A new mathematical model is presented to study the effects of macrophages on the bone fracture healing process. The model consists of a system of nonlinear ordinary differential equations that represents the interactions among classically and alternatively activated macrophages, mesenchymal stem cells, osteoblasts, and pro- and anti-inflammatory cytokines. A qualitative analysis of the model is performed to determine the equilibria and their corresponding stability properties. Numerical simulations are also presented to support the theoretical results and to monitor the evolution of a broken bone for different types of fractures under various medical interventions. The model can be used to guide clinical experiments and to explore possible medical treatments that accelerate the bone fracture healing process either by surgical interventions or drug administrations.

Bioimpedance measurements are used increasingly in health applications because bioelectric parameters have been associated with anatomical and physiological properties, thus enabling to distinguish medical conditions. For bone fracture diagnostics, nevertheless, there is no established non-invasive method. Ex vivo studies and In vivo bioimpedance procedures, both invasive and non-invasive, on mammalians long bones are associated with promising results. In this work, out of a total of 568 papers, we reviewd 59 articles that mention long bone integrity by electric properties, be it Bioimpedance Analysis, Electrical Impedance Spectroscopy or Electrical Impedance Tomography. The papers are described in three sections, “Ex vivo measurements”, “In vivo invasive measurements” and “In vivo non-invasive measurements”. This review allows to establish the basics to planning the development of new technology to detect bone fracture via bioimpedance measurements.

The problem of filling the bone cavity remains relevant in maxillofacial and oral surgery. There is a large selection of osteotropic materials of various natures for filling of bone defects of different etiology. The aim of our research was to improve the result of surgical treatment in a patient with a complicated mandibular fracture with the use of collagenic xenograft during osteosynthesis. In this article, we introduce our experience in the treatment of a patient with a complicated mandibular angle fracture in a combination with the follicular cyst. The obligate steps of treatment included stabilization of the bony fragments, a decrease of risk in fracture line malposition along with titan mini- plates, and shortening in the time of bone regeneration due to a filling of bone defect with the osteotropic material. This approach allowed us to reduce the rehabilitation period and further prosthetic treatment after 4-5 months without additional bone grafting manipulations. Though, the use of collagen osteotropic material, possessing osteoconductive properties, can improve the treatment of patients with mandibular fractures.

Bone fractures are common injuries that require quick and accurate diagnosis to provide the right medical care. The “convolutional neural network” technique relies mostly on manual inspection, by radiologists and can be laborious and prone to error. The objective of this work was to increase the efficiency and accuracy of fracture identification by automating the examination of X-ray images using convolutional neural networks. A “convolutional neural network” model created to detect bone fractures in X-ray images was used in the present study. The model was trained and validated using an extensive dataset of X-ray images, which included both fractured and nonfractured bones. Multiple convolutional layers were used in the “convolutional neural network” architecture for feature extraction, and pooling and fully connected layers were added for classification. The main measures used to assess the model's performance were sensitivity, specificity, and accuracy. In regard to identifying bone fractures, the “convolutional neural network”-based model outperformed the conventional technique. With significant gains in sensitivity and specificity, this approach achieved a high accuracy rate and decreased the frequency of false positives and false negatives. We used “convolutional neural network” tool in PyTorch for bone fracture detection and we outlined the important considerations that must be considered when attempting to achieve this goal Additionally, we contrasted every study with our baseline. Here our maximum accuracies were 99.05%, 98.60%, 99.45% and 99.74% for epochs 8, 9, 10 and 11, respectively. These findings highlight the model's ability to improve the diagnostic efficiency and accuracy in clinical settings. Using “convolutional neural network” to identify bone fractures from X-ray images is a promising development in medical imaging. In the end, our method improves patient outcomes by ensuring faster and more reliable fracture diagnosis while also lessening the diagnostic burden on radiologists. Subsequent investigations will focus on incorporating this system into clinical procedures and investigating its utilization in real-time emergency situations. Since there was no medical intervention on human subjects in this investigation, trial registration regulations were not applied.

Bone/fracture healing is a complex process with different steps and four basic tissue layers being affected: cortical bone, periosteum, fascial tissue surrounding the fracture, and bone marrow. Stem cells and their derivatives, including embryonic stem cells, induced pluripotent stem cells, mesenchymal stem cells, hematopoietic stem cells, skeletal stem cells, and multipotent stem cells, can function to artificially introduce highly regenerative cells into decrepit biological tissues and augment the healing process at the tissue level. Stem cells are molecularly and functionally indistinguishable from standard human tissues. The widespread appeal of stem cell therapy lies in its potential benefits as a therapeutic technology that, if harnessed, can be applied in clinical settings. This review aims to establish the molecular pathophysiology of bone healing, the current stem cell interventions that disrupt or augment the bone healing process, and finally, consider the future direction/therapeutic options related to stem cells and bone healing.

Background Bone fracture fixation surgery is one of the most commonly performed surgical procedures in the orthopedic field. However, fracture healing complications occur frequently, and the choice of the most optimal surgical approach often remains challenging. In the last years, computational tools have been developed with the aim to assist preoperative planning procedures of bone fracture fixation surgery. Objectives The aims of this review are (1) to provide a comprehensive overview of the state-of-the-art in computer-assisted preoperative planning of bone fracture fixation surgery, (2) to assess the clinical feasibility of the existing virtual planning approaches, and (3) to assess their clinical efficacy in terms of clinical outcomes as compared to conventional planning methods. Methods A literature search was performed in the MEDLINE-PubMed, Ovid-EMBASE, Ovid-EMCARE, Web of Science, and Cochrane libraries to identify articles reporting on the clinical use of computer-assisted preoperative planning of bone fracture fixation. Results 79 articles were included to provide an overview of the state-of-the art in virtual planning. While patient-specific geometrical model construction, virtual bone fracture reduction, and virtual fixation planning are routinely applied in virtual planning, biomechanical analysis is rarely included in the planning framework. 21 of the included studies were used to assess the feasibility and efficacy of computer-assisted planning methods. The reported total mean planning duration ranged from 22 to 258 minutes in different studies. Computer-assisted planning resulted in reduced operation time (Standardized Mean Difference (SMD): -2.19; 95% Confidence Interval (CI): -2.87, -1.50), less blood loss (SMD: -1.99; 95% CI: -2.75, -1.24), decreased frequency of fluoroscopy (SMD: -2.18; 95% CI: -2.74, -1.61), shortened fracture healing times (SMD:-0.51; 95% CI: -0.97, -0.05) and less postoperative complications (Risk Ratio (RR): 0.64, 95% CI: 0.46, 0.90). No significant differences were found in hospitalization duration. Some studies reported improvements in reduction quality and functional outcomes but these results were not pooled for meta-analysis, since the reported outcome measures were too heterogeneous. Conclusions Current computer-assisted planning approaches are feasible to be used in clinical practice and have been shown to improve clinical outcomes. Including biomechanical analysis into the framework has the potential to further improve clinical outcome.

Periodontitis is a chronic inflammatory disease which results in the destruction of the tooth’ s supporting tissues and the alveolar bone resorption. The complement becomes a major link between infection and inflammatory pathology including periodontitis. Gingipians as important virulence factors of P. gingivalis have the activity of C5 convertase, could cleave C5 into fully functional C5a to activate C5aR. The above process could be blocked by the C5aR antagonist (PMX-53) to suppress local periodontal inflammation, and then achieves the purpose of treatment of periodontitis. Nanoparticles incorporated within gelatin are promising carrier system for drug delivery in recent years. This study aimed to investigate whether gelatin nanoparticles loaded with PMX-53 prevents alveolar bone resorption in miniature swines model of periodontitis. Four miniature swines were placed ligatures around the maxillary and mandibular fourth premolar and first molar on both sides for seven weeks to induce periodontitis. Then, animals were assigned randomly to four groups: minocycline-treated group, gelatin with PMX53-treated group, gelatin-treated group and a sham control group. They were treated with 1ml related drugs respectively, into gingival sulcusl for 4 times at one-week intervals. We showed that local treatments with gelatin nanoparticles loaded with PMX-53 could inhibit alveolar bone loss of periodontitis. Our study revealed that gelatin nanoparticles loaded with PMX-53 prevented alveolar bone resorption miniature swines model of periodontitis. In addition, provided proof-of-concept for local targeting of gelatin nanoparticles loaded with PMX-53 as a powerful candidate for the treatment of periodontitis.

Percutaneous kyphoplasty (PKP) is a highly successful treatment option for Kümmell's disease (KD). Due to the obstruction of the fibrocartilaginous membrane at the periphery of the intervertebral vacuum cleft (IVC) and inadequate osteointegration of conventional bone cement, there is insufficient locking strength between trabecular bone and bone cement in Kümmell's disease (KD), leading to postoperative displacement of the bone cement and sub-sequent early surgical failure. However, there is no standard strategy managing this complica-tion at present. We reported a rare case of premature bone cement displacement resulting in adjacent vertebra fracture. An 80-year-old male with Kümmell's disease at T10 received per-cutaneous kyphoplasty (PKP) with bone cement leaking into the upper disc. Only 3 days after the surgery, the patient complained of severe back pain again. X-ray and MRI showed bone cement displacement at T10, adjacent vertebra fracture at T9. In consideration of poor toler-ance of open surgery for the old patient, we successfully revised by using percutaneous ky-phoplasty with multi-point anchoring technique (A-PKP). During a 10-month postoperative follow-up, the patient reported pain relief. X-ray and three-dimensional CT scan revealed no obvious progress of bone cement displacement. Although the exact mechanism underlying this rare complication remains unclear, we observed that the premature bone cement dis-placement can result in adjacent vertebra fracture especially when the pattern of bone cement is blocky. Percutaneous kyphoplasty with multi-point anchoring technique (A-PKP) appears effective in managing this complication.

An 11-month-old castrated male Pomeranian presented with nonunion following a femoral fracture that occurred after femoral head and neck osteotomy. Radiography and computed tomography revealed severe atrophy of the proximal bone fragment and retardation of the ipsilateral distal fragment and tibia. An autogenous bone graft using coccygeal bone was performed, in which three-and-a-half coccyges were placed in series and fixed using an orthogonal locking plate. To promote bone healing and facilitate proper weight bearing and ambulation, bone morphogenetic proteins, biphasic calcium phosphate, platelet-rich plasma, passive range of motion exercises, transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation, and low level laser therapy were applied. During the four-year follow-up, it was observed that the previously engrafted bone healed well and maintained stability over a prolonged period, resulting in the patient being able to walk and trot comfortably with good outcomes. However, some degree of lameness was noted during galloping owing to limb shortening and joint contracture.

Increasing evidence suggests that prenatal exposure to opioids can adversely influence brain development, yet, limited data exists on the effects of opioid-exposure on preschool language development. Our study aimed to characterize the nature and prevalence of language problems in children prenatally exposed to opioids, and the factors that support or hinder language acquisition. A sample of 100 children born to pregnant women in methadone maintenance treatment and 110 randomly identified non-exposed children were studied from birth to age 4.5 years. At 4.5 years, 89 opioid-exposed and 103 non-exposed children completed the preschool version of the Clinical Evaluation of Language Fundamentals (CELF-P) as part of a comprehensive neurodevelopmental assessment. Children prenatally exposed to opioid had poorer receptive and expressive language outcomes at age 4.5 years compared to non-exposed children. After adjustment for child sex, maternal education, other pregnancy substance use, maternal pregnancy nutrition and prenatal depression, opioid exposure remained a significant independent predictor of children’s total CELF-P language score. Examination of a range of potential intervening factors showed that a composite measure of the quality of parenting and home environment at 18 months and early childhood education participation at 4.5 years were important positive mediators.

To determine the fracture rate of ceramic crowns and causes of ceramic crown failure, this study used keywords—namely “endocrown,” “veneered fixed dental prosthesis,” “monolithic lithium disilicate (LS2),” and “all-ceramic single crown”—to search for articles published in English from 2005 to 2023 in the PubMed electronic database. Rather than using the Boolean logic algorithm between MESH terms and keywords, we accurately calculated the numbers of final clinically tracked cases with crown fractures from the contents of articles. The titles and abstracts of many related articles focused on implant or abutment fracture, while crown fracture was investigated and mentioned only in the main texts of the articles. Our studies included those crowns as well as having more complete data collection. Our search yielded 228, 93, 404, and 358 articles for the keywords “endocrown,” “veneered fixed dental prosthesis,” “monolithic lithium disilicate (LS2),” and “all-ceramic single crown,” respectively. We used the Newcastle–Ottawa Scale (NOS) to assess article quality, and our inclusion criteria were randomized controlled trials (RCT) and cohort study articles involving more than 3 years of follow-up and more than 20 cases. After reviewing, 16 high-quality articles were selected for analysis. The 4.4% crown fracture rate recommended on the basis of most clinical results was achieved in only 6 of the 16 articles. In these 6 articles, the researchers concluded the following reasons that may cause the crown fractures: the thickness of the veneer ceramic material; the connector dimensions; pontic span of the fixed prosthesis; the type of cement; the treatment of the ceramic surface before luting. Other articles inferred that the computer-aided design libraries that were insufficient for the creation of appropriate anatomically supported frameworks for prostheses with ceramic veneers; the thermal expansion coefficient and fracture toughness of the framework material did not match those of the veneer ceramic, resulting in an insufficient area supporting the ceramic veneer then leads to premature crown failure after a long period chewing. The future prospective for material developing could focus on solving those problems and have better clinical results.

Octacalcium phosphate (OCP) is a precursor of biological apatite crystals that has attracted attention as a possible bone substitute. On the other hand, few studies have examined this material at the experimental level due to the limitations of OCP mass production. Recently, mass production technology of OCP was developed, and the launch of OCP bone substitutes is occurring. In this study, the bone regeneration capacity of OCP products was compared with two of the most clinically used materials: heat-treated bovine bone (BHA) and sintered biphasic calcium phosphate (BCP). Twelve rabbits were used, and defects in each tibia were filled with OCP, BHA, BCP, and left unfilled as control (CON). The tibias were harvested at 4 and 12 weeks, and 15 μm slides were prepared using the diamond grinding method after being embedded in resin. Histological and histomorphometric analyses were performed to evaluate the bone regeneration ability and mechanism. The OCP showed significantly higher resorption and new bone formation in both periods analysed (p<0.05). Overall, OCP bone substitutes can enhance bone regeneration significantly by activating osteoblasts and a rapid phase transition of OCP crystals to biological apatite crystals (mineralisation), as well as providing additional space for new bone formation by rapid resorption.

