculate the spatial distribution of “pulsating” glaciers in the Hissar–Alay range, predicting a 20% prevalence of unstable flow and claiming highly accurate detection. These findings were unconfirmed in subsequent studies, which typically reported fewer than 10 surge-type glaciers in the region. Here, we address this discrepancy by reassessing the GS1980 predictions using a newly compiled multi-sensor satellite dataset covering nearly six decades. We systematically examine glacier dynamics in the region, assessing ice flow instabilities from changes in terminus position, ice thickness, and surface morphology. We identify 171 glaciers that exhibit pulsating behavior, corresponding to 25% of the sample—in broad agreement with GS1980. Flow instabilities tend to be modest in scale, with slow advances and long active phases (mean duration of 14 years). We find that the GS1980 model shows some ability to distinguish pulsating from stable-flowing glaciers; however, its predictive power is lower than claimed due to the simplifying assumptions of its morphology-based approach and the uncertainties in the input data. Our results indicate that pulsations in the region are more widespread than previously reported, but fall at the weaker end of the spectrum of glacier instability, which may not be well represented by a sharp binary classification (surge-type versus stable). As more detailed satellite records become available, we suggest that a more nuanced framework may be useful to recognize and interpret subtler instabilities of small glaciers. Full article

This paper applies the reliability-based robust optimization (RBRO) technique to investigate the probabilistic structural design characteristics of the Fairlead Chain Stopper (FCS), a newly developed detachable mooring apparatus for installation on a 10 MW floating offshore wind turbine. The thickness dimensions of the FCS’s major structural members were considered as random design variables, including uncertainties such as manufacturing tolerances. The structural strength performance was defined as a probabilistic constraint function based on the allowable stresses specified by DNV classification rule. The structural strength performance of the FCS was evaluated through finite element analysis (FEA) using design load conditions for moored (LC1, LC2) and towed (LC3) conditions based on DNV classification rules. The RBRO design problem was formulated with weight minimization as the objective function, with probabilistic constraints on strength performance and 3-sigma robustness applied as side constraints. To evaluate reliability analysis methods suitable for probabilistic optimal design, the Mean Value Reliability Method (MVRM) and the Adaptive Importance Sampling Method (AISM) were applied during the RBRO process, and the results were compared and analyzed. The probabilistic optimal design using RBRO exhibited conservative design characteristics compared to the deterministic optimal design, ensuring robustness and reliability. After comprehensively considering the weight reduction rate and numerical computational cost (number of function evaluations), the RBRO method using MVRM was confirmed to be the most reasonable method for the probabilistic optimal structural design of the FCS. Full article

Permafrost thickness serves as a critical indicator of hydrogeological conditions in cold regions and significantly influences the safety of engineering infrastructure. Due to the combined effects of climate, ecology, and human activities, the thermal characteristics and spatial distribution of permafrost in the Greater and Lesser Khingan Mountains of Northeast China exhibit high complexity, rendering existing permafrost thickness estimation methods largely inapplicable in this region. We developed an integrated estimation framework that bridges the gap between limited deep ground temperature measurements and regional-scale mapping. To overcome the scarcity of deep borehole (>20m) data, a physical-statistical inversion method was employed to derive permafrost base depths from shallow borehole temperature profiles, thereby expanding the foundational dataset to 104 representative sites. Integrating these ground observations with satellite-derived products (e.g., MODIS NDVI) and auxiliary environmental covariates (e.g., DEM-based topography and gridded climatic data), a Random Forest algorithm (RF) was applied to generate a 1 km-resolution permafrost thickness distribution map across Northeast China with a classification accuracy of 0.74. The results indicate that the average permafrost thickness in the study area is 47.71 ± 10 m, exhibiting a spatial pattern of thicker in the north and west, thinner in the south and east, and greater in mountainous areas than in plains. The top three influencing factors of permafrost thickness are atmospheric precipitation, surface thawing degree days (TDDs), and topographic position index (TPI), revealing that the thickness of discontinuous permafrost in northeastern China is primarily governed by local factors such as soil moisture, represented by the thick permafrost existed under a small patch of ground surface. This study provides a new methodological framework for estimating permafrost thickness in regions with limited ground temperature gradient measurement in deep boreholes. Full article

