We performed arthroscopically assisted coracoclavicular (CC) stabilization using a suture button device for modified Neer type IIb lateral clavicle fractures accompanied by CC ligament injury. The purpose of the present study was to evaluate the radiological and clinical outcomes of this procedure. Six consecutive patients with modified Neer type IIb fractures were treated with the technique and followed for 12 months. Postoperative ranges of motion (ROMs) and X-rays were evaluated every 3 months. Shoulder functional scores (University of California Los Angeles score, Japanese Orthopedics Association score), visual analog scale (VAS) scores for pain at rest, at night, and during motion, and VAS score for satisfaction were analyzed at 12 months after surgery. For the clinical outcomes, early ROM recovery and excellent outcomes were achieved. For the radiological outcomes, all patients accomplished bone union, slight superior displacement was noted in the CC distance and Dog Bone distance, and bone hole dilation was observed in the superior coracoid and inferior clavicle, but there were no critical complications. The present findings indicate that arthroscopically assisted CC stabilization with a suture button device for unstable lateral clavicle fractures can produce satisfactory radiological and clinical results.

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.

The construction of sustainable road and highway networks in the world, despite numerous feasibility, pre-feasibility and execution studies, are always confronted with the demands and vagaries of foreseeable and unforeseeable natural disasters. Studying cyclones, earthquakes, fracturing and landslide zones along roads is therefore a challenge for the sustainability of these infrastructures. In many countries around the world, the methods generally used for these studies are not only expensive and time-consuming, but the results obtained are not always efficient. This work examines whether Landsat 8 (with a high cloud level) and SRTM data can be used in both equatorial and coastal Central Africa zones to produce relevant mapping, locating fracture and landslide zones, in order to contribute not only to better road layout at lower cost and in a relatively short time, but also to better prevention of geological disasters that may occur on its network. To this end, a map of the main road network was produced and validated with field data, as well as the maps of the main unstable slopes, faults and fractures zones intersecting the road or highway network. These approaches are useful for sustainable planning, management, monitoring and extension of roads worldwide especially, in Central Africa.

This study investigated the mechanical properties and fatigue behavior of FH36 steel plate rolled in different directions. By adopting a sequential rolling process in the rolling direction (RD) and transverse direction (TD), the differences in properties between RD and TD were eliminated, resulting in nearly identical tensile properties. The steel plate exhibited a yield strength of approximately 420 MPa, a tensile strength of approximately 506 MPa, and an elongation of approximately 25%. Fatigue tests conducted at room temperature and -60℃ showed a fatigue limit of the maximum stress of 488 MPa at room temperature and 500 MPa at -60℃, indicating improved low-temperature fatigue performance. The fracture surfaces displayed distinct characteristics, such as oblique shearing fractures for high-cycle fatigue and cup-cone shape fractures for low-cycle fatigue. The fatigue source zone were both on the surface of the specimens. As the maximum stress increased, the area of the crack propagation zone for high-cycle fatigue decreased, while the area of the final fracture zone, the number of dimples and the proportion of the LAGBs increased.

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.

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.

Medicinal plants for bone grafts are promising because they are free from infecting microorganisms and biocompatible. We report a novel study evaluating osteoregeneration of bone grafts from extracts of Alternanthera brasiliana and Fridericia platyphylla after bone injury induced by radius fracture in rats. Grafts were obtained using 2% chitosan gel and 0.5% hydroalcoholic extract. The rats were randomly divided into four experimental groups (N= 12): Negative control (NC) - Chitosan gel; Positive control (PC) - bovine mineral bone graft (Lumina Bone®, fine powder 0.5); F. platyphylla Graft (FRID) - 0.5% bone graft; A. brasiliana Graft (ABRA) - 0.5% bone graft. The animals were evaluated for three periods, 30, 60, and 90 days after fracture induction. Bone alkaline phosphatase (BSAP) and radiographic and histological evaluations were followed. After 90 days, there was an increase in BSAP for the ABRA group on the newly formed bone matrix but not for FRID, indicating the presence of active osteoblasts. Additionally, mature bone tissue and bone remodeling were observed, and a conspicuous presence of type I collagen for both FRID and ABRA. We demonstrated that FRID and ABRA grafts produced early bone neoformation. New perspectives for these species as a graft are suggested.