In this paper, we propose a modeling method based on peridynamics for ductile fracture at high temperatures. A thermoelastic coupling model combining peridynamics and classical continuum mechanics is used to limit the peridynamics calculations to the failure region of a given structure, thereby reducing computational costs. Then, a plastic constitutive model of peridynamic bonds is developed to capture the ductile-fracture process of the structure. Furthermore, an iterative algorithm for ductile-fracture calculation is presented. Finally, several numerical examples are shown. Particularly, the fracture processes of a superalloy structure under 800℃ and 900℃ environments are simulated and compared with experimental results. Our comparisons show that the crack modes captured by the proposed model are similar to experimental observations, which verifies the validity of the proposed model.

Bone metastasis detection and quantification on bone scintigraphy is challenging and clinical important for treatment and patient’s life quality. To develop a CNN based diagnostic system for automated segmentation on bone metastasis regions is non-trivial, especially for a small dataset. A dataset in house comprising 100 breast cancer patients and 100 prostate cancer patients is utilized for this research. The Double U-Net model is adapted through the integration of background removal, adding negative samples, and transfer learning methods for bone metastasis detection. The performance is investigated via 10-fold cross-validation and computed in pixel-wise scale. The best model we achieved has precision of 63.08%, sensitivity of 70.82%, and F1-score of 66.72%. The developed system has the potential to provide pre-diagnostic reports for physicians in final decisions and the calculation of the bone scan index (BSI) with the combination with bone skeleton segmentation.

Objectives Bone fractures are very common diseases, which can be caused by impact injuries or physiological disorders. Thus, the present review aimed to study the use of medicinal plants in the healing mechanism of bone fractures. Evidence acquisition Through research in the PubMed, Google Academic, and Scielo databases, this article reviews 11 ethnopharmacological studies and 34 preclinical studies on the biological actions of different plants in bone fracture healing mechanism. Results Indian tribes have highlighted in the plants ethnopharmacological study for various diseases, including bone fractures. However, despite the large citations of traditional use, technical-scientific studies are still scarce in the literature. Chenopodium ambrosioides, Piper sarmentosum, quadrangular Cissus, Ricinus communis and Radix salvia miltiorrhiza plants were the most studied in the literature regarding their osteogenic, angiogenic, anti-inflammatory and remodeling effects, acting on bone receptors, stimulating bone metabolism, increasing minerals uptake, and assisting in free radicals breakdown. Conclusion Thus, the medicinal plants use is promising in the field of bone regeneration, as well as being alternative when conventional therapies are unfeasible, increasing herbal medicines demand and popularity.

Cadaver bone is possibly the most common transplant material used today. Common types of cadaver bone transplants are freeze dried bone allografts and xenografts. In the case of freeze dried bone allograft transplants, it was theorized that these materials mineralize by way of osteoinduction and stimulating osteogenesis. However, these theories have been proven false. It has been proposed that these materials mineralize via osteoconduction however, there are no studies to support this hypothesis. This study was undertaken to determine how these transplants mineralize and what type of bone they produce. Materials and Methods: This study is a histological analysis of human cadaver bone graft healing from the incipient stages of mineralization through completed mineralization. All cadaver bone grafts used for evaluation in this study were particulate bone graft materials in the maxilla or mandible. No block grafts were evaluated. Results: The mineralization of cadaver bone transplants was produced by an inflammatory response to the transplanted tissue. The histologic findings of the mineralized bone produced by this process was sclerotic bone. No resorption of cadaver bone graft particles was found. When loaded the sclerotic bone was found to fail through an accumulation of microfractures.Conclusions: Particulate freeze-dried bone allografts and xenografts do not heal via the normal processes of mineralization. Cadaver bone grafts produce significant inflammation and are hypothesized to mineralize by a process termed antigenic ossification. The process of antigenic ossification produces sclerotic bone that is not capable of self-repair which can ultimately lead to bone failure.

Objectives Independent validation of risk scores after hip fracture is uncommon, particularly for evaluation of outcomes other than death. We aimed to assess the Nottingham Hip Fracture Score (NHFS) for prediction of mortality, physical function, length of stay and postoperative complications. Design Analysis of routinely collected prospective data partly collected by follow-up interviews. Setting and Participants Consecutive hip fracture patients were identified from the Northumbria hip fracture database between 2014-2018. Patients were excluded if they were not surgically managed or if scores for predictive variables were missing. Methods C-statistics were calculated to test the discriminant ability of the NHFS, Abbreviated Mental Test Score (AMTS), and ASA grade for in-hospital, 30- and 120-day mortality, functional independence at discharge, 30-days and 120-days, length of stay, and postoperative complications. Results We analysed data from 3208 individuals, mean age 82.6 (SD 8.6). 2192 (70.9%) were female. 194 (6.3%) died during the first 30-days, 1686 (54.5%) were discharged to their own home, 211 (6.8%) had no mobility at 120-days, 141 (4.6%) experienced a postoperative complication. The median length of stay was 18 days (IQR 8-28). For mortality, c-statistics for the NHFS ranged from 0.68-0.69, similar to ASA and AMTS. For postoperative mobility, the c-statistics for the NHFS ranged from 0.74-0.83, similar to AMTS (0.61-0.82) and better than the ASA grade (0.68-0.71). Length of stay was significantly correlated with each score (p<0.001 by Jonckheere-Terpstra test); NHFS and AMTS showed inverted U-shaped relationships with length of stay. For postoperative complications, c-statistics for NHFS (0.54-0.59) were similar to ASA grade (0.53-0.61) and AMTS (0.50-0.58). Conclusions and Implications The NHFS performed consistently well in predicting functional outcomes, moderately in predicting mortality, but less well in predicting length of stay and complications. There remains room for improvement by adding further predictors such as measures of physical performance in future analyses.

This paper presents the results of experiments on the study of a hydraulic fracture interaction with a preliminary created fracture that simulates a natural fracture. A distinctive feature of the conducted experiments is the ability to use an ultrasonic sounding to measure the fracture propagation and opening simultaneously with the fluid pore pressure measurements at the several points of the porous saturated sample. It allows to obtain the pressure distributions at various experiment stages and to establish a relation between the pore pressure distribution and the hydraulic fracture propagation and its interaction with macroscopic natural fracture. The possibilities of active ultrasonic monitoring have been expanded due to preliminary calibration experiments, which make it possible to estimate the fracture opening value by attenuation of ultrasonic pulses. The experiments show that the fracture propagation is limited by the natural fracture. This is caused by the hydraulic fracturing fluid leaks into the natural fracture, so both hydraulic fracture and natural fracture compose united hydraulic system.

Background: Bone metastases (BM) have a detrimental effect on survival for patients with solid cancers. Materials and methods: This systematic review respected the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: When investigating OP as a risk factor for BM development, for breast cancer patients, some articles do not differentiate between intrinsic breast cancer subtypes. BMD does not seem to contribute in a significant manner when investigating Luminal A breast cancer. While researching breast cancer regardless of intrinsic subtype, untreated OP increases the risk of bone metastasis when compared to no OP group or treated OP group. In urological cancer cases, OP seems to predispose the patients to BM, especially early after diagnosis. Investigating risk factors for OP development in cancer patients resulted in the identification of 32 articles. Most articles identified risk factors for osteoporosis development in the context of breast cancer patients. Other commonly investigated solid cancers were prostate, other urological cancers, gynecological malignancies, and other less common subtypes of solid tumors. Discussion: While investigating OP as a risk factor for BM, it becomes clear that there is a high grade of heterogeneity in the behavior of each type of cancer in its dynamic concerning bone metastasis, and thus, OP might have different behaviors as a risk factor depending on the situation. Conclusion: There is a need for data regarding cancer subtypes that have not been explored concerning their interaction with the skeletal system in a low bone mineral density scenario.

This study reviews methods for detecting fracture closure pressure in both unconventional and conventional reservoirs using mathematical models and fluid flow equations. It evaluates tech-niques such as the Nolte method, tangent method, and compliance method. The investigation re-lies on observing changes in fluid flow regimes from pre-closure to post-closure, using fluid flow equations to examine the post-closure flow regime effect on the G function. Reverse calculations model pressure decline across synthesized flow regimes, facilitating a detailed investigation of the closure process. The analysis reveals that the tangent method is sensitive to post-closure fluid flow, while the compliance method is less effective in reservoirs with significant tortuosity or natural fractures. The paper recommends assessing natural fractures' characteristics and perme-ability to identify the source of leak-off before selecting a technique. It proposes integrating vari-ous methods for a comprehensive understanding of subsurface formations, combining their strengths for accurate fracture closure identification and better understanding of subsurface formations. The new proposed workflow employs the Continuous Wavelet Transform (CWT) technique for fracture closure detection, avoiding physical model pre-assumptions or simplifica-tions to confirm the results. This approach offers guidance on selecting appropriate methods by integrating different techniques.

Introduction: Bone fractures may be the result of high force impact or stress, or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, osteopenia, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture. Bone cancer can be primarily or secondary to metastasis. Case presentation: We report a rare case of left humerus fracture in a 59-year-old male patient due to metastatic renal cell carcinoma. Our patient had no important past medical history. He suffered from two months of left arm pain, moderate disability and fever at night. Analgesics consumption resulted in minimal relieve. Trauma history was negative. X-ray of the left arm showed an osteolytic lesion with humerus fracture. Abdominal computed tomography with contrast showed right renal mass.Radical right nephrectomy was performed in addition to alignment nailing of the left humerus fracture with biopsy. Pathology report documented clear cell carcinoma with metastatic bone. The treatment was completed by chemotherapyDiscussion: Secondary bone tumors are metastatic lesions which have spread from other organs, most commonly carcinomas of the breast, lung, and prostate, and rarely from kidney. In some cases, bone metastasis could be the first symptoms of renal cell carcinoma. Conclusion: suspected pathological bone fractures should be investigated completely. It may hide a tumor as a cause.

The paper describes the Field Boundary Element Method applied to the fracture analysis of a 2D rectangular plate made of Functionally Graded Material to calculate Mode I Stress Intensity Factor. The object of the Field Boundary Element Method is the transversely isotropic plane plate. Its material presents an exponential variation of the elasticity tensor depending on a scalar function of position, i.e., the elastic tensor results from multiplying a scalar function by a constant taken as a reference. Several examples using a parametric representation of the structural response show the suitability of the method that constitutes a sight of Stress Intensity Factor evaluation of Functionally Graded Materials plane plates even in the case of more complex geometries.

Abstract: This study was aimed to determine the influence of the volume fraction of steel fibers and on fracture parameters of concrete. Fifty notched steel fiber reinforced concrete (SFRC) beams and ordinary concrete beams with dimensions of 100mm×100mm×515mm were cast and tested via three-point bending test. Among them, the type of steel fiber is milling type (MF), and the volume fraction of steel fiber added is 0%, 0.5%, 0.5%, 1.5%, 1.5%, 2%, respectively. The effects of the steel fiber volume fraction (VF) on the critical stress intensity factor (KIC), fracture energy (GF), the deflection at failure(δ0), the critical crack mouth opening displacement (CMODC) and the critical crack tip opening displacement (CTODC)were studied. Through the analysis of test phenomena and test data such as load-deflection (P-δ) curve, load-crack mouth opening displacement (P-CMOD) curve and load-crack tip opening displacement (P-CTOD) curve following conclusions are drawn: With the increase of steel fiber volume fraction, some fracture parameters increase gradually and maintain a certain linear growth. The gain ratio of fracture parameters increases significantly, and the gain effect is obvious. Through this law of growth, the experimental statistical formulas of fracture energy and critical stress intensity factor are summarized.

Pre-existing fracture and secondary cracks in rock mass are formed by natural power, such as magma condensed to igneous rocks and tectonic movement. The orientation and inclination of these fractures obey certain laws relating to the stress, temperature, minerals, water and so on. Therefore, cracks react differently under the same external loading on the condition of various inclination, fissure apertures, stiffness and joint roughness. To simulate the crack propagation, experiments on hollow cylinder cut by one oblique interface mimicking single fracture accumulated numerous data discovering the failure criterion in accordance with the Mohr-Coulomb criterion. And theory on the Terzaghi’s effective principle take an essential role in controlling the behavior of triggering fault. This paper introduced a series of oblique plane cutting the cylinder regarded as fractures at different inclination to concentrate on how the fracture characteristics effect the stress and strain distribution inside the specimen, especially, the relationship between displacement and water head. The key point of this numerical simulation is coupling the solid phase and the fluid phase, specifically, the mechanic and seepage field. According to the statics, curves referring to deformation and water head could be described as increasing lines. Besides, simulation on coupling solid phase and fluid phase can supply crucial evaluation on activating existing fault, and thus predicting induced seismicity in reservoirs or estimating damage in shale gas exploration.

The present study investigates the failure mechanisms of industrial fiber materials, using a custom designed fiber cutting performance test bench. The fracture morphologies of single PA6 fibers are examined by scanning electron microscopy. The analysis reveals that fiber cutting can be distinguished according to four distinct stages of fiber failure represented by shearing, cutting, brittle fracture, and tensile failure, which are the result of different mechanisms active during the processes of crack initiation, extension and fracture. The results of fractographic analysis are further verified by an analysis of the blade assembly speed with respect to time over the entire fracture failure process based on high-speed camera data. The results of fractographic analysis and blade assembly speed are fully consistent.

Most of our bone are formed thought a process called endochondral ossification, which is a tiny, regulated process leaded by the chondrocytes of the GP and which require continuous cross talk between these cells and chondrocytes and invading cell populations, including osteoblasts, chondroclasts and vascular cells. The better understanding of these signaling pathways is not only important in the normal growth and maturation of the skeleton but might be highly relevant to pathophysiological processes in bones and joints. Since there is poor information about communication between chondrocytes and other cell types in the developing bones, this review examines the current knowledge of how interactions between chondrocytes and bone forming cells modulate bone growth.