Pathologic myopia has become a major global cause of blindness, making timely surgical management for myopic traction maculopathy (MTM) increasingly important. This study aimed to identify prognostic factors associated with functional and anatomical outcomes following surgery for MTM and to determine the optimal timing for intervention. This retrospective study included 33 eyes from 28 patients with MTM without full-thickness macular hole who underwent pars plana vitrectomy with internal limiting membrane peeling and gas tamponade. Better preoperative best-corrected visual acuity (BCVA) and lower foveal height were associated with better postoperative BCVA, whereas longer axial length, higher MTM, and higher Atrophy–Traction–Neovascularization (ATN) classification grade were correlated with thinner postoperative central foveal thickness. Foveal detachment (FD), ellipsoid zone (EZ) disruption, and advanced MTM grade were associated with poorer functional and anatomical outcomes. Postoperative visual outcomes should be interpreted with caution, as they may have been influenced by lens-related factors, including combined cataract surgery, post-vitrectomy cataract progression, and posterior capsule opacity. Nonetheless, consistent anatomical improvement was observed, supporting early surgical consideration in eyes with MTM showing progressive macular traction or EZ disruption, even in the absence of FD. These findings highlight the importance of serial OCT monitoring and individualized surgical timing based on preoperative assessments. Full article

Background/Objectives: Although unrestricted kinematic alignment (uKA) has gained increasing acceptance in total knee arthroplasty (TKA), its application in knees with lateral compartment osteoarthritis (OA) remains a subject of debate due to concerns over postoperative gap imbalance and alignment outliers. The purpose of this study was to evaluate the surgical, radiographic, and clinical outcomes of contralateral non-OA knee–referenced, caliper-verified uKA in lateral compartment OA. Methods: This retrospective study included 40 patients with isolated lateral compartment OA who underwent primary TKA using contralateral non-OA knee–referenced, caliper-verified uKA. Surgical outcomes were assessed by measuring bone resection thicknesses of the distal femur, posterior femur, and proximal tibia, as well as extension and 90° flexion gaps. Radiographic outcomes included mechanical hip–knee–ankle angle, medial proximal tibial angle, lateral distal femoral angle, and Coronal Plane Alignment of the Knee (CPAK) classification. Patient-reported outcomes (PROs), including Pain VAS, EQ-5D, satisfaction, and Forgotten Joint Score, were assessed at a minimum follow-up of 2 years. Results: The resected osteochondral thickness was consistently greater on the medial side than on the lateral side, and all gap balances were well maintained, with a gap difference ≤ 2 mm observed in 95% of knees in full extension. Postoperatively, restoration to the same CPAK category was achieved in approximately 90% of cases. All PROs improved and reached levels comparable to those of the contralateral knee. Conclusions: In patients with lateral compartment OA, caliper-verified uKA may be appropriately applied when guided by a reliable anatomic reference, such as the contralateral non-OA knee. This strategy achieves stable soft-tissue balance, reliable coronal alignment restoration, and favorable clinical outcomes in carefully selected valgus knees undergoing TKA. Full article

Aluminum (Al) toxicity is a major constraint on crop growth and productivity in acidic soils, affecting root development, nutrient uptake, and photosynthetic performance. The use of Si is a promising strategy to overcome the adverse effects of Al toxicity on species of agronomic interest. Between 2020 and 2026, 15 studies across nine species consistently demonstrated that silicon mitigated aluminum toxicity, regardless of their classification as silicon accumulators. In plants, Si mitigates Al toxicity through a combination of physical, chemical, and biochemical mechanisms that operate simultaneously. In the rhizosphere, Si interacts directly with Al³⁺ ions, favoring the formation of hydroxyaluminosilicates (HASs), which reduces the bioavailable fraction of Al. Evidence indicates that solution pH is a critical factor governing HAS formation, with minimal attenuation of Al toxicity observed at pH values below 4.5. Within the plant, Si modulates the antioxidant defense system by enhancing the activity of enzymes such as catalase, peroxidase, and ascorbate peroxidase, thereby reducing oxidative stress typically triggered by Al toxicity. Moreover, Si influences the biosynthesis of lignin and phenolic compounds with Al-chelating capacity, contributing to detoxification at the cellular level. In soybean and rice, Si supply substantially reduced Al deposition in the root apical cell wall, with decreases of approximately 52% and 41.3%, respectively. This reduction was consistently associated with improved root elongation, maintenance of root structural integrity, mitigation of cellular deformation, and preservation of root thickness and vascular organization. Although these mechanisms have been described, a comprehensive synthesis of studies published from 2020 to 2026 has been lacking, particularly regarding the integration of in-plant processes and species-specific responses. This review fills this gap by critically examining recent findings, highlighting the multifaceted role of Si in alleviating Al stress, and discussing implications for agronomic applications in acidic soils. Collectively, the evidence underscores Si as an effective tool to enhance plant tolerance to Al; however, most available evidence is derived from early plant developmental stages and hydroponic or highly controlled systems, which limits the direct extrapolation of these findings to soil and field conditions. Future advances will require studies under soil environments, accounting for species-specific responses, soil properties, management systems, and plant developmental stages. Full article