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.

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.

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.

Multi-wire saw machining (MWSM) used for slicing hard-brittle materials in semiconductor, is an important material removal process that uses free abrasives. Cutting model of single-wire saw machining (SWSM) is the basis of MWSM, and the material removal mechanism of SWSM can better understand than MWSM. Mathematical model (includes brittle fracture and plastic deformation) is presented in this paper for SWSM ceramic with abrasives. This paper determines the effect of various machining parameters on the removal of hard-brittle materials. For brittle fracture of SWSM ceramics, the minimum of the strain energy density is used as a fracture criterion. The material removed of SWSM ceramics due to plastic deformation is calculated using the equations of motion. Actual wire-sawing experiments are conducted to verify the results from the developed mathematical model. Theoretical results agree with experimental data and practical experience. The developed mathematical model shows that brittle fracture plays a major concern role in material removed of SWSM ceramics. Wire speed and working load have positively correlated with material removed of SWSM ceramics. The coefficient of friction is low, a lateral crack, which propagates almost parallel to the working surface, leads to more brittle fracture and material removed is increased on SWSM ceramics.

We present a generic and open-source framework for the numerical modeling of the expected transport and storage mechanisms in unconventional gas reservoirs. These unconventional reservoirs typically contain natural fractures at multiple scales. Considering the importance of these fractures in shale gas production, we perform a rigorous study on the accuracy of different fracture models. The framework is validated against an industrial simulator and is used to perform a history-matching study on the Barnett shale. This work presents an open-source code that leverages cutting-edge numerical modeling capabilities like automatic differentiation, stochastic fracture modeling, multi-continuum modeling and other explicit and discrete fracture models. We modified the conventional mass balance equation to account for the physical mechanisms that are unique to organic-rich source rocks. Some of these include the use of an adsorption isotherm, a dynamic permeability-correction function, and an embedded discrete fracture model (EDFM) with fracture-well connectivity. We explore the accuracy of the EDFM for modeling hydraulically-fractured shale-gas wells, which could be connected to natural fractures of finite or infinite conductivity, and could deform during production. Simulation results indicates that although the EDFM provides a computationally efficient model for describing flow in natural and hydraulic fractures, it could be inaccurate under these three conditions: 1. when the fracture conductivity is very low. 2. when the fractures are not orthogonal to the underlying Cartesian grid blocks, and 3. when sharp pressure drops occur in large grid blocks with insufficient mesh refinement. Each of these results are very significant considering that most of the fluids in these ultra-low matrix permeability reservoirs get produced through the interconnected natural fractures, which are expected to have very low fracture conductivities. We also expect sharp pressure drops near the fractures in these shale gas reservoirs, and it is very unrealistic to expect the hydraulic fractures or complex fracture networks to be orthogonal to any structured grid. In conclusion, this paper presents an open-source numerical framework to facilitate the modeling of the expected physical mechanisms in shale-gas reservoirs. The code was validated against published results and a commercial simulator. We also performed a history-matching study on a naturally-fractured Barnett shale-gas well considering adsorption, gas slippage & diffusion and fracture closure as well as proppant embedment, using the framework presented. This work provides the first open-source code that can be used to facilitate the modeling and optimization of fractured shale-gas reservoirs. To provide the numerical flexibility to accurately model stochastic natural fractures that are connected to hydraulically-fractured wells, it is built atop other related open-source codes. We also present the first rigorous study on the accuracy of using EDFM to model both hydraulic fractures and natural fractures that may or may not be interconnected.

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.

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.