Background: The implementation of tyrosine kinase inhibitors (TKIs) in the treatment of chronic myeloid leukemia (CML) has brought a significant improvement in the prognosis for CML patients and a decrease in the number of patients requiring allogeneic hematopoietic stem cell transplantation (allo-HCT). Nevertheless, the impact of TKIs on allo-HCT outcomes have not been thoroughly explored. Objectives: The main endpoint of our research was to assess the impact of prior TKI treatment on acute graft-versus-host disease (aGvHD) and chronic graft-versus-host disease (cGvHD). Methods: In our retrospective analysis we included 240 patients treated between 1993 and 2013, and divided them into 3 groups according to the therapy administered prior to matched related or matched unrelated donor allo-HCT (imatinib group n=41, dasatinib/nilotinib group n=28, TKI naïve group n=171). Results: Both the cumulative incidence of aGvHD (p=0.044) and cGvHD (p&lt;0.001) in individuals receiving second generation TKIs (2G-TKIs) prior to allo-HCT compared to patients receiving no TKIs or imatinib (IMA) (40.7% vs 61.4% vs 70.7%, p=0.044; 25.0% vs 76.4% vs 51.2%, p&lt;0.001, respectively). In case of the 2G-TKI cohort, the number of low-grade aGvHD and cGvHD was significantly lower compared to the IMA and TKI-naïve groups (p=0.018, p=0.004; p&lt;0.001 versus TKI-naïve, respectively). In terms of 3-year overall survival (OS) there were no important variations between TKI-naïve, IMA and 2G-TKI (55% vs 49.9% vs 69.6%, p=0.740). Conclusions: The results of our study suggest that TKI treatment prior to allo-HCT may have protective impact on immune-mediated outcomes.

This research investigates the fatigue behaviour and fracture mechanics of high-performance concrete (HPC), including various compositions such as HPC with basalt aggregates (HPC-B), HPC with gravel (HPC-G), and high-strength coarse mortar (CM) static and cyclic tensile loading within the special priority program SPP 2020. The study aims to integrate fracture mechanics into structural analysis to enhance design guidelines for slender cross-sections and safety-related high-performance structural components. The experimental investigations reveal HPC-B's re-markable superiority, displaying higher compressive strength, modulus of elasticity, and tensile strength compared to HPC-G and CM. A modified disk-shaped compact tension (MDCT) based on ASTM standards, aided by digital image correlation (DIC) unveils fracture behaviour, empha-sizing fracture energy as a crucial parameter. HPC-B exhibits improved crack resistance and notch sensitivity reduction attributed to crushed basalt aggregates and enhanced interfacial transition zone (ITZ). The research scrutinizes factors like material characterization, aggregate morphology, stress levels, and displacement rate on crack formation. High-cycle fatigue tests show HPC-B's superior performance, and post-fatigue analysis reveals enhanced residual fracture toughness attributed to nano-level structural changes, stress redistribution and aggregate-matrix interac-tion. 3D image analysis via Computed Tomography (CT) scans captures mesostructural crack propagation and provide quantitative insights. This study advances the understanding of HPC fatigue behaviour, emphasizing the interplay of aggregate types, morphologies, and their dy-namic response to cyclic loading, offering valuable insights for optimizing design guidelines and fostering innovation in structural engineering.

The potential of sericin, a protein derived from silkworms, is explored in bone graft applications. Sericin's biocompatibility, hydrophilic nature, and cost-effectiveness make it a promising candidate for enhancing traditional graft materials. Its antioxidant, anti-inflammatory, and UV-resistant properties contribute to a healthier bone-healing environment, and its incorporation into 3D-printed grafts could lead to personalized medical solutions. However, despite these promising attributes, there are still gaps in our understanding. The precise mechanism through which sericin influences bone cell growth and healing is not fully understood, and more comprehensive clinical trials are needed to confirm its long-term biocompatibility in humans. Furthermore, the best methods for incorporating sericin into existing graft materials are still under investigation, and potential allergic reactions or immune responses to sericin need further study.

Physical activity is widely recognized as a biotherapy by WHO in the fight and prevention of bone diseases such as osteoporosis. It reduces the risk of disabling fractures associated with many comorbidities, and whose repair is a major public health and economic issue. Bone tissue is a dynamic supportive tissue that reshapes itself according to the mechanical stresses to which it is exposed. Physical exercise is recognized as a key factor for bone health. However, the effects of exercise on bone quality depend on exercise protocols, duration, intensity and frequency. Today, the effects of different exercise modalities on capillary bone vascularization, bone blood flow and bone angiogenesis remain poorly understood and unclear. As vascularization is an integral part of bone repair process, the analysis of the preventive and/or curative effects of physical exercise is currently very undeveloped. Angiogenesis-osteogenesis coupling may constitute a new way for understanding the role of physical activity, especially in fracturing or in the integration of bone biomaterials. Thus, this review aims to clarify the link between physical activities, vascularization and bone repair.

Modeling carbonate growth in fractures and pores is important for understanding carbon sequestration in the environment or when supersaturated solutions are injected into rocks. Here we study the simple but nontrivial problem of calcite growth on fractures with rough walls of the same mineral using kinetic Monte Carlo simulations of attachment and detachment of molecules and scaling approaches. First we consider wedge-shaped fracture walls whose upper terraces are in the same low energy planes and show that the valleys are slowly filled by propagation of parallel monolayer steps in the wedge sides. The growth ceases when the walls reach these low energy configurations, so that a gap between the walls may not be filled. Secondly we consider fracture walls with equally separated monolayer steps (vicinal surfaces with roughness below $1$~nm) and show that growth by step propagation will eventually clog the fracture gap. In both cases, scaling approaches predict the times to attain the final configurations as a function of the initial geometry and of the step propagation velocity in the chosen supersaturation. The same reasoning applied to a random wall geometry shows that step propagation leads to lateral filling of surface valleys until the wall reaches the low-energy crystalline plane that has the smallest initial density of molecules. Thus, the final configurations of the fracture walls are much more sensitive to the crystallography than to the roughness or to the local curvature. The framework developed here may be used to determine those configurations, the times to reach them, and the mass of deposited mineral.

Post-mortem characterisation is a pivotal tool to trace back to the origin of structural failures in modern engineering analyses. This work presents a comparison of both the crack propagation profiles and the rupture roughness profiles based on areal parameters for total fracture area. Notched and smooth samples made of weather-resistant structural steel (10HNAP), popular S355J2 structural steel and aluminium alloy AA2017A under bending, torsion, and combined bending-torsion are investigated. After the fatigue tests, fatigue fractures are measured with an optical profilometer, and the relevant surface parameters are critically compared. The results show a great impact of the loading scenario on both the local profiles and the total fracture areas. In this work, the results of both approaches (local and total fracture zones) for specimens with different geometries are investigated. For all specimens, measured texture parameters decreased in the following order: total area, rupture area, and propagation area.

The loss or dysfunction of skeletal tissue often necessitates surgical intervention, particularly in cases involving trauma, tumors, or abnormal development leading to critical-sized defects. Despite autografts being considered the gold standard for bone grafts, their limitations and complications prompt the exploration of alternative approaches for bone repair and regeneration. Current advancements in bone tissue engineering have led to innovative strategies aiming to regenerate injured bone structures, providing viable alternatives to traditional autografts or allografts. Among these strategies, Hydrogel Microparticles (HMPs) have emerged as promising scaffolds due to their notable characteristics, including high porosity and mechanical tunability. HMPs play an important role in facilitating vasculature formation, mineral deposition, and overall bone tissue regeneration. HMPs, fabricated through various techniques, exhibit versatility in functions such as drug and cell delivery, structural scaffolding, and bioinks for 3D printing. In addition, these microgels can be injected for minimally invasive delivery and can display modular properties with different designs and configurations. This review exclusively focuses on the advancements in HMPs for bone regeneration, delving into synthesis and functionalization techniques while highlighting their diverse applications documented in the literature. Our aim is to shed light on the unique benefits and potential of HMPs in the intricate field of engineering bone tissue.

The lytic bone disease is a hallmark of multiple myeloma, being present in about 80% of patients with newly diagnosed MM, and in more during the disease course. The myeloma associated bone disease (MBD) severely affects the morbidity and quality of life of the patients. MBD defines treatment demanding MM. In recent years, knowledge of the underlying pathophysiology has increased, and novel imaging technologies, medical and non-pharmaceutical treatments have improved. In this review, we highlight the major achievements in understanding, diagnosing and treating MBD. For diagnosing MBD, low-dose whole-body CT is now recommended over conventional skeletal survey, but also more advanced functional imaging modalities, such as diffusion-weighted MRI and PET/CT are increasingly important in the assessment and monitoring of MBD. Bisphosphonates have, for many years, played a key role in management of MBD, but denosumab is now an alternative to bisphosphonates, especially in patients with renal impairment. Radiotherapy is used for uncontrolled pain, for impeding fractures and in treatment of impeding or symptomatic spinal cord compression. Cement augmentation has been shown to reduce pain from vertebral compression fractures. Cautious exercise programs are safe and feasible and may have the potential to improve the status of patients with MM.

Traumatic brain injury (TBI) is a major source of worldwide morbidity and mortality. Patients suffering from TBI exhibit a higher susceptibility to bone loss and an increased rate of bone fractures; however, the underlying mechanisms remain poorly defined. Herein, we observed significantly lower bone quality and elevated levels of inflammation in bone and bone marrow niche after controlled cortical impact-induced TBI in in-vivo CD-1 mice. Further, we identified dysregulated NFB signaling, an established mediator of osteoclast differentiation and bone loss, within the bone marrow niche of TBI mice. Ex vivo studies revealed increased osteoclast differentiation in bone marrow-derived cells from TBI mice, as compared to sham injured mice. Finally, we found bone marrow derived extracellular vesicles (EVs) from TBI mice enhanced the colony forming ability and osteoclast differentiation efficacy of bone marrow cells and activated NFB signaling genes in bone marrow-derived cells. Taken together, we provide evidence that TBI-induced inflammatory stress on bone and the bone marrow niche may activate NFB leading to accelerated bone loss. Targeted inhibition of these signaling pathways may reverse TBI-induced bone loss and reduce fracture rates.

Background: Good reduction of the articular surface and restoration of the congruent joint space are crucial for promoting positive outcomes in ankle fracture treatment. A good understanding of the mechanism of ankle fractures is indispensable to achieve these goals. Unfortunately, until now, the mechanism has still not been fully elucidated, particularly regarding the posterior malleolar fractures (PMFs). This study aims to provide insight into the mechanism of PMFs, thereby grasping the key to proceeding with PMFs reduction and fixation. Methods: An FE model of a normal ankle in tiptoe posture with 9 collateral ligaments was constructed from CT images. On the model, lateral malleolar fractures were made below, through, and above the syndesmosis; the medial malleolus was broken at its base; and ligaments were suppressed to simulate ligament rupture. A force of 1000 Newtons was applied on the talus head along talus axis. The posterior malleolar fragment (PMF) displacement, whether the talus impacts the posterior malleolus, and the initial mechanism displacing the PMF, were recorded. Results: A total of 15 tests were conducted. The tests, 'all collateral ligaments rupture', 'LMFB', 'LMFC+AITFL rupture', 'ATFL+CFL+PTFL rupture', 'ATTL+PTTL+TCL rupture', 'MMF', and 'MMF+AITFL rupture', presented significant PMF displacement. In tests 'MMF' and 'ATTL+PTTL+TCL rupture', the talus hit the medial edge of the PMF; but in tests 'ATFL+CFL+PTFL rupture' and 'all collateral ligaments rupture', the talus impacted the center part of the PMF. Except tests 'all collateral ligaments rupture' and 'ATFL+CFL+PTFL rupture', where PMF displacement was initially caused by talus impact, the other tests demonstrated PMF displaced following PITFL drag. Conclusions: This research discovered that rotation is the initial and major mechanism causing PMF displacement. The subsequent impact of the talus on the posterior malleolus may be the reason for large/blocky PMF. The talus impacting the posterior malleolus is always combined with talus rotation. Without the medial ankle structure being broken, big/blocky PMF may not occur. These findings suggest that, in clinical practice, reconstructing both the medial and lateral ankle structures is critical for achieving ankle stability, and this procedure even takes precedence over posterior malleolar fracture fixation itself.

Osteoporotic vertebral fracture is the most common fracture from osteoporosis, and are largely undiagnosed due to the mostly asymptomatic nature of the condition. It increases the risk of subsequent fractures and contributes to societal burden. Risk factors for osteoporotic fractures are found in the WHO fracture risk assessment model and used as a tool for monitoring bone health. Vertebral fractures are diagnosed from anteroposterior and lateral spine radiographs and are confirmed with an approximate loss of 20% vertebral height as compared to adjacent vertebrae. One of the most used grading for vertebral fractures is the SQ grading. Mild vertebral fractures could easily be misdiagnosed due to some peculiarities of the vertebral column. CT scan is useful for planning surgical intervention while an MRI scan can provide information about the recency of the fracture and rule out cancer-related fractures. Management depends on the severity of the fracture which could range from conservative management to surgical vertebral augmentation and decompression. Bisphosphonates are used to treat osteoporosis in acute and long-term management of fractures. Osteoimmunological therapies such as denosumab and romosozumab are new therapeutic interventions for osteoporosis while there are many other potential treatment options. Precision medicine provides an individualized treatment approach while regenerative medicine utilizes mesenchymal stem cells for fracture repair.

NASA/ESA/CSA joint venture James Webb Space Telescope is about to be launched. It is hypothesized to operate in near-infrared range. It is also hypothesized to unveil early star formation, galaxies, and universe due to its orbit, point in orbit and orbital motion. It has been under manufacturing for over 20 years at a staggering cost of 10 billion US dollars (most expensive scientific experiment in history). Beryllium (Be) is chosen to be element for construction of its main mirrors due to its high stiffness, low density, low linear coefficient of thermal expansion (α) in cryogenics and high thermal conductivity. It is followed by gold (Au) layer deposition on its (Be) surface to enhance its sensitivity towards infrared radiation as later is hypothesized to bear superior properties. However, serious mistakes have been made in selecting this material for this application. Owing to its crystal structure (hexagonal close packed (hcp)), slip planes (basal, prismatic and pyramidal) and mechanisms of their activation, Be necessitates easy fracture at cryogenic temperature. It has anisotropic properties and prone to transverse fracture under tensile loading. Furthermore, its ductile to brittle transition temperature is very low making it entirely unsuitable for such an application. It is one of most expensive metals on planet. This study constitutes revisiting these fundamental properties and mechanisms which were entirely ignored during materials selection thus rendering whole project useless.