This study addresses a critical knowledge gap in quantifying strategic mineral resources within hyper-arid, tectonically complex terrains by establishing a recursive framework that reconciles deterministic resource estimation with the nonlinear dynamics of tectonically mediated metamorphic systems. Using Libya’s Wadi El Shati as a case study, legacy lithological misclassifications are rectified through the fusion of Sentinel-1 Synthetic Aperture Radar, Sentinel-2 multispectral imagery, and Digital Elevation Model analytics within a unified geospatial workflow. The methodology synergizes atmospherically corrected optical data, processed via supervised Maximum Likelihood Classification, with calibrated radar-derived structural lineaments. Classified marble-bearing zones within the Al Mahruqah Formation are integrated with DEM data and field-validated thickness measurements using Triangulated Irregular Network models to resolve surface–subsurface dependencies and compute volumes. The results demonstrate a 91% lithological classification accuracy, rectifying a 22% error in legacy maps. Structural analysis of 1213 lineaments confirms a dominant NE–SW extensional regime (σ₃) that facilitated fluid conduits. The quantified marble-bearing horizon spans ~334 km² with a volume of 6.0 km³ (±9%). Spatial analysis reveals a causal link between high-grade marble clusters, basaltic intrusions, and NE–SW fault systems, refining models of contact metamorphism in rift-related settings. Full article

Background/Objectives: Impacted third molars are frequent and may increase surgical complexity, particularly when the mandibular third molar is in close proximity to the inferior alveolar canal (IAC). This study aimed to estimate the prevalence and impaction patterns of third molars in a Portuguese population and to characterize, using a nested CBCT subsample, the three-dimensional relationship between mandibular third molars and the IAC, including cortical integrity and lingual plate thickness. Methods: A retrospective observational analysis of 1062 orthopantomograms (OPGs) was performed to determine the prevalence and panoramic patterns using Winter, Pell and Gregory classifications and Rood–Shehab signs. A consecutive CBCT subsample (n = 205) was assessed for IAC position, contact status (no contact; contact with cortical bone; contact without cortical bone), cortical integrity, and lingual plate thickness. Descriptive statistics were complemented by effect sizes to support clinical interpretability. Results: The prevalence of impacted third molars was 34.9%, occurring predominantly in the mandible. Vertical angulation was the most prevalent pattern in both jaws. In the CBCT subsample, IAC position and contact patterns varied widely, and loss of cortical integrity was more often observed when panoramic high-risk signs were present. No clinically meaningful left–right asymmetry was identified across key anatomical risk indicators. Conclusions: In this Portuguese cohort, impacted third molars showed consistent panoramic patterns, while CBCT provided clinically relevant three-dimensional risk descriptors—particularly IAC contact type and cortical integrity—supporting selective CBCT use based on anatomical risk indicators rather than routine imaging. Full article