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 scratch test consists in pushing a tool across the surface of a material at a given penetration depth or applied load. It has several applications in Science and Engineering including strength testing, damage and quality control of thin films and coatings. Despite numerous attempts in scientific literature, the application of scratch test to characterizations of fracture properties remains a heavily controversial topic. Therefore, this investigation arises as an experimental study in order to assess the fracture toughness using scratch test. A study on the effect of cryogenic treatment, performed after tempering, on fracture toughness, via scratch test experiments, of different tool steels has been made. A laboratory investigation on AISI D2, AISI M2 and X105CrCoMo18 steel confirms the possibility of increasing the fracture toughness by carrying out the cryogenic treatment after the usual heat treatment

Hydraulic fracturing in shale gas reservoirs has usually resulted in complex fracture network. The results of micro-seismic monitoring showed that the nature and degree of fracture complexity must be clearly understood to optimize stimulation design and completion strategy. This is often called stimulated reservoir volume (SRV). In the oil & gas industry, stimulated reservoir volume has made the shale gas exploitation and development so successful, so it is a main technique in shale gas development. The successful exploitation and development of shale gas reservoir has mainly relied on some combined technologies such as horizontal drilling, multi-stage completions, innovative fracturing, and fracture mapping to engineer economic completions. Hydraulic fracturing with large volumes of proppant and fracturing fluids will not only create high conductivity primary fractures but also stimulate adjacent natural fractures. Fracture network forming around every hydraulic fracture yields a stimulated reservoir volume. A model of horizontal wells which was based on a shale gas reservoir after volume fracturing in China was established to analyze the effect of related parameters on the production of multi-fractured horizontal wells in this paper. The adsorbed gas in the shale gas reservoir is simulated by dissolved gas in the immobile oil. The key to simulate SRV is to accurately represent the hydraulic fractures and the induced complex natural fracture system. However, current numerical simulation methods, such as dual porosity modeling, discrete modeling, have the following limitations: 1) time-consuming to set up hydraulic and natural fracture system; 2) large computation time required. In this paper, the shape of the stimulated formation is described by an expanding ellipsoid. Simplified stimulated zones with higher permeability were used to model the hydraulic fracture and the induced complex natural fracture system. In other words, each primary fracture has an enhanced zone, namely SRV zone. This method saves much developing fine-grid time and computing time. Compared with the simulation results of fine-grid reference model, it has shown that this simplified model greatly decreases simulation time and provides accurate results. In order to analyze the impacts of related parameters on production, a series of simulation scenarios and corresponding production performance were designed. Optimal design and analyses of fracturing parameters and the formation parameters have been calculated in this model. Simulation results showed that the number of primary fractures, half length, SRV half-width and drop-down have great effects on the post-fracturing production. Formation anisotropies also control the production performance while the conductivity of the primary fractures and SRV permeability do not have much impact on production performance. The complexity of stimulated reservoir volume has strong effect on gas well productivity. Fracture number mainly affects the early time production performance. The increase of SRV width cannot enlarge the drainage area of the multi-fractured horizontal wells, but it can improve the recovery in its own drainage region. Permeability anisotropies have much effect on production rate, especially the late time production rate. The results prove that horizontal well with volume fracturing plays an irreplaceable role in the development of ultra-low permeability shale gas reservoir.

H-adaptivity is an effective tool to introduce local mesh refinement in FEM-based numerical simulation of crack propagation. The implementation of h-adaptivity could benefit the numerical simulation of fatigue or accidental load scenarios involving large structures such as ship hulls. In engineering applications, the element deletion method is frequently used to represent cracks. However, the element deletion method has some drawbacks such as strong mesh dependency and loss of mass or energy. In order to mitigate this problem, the element splitting method could be applied. In this study, a numerical method called ‘h-adaptive element splitting’ (h-AES) is introduced. The h-AES method is applied in FEM programs by combining h-adaptivity with the element splitting method. Two examples using the h-AES method to simulate cracks in large structures under linear-elastic fracture mechanics scenario are presented. The numerical results are verified against analytical solutions. Based on the examples, the h-AES method is proven to be able to introduce mesh refinement in large-scale numerical models that consist of structured coarse meshes. By employing the mesh refinement introduced in this paper, very small cracks are well represented in large structures.