The paper aims in assessing risks of mandible fractures consequent to impacts or sport accidents. The role of the structural stiffness of mandible, related to disocclusion state, is evaluated through numerical simulations using the finite element method (FEM). It has been assumed that the quasi-static stress field, due to distributed forces developed during accidents, could explain the common types of mandibular fractures. Geometric model of adolescent mandible was built, upon the basis of medical imaging, in CAD software with distinction between cortical layer and inner spongy bone. The finite element model of disoccluded mandible was next created. Mandibular condyles were supposed jammed in the maxillary fossae. The total force of 700 N, simulating an impact on mandible, has been sequentially applied in three distinct areas: centrally, at canine zone and at the mandibular angle. Clinically most frequent fractures of mandible were recognized through the analysis of maximal principal stress and maximal principal strain fields. Mandibular fracture during accidents can be analyzed at satisfactory level using linear quasi-static FE models for designing protections in sport and transport. The proposed approach can be improved by introducing more realistic interactions between condylar processes and fossae.

Plasma treatment of soft polymers is the promising technique to improve biomedical properties. The response to the deformation of such materials is not yet clear. Soft elastic polyurethane treated with plasma immersion ion implantation is subjected to fatigue uniaxial loading (50000 cycles, frequency – 1 Hz, strain amplitude – 10, 20, 40%). The influence of the strain amplitude and the plasma treatment regime on damage character is discussed. Surface defects are studied in unloaded and stretched states of the material. As a result of fatigue loading, transverse cracks (with closed overlapping edges as well as with open edges deeply propagating into the polymer) and longitudinal folds which are break and bend inward, appear on the surface. Hard edges of cracks cut the soft polymer which is squeezed from the bulk to the surface.

Study design: Retrospective cohort study. Objectives: To investigate the outcomes of early ballon kyphoplasty (BKP) intervention compared with late intervention for osteoporotic vertebral fracture. Background: Osteoporotic vertebral fractures, can lead to kyphotic deformity, severe back pain, depression, and disturbances in activities of daily living (ADL). BKP has been widely utilized to treat symptomatic OVFs and has proven to be a very effective surgical option for this condition. BKP is relatively a safe and effective method due to less acrylic cement leakage and greater kyphosis correction. Materials and Methods: A retrospective comparative study was conducted at our hospital for patients who underwent BKP for osteoporotic vertebral fractures in the time frame between January 2020 and December 2022. Ninety-nine patients were included in this study, patients were classified into two groups: 36 patients underwent early BKP intervention (EI)

Cervical injuries from athletic activities are rare; they can have severe consequences if not diagnosed and managed promptly. The choice of diagnostic imaging modality is pivotal in ensuring timely and accurate diagnosis. We detail the case of a 19-year-old female athlete who sustained a C2 Durel Type II Subclass C fracture during a short-track speed skating championship. Initial evaluation using X-ray imaging at the athletic center medical facility did not detect the injury, allowing her to continue competing. Persistent pain led to further evaluation at our institution, where MRI and CT scans confirmed the fracture. Approximately 45 days post-injury, the patient underwent a successful surgical intervention utilizing O-arm CBCT navigation for C1-C2 dorsal fusion. Post-surgery, she embarked on a comprehensive rehabilitation program and fully recovered within 12 weeks. This case underscores the limitations of relying solely on X-ray imaging for diagnosing cervical fractures post-trauma. Our findings advocate prioritizing CT scans as a primary diagnostic tool in such scenarios, emphasizing the need for a robust diagnostic approach to ensure athlete safety and well.

Fracture and failure performance of foamed concrete materials were conducted using three methods, i.e., inverse analysis, digital image correlation (DIC) and finite element modelling (FEM) from tested normalized notched beams under three-point bending. From this study, several characteristics both experimental and FEM are discussed. However inverse analysis is only well applicable for series GF-30. The bilinear softening of the testing beam was estimated to identify fracture energy (GF), critical crack length (ac) and elastic modulus (E) with values of 0.015 N/mm, 54.5 mm, and 13 GPa, respectively. Additionally, fracture toughness was calculated by adopting double-K (initiation fracture of 6.907 MPa.mm0.5, unstable fracture of 23.186 MPa.mm0.5 and cohesive fracture of 16.278 MPa.mm0.5). Two-dimensional FEA Modelling of fracture was carried out using a Traction Separation Law (TSL), incorporating extended finite element method (XFEM) and cohesive zone (CZM) techniques. A sensitivity study was carried out, global mesh size of two and damage stabilization cohesive with the value of 1 × 10-5 showed good convergence and were used in other models. Furthermore, by comparing experimental observation using DIC, reliability FEM was validated and showed good acceptance to simulating the crack propagation.

Geological structures such as joints and faults in rock mass have significant influence on open pit mining. Hence, it is critical to develop a understanding of dynamic joint behaviour under blasting loading. This in turn can provide both theoretical and practical guidance to improve blasting rock fragmentation and associated bucket excavating efficiency. In this paper, delayed blasting on the highwall bench at Baiyunebo open-pit mine was used as an example, a nonlinear joint blasting model was also constructed. By simplifying the blasting wave propagation velocity, the P-wave normal incidence to the joint was obtained. The peak vibration velocity was 0.33m/s at 3.0s. The S-wave reflected by the joint interface was first reflected backward and then forward, which the peak vibration velocity was 0.027 m/s. By combining the relevant stress and displacement theories of type I and II cracks, the equipotential diagrams of the stress and displacement field with the vibration velocity of the particle were obtained. σx was positive in the direction of 0~330° and subjected to tensile stress, whereas σy was positive in the direction of 0~180° and under tensile stress. The longitudinal σy along joint was low in compressive stress distribution area and did not affect surrounding rock at the time. The stress concentration appeared in the lower right corner. Based on the continuous behavior of stress wave in joints, the asymmetry and continuous changes reflected in the whole process could not be analysed by the contour diagram. Hence, ANSYS used to analyse distribution of the stress field. The intensity of the shock wave after detonation was greater than that of the rock strength. Subsequently, the sub-layer shock wave supplemented the shock wave energy that was not enough to break the rock and induced further cracking. This was able to be visualized by the degree of color change post-processing. It was concluded that with the attenuation of the detonation wave energy, the stress exhibited a decreasing trend in this process. According to distribution of the peak effective stress, it was found that the peak value first increased to 10-12 MPa and then showed a downward trend. Overall, the results were validated against the finite element simulation and mathematical analysis.

A single fracture is the basic unit of fracture medium, and the roughness of fracture wall surface is an important factor influencing hydraulic characteristics of the flow in bedrock fracture. However, effects of the shape and density of roughness elements (various bulges/pits on rough fracture wall surfaces) on water flow in a single rough fracture have not been thoroughly discovered. Thus the water flow in single fracture with different shapes and densities of roughness elements was simulated by using Fluent software in this study. The results show that in wider fractures the flow rate mainly depends on fracture aperture, while in narrow and close fracture medium the surface roughness of fracture wall is the main factor of head loss of seepage; there is a negative power exponential relation between the hydraulic gradient index and the average fracture aperture, i.e. with the increase of fracture aperture, the relative roughness of fracture and the influence weight of hydraulic gradient both decrease; and in symmetrical-uncoupled fractures there is a super-cubic relation between the discharge per unit width and average aperture. Above results would help to deepen the understanding of rough fracture seepage.

Acid fracturing simulation is used widely to optimize carbonate reservoirs and improve acid fracturing treatment performance. In this study, a method was used to minimize the risk of the acid fracturing treatment. First, optimal fracture geometry parameters with UFD methods are calculated. After that, design components change as long as fracture geometry parameters reach their optimal values. The results showed a high flow rate needed to achieve optimal fracture geometry parameters with increasing acid volume. Sensitivity analysis was performed on controllable and reservoir parameters. It observed that a high flow rate should be applied for a low fluid viscosity to achieve the optimization goals. Straight acid reaches optimal conditions at a high flow rate and low volume. These conditions for retarded acids appear only at a low flow rate and high volume. The study of the acid concentration for gelled acid showed that as it increased, the flow rate and volume increased. Besides, for low permeability formation, a large fracture half-length and small fracture width are desirable. In this case, a higher flow rate will be required. The sensitivity analysis showed that the optimum flow rate and acid volume increase and decrease for the high Young's modulus. The effect of closure stress was also investigated and observed for a sample with high closure stress, low flow rate, and high acid volume are required.

Total Hip Arthroplasty is one of the most successful surgery. However, due to the worldwide growing population life expectancy and the related incidence of age-dependent bone diseases, a growing number of cases of intra-operative fractures lead to revision surgery with high rates of morbidity and mortality. Surgeons choose the type of the implant, either cemented or cementless prosthesis, on the basis of the age, the quality of the bone and the general medical conditions of the patients. Generally, no quantitative measures are available to assess the intra-operative fracture risk. Consequently, the decision-making process is mainly based on medical operators’ expertise and qualitative information obtained by imaging. Motivated by this scenario, we here propose a mechanical-supported strategy to assist surgeons in their decisions, by giving intelligible maps of the risk fracture which take into account the interplay between actual strength distribution inside the bone tissue and its response to the forces exerted by the implant. To this end, we produce charts and patient-specific synthetic “traffic-light” indicators of fracture risk, by making use of ad hoc analytical solutions to predict the stress levels in the bone by means of CT-based mechanical and geometrical parameters of the patient. We felt that, if implemented in a friendly software or proposed as an app, the strategy could constitute a practical tool to help the medical decision-making process, in particular with respect to the choice of adopting cemented or cementless implant

Modeling fluid flow in three-dimensional (3D) Discrete Fracture Networks (DFNs) is of relevance in many engineering applications, such as hydraulic fracturing, oil/gas production, geothermal energy extraction, nuclear waste disposal and CO₂ sequestration. A new Boundary Element Method (BEM) technique with discontinuous quadratic elements and a parallel Domain Decomposition Method (DDM) is presented herein for the simulation of the steady-state fluid flow in 3D DFN systems with wellbores, consisting of planar fractures having arbitrary properties and wellbore trajectories. Numerical examples characterized by DFNs of increasing complexity are investigated to evaluate the accuracy and efficiency of the presented technique. The results show that accurate solutions can be obtained with less nodes than with mesh-based methods (e.g. Finite Element Method). In addition, the DDM algorithm used provides a quite fast convergence. The simulation results of the fluid flow around intersections among traces (linear intersections between fractures), intersections between traces and a fracture boundaries, and wellbore intersections is accurate. Source code is available at : https://github.com/BinWang0213/PyDFN3D.

The reinforcement of concrete by using polyolefin fibres may be considered in structural design to meet the requirements of the applicable code rules. In order to achieve a reliable use of such a composite material, use of full-scale real structures is needed. The conversion of lab testing data into real practice properties is challenging and significantly influenced by various aspects, among which the size effect is a key one. Given that the available literature does not report coinciding conclusions about such an effect on quasi-brittle materials reinforced with fibres, further research is justified. Therefore, this work studies the behaviour of notched beams with three proportional sizes by using self-compacting polyolefin reinforced concrete with a fibre volume fraction of 1.1%. Flexural testing was carried out according to the standard EN-14651, with the results revealing the existence of the size effect. In addition, a reduction of the residual strength identified in the larger specimens was observed in fracture surfaces with equal fibre content.

Fracture grouting has been a widely used mitigation measure against seepage in the Yellow River Embankment. However, there is currently a lack of systematic investigation for evaluating the anti-seepage effectiveness of fracture grouting employed in this longest river embankment in China. Therefore, in this work, laboratory and in-situ experiments are carried out for investigating the reinforcement effect of fracture grouting in the Jinan Section of the Yellow River Embankment. In particular, firstly, the laboratory tests concentrate on studying the optimum strength improvement for cement-silicate grout by varying the content of backfilled fly ash and bentonite as admixtures. Flexural strength and Scanning Electron Microscope photographs are investigated for assessing the strength and compactness improvement. Subsequently, based on the obtained optimum admixtures content, in-situ grouting tests are carried out in the Jinan Section of the Yellow River Embankment to evaluate the anti-seepage effectiveness of fracture grouting, where geophysical prospecting and pit prospecting methods are employed. Laboratory results show that, compared with pure cement-silicate grouts, the gelation time of the improved slurry is longer and gelation time increases as fly ash content increases. The optimum mixing proportion of the compound cement-silicate grout is 70% cement, 25% fly ash and 5% bentonite, and the best volume ratio is 2 for the investigated cases. Geophysical prospecting using the Ground Penetrating Radar and High Density Resistivity methods can reflect the anti-seepage effectiveness of fracture grouting on site. It shows that the grouting material mainly flows along the axial direction of the embankment. The treatment that is used to generate directional fracture is proved to be effective. The injection hole interval distance is suggested to be 1.2 m, where the lapping effect of the grouting veins is relatively significant. For the investigated cases, the average thickness of the grouting veins is approximately 6.0 cm and the corresponding permeability coefficient is averagely 1.6 × 10⁻⁶ cm/s, which meets the anti-seepage criterion in practice.

Segmental bone defects caused by trauma, infection, tumor resection or osteoporotic fractures present significant surgical treatment challenges. Host bone autograft is considered the gold standard to restore function but comes with the cost of harvest site comorbidity. Allograft bone is a secondary option but has its own limitations in incorporation with host bone as well as cost. Therefore, developing new bone tissue engineering strategies to treat bone defects is critically needed. In the past three decades, the use of stem cells delivered with different scaffolds or growth factors for bone tissue engineering has made tremendous progress. Many varieties of stem cells have been isolated from different tissues for use in bone tissue engineering. This review summarizes the progress in using different postnatal stem cells including bone marrow mesenchymal stem cells, muscle-derived stem cells, adipose-derived stem cells, dental pulp stem cells/periodontal ligament stem cells, periosteum stem cells, umbilical cord-derived stem cells, peripheral blood stem cells and urine-derived stem cells for bone tissue engineering and repair. This review also summarizes the progress using exosomes or extracellular vesicles delivered with various scaffolds for bone repair. The advantages and disadvantages of each type of stem cell are also discussed and explained in detail. It is hopeful in the future that these preclinical results will translate into new therapies for bone defect repair.