Friction stir welding (FSW) of high-strength aluminum alloys, including EN AW 7020-T651, encounters significant challenges under weld line gap conditions, leading to compromised joint integrity. This study develops a predictive, data-driven framework to assess and optimize the gap bridgeability performance of FSW joints with weld line gaps ranging from 0 to 4 mm in 2 mm thick plates. A structured experimental matrix was implemented, systematically varying rotational speed, welding speed, axial force, and tool shoulder diameter. To promote stable material flow and consistent weld quality under varying gap conditions, a multi-pin tool was employed throughout the welding trials. This configuration supported defect-free weld formation across a broad process window and contributed to improved weld soundness under gap conditions. Weld quality was evaluated using a comprehensive, multi-criteria approach that required (i) defect-free joints verified by visual and cross-sectional (metallographic) inspection, (ii) an ultimate tensile strength of at least 230 MPa, and (iii) a novel metric termed weak area percentage (WAP). Derived from micro-hardness mapping, WAP quantified the proportion of the heat-affected zone (HAZ) exhibiting hardness below 96 HV, providing a more robust and spatially sensitive measure of mechanical integrity than conventional average hardness values. Two machine learning models, Logistic Regression and Random Forest, were trained to classify weld acceptability. The Random Forest model demonstrated superior performance, achieving 92.5% classification accuracy and an F1-score of 0.90. Feature importance analysis identified the interaction terms “welding speed × gap size” and “rotational speed × gap size” as the most influential predictors of weld quality. Full article

Background/Objectives: Diagnosing Rotator Cuff Tears (RCTs) via Magnetic Resonance Imaging (MRI) is clinically challenging due to complex 3D anatomy and significant interobserver variability. Traditional slice-centric Convolutional Neural Networks (CNNs) often fail to capture the necessary volumetric context for accurate grading. This study aims to develop and validate the Patient-Aware Vision Transformer (Pa-ViT), an explainable deep-learning framework designed for the automated, patient-level classification of RCTs (Normal, Partial-Thickness, and Full-Thickness). Methods: A large-scale retrospective dataset comprising 2447 T2-weighted coronal shoulder MRI examinations was utilized. The proposed Pa-ViT framework employs a Vision Transformer (ViT-Base) backbone within a Weakly-Supervised Multiple Instance Learning (MIL) paradigm to aggregate slice-level semantic features into a unified patient diagnosis. The model was trained using a weighted cross-entropy loss to address class imbalance and was benchmarked against widely used CNN architectures and traditional machine-learning classifiers. Results: The Pa-ViT model achieved a high overall accuracy of 91% and a macro-averaged F1-score of 0.91, significantly outperforming the standard VGG-16 baseline (87%). Notably, the model demonstrated superior discriminative power for the challenging Partial-Thickness Tear class (ROC AUC: 0.903). Furthermore, Attention Rollout visualizations confirmed the model’s reliance on genuine anatomical features, such as the supraspinatus footprint, rather than artifacts. Conclusions: By effectively modeling long-range dependencies, the Pa-ViT framework provides a robust alternative to traditional CNNs. It offers a clinically viable, explainable decision support tool that enhances diagnostic sensitivity, particularly for subtle partial-thickness tears. Full article

Background and Objectives: Keratoconus is a bilateral but often asymmetric ectatic corneal disease characterized by progressive thinning, increased curvature, and conical shape of the cornea. Previous studies have reported that the use of swimming goggles in patients with keratoconus can lead to increased intraocular pressure (IOP) and a transient reduction in anterior chamber volume (ACV), potentially affecting anterior segment morphology. This study aimed to evaluate the short-term effects of periorbital pressure induced by swimming goggles on corneal parameters in keratoconic eyes. Materials and Methods: A total of 44 eyes of 44 patients (mean age: 26.1 ± 5.1 years) diagnosed with keratoconus Stage 1–4 according to the Amsler–Krumeich classification were included. Measurements were taken using a Pentacam^® Scheimpflug camera before swimming goggle application and immediately after 20 min of wear. The parameters assessed included keratometry values (K1, K2, Km, Kmax), central and thinnest corneal thickness, corneal volume within the 10 mm zone (CV10), ACV, anterior chamber depth (ACD), iridocorneal angle (ICA), and pupil diameter (PD). Results: No statistically significant changes were observed in keratometric values, central and thinnest corneal thickness, ACV, ACD, ICA, PD, or IOP (all p > 0.05). CV10 showed a small reduction following goggle wear (Δ = −0.18 mm³, corresponding to a 0.3% decrease), which was statistically significant in the unadjusted analysis (p = 0.008) but did not remain significant after correction for multiple comparisons (p for false discovery rate [FDR] = 0.10). Conclusions: Short-term swimming goggle use may induce subtle reductions in CV10 in keratoconic eyes, suggesting a potential biomechanical sensitivity to transient periocular pressure. Although the observed change in CV10 did not retain statistical significance after multiple-comparison correction, it may reflect an early physiological response in structurally compromised corneas. CV measurements could serve as exploratory indicators of mechanical responsiveness in keratoconus, warranting further investigation in larger controlled studies. Full article