This article presents a narrative review of neonatal and paediatric complications in post-dated pregnancy and covers scientific views on the aetiology, pathology, risk factors, symptoms and complications of post-dated pregnancy. A pregnancy extending beyond 42 weeks of gestation is termed as a post term pregnancy. There are multiple complications that can occur in the perinatal period, some of the most common ones are stillbirth, asphyxia, meconium aspiration syndrome, fetal distress syndrome, etc which are found to be greater in post-dated pregnancy and hence ultimately leads to increased mortality and morbidity of the new born. Studies have shown that post-term pregnancy also causes increased risk of developing behavioural and emotional problems in children of paediatric age group. It is surprising not much importance has been given to the maternal and neonatal consequences of post- term pregnancies. It is not well understood why some women experience post-dated pregnancies. It is found that factors such as hormones and genetic build up, are responsible for causing post-term pregnancy in an obese female. The treatment and management of a post-term pregnancy still poses a challenge to clinicians in determining the right choice and right time for a particular intervention so that both mother and fetus can be prevented from having complications.

Introduction: Outcome measures using telerehabilitation (TR) in the context of post-stroke rehabilitation is an area of emerging research. The current review assesses the literature related to TR for patients requiring post-stroke rehabilitation. The purpose of this study additionally is to survey the outcome measures used in TR studies and to define which parts of the International Organization of Functioning are measured in trials. Methods: TR studies were searched in Cochrane Central Register of Controlled Trials, PubMed, Embase, Scopus, Google Scholar, and Web of Science from 2016 to June 2023. Two reviewers individually assessed the full text. Disagreements about inclusion or exclusion were determined by consensus or by checking with a third reviewer. Results: A total of 24 studies were included in the current review. The results were synthesized and reported considering the implications of the results within clinical practice, areas of investigation, and strategic implementation. Conclusions: The current scoping review recognized a wide range of outcome measures used in TR studies and helped elucidate gaps in the current use of outcome measures in the literature. The scoping review also informs researchers and end users (i.e. clinicians and policymakers) regarding the most suitable outcome measures for TR.

The purpose of this study was to analyze the influence of Chitosan 0.2% in various final cleaning methods on the bond strength of fiberglass post (FP) to intrarradicular dentin. Ninety bovine incisors were sectioned to obtain root remnants measuring 18 mm in length. The roots were divided: G1: EDTA 17%; G2: EDTA 17% + PUI; G3: EDTA 17% + EA; G4: EDTA 17% + XPF; G5: Chitosan 2%; G6: Chitosan 2% + PUI; G7: Chitosan 2% + EA; G8: Chitosan 2% +XPF. After carrying out the cleaning methods, the posts were installed, and the root cleaved to to generate two disks from each root third. Bond strength values (MPa) obtained from the micro push-out test data were assessed by Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests for multiple comparisons (α = 5%). Differences were observed in the cervical third between G1 and G8 (p=0.038), G4 and G8 (p=0.003), G6 and G8 (p=0.049), and Control and G8 (p=0.019). The final cleaning method influenced the adhesion strength of cemented FP to intrarradicular dentin. Chitosan 0.2% + XPF positively influenced adhesion strength, with the highest values in the cervical third.