The regeneration of bone tissue is a main purpose of most therapies in dental medicine. For bone regeneration, calcium phosphate (CaP)-based substitute materials based on natural (allo- and xenografts) and synthetic origins (alloplastic materials) are applied for guiding the regeneration processes. The optimal bone substitute has to act as a substrate for bone ingrowth into a defect, while it should be resorbed even in the time frame needed for complete regeneration up to the condition of restitution ad integrum. In this context, the modes of action of CaP-based substitute materials have been frequently investigated and it has been shown that such materials strongly influence regenerative processes such as osteoblast growth or differentiation and also on osteoclastic resorption due to different physicochemical properties of the materials. However, the material characteristics needed for the required ratio between the formation of new bone tissue and material degradation has not been found until now. The addition of different substances such as collagen or growth factors and also of different cell types have already been tested but did not allow for sufficient or prompt application. Moreover, metals or metal ions are differently used as basis or as supplement for different materials in the field of bone regeneration. Moreover, it has already been shown that different metal ions are integral components of bone tissue playing functional roles in the physiological cellular environment as well as in the course of bone healing. The present review focuses on frequently used metals as integral parts of materials designated for bone regeneration with the aim to give an overview of currently existing knowledge about the effects of metals in the field of bone regeneration.

INTRODUCTION AND OBJECTIVES: Osteoporosis is a common consequence of androgen deprivation therapy (ADT) for prostate cancer. Up to 20% of men on ADT have suffered from fracture within 5 years. The WHO Fracture Risk Assessment Tool (FRAX) has been utilized to predict the 10-year probability of major osteoporotic and hip fracture. However, no large studies assessing the utility of FRAX with versus without dual-energy X-ray absorptiometry (DEXA) in prostate cancer patients have been performed. We validated the usefulness of FRAX combined with DEXA in men with prostate cancer. METHODS: FRAX was done in a total of 1,220 prostate cancer patients including those who underwent brachytherapy (n=547), radical prostatectomy (n=200), external beam radiation therapy (n=264), hormonal therapy only (n=187), and definitive treatment along with hormonal therapy (n=645) in Yokohama City University Hospital. Of these, 109 patients received DEXA. RESULTS: In men without receiving DEXA, the median (mean ± SD) risks for major osteoporotic and hip fracture were 8.5% (9.3 ± 4.8) and 3.2% (4.2 ± 3.9), respectively. One hundred sixteen (9.5%) and 634 (52.0%) of these patients had the major osteoporotic risk of more than 15% and hip fracture risk of more than 3%, respectively. In contrast, in men with DEXA, the median (mean ± SD) risks for major osteoporotic and hip fracture were 5.3% (5.4 ± 2.1) and 0.85% (1.3 ± 1.2), respectively. Two (0.2%) and 4 (8.0%) of these patients had the major osteoporotic risk of more than 15% and hip fracture risk of more than 3%, respectively [Table1]. In the same cohort who received DEXA, the risks for major osteoporotic (p < 0.001) and hip (p < 0.001) fracture were significantly lower in men with DEXA than in those without DEXA. CONCLUSIONS: Our results suggest that FRAX combined with DEXA might prevent unnecessary osteoporosis medication in prostate cancer patients.

The occurrence of bone-related disorders and diseases has increased dramatically in recent years around the world. Demineralized bone matrix (DBM) has been widely used as a bone implant due to its osteoinduction and bioactivity. However, the use of DBM is limited because it is a particulate material, which makes it difficult to manipulate and implant with precision, in addition, these particles are susceptible to migrate to other sites. To address this situation, DBM is commonly incorporated into a variety of carriers. An injectable scaffold has advantages over bone grafts or preformed scaffolds, such as the ability to flow and fill the bone defect. The aim of this research is to develop a DBM carrier with such viscoelastic properties to obtain an injectable bone substitute (IBS). The DBM carrier developed consisted of a PVA/glycerol network cross-linked with borax and reinforced with CaCO3 as a pH neutralizer, porosity generator, and source of Ca. The physicochemical properties were determined by the injectability test, FTIR, SEM, and TGA. Porosity, degradation, bioactivity, possible cytotoxic effect, and proliferation in osteoblasts were also determined. The results show that the developed material has great potential to be used in bone tissue regeneration

Background: One challenge in implant dentistry is to reduce marginal bone resorption to avoid long-term esthetic and biological complications. Sub-gingival implant placement has been suggested as a suitable strategy. Methods: 38 healthy patients were enrolled to receive bone level (BL – Control group) or 2 mm sub-crestal (SC - Test group) conical connection, platform-switched implants. An immediate tissue level abutment was used in the Test group by following a One Time Abutment (OTA) restorative procedure. Marginal Bone Modification (MBM) was calcu-latied on standardized radiographs at surgery (T0), loading (T1), and 6 months (T2) and 12 months after loading (T3), and cathegorised in Bone Loss (BL) if the resorption occurred below the implant neck and Bone Remodeling (BR) if above. Pocket probing depth (PPD), Bleeding on probing (BoP) and Plaque Index (PI) were also collected. Results: The mean MBM in the test group after 12 months was 0.61mm, compared to 0.52mm in the control group. However, no BL was observed in the test group, as the MBM completely occurred above the implant neck as BR, whilst in the control group MBM corresponded in total to BL. The average PPD was 2.38mm in the test group and 3.04mm in the control group after 12 months, BoP 50% and 43%, PI 33% and 19.44% respectively. Conclusions: Sub-crestal conical connection, platform-switched implants could be a suitable clinical choice to avoid BL with exposure of the treated implants surfaces.

This review summarises the complex relationship between medications used to treat type 2 diabetes, and bone health. T2DM patients face an increased fracture risk despite higher bone mineral density, thus we analysed the impact of key drug classes, including Metformin, Sulphonylureas, SGLT-2 inhibitors, DPP-4 inhibitors, GLP-1 agonists, and Thiazolidinediones. Metformin, despite promising preclinical results, lacks a clear consensus on its role in reducing fracture risk. Sulphonylureas present conflicting data, with potential neutral effects on bone. SGLT-2 inhibitors seem to have a transient impact on serum calcium and phosphorus, but evidence on their fracture association is inconclusive. DPP-4 inhibitors emerge as promising contributors to bone health, as well as GLP-1 agonists exhibit positive effects on bone metabolism, reducing fracture risk. Thiazolidinediones, however, demonstrate adverse impacts on bone, inducing loss through mesenchymal stem cell effects. Insulin presents a complex relationship with bone health. While it has an anabolic effect on bone mineral density, its role in fracture risk remains inconsistent. In conclusion, a comprehensive understanding of diabetes medications' impact on bone health is crucial. Further research is needed to formulate clear guidelines for managing bone health in diabetic patients, considering individual profiles, glycemic control and potential medication-related effects on bone.

Background: The conformation of the recipient site for an inlay graft presents an increased contact with the parent bone compared to the onlay graft. This might favor bone growth within the inlay compared to the onlay grafts. Hence, the objective of this study was to compare bone incorporation and remodeling process of xenogeneic en bloc grafts, placed using two bone grafting techniques, i.e., onlay vs. inlay. Methods: In this prospective, randomized, split-mouth study (test and control sides in the same animal), two bone grafting techniques were comparatively evaluated on the lateral aspect of the rabbit mandibles. One side was prepared with perforations (onlay site), whereas the other side was prepared with trephines and drills to obtain a wide (7 mm) standardized recipient site (inlay site). A xenogeneic bone block was fixed in the center with a titanium screw in both sides of the mandible and covered with a collagen membrane. Two healing periods were applied in the study: 2 and 10 weeks of healing. Results: after 2 weeks of healing, the mean percentage of new bone was 10.4% and 23.3% at the onlay and inlay grafts, respectively (p=0.022). After 10 weeks of healing, new bone increased to 13.2% and 25.4%, respectively (p=0.080). In this period of healing, the inlay grafts presented new bone percentage &gt;20% in all regions examined while the onlay graft presented a lower percentage in the most external regions of the graft. Conclusion: The percentage of new bone increased faster and was higher in the inlay compared to the onlay grafts. The composition of the grafts allowed new bone to reach the most peripheral regions in both graft groups, even though it was higher in the inlay group. A marginal closure of the defects by newly formed bone was observed in the inlay group.

A potential association between hematopoietic stem cell status in the bone marrow and the surrounding bone tissue has been hypothesized, and some studies have investigated the link between blood count and bone mineral density (BMD), although their exact relationship remains controversial. Moreover, biological factors linking the two are largely unknown. In our present study, we found no clear association between platelet count and BMD in the female group, with aging having a very strong effect on BMD. On the other hand, a significant negative correlation was found between platelet count and BMD in the male group. As a potential mechanism, we examined whether megakaryocytes, the source of platelet production, secrete cytokines that regulate BMD, namely OPG, M-CSF, and RANKL. We detected the production of these cytokines by megakaryocytes deriving from bone marrow mononuclear cells and found that RANKL was negatively correlated with BMD. This finding suggests that RANKL production by megakaryocytes may mediate the negative correlation between platelet count and BMD. To our knowledge, this is the first report to analyze bone marrow cells as a mechanism for the association between blood count and BMD. Our study may provide new insights into the development and potential treatment of osteoporosis.

Background: Our previous study revealed that the addition of pentavalent cations, such as niobium (Nb), to zirconia stabilized with trivalent cations, such as yttrium (Y), increased fracture toughness. However, the coefficient of thermal expansion (CTE) and opacity also increased undesirably. Thus, a novel surface treatment is required to enhance fracture toughness without changing the CTE and the translucency. Methods: The surfaces of pre-sintered 3-mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) and 4.2-mol% yttria-stabilized partially stabilized zirconia (4.2Y-PSZ) were treated with an Nb sol solution containing Nb2O5 nanoparticles. After drying and final sintering, a surface layer with high Nb content formed to a depth of approximately 1 mm. Results: Nb was equivalent to that of the bulk uniformly containing 1 mol% Nb2O5. The tetragonality of tetragonal zirconia near the surface increased with the addition of Nb, leading to improve fracture toughness in the surface layer and enhancing the fracture toughness of the entire specimen. However, the CTE and the translucency remained unchanged. Conclusions: The addition of pentavalent cations such as Nb, confined to the surface vicinity, improved fracture toughness without affecting the CTE and the translucency. By selectively adding Nb to the surface of weak parts of zirconia prosthesis, the overall strength can be improved, making it possible to produce highly reliable dental restorations.

Our daily activities hinge on the flexibility of our fingers, and a fractured finger can significantly disrupt these routines. The finger bones enable us to bend and fold the fingers and thumb to pick up or grasp objects and do all of our daily activities. A broken finger can cause adverse effects on our daily life activities. It is important to treat broken finger as soon as possible. Swift and precise treatment begins with capturing multiple X-rays, followed by the critical step of fracture detection in these images. Relying on the naked eye for this task carries the risk of overlooking small fractures. To address this issue an automated diagnoses of fractured fingers from images is required for which the current research employs advanced deep learning models—ResNet34, ResNet50, ResNet101, ResNet152, VGG-16, and VGG-19—to classify finger images from the Musculoskeletal Radiographs (MURA) dataset as either fractured or non-fractured. The results emphasize the consistently strong performance of ResNet models, attaining an impressive accuracy of 81.9%. This surpasses VGG models by 3.4% and establishes ResNet as the new benchmark for state-of-the-art accuracy.

Hydraulic fracturing is an efficient method to develop oil/gas resources economically. Temporary plugging and diverting fracturing (TPDF) can generate diversion fractures perpendicular to the initial fractures and enhance the stimulated area. The aperture of the diversion fractures determines its conductivity and the oil/gas production. This work established a fluid-solid fully coupled simulation model to investigate the fracture aperture influenced by various factors during TPDF. The factors include the permeability of the tight plug, the length of the tight plug, Young’s modulus, rock tensile strength, in-situ stress contrast, the leak-off coefficient of the fracture surface, and fluid injection rate. Results show that the aperture of the previous fracture can be enlarged, and the aperture of the diversion fracture can be decreased by the tight plug. The aperture at the diversion fracture mouth is much smaller than that along the diversion fracture. Reservoirs with low Young’s modulus and high rock tensile strength can generate the diversion fracture with a wider aperture. Moreover, increasing the fluid injection rate can effectively increase the fracture mouth aperture. In this way, the risk of screenout can be lowered. This work is beneficial for the design of the TPDF and ensures safe construction.

Background: Calcaneal fractures are the most frequent traumatic injuries of the hindfoot and can cause severe disability with social and economic sequelae; since 1980 an increasing number of studies and new technologies have led to an improvement in their management and complications but treatment is still controversial. The purpose of the study to review the secondary scientific literature looking for the optimal management of calcaneal fracture; Methods: through the PubMed MEDLINE database, 4856 articles were identified; only meta-analyses and systematic reviews were included in the study. Results: 59 reviews with more than 10,000 calcaneus fractures were examined and results were divided into various topics; the majority of articles agree on the superiority of surgical versus conservative treatment; minimally invasive access to the sinus tarsi shows better results and fewer complications than traditional extended lateral access; reduction and osteosynthesis with percutaneous and/or minimally invasive techniques seem to provide better outcomes if compared to open treatments. Conclusions: The management of calcaneus fractures requires an individualized planning based on the functional demands of the patient, the type of fracture and associated injuries. New technologies and further studies may still improve the management of these lesions.

Background and objectives: Thoracolumbar fracture – dislocations (AO type C) are rare injuries that occur due to very high-energy trauma, and the result is transitional and rotational instability of the spinal column and neurological impairment. Several reduction maneuvers have thus far been published, each of which can be of use in certain specific situations. We developed a novel modification to the previously described reduction technique. Materials and methods: This is a retrospective review of the management of thoracic AO type C fracture-dislocations managed with a modified novel reduction technique. The success of the reduction and intraoperative iatro-genic complications such as dural tear and screw pull out were the outcomes analyzed. Results: A total of 4 cases were successfully reduced with this novel reduction technique. We did not note any complications such as a dural tear or screw failure with this modified novel reduction tech-nique. Conclusion: The novel modification to the reduction technique employed in the management of thoracic fracture-dislocations resulted in a successful reduction without the risk of iatrogenic complications due to the reduction maneuver.