Soil corrosion is a critical durability and cost factor for metallic foundations in photovoltaic (PV) power plants, yet it is still addressed with fragmented criteria compared with atmospheric corrosion. This paper reviews the main soil corrosivity drivers relevant to PV installations—moisture and aeration dynamics, electrical resistivity, pH and buffer capacity, dissolved ions (notably chlorides and sulfates), microbiological activity, hydro-climatic variability and geological heterogeneity—highlighting their coupled and non-linear effects, such as differential aeration, macrocell formation and corrosion localization. Building on this mechanistic basis, an engineering-oriented methodological roadmap is proposed to translate soil characterization into durability decisions. The approach combines soil corrosivity classification according to DIN 50929-3 and DVGW GW 9, tiered estimation of hot-dip galvanized coating consumption using AASHTO screening, resistivity–pH correlations and ionic penalty factors, and verification against conservative NBS envelopes. When coating life is insufficient, a traceable steel thickness allowance based on DIN bare-steel corrosion rates is introduced to meet the target service life. The framework provides a practical and auditable basis for durability design and risk control of PV foundations in heterogeneous soils. The proposed framework shows that, for soils exceeding AASHTO mild criteria, zinc corrosion rates may increase by a factor of 1.3–1.7 when chloride and sulfate penalties are considered, potentially reducing coating service life by more than 40%. The methodology proposed enables designers to estimate the penalty factors for sulfates ($f_p\left({SO}_4^{2-}\right)$) and chlorides ($f_p\left({Cl}^{-}\right)$) in each specific project, calculating the appropriate values of $K_{{SO}_4^{2-}}$ and $K_{{Cl}^{-}}$ using electrochemical techniques—ER/LPR and EIS—to estimate the effect of the soluble salts content in the ${Zn}_{Corr Rate}$, not properly catch by the proxy indicator $V_{corr}\left(ER, pH\right)$ when sulfate and chloride content are over AAHSTO limits for mildly corrosive soils. Full article

Background: Altered passive eruption (APE) is one of the etiological factors associated with excessive gingival display and is commonly treated with esthetic crown lengthening (ECL). However, existing classification systems provide limited guidance for selecting appropriate treatment approaches. Objectives: The aim of this study was to evaluate (1) the expected outcome of ECL in eliminating unattractive excessive gingival display (4 mm) based on digital smile assessment and (2) the distribution of teeth and patients according to the modified APE classification. Methods: Forty-two Thai patients with APE underwent clinical examination, digital smile assessment, intraoral scanning, and CBCT. Predicted gingival display (PGD) was calculated to assess the expected outcomes of ECL. The modified APE classification, incorporating CEJ–BC distance and buccal bone thickness, was analyzed at both the tooth and patient levels. Results: A total of 252 maxillary anterior teeth were assessed. Most patients (78.57%) presented with APE and hyperactive upper lip. The mean gingival display (GD) was 6.04 ± 1.76 mm, with GD ≥ 4 mm observed in 92.86% of patients. The mean PGD was 3.56 ± 1.71 mm, and ECL was predicted to reduce GD to < 4 mm in 66.67% of patients. Teeth were classified as Class I (28.97%), II (15.48%), III (41.27%), and IV (14.28%); only Types II (11.9%) and III (88.1%) occurred at the patient level. Conclusions: ECL performed at the CEJ level is predicted to eliminate excessive gingival display in approximately two-thirds of APE patients. The modified APE classification offers guidance for selecting surgical approaches, highlighting the necessity of open-flap procedures and the limited applicability of flapless approaches. Full article