Actively combating post-harvest food spoilage and waste can dramatically increase the efficiency of food utilization worldwide. In climacteric fruits, chemical treatments such as 1-MCP are an effective way of reducing post-harvest spoilage and waste by inhibiting the fruit’s ability to perceive ethylene. 1-MCP treatment is increasingly being used to explore the complex nature of ripening physiology at a fundamental level, however, differences in application and quantitation methods create difficulties in comparing conclusions across studies. Here we report an effective and reproducible method for 1-MCP application and quantitation for small-medium sized research applications. By use of surrogate alkene standards 1-butene and cis-2-butene, the highly volatile and elusive 1-MCP molecule can be identified and quantified by gas chromatography and subsequent standard curves may be developed. It is hoped that the methodology outlined here can help standardize consistent 1-MCP application for post-harvest research without excessive investment in specialized equipment.

Post-evaluation of ecological redevelopment is a good method for its achievements. The eco-engineering technologies and achievements of landscape water reconstructed from aquaculture ponds in Shanghai Chenshan Botanical Garden have been introduced in this study. The sediments and water quality were also sampled and tested for basic physicochemical parameters and heavy metal concentration. The ecological redevelopment of landscape water reconstructed from aquaculture ponds was evaluated using the Nemero comprehensive pollution index method. The results shown that nutrients including organic matter, organic nitrogen and their ratio of sediment were found to be in a state of moderate pollution, while their ecological risk of heavy metals was low. Although total nitrogen and total phosphorus of water quality was really higher than that of other indexes, the decline trends of ammonia nitrogen, total nitrogen and total phosphorus was obvious presented over time. In general, this is a good example that redevelopment of water ecosystems from aquaculture ponds using eco-engineering technologies.

Residential satisfaction with post-disaster housing is crucial for the success and sustainability of a resettlement project. However, little attention has been given to this aspect in the permanent houses developed after the 2015 Gorkha earthquake. To bridge this gap, the study examined factors affecting residential satisfaction among poor displaced households resettled in the Panipokhari Integrated Settlement of Nepal. Data were collected through a questionnaire survey, interviews, and field observation. Internal consistency and reliability were assessed using Cronbach's Alpha test, while satisfaction was measured by mean satisfaction scores. The relative importance index ranked the factors, and Spearman's rank correlation coefficient analyzed their relationship with overall residential satisfaction. The study identified several crucial fac-tors influencing residential satisfaction, including the design and layout of the house, space for modification, provision of a kitchen garden and cattle shed, thermal comfort, completeness of the house, provision of a hearth, and spaces for rituals and cultural events. These findings shed light on the resettlement decisions of affected populations and provide valuable insights for policymakers, implementers, and researchers aiming for successful and sustainable resettlement outcomes.

Background: Optimal hypofractionated schedule of post-prostatectomy radiotherapy remains to be established. We evaluated treatment outcomes and toxicity of the moderately hypofractionated post-prostatectomy radiotherapy in 16 daily fractions delivered with IMRT/VMAT. The treatment schedule selection was motivated by limited technology resources. Methods: One hundred consecutive M0 patients with post-prostatectomy radiotherapy were evaluated. Radiotherapy indication was adjuvant (ART) in 19%, early salvage (eSRT) in 46% and salvage (SRT) in 35%. The dose prescription for prostate bed PTV was 52.8 Gy in 16 fractions of 3.3 Gy. The Common Terminology Criteria v.4 for Adverse Events scale was used for toxicity grading. Results: The median follow-up was 61 months. Five-year biochemical recurrence-free survival (bRFS) was 78.6%, distant metastases-free survival was 95.7% and overall survival was 98.8%. Treatment indication was the only significant factor for 5-year bRFS in multivariate analysis which was 84.6% vs. 67.6% for ART or eSRT vs. SRT respectively (HR 0.15, 95% CI 0.05–0.47, p=0.001). Acute GI toxicity grade 2 was recorded in 24%, grade 3 in 2% and acute GU toxicity grade 2 in 10% and no grade 3. Cumulative rate of late GI toxicity grade ≥2 was observed in 9% and late GU toxicity grade ≥2 in 16%. Conclusion: Observed results confirmed efficacy and acceptable toxicity of post-prostatectomy hypofractionated radiotherapy in 16 daily fractions.