Hydraulic fracturing for oil-gas and geothermal reservoir stimulation is closely related to the generation and propagation of Mode I crack. Nonlinear deformation due to rock heterogeneity occurs at such crack tip, which causes the fracture process zone (FPZ) to form before the crack propagates unsteadily. However, the relationship between the FPZ characteristics and rock heterogeneity still remain elusive. We used three rock types common in reservoir for experimental investigation, and each of them includes two subtypes with different heterogeneity due to grain size or microstructural characteristics. Drawing on the experiment results, we calculated the FPZ size in each cracked chevron notched Brazilian disk, and we reproduced the formation process of the FPZ in marble by discrete element method. We showed that strong heterogeneity is favorable to large FPZ size, can enhance the ability of crack generation and complicate crack morphology. Coupling the Weibull distribution with fracture mechanics, the dependence of the FPZ size on heterogeneity degree can be theoretically explained, which suggests that inherent heterogeneity of rocks set physical foundation for formation of FPZ. These findings can improve our recognition to formation mechanism of the Mode I crack and provide useful guidelines for evaluating reservoir fracability.

This paper concerns the effect of proppant embedment related with hydraulic fracturing treatment. This phenomenon occurs if the strength of the reservoir rock is lower than proppant grains. The aim of the research is laboratory determining the loss of width of the proppant pack built of light ceramic grains. The laboratory simulation of the embedment phenomenon was carried out for a shale rock on a hydraulic press, in a specially prepared for this purpose a heated embedment chamber. Tests were conducted at high temperature and axial compressive stress conditions. The surfaces of the cylindrical core plugs (fracture faces) were imaged under an optical microscope equipped with 3D software. The fracture faces were examined and compared before and after the embedment phenomenon. The analysis of the obtained images of the fracture face were made based on the research method of the embedment phenomenon developed at Oil and Gas Institute-NRI. On the basis of laboratory tests, the parameters characterizing the embedment phenomenon were collected and discussed. In addition, the percentage reduction in the width of the proppant pack was determined.

Nonlinear rheological properties of chiral crystal cholesteryl oleyl carbonate (COC) in blue phase III are investigated under different shear deformations; large amplitude oscillatory shear, step shear deformation, and continuous shear flow. Rheology of the liquid crystal is significantly affected by structural rearrangement of defects under shear flow. One of the examples on the defect-mediated rheology is the blue phase rheology. Blue phase is characterized by three dimensional network structure of the disclination lines. It has been numerically studied that the rheological behavior of the blue phase is dominated by destruction and creation of the disclination networks. In this study, we find that the nonlinear viscoelasticity of BPIII is characterized by the fracture of the disclination networks. Depending on the degree of the fracture, the nonlinear viscoelasticity is divided into two regimes; the weak nonlinear regime where the disclination network locally fractures but still show elastic response, and the strong nonlinear regime where the shear deformation breaks up the networks, which results in a loss of the elasticity. Continuous shear deformation reveals that a series of the fracture process delays with shear rate. The shear rate dependence suggests that force balance between the elastic force acting on the disclination lines and the viscous force determines the fracture behavior.

Laser patterning of implant materials for bone tissue engineering purposes has shown to be a promising technique to control cell properties such as adhesion or differentiation, resulting in an enhanced osteointegration. However, the perspective of patterning the bone tissue side interface to generate microstructure effects has never been investigated. In the present study, three different laser-generated patterns were machined on the bone surface with the aim to identify the best surface morphology compatible with osteogenic-related cells recolonization. The laser patterned bone tissue was characterized by electron scanning microscopy and confocal microscopy in order to obtain a comprehensive picture of the bone surface morphology. Cortical bone patterning impact upon cell compatibility and cytoskeleton rearrangement to the patterned surfaces was performed with Stromal Cells from Apical Papilla (SCAPs). Results indicated that laser machining had no detrimental effect upon consecutively seeded cells metabolism. Orientation assays revealed that surface patterning characterized by larger hatch distances was correlated with a higher cell cytoskeletal conformation to the laser-machined patterns. For the first time, to our knowledge, bone is considered and assessed here as a potentially engineered-improvable biological interface. Further studies shall focus on in vivo implications of this direct patterning.

Metastasis is the leading cause of cancer-related death and drives patient morbidity as well as healthcare costs. For several cancers, breast and prostate in particular, bone is the primary site of metastasis. Efforts to treat bone metastases have been stymied by a lack of models to study the progression and cellular players and signaling pathways driving bone metastasis. In this review, we examine the newly described and classic models of bone metastasis. Through the use of current in vivo, microfluidic and in silico computational models bone metastasis models we may eventually understand how cells escape the primary tumor and how these circulating tumor cells then home to and colonize the bone marrow. Further, future models may uncover how cell enter and escape dormancy to develop into overt metastases. Recreating the metastatic process will lead to the discovery of therapeutic targets for disrupting and treating bone metastasis.

When bone substitutes materials are used, the increased risk of infection due to the none-autogenic graft is often discussed. The treatment of large bone defects in geriatric patients, often with osteoporotic bone, often presents major challenges to surgery. Bone substitutes materials are available indefinitely without the risk of additional surgery in each patient. Can bone substitutes materials be used without hesitation in the geriatric patient?Eighty-three patients suffered traumatic fractures of the distal radius, proximal humerus, and proximal tibia. The defect zones were filled with bone substitute material based on nanocrystalline hydroxyapatite (NHA) or calcium phosphate (CP). For comparison, a reference group without the void filling with a bone graft substitute (void defects, ED) was studied. All patients over the age of 64 years were retrospectively evaluated for complications and radiological outcomes. Results: 106 patients sustained traumatic fractures of the distal radius (68.9%), proximal humerus (5.7%), and proximal tibia (22.6%). No differences in infections were found when comparing the groups (p=1.0). retrospectively evaluated. The KEM group had a nonsignificantly lower rate of pseudarthrosis (p=0.09). A relative risk (RR) reduction of complications of 32.64% was observed when bone grafting material was used. The NNT for the prevention of complications was 5.99. When bone healing was assessed by radiological images, some follow-up studies showed significant differences in fracture bridging (p<0.001).Conclusions: In contrast to previous studies, bone substitutes materials can support the healing process in geriatric patients without relevant disadvantages. With an NNT of 6 regarding complications, many patients could benefit from bone graft augmentation. No increased infection rate was observed.

When bone substitutes materials are used, the increased risk of infection due to the none-autogenic graft is often discussed. The treatment of large bone defects in geriatric patients, often with osteoporotic bone, often presents major challenges to surgery. Bone substitutes materials are available indefinitely without the risk of additional surgery in each patient. Can bone substitutes materials be used without hesitation in the geriatric patient? Eighty-three patients suffered traumatic fractures of the distal radius, proximal humerus, and proximal tibia. The defect zones were filled with bone substitute material based on nanocrystalline hydroxyapatite (NHA) or calcium phosphate (CP). For comparison, a reference group without the void filling with a bone graft substitute (void defects, ED) was studied. All patients over the age of 64 years were retrospectively evaluated for complications and radiological outcomes. Results: 106 patients sustained traumatic fractures of the distal radius (68.9%), proximal humerus (5.7%), and proximal tibia (22.6%). No differences in infections were found when comparing the groups (p=1.0). retrospectively evaluated. The KEM group had a nonsignificantly lower rate of pseudarthrosis (p=0.09). A relative risk (RR) reduction of complications of 32.64% was observed when bone grafting material was used. The NNT for the prevention of complications was 5.99. When bone healing was assessed by radiological images, some follow-up studies showed significant differences in fracture bridging (p<0.001). Conclusions: In contrast to previous studies, bone substitutes materials can support the healing process in geriatric patients without relevant disadvantages. With an NNT of 6 regarding complications, many patients could benefit from bone graft augmentation. No increased infection rate was observed.

Objective: Regeneration of bone defects remains a challenge for maxillofacial and reparative surgeons. The purpose of this histological study was to assess the osteogenic potential of octacalcium phosphate (OCP) and bone matrix gelatin (BMG) alone and in combination in artificially created mandibular bone defects in rats. The quality of the newly formed bone was also evaluated. Methods: Thirty-six male Sprague Dawley rats (6-8 weeks old with 120-150 g weight) were randomly divided into four groups. Defects (3 mm in diameter and 2 mm in depth) were created in the mandible of rats and filled with 6 mg of OCP, BMG or a combination of both (1/4 ratio), respectively. Defects were left unfilled in the control group. To assess osteoinduction and bone regeneration and determine the quality of the newly formed bone, tissue specimens were harvested at seven, 14, and 21 days post-implantation. The specimens were processed, stained with hematoxylin and eosin (H&E) and histologically analyzed under light microscopy. Results: In the experimental groups, new bone formation was initiated at the margins of defects from seventh day after implantation. At the end of the study period, the amount of the newly formed bone increased and the bone was relatively mature. Osteoinduction and new bone formation were greater in OCP/BMG group. In the control group, slight amount of new bone had been formed at the defect margins (next to host bone) on day 21. Conclusion: Combination of OCP/BMG may serve as an optimal biomaterial for treatment of mandibular bone defects.

Objectives. To compare the audiological benefits of a non-implantable wearing option of a bone conduction (BC) implant mounted on an arch (SoundArc) to traditional BC hearing aids (HA) mounted on eyeglasses (BCHA) in patients with moderate to severe conductive or mixed hearing loss. Methods: A preliminary cross-sectional observational prospective cohort study was conducted at a Tertiary Audiological Department, University Hospital. Fourteen adults with conductive or mixed hearing loss (PTA at 0.5-1-2-4 KHz = 67 ± 15 dB HL) had been wearing conventional BCHA on eyeglasses for at least 3 years, and refused the surgical implantation of a BC hearing implant (BCHI). Unaided and aided pure-tone AC and BC thresholds and speech test in quiet and in noise were recorded at baseline and in two different settings: with a BCHI mounted on SoundArc®, and with their own BCHA with two couplers, mounted on eyeglasses. International Inventory for Hearing Aids [IOI – HA], the Hearing Handicap Inventory [HHIA/E], Speech, Spatial, Qualities of Hearing Scale [SSQ], a 10-scores visuo-analogic scale [VAS], and Fatigue impact scale [FIS] score were asked in both conditions. Results: a statistical significative functional gain was observed for both settings. (p=.0001) Better speech perception performances in quiet and in noise were observed with SoundArc compared to their conventional BCHA on eyeglasses (word repetition score in noise improvement of +19.3 at SNR +10 dB, p=.002; + 12.1 at SNR 0 dB, p=.006; and +11.4 at SNR -10 dB, p=.002) No significant differences were found in IOI–HA, FIS, and HHIA/E scores, while significative better SSQ scores in all domains were reported for SoundArc. (p=.0038) Conclusions: Although patients were accustomed to their BCHA on eyeglasses, the non-implanted wearable option of the BCHI proved to be a viable alternative in adult patients with conductive or mixed hearing loss unable to receive or refusing BCHI surgery.

Selected glasses with 10 Na₂O + (90-x) P₂O₅ + x BCD where bypass cement dust (BCD) x value =10, 20, 30 in mol% were synthesized by recognizable melting annealing technique. Cooperative characterization of the prepared glasses were carried out through FTIR and SEM analysis before and after immersed in simulated body fluid (SBF) solution for 13 and 23 days at 37 ^oC. After immersion in SBF, apatite layer is produced on the glass surface after 13 day and increase after 23 day, showing good bioactivity after immersion in the SBF especially for bioglass sample with 30% BCD. A porous hydroxy apatite layer produced on the surface of SBF-glass composite and this layer became denser after more soaking time, periods were extended from 13 to 23 days. Atomic absorption spectroscopy explained the early period of soaking that cause release of both Si and Ca ions through the glass beside decreasing of phosphrous ions. Bioglass (BCD-30) is studied as shielding for gamma, protons and alphas by using Phy-X software, SRIM Monte Carlo simulation code and its subroutine TRIM. The gamma shielding parameters, mass stopping power (MSP), range for both proton (H- ions) and alpha (He- ions) in bioglass- BCD-30 and human bone tissue have estimated. Also, comparison between them is calculated in predicting the radiation damage and atomic displacements per atom (dpa).

Purpose: Proximal Femur Fractures (PFFs) in elder patients lead to decreased productivity. Skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs) are non-home destinations for post-discharge disposition. This study aims to evaluate the loss of independence (LOI) following PFFs and examine the economic impact it entails. Method: Literature from various databases was collected and analyzed retrospectively. The inclusion criteria included patients age >18 years and articles published after 1990. All studies were screened and a PRISMA chart was used to demonstrate the search process. 24 studies were finally used for review. Results: LOI following PFFs significantly increases with age. Fractures in geriatrics avail a significant amount of post-care resources and had longer lengths of stay. Furthermore, six pre-operative risk factors were identified for non-home disposition including age >75, female, non-Caucasian race, Medicare status, prior depression, Charlson Comorbidity Index. Patients discharged directly to home have lower total cost compared to those discharged to rehabilitation units. Loss of independence increases with advancing age. Discussion: PFFs can lead to serious loss of independence among elderly patients with direct impact on economic, social, psychological aspects and the healthcare system.

The integration of three-dimensional (3D) printed resin denture teeth represents a significant ad-vancement in digital dentistry. This study aimed to assess their ability to withstand chipping and indirect tensile fractures, comparing them with conventionally manufactured resin denture teeth. Four groups, each comprising 30 specimens, were examined: Group 1 featured 3D printed denture teeth (NextDent, 3D Systems, Soesterberg, The Netherlands), while the others included commer-cially obtained Ivostar Shade, SpofaDent Plus, and Major Super Lux teeth. Stereolithography 3D printing was utilized to produce methacrylate-based photopolymerized resin teeth models for Group 1, while the remaining groups were commercially sourced. Chipping and indirect tensile fracture tests were performed at a speed of 1 mm/min until fracture occurred. Statistical analysis was conducted using one-way analysis of variance (ANOVA) with Tukey's honestly significant difference multiple comparisons test (p < 0.05). Results indicated that 3D-printed teeth exhibited higher indirect tensile fracture resistance than Major Super Lux and Ivostar Shade but lower than SpofaDent Plus. Additionally, in the chipping test, buccal chipping occurred in 3D-printed resin teeth without distortion. In the indirect tensile test, the fracture line emerged near the loading point, extending cervically from the inner incline of both cusps. Overall, denture teeth produced via 3D printing with printable resin materials demonstrated sufficient fracture resistance, making them suitable for prosthetic applications.

Background and objectives: The incidence of hip fractures in advanced age is increasing due to the aging society. In trochanteric region fractures of the femur, patient positioning can be performed various ways. The aim of this study is to clinically and radiologically compare the use of the supine hemilithotomy position, the lateral decubitus position, and the traction table when performing PFN surgery for femoral intertrochanteric fractures in the geriatric age group.Materials and Methods: A total of 170 older patients with femoral intertrochanteric fractures were included in this cross-sectional study. The patients were divided into three groups the supine hemilithotomy group, lateral decubitus group and fracture table. For the postoperative period, complications, length of stay in the intensive care unit, and length of stay in hospital were examined, while in postoperative radiographs, tip-apex distance (TAD), collodiaphyseal angle (CDA), and Cleveland-Bosworth quadrants were examined to evaluate the placement of the lag screw in the femoral head. Quality of fracture reduction was evaluated according to the modified Baumgaertner criteria.Results: The mean age of the patients was 77.77±8.8; 57.6% of patients were female. According to the modified Baumgaertner criteria, it was determined that patients with ‘poor’ reduction quality had an approximately ten times higher risk of cut-out than those with ‘good’ reduction quality. (OR = 10.111, p = 0.002, 95% confidence interval; 2.313-44.207). The duration of surgery of patient in the fracture table group was found to be higher than in the other groups, the CDA in the supine position group were found lower than in the other groups, and the TAD in the supine position group was found higher than in the other groups. Complications were mostly detected in patients who underwent surgery in the lateral decubitus position. (p<0,05) Conclusion: We believe that it is necessary to be familiar with all methods, since it is very difficult to choose the most appropriate method according to the surgeon’s experience, the hospital’s facilities and conditions, and the patient’s clinical status.

Using numerical software to establish a three-dimensional geological model of shield tunneling through fault fracture zones, considering the synchronous grouting effect at the shield tail, the disturbance of various geotechnical structures in the fault fracture zone under deep burial and high water pressure conditions is studied. According to the comparison between the numerical model analysis results and the on-site inspection results of the entire process of Shiziyang B3 section, synchronous grouting at the shield tail is the main reason for the changes in soil and water pressure in the fault fracture zone area. The soil and water pressure changes strongly during shield tunneling, and the maximum excess pore pressure value occurs when the shield tail passes. When the shield tunneling machine is far away, the soil and water stress shows a downward trend. The impact of synchronous grouting decreases with the increase of tunneling distance. Due to the difference in permeability, the variation law of pore pressure in the fault fracture zone is significantly different from the original rock, leading to a faster increase in pore pressure in the fracture zone area and a wider range of influence.

Numerous reservoirs that play a significant role in worldwide petroleum production and reserves contain fractures. Typically, the fractures must form a connected network for a reservoir to be classified as naturally fractured. Characterizing the reservoir with a focus on its fracture network is crucial for modeling and predicting production performance. To simplify the solution, dual continuum modeling techniques are commonly employed. However, to use continuum-scale approaches, properties such as average aperture, permeability, and matrix fracture interaction parameters must be assigned, making it necessary to improve fracture depiction and modeling methods. This study investigates a fractured reservoir with a low matrix permeability and a well-connected fracture network. The focus is on the impact of the hyrachical fracture network on the production performance of gas-based enhanced oil recovery methods. The Discrete Fracture Model (DFN) was utilized to create comprehensive two-dimensional models for three processes: Gas Injection (GI), Water Alternating Gas (WAG), and Foam Assisted Water Alternating Gas (FAWAG). Moreover, dimensionless numbers were employed to establish connections between properties across the entire fracture hierarchy, spanning from minor to major fractures and encompassing the fracture intensity. The results indicate that the FAWAG is more sensitive to fracture types and networks than the WAG and GI processes. Hence, the sensitivity of the individual EOR method to the fracture network requires a respective depth of description of the fracture network. However, other factors, such as reservoir fluids properties and fracture properties, might influence the recovery when the minor fracture networks are excluded. This study has determined that, among the enhanced oil recovery (EOR) techniques examined, the significance of the hyrachical depth of fracture networks diminishes as the ratio of major (primary fracture) aperture to the aperture of medium and minor fractures increases. Additionally, the impact of the assisted-gravity drainage method was greater with increased reservoir height; however, as the intensity ratio increased, the relative importance of medium and minor fracture networks decreased.

The nature of the fracture and fragmentation process of concrete medium under blast loading is the transformation process of the medium from continuum to discontinuity, coupled with the significant rate correlation of concrete medium, its mechanical behavior presents a high degree of complexity. Problems such as grid distortion and even negative volume are often encountered in the finite element method and others when solving this problem, while the material point method can effectively avoid these problems. In addition, the widely used HJC concrete constitutive model does not take into account the segmented characteristics of the calculation function for dynamic increasing factor. Therefore, in this paper, firstly, the calculation function for dynamic increasing factor in the HJC concrete model is modified by SHPB experiment, and the improved HJC concrete model is proposed; secondly, the material point method simulation program is developed, and the improved HJC concrete model is embedded into the simulation program; finally, the simulation program is verified by numerical examples, and the results show that the developed simulation program can better simulate the fracture and fragmentation process of concrete medium under blast loading, especially the pulverization characteristics of the medium in the near zone of the load.

The purpose of this work is to compare two fracture prediction models with real-world data. The pure Artificial Neural Network (ANN) model emphasizes regression analysis, while the hybrid model (SVM-ANN) focuses on the combination of regression and classification analysis or Support Vector Machine. The results were subsequently tested against logging data by combining the Machine Learning approach with advanced logging tools. In this context, we used electrical image logs and the dipole acoustic tool which together allowed the distinction of 404 open fractures and 231 closed fractures and, consequently the estimation of fracture porosity. The results are then fed into two machine-learning algorithms. Pure Artificial Neural Networks and hybrid models are used to establish comprehensive results, which are subsequently tested to check the accuracy of the models. The outputs obtained from the two methods demonstrate that the hybridized model has a lower Root Mean Square Error (RMSE) than pure ANN. The results of our approach strongly suggest that incorporating hybridized machine learning algorithms in fracture porosity estimations can contribute to the development of more trustworthy static reservoir models in simulation programs. Finally, the combination of Machine Learning (ML) and well-log analysis do permit reliable estimation of fracture porosity in the Ahnet field in Algeria, where, in many places, advanced logging data is absent and costly.

Background: Post-operative delirium in elderly with hip fracture is associated with various adverse clinical outcomes. Nevertheless, the pathophysiological processes underpinning delirium have remained elusive. The aim of this study is to explore the associations between delirium and its features and immune-inflammatory and blood gas biomarkers.Methods: In this prospective study we examined 65 patients who underwent a hip fracture surgery and assessed the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Richmond Agitation-Sedation Scale (RASS), and Delirium Rating Scale Revised-98 (DRS-R-98) before and during 4 days after the surgery. Complete Blood Count (CBC) and venous blood gas markers were obtained at the same time points.Results: Delirium was observed in 19 patients and was accompanied by significantly increased pO2, number of white blood cells, neutrophil percentage, and neutrophil/lymphocyte ratio, and lower mean platelet volume (MPV) (after adjusting for age, central nervous system (CNS) disease, blood loss during surgery, sleep disorders, and body mass index. The severity of delirium was associated with lowered number of platelets and MPV. Psychomotor disorders were associated with lower bicarbonate levels. The requirement of physical restraint of the patients was predicted by increased percentages of neutrophils and lymphocytes. Prior CNS disease was together with these biomarkers a significant predictor of delirium and severity of delirium. Conclusion: Delirium and psychomotor disorders following hip fracture and surgery may be caused by immune-inflammatory and oxidative stress pathways probably attributable to an aseptic inflammatory process. Oxygen administration may aggravate these pathways.

Concrete has become the most common construction material showing among other advantages good behaviour when subjected to high temperatures. Nevertheless, concrete is usually reinforced with elements of other materials such as steel in the form of rebars or fibres. Thus, the behaviour under high temperatures of these other materials can be critical for structural elements. In addition, concrete spalling occurs when concrete is subjected to high temperature due to internal pressures. Micro polypropylene fibres (PP) have shown to be effective for reducing such spalling although this type of fibres barely improve any of the mechanical properties of the element. Hence, a combination of PP with steel rebars or fibres can be effective for the structural design of elements exposed to high temperatures. New polyolefin fibres (PF) have become an alternative to steel fibres. PF meet the requirements of the standards to consider the contributions of the fibres in the structural design. However, there is a lack of evidence about the behaviour of PF and elements made of polyolefin fibre reinforced concrete (PFRC) subjected to high temperatures. Given that these polymer fibres would be melt above 250 °C, the behaviour in the intermediate temperatures was assessed in this study. Uni-axial tests on individual fibres and three-point bending tests of PFRC specimens were performed. The results have shown that the residual load-bearing capacity of the material is gradually lost up to 200 °C, though the PFRC showed structural performance up to 185°C.

The formation of rock fractures in nature has a certain relationship with water seepage. In order to analyze the shape of rock fracture, we propose a rock deformation theoretical model in three-dimensional space considering with the condition of seepage water pressure, and establish the mass conservation equation, seepage equation, surrounding rock displacement equation, so as to deduce the rock deformation control equation under seepage pressure action. The numerical analysis of the nonlinear quadratic partial differential equation obtains the fracture deformation distribution in the example, and verifies with the calculated fracture morphology. And we further use this principle to analyze the fracture morphology in nature and prove the rationality of the theory.

Fracture density, a critical parameter of unconventional reservoirs, can be used to evaluate potential of unconventional reservoirs and location of production wells. Many technologies, such as amplitude variation with offset and azimuth (AVOA) technology, vertical seismic profiling (VSP) technology, and multicomponent seismic technology, are generally used to predict fracture of reservoirs. they can qualitatively predict fracture by analyzing seismic attributes, including seismic wave amplitudes, seismic wave velocities, which are sensitive to fracture. However, it is important to quantitatively describe fracture of reservoirs. In this study, based on a double-layer model, the relationships between fracture density and the double-layer model’s physical parameters, such as velocity of fast shear-wave, velocity of slow shear-wave, and density, were established, and then a powerful quantitative prediction method for fracture density was proposed dramatically. Afterwards, the Hudson model for crack was used to test the applicability of the method. The result shown that the quantitative prediction method for fracture density can be applied suitable to the Hudson model for crack. Finally, the result of validation models indicated that the method can predict fracture density effective, in which absolute relative deviation (ARD) were less than 5% and root-mean-square error (RMSE) was 4.88×10-3.

New biocements based on a powdered mixture of calcium phosphate/monetite (TTCPM) modified with the honey addition were prepared by mixing the powder and honey liquid components at a non-cytotoxic concentration of honey (up to 10% (w/v)). The setting process of the cements was not affected by the addition of honey, and the set-ting time of ~4 min corresponded to the fast setting calcium phosphate cements (CPC´s). The cement powder mixture was completely transformed into calcium-deficient nanohydroxyapatite after 24 hours of hardening in simulated body fluid, and columnar growth of long needle-like nanohydroxyapatite particles around the original calcium phosphate particles was observed in honey cements. The compressive strength of honey cements was reduced with the content of honey in the cement. The comparable antibacterial activity of cements with honey solutions was found on Escherichia coli, but very low antibacterial activity was found for Staphylococus aureus for all cements. The enhanced antioxidant inhibitory activity of composite extracts was verified. In vitro cytotoxicity testing verified the non-cytotoxic nature of honey cement extracts, and the addition of honey promoted alkaline phosphatase activity, calcium deposit production, and upregulation of osteogenic genes (osteopontin, osteocalcin, and osteonectin) by mesenchymal stem cells, demonstrating a positive synergistic effect of honey and CPC on the bioactivity of cements that could be promising therapeutic candidates for the repair of bone defects.

Bone Scan Index (BSI) is an image biomarker for quantification on bone metastasis of cancers. To compute BSI, not only the hotspots (metastasis) but also the bones have to be segmented. Most related researches focus on binary classification on bone scintigraphy: having metastasis or none. Rare studies focus on pixelwise segmentation. In this study we compare three advanced convolutional neural network (CNN) based models to explore the bone segmentation on dataset in house. The best model is Mask R-CNN, which reaches the precision, sensitivity and F1-score: 0.93, 0.87, 0.90 for prostate cancer patients and 0.92, 0.86, 0.88 for breast cancer patients, respectively. The results are the average of 10-fold cross-validation, which reveals the reliability for clinical use on bone segmentation.

Burn injury serves as an example of a condition with a robust inflammatory response. The elevation of circulating interleukins (IL)- 1 beta and -6 in children with severe burn injury up-regulate the parathyroid calcium sensing receptor (CaSR) resulting in hypocalcemic hypoparathyroidism with urinary calcium wasting. This effect protects the body from the hypercalcemia resulting from bone resorption liberating calcium into the circulation. Extracellular calcium can exacerbate and prolong the inflammatory response by stimulating mononuclear cell chemokine production as well as the NLRP3 inflammasome of the innate immune system, resulting in increased IL-1 production by monocytes and macrophages. Interestingly, the CaSR response to inflammatory cytokines disappears with age, potentially trapping calcium from bone resorption in the circulation and allowing it to contribute to increased inflammation and possibly increased calcium deposition in small arteries, , such as the coronaries, as conditions with increased chronic inflammation, such as spinal cord injury, osteoarthritis and rheumatoid arthritis have an incidence of cardiovascular disease and coronary artery calcium deposition significantly higher than the unaffected age-matched population.