Current study was to estimation the post-harvest loss of avocado at the producer level using cross-sectional data obtained from 385 proportionately sampled respondents from Wolaita and Kembata Tembaro Zones, the SNNPR of Ethiopia. Descriptive and multiple regression analysis were used to the amount and determinant of post harvest loss of avocado fruits. Estimated total post harvest- loss of avocados was 24%; of which 5.7% unacceptable harvesting methods and 4.9% of improper storage practices. The respondent's sex, education, income, training, contact with extension agents, distance from the nearest road, and off-farm income were found to be negative determinants, whereas storage accessibility and avocado harvest techniques were found to be positive determinants of post-harvest loss of avocado fruits. Post-harvest management techniques for avocados need to be better understood and used by avocado growers if they are to minimize losses. Post-harvest losses contribute considerably to food insecurity and create a problem for the source of revenue for people and the economy of the country as well. Therefore, the use of a practical and effective post-harvest loss reduction technique could be a sustainable solution to increase food availability, eliminate hunger and improve farmers' livelihoods.

The universal chirality is the commonly accepted view of nature. Biological chirality is the distinct part of the more general phenomena. Following this view, all living organisms are characterized by the non-equilibrium state of their molecular constituents. From the thermodynamic perspective, the non-equilibrium state of biomolecular ensemble holds inevitable consequences being the substrate of spontaneous reactions directed to equilibrium (not associated with life) state. At the protein level, spontaneous biological reactions represent the natural part of proteins' post-translational modifications (PTMs). The essential contribution to the origin and maintenance of the non-equilibrium state belongs to prevalent bio-molecular chirality. Correspondently, spontaneous PTMs such as racemization and glycation, working against life-supporting prevalent chirality, are known as the significant determinants of protein misfolding, dysfunctions, and aggregation. Accumulation of aberrant protein during life-span allows consideration of time-dependent spontaneous racemization and glycation as protein aging. Spontaneous PTMs of proteins is occurring in the interaction with other forms of enzymatic and non-enzymatic PTMs. In this review, we are considering the contribution of spontaneous racemization and non-enzymatic glycosylation to protein aging.

Smoking during pregnancy remains one of the most significant risk factors for poor birth outcomes. The Loma Linda University Health Comprehensive Tobacco Treatment Program (CTTP) is the largest maternal tobacco cessation program in San Bernardino County – the largest county in the contiguous US. CTTP is an eight week, incentivized, behavioral intervention for tobacco cessation for pregnant smokers. As part of program evaluation, we used a retrospective cohort design to assess smoking abstinence and to identify predictors of relapse/smoking after enrollment. Among CTTP cohort enrollees (n=233) from 2012-2013 we found: 1) a 28.4% 8 week point prevalence abstinence (PPA), and at a median of 9 months of follow-up after the PPA, 81.6% continued to indicate tobacco cessation, and 2) a high rate of relapse or loss to follow-up (56%). Our modeling of relapse/smoking after enrollment indicated that this was higher in young mothers, non-Hispanic mothers (White, Black), first/third trimester mothers, and rural mothers. The evaluation identified efficacy of the behavioral model at 8 weeks, but that relapse/smoking was occurring in disparity populations. Formative research is needed to expand the programmatic outreach and enrollment of mothers wanting to quit smoking.

Postpartum depression (PPD), a condition that affects up to the 15% of mothers in high-income countries, reduces attention toward the needs of the child and it is among the first causes of infanticide. PPD is usually identified using self-report measures and therefore the diagnosis may not always be valid. Previous studies highlighted the presence of significant differences in the acoustical properties of the vocalizations of children of depressed and healthy mothers. In this study, cry episodes of infants of depressed and non-depressed mothers are analyzed to investigate the possibility that a machine learning model can identify PPD in mothers from the acoustical properties of infants' vocalizations. Acoustic features (F0, F1-4, Intensity) are first extracted from recordings of crying infants, then novel cloud-based artificial intelligence models are employed to identify maternal depression versus non depression from estimated features. Trained model shows that commonly adopted acoustical features can be successfully used to individuate Post-Partum Depressed mothers with very high accuracy (89.5%).