It is very difficult to repair large bone defects, especially when they have a complex shape. We have developed a new technique to make a desired copy of rabbit bones. A rabbit distal femur was scanned by computed tomography (CT), and a rectangular-shaped beta-tricalcium phosphate (β-TCP) block with 75% porosity was automatically machined using milling tools into a half-scale copy of the distal femur based on the CT data. The β-TCP block was seeded with bone morphogenetic protein-2 and bone marrow cells obtained from the femur and implanted on the periosteum of the femur. At 10 weeks after implantation, most of the β-TCP block had been replaced by bone and a complete copy of the distal femur was reconstructed. Our findings indicate that this technique will be useful in the clinical setting. We also report the representative clinical results of treatment with β-TCP graft in patients with bone defects since 1989.

Materials based on Mg2+-containing phosphates are gaining great relevance in the field of bone tissue repair via regenerative medicine methods. Magnesium ions, together with condensed phosphate ions, play a significant role in the process of bone remodeling, affecting the early stage of bone regeneration through active participation in the process of osteosynthesis. Here we pro-vide a comprehensive overview of the usage of biomaterials based on magnesium phosphate and magnesium calcium phosphate in bone reconstruction. The role of magnesium ions in angiogene-sis, an important process associated with osteogenesis, is considered. Finally, the biological properties of magnesium phosphates for bone regeneration are summarized. They show promis-ing results in terms of use as bone replacement material.

Bone is a dynamic tissue with the capacity of repair and regeneration in specific conditions. Nevertheless, due to the increased incidence of bone disorders, the need of bone grafts has been growing over the past decades and the development of an ideal bone graft with optimal properties remains a clinical challenge. This review addresses the bone properties (morphology, composition and their repair and regeneration capacity) and puts the main focus on the potential strategies for developing bone repair and regeneration materials. It describes the requirements for designing a suitable scaffold material, types of materials (polymers, ceramics and composites) and techniques to obtain the porous structures (additive manufacturing techniques/robocasting or derived from marine skeletons) for bone tissue engineering applications. The main objective of this review is to gather the knowledge on the materials and methods for the production of scaffolds for bone tissue engineering and highlighting the potential of natural porous structures such as marine skeletons as promising alternative bone graft substitute materials without any further mineralogical changes, or after partial or total transformation into calcium phosphate. The suitability of the marine-derived porous bone graft substitutes for the intended applications will be also discussed.

It was assumed that only autogenous bone had appropriate osteoconductive and osteoindutive properties for bone regeneration, but this assumption has been challenged. Many studies have shown that synthetic biomaterials must be considered as the best choice for bone guided regeneration. The objective of this work is to compare the performances of nano-hydroxyapatite/β-Tricalcium phosphate (n-HA/β-TCP) composite and autogenous bone graft in bone regeneration applications. Th composite was characterized by scanning electron microscopy (SEM) and used as an allograft in bone defects made in adult Wistar rats. The bone defects in the dorsal cranium were grafted with autogenous bone on one side and the n-HA/β-TCP composite on the other. Histomorphometry evaluation by different staining methods (Goldner trichrome, PAS, Sirius red) and TRAP histochemistry were performed. The immunohistomorphometries to OPN, Cathepsin-K, TRAP, Acid phosphatase, VEGF, NFκ-β, MMP-2, MMP-9, and TGF-β were carried out. The RT-PCR method to RANK-L, Osteocalcine, Alcaline Phosphatase, Osterix, and Runx2 were conducted as well. The results showed that all morphometric evaluations on the different staining methods, histochemistry and immunohistochemistry, VEGF and NFκ-β, were higher on the n-HA/β-TCP composite group than in the autogenous bone graft group. The RT-PCR markers were higher in the autogenous bone group than on the n-HA/β-TCP composite group. The n-HA/β-TCP composite exhibited enhanced cell-matrix interactions in bone remodeling, higher adhesion, proliferation, and differentiation, and increased vascularization. These results suggests that the n-HA/β-TCP composite induces faster bone formation than autogenous bone.

In orthopedics, bone drilling is a crucial part of a surgical method commonly carried out for internal fixation in bone fracture treatment. The primary purpose of bone drilling is the creation of holes for screw insertion to immobilize fractured parts. The bone drilling task depends on the orthopedist and surgeon’s high level of skill and experience. This paper aimed to provide a summary of previously published review studies in the field of bone drilling. This review paper also presents a comprehensive review of the application of machine learning for bone drilling and as a future direction for the automation system. This review can also help medical surgeons and bone drillers understand the latest improvements through parameter selection and optimization strategies to reduce bone damage in bone drilling procedures. Apart from the review study, bone drilling vibration data collected in the University laboratory experiment is also presented in this study. The vibration data consist of three different layers of femur cow bone which are processed and classified using several machine learning methods. LSTM is, used in the bone drilling classification study to prove that the layers of the bone drilling are associated with the vibration signal and can be classified and predicted using the machine learning method.

As humans age, aberrancies in several signaling pathways occur. In the aging population, some patients display abnormal bone morphogenetic protein (BMP) signaling. This can lead to osteoporosis (OP), a debilitating bone disorder caused by an imbalance between osteoblasts and osteoclasts. In 2002, the Food and Drug Administration (FDA) approved usage of recombinant human BMP-2 (rhBMP-2) during spinal fusion surgery as it is crucial for bone formation. However, complications have been reported with rhBMP-2 and primary osteoblasts isolated from OP patients are unresponsive to BMP-2. While patient samples are available, previous medical history may alter results. Therefore, C57BL/6 mice, an aging model that displays aberrant BMP-signaling, can be utilized to investigate OP and aging. We show that BMP receptor type Ia (BMPRIa) is upregulated in the bone marrow stromal cells (BMSCs) of 15-month mice similar to previous data. We show that a conjugation between BMP-2 and Quantum Dots (QDot®s) effectively binds to BMPRIa and can investigate BMP-2 activity. After incubating BMSCs with methyl-β-cyclodextrin (MβCD), BMP-signaling is restored in 15-month mice as shown by western blotting and the von Kossa assay. MβCD may be used to rescue BMPRIa and the BMP-signaling pathway can be utilized by future therapeutics to treat OP.

Objective: To evaluate the clinical efficacy of antibiotic bone cement plus lateral bone repositioning for severe diabetic foot and its impact on wound healing rate. Methods: Sixty patients with hemodialysis anemia admitted to the endocrinology department of our hospital from July 2020 to July 2021 were included and randomly assigned to receive antibiotic bone cement plus lateral bone repositioning (observation group) or vacuum sealing drainage (VSD) (control group). Outcome measures included skin temperature of the affected limb, ankle-brachial index, sensory threshold, foot wound healing, dorsalis pedis artery hemodynamics, lower limb function and clinical efficacy. Results: Antibiotic bone cement plus lateral bone repositioning resulted in significantly higher treatment efficiency and transcutaneous partial pressure of oxygen, smaller wound, and lower trauma pH versus VSD, suggesting that antibiotic bone cement plus lateral bone repositioning contributes to potentiating the treatment efficacy and reducing the foot ulcer trauma, thereby facilitating rapid recovery. Patients given antibiotic bone cement plus lateral bone repositioning had larger vascular internal diameter and blood flow and better sensory conduction velocity of the common peroneal nerve and the motor conduction velocity of the tibial nerve versus those given VSD, indicating its vascular and neurological benefits. Conclusion: Antibiotic bone cement plus lateral bone repositioning enhances the treatment efficiency, boosts trauma healing, and promotes postoperative functional recovery of patients.

Bone tissue engineering has developed significantly in recent years as the increasing demand for bone substitutes due to trauma, cancer, arthritis, and infections. The scaffolds for bone regeneration need to be mechanically stable and have a 3D architecture with interconnected pores. With the advances in additive manufacturing technology, these requirements can be fulfilled by 3D printing scaffolds with controlled geometry and porosity using a low-cost multistep process. The scaffolds, however, must also be bioactive to promote the environment for the cells to regenerate into bone tissue. To determine if a low-cost 3D printing method for bespoke SiOC(N) porous structures can regenerate bone these structures were tested for osteointegration potential by using human mesenchymal stem cells (hMSCs). This includes checking the general biocompatibilities under the osteogenic differentiation environment (cell proliferation and metabolism). Moreover, cell morphology was observed by confocal microscopy and gene expressions on typical osteogenic markers at different stages for bone formation were determined by real-time PCR. The results of the study showed the pore size of the scaffolds had a significant impact on differentiation. A certain range of pore size could stimulate osteogenic differentiation, thus promoting bone regrowth and regeneration.

In the history of high-performance polymer composite parts with continuous in-plane fibre reinforcement, the comparatively moderate structural-mechanical properties in their out-of- plane-z-direction and the limited load carrying capability between individual reinforcement layers within the laminated structures have always been one of the greatest challenges. Plenty of research work has been carried out to improve load transfer capability as well as fracture toughness for crack opening events between the reinforcement layers by means of out-of-plane fibre reinforcement implementation, for example by sewing or z-pinning technologies. However, the results have not become established across a wide range of applications so far, because the technologies used have led to considerable losses of in-plane strength properties. In this paper first results are presented for a new method of a low fraction z-fibre reinforcement by means of very thin diameter laser drilled holes filled with short carbon fibres, demonstrating potential to improve Mode II fracture toughness.

Study design: Technical note. Objectives: To present a new technique of treatment for a patient with thoracolumbar focal kyphosis due to osteoporotic verte-bral fracture (OVFs). Background : OVFs are common among the elderly population. Following a severe wedged fracture, patients often experience low back pain and disruptions in activities of daily living. Reconstruction surgeries, such as corpectomy, are among the treatment options for this condition. However, corpectomy requires longer surgical times and involves a significant amount of blood loss. Materials and Methods : An 80-year-old woman presented to our hospital with severe low back pain and gait disturbance. She had experienced an L2 OVF six years prior. Although she had no neurological deficit, she could not walk more than 200m due to pain. Preoperative spinal radiographs revealed severe sagittal malalignment, with the L2 vertebra collapsed and focal kyphosis of L1-3 measuring 34 degrees. Results: The patient underwent anterior and posterior surgery in the right decubitus position using a C-arm free technique. The surgical time was 133 minutes with an estimated blood loss of 100 ml. Hyperlordotic cages were inserted in the upper and lower disc space via a lateral approach, while percutaneous pedicle screws (PPS) were inserted from a posterior approach. These procedures were performed simultaneously under navigation guidance only. Post-operative images showed excellent spinal alignment, with local kyphosis reduced from 34 to 14 degrees, and no major or severe complications occurred. At one-year follow-up, the patient was able to walk smoothly, with her visual analogue scale for low back pain improving from 73mm to 13mm, and her Oswestry Disability Index improving from 53.3% to 13.3%. Conclusions/Level of Evidence : The simultaneous use of hyperlordotic cages and PPS is an effective and innovative navigation technique that yields promising outcomes for thoracolumbar focal kyphosis resulting from OVFs. This approach not only reduces surgical time but also minimizes intraoperative blood loss. Level V.

In response to a threefold increase in osteoporotic vertebral fractures (OVF) at our institution over the past decade and the subsequent development of new fractures within a year in a third of cases, we evaluated the effectiveness of STIR MRI scans in conjunction with CT scans for initial OVF diagnosis. This study, conducted over five months, involved full spine sagittal STIR MRI scans alongside CT scans for patients over 50 with minor injury-related vertebral fractures. The independent assessments by radiologists and neurosurgeons of 64 patients revealed that while CT scans identified 161 fresh fractures, of which only 68 were previously reported, MRI detected 266 fractures, 1.65 times more than CT. CT scans showed single fractures in 27% of patients and multiple fractures in 73%, whereas MRI identified single fractures in 9% and multiple fractures in 91% of patients. Additionally, MRI demonstrated a 1.5-fold increase in adjacent fracture detection. The use of MRI influenced treatment plans in 67% of cases. Given these findings, we advocate for including a STIR MRI of the entire spine alongside CT scans in OVF cases, as it significantly enhances fracture detection and can alter treatment strategies.

The management of blunt abdominopelvic trauma with combined hemoperitoneum and pelvic fractures is challenging for trauma surgeons. Although angioembolization can achieve hemostasis in most visceral organ injuries and pelvic fractures after blunt abdominal trauma, it cannot effectively control hemorrhage in patients with blunt bowel mesenteric injury (BBMI). This study aimed to determine the risk factors associated with hemodynamically unstable patients with BBMI and to test the hypothesis that pelvic fracture is an independent risk factor for patients with unstable BBMI and concomitant pelvic fracture to guide the therapeutic sequence for difficult-to-manage patients. This retrospective study reviewed the data of hospitalized patients with trauma between 2009 and 2021 and included 158 adult patients with surgically proven BBMI. The patients were divided on the basis of the presence of a shock episode before emergency laparotomy. The shock group included 44.3% of all patients in the study (n = 70). Clinical injury severity and prognosis for patients in the shock group were poorer than those for patients in the non-shock group, and more invasive treatments and transfusions were performed for patients in the shock group than for those in the non-shock group. Pelvic fractures were more frequently associated in the shock group than in the non-shock group (21.4% vs. 5.7%; p = 0.003). In multivariate analysis, the presence of intracerebral hemorrhage (odds ratio [OR] = 10.87, 95% confidence intervals [CIs]: 1.70–69.75) and rib fracture (OR = 5.94, 95% CIs = 1.06–33.45) were identified as independent predictors of shock, whereas the effect of pelvic fracture did not achieve statistical significance (OR = 2.94, 95% CIs = 0.66–13.13) after adjusting for confounding factors. For patients with BBMI, outcomes need to be improved during early diagnosis and treatments should be expeditiously performed on the basis of the rapid identification of unstable hemodynamic status. In unstable patients with concomitant pelvic fractures, we support the current management algorithm that recommends performing laparotomy first.

The formation and propagation of cracks occurs through irreversible dislocation movements at notches, material defects and grain boundaries. Since this process is partly thermally controlled, the resistance to dislocation movements at low temperatures increases. This slows both fatigue initiation and fatigue crack propagation. From recent experimental data, it can be seen that fatigue crack growth is accelerated below the fatigue transition temperature (FTT) that correlates with the ductile-brittle transition temperature (DBTT) found by well-known fracture mechanics tests, i.e., Charpy impact, fracture toughness, and CTOD. Hence, this study investigates the relation between FTT and DBTT in S500 high-strength steel base material and welded joints at low temperatures using fatigue crack growth, fracture toughness tests as well as scanning electron microscopy. From the tests, an almost constant decrease in fatigue crack propagation rate is determined with decreasing test temperature even below the DBTT.