Background: Paracetamol may be use as antipyretic agent for the treatment of fever, as well as an analgesic in the treatment of mild to moderate pain on post vaccination in infants. The use of Paracetamol during fever may be or may not be recommended since it may alter natural human body immune response although it may reduce pain. Objectives: This study described the relevancy of Paracetamol use post infants vaccination based on data collection systematic review analyses. This study aims to describe the effectiveness of breastfeeding in reducing pain and Paracetamol in reducing fever and pain post infants vaccination. Data Sources and Study Selection: Electronic literature search by hand searching six (6) databases which include Ovid LWW Total Access Collection and Medline, CINAHL (Cumulative Index to Nursing and Alled Health Literature) Plus with Fulltext, Science Direct, Proquest Dissertations and Theses, Proquest Education Journal and Proquest Health and Medical Complete. Additionally, manual reference checks of all articles on Paracetamol and breastfeeding post infants vaccination published in English Language between 1978 and 2017. Two level of screening were used on 9614 citations which include screening of abstracts and titles followed by full text screening. Data Synthesis: Data synthesis were tabulated into study characteristics, quality and effects. Authors of trials were not contacted for further details or provision of original data if the published report contained insufficient information. The study findings, as reported by the authors, were included in this review. The data in this research cannot be pool due to not enough data regarding odd ratio or relative risk as well as confidence interval in each study. Results: Systematic review of breastfeeding included three (3) studies from 9614 of database searching. The reviews of all these three (3) studies found significant benefit from breastfed in pain score and duration of crying as well as behavioral changes. None study stated the unbeneficial of breastfeeding before, during and after immunization. Meanwhile, systematic review of Paracetamol effectiveness included four (4) studies from 1177 of database searching. The reviews of two (2) studies found significant benefit from prophylaxis Paracetamol in fever and only one (1) study found significant benefit from prophylaxis Paracetamol in fussiness. On the other hand, there was one (1) study found not signifiant benefit from prophylaxis Paracetamol in fever. Other than that, there were two (2) studies evaluate the safety of prophylactic Paracetamol which revealed different outcomes, in which study by Prymula et. al. in 2009 found that antibody responses to several antigens were reduced significantly, and the other study by Uhari et. al. in 1988 found that antibody titres to DTP bacteria of placebo and PCM not differ significantly. Thus, Paracetamol seems to be not relevant post infants vaccination and breastfeeding was found to be beneficial post infants vaccination. Conclusions: The relevancy of giving Paracetamol post all types of vaccination may be questionable since the safety issue of this intervention may be arised. Breastfeeding before, during and after immunization are recommended for pain reduction as it was proved effectively. Finally, in deciding Paracetamol to be of rational use following infants immunization, it may need for further research which include in depth quantitative and qualitative studies to identify specific problem and causes regarding this issue.

Faced with difficulties stemming from the complex interactions between tight gas sand bodies and fractures when describing and identifying reservoirs, a composite reservoir model was established. By setting the supply boundary to characterize the superposition characteristics of sand bodies, a mathematical model of unstable seepage in fractured vertical wells in tight sandstone gas reservoirs was constructed considering the factors such as stress sensitivity, fracture density and fracture symmetry. The seepage law and pressure response characteristics of gas well in tight sandstone discontinuous reservoir with stress sensitivity, semi-permeable supply boundary and complex fracture topology were determined, and the reliability of the model was verified. The research results more accurately depict the pressure characteristic curve of the superposed sand body complex fracture vertical well, and provide a more comprehensive model for tight gas production dynamic analysis and well test data analysis, which can more accurately guide the dynamic inversion of reservoir and fracture parameters.

This paper deals with the quantitative analysis of measured fracture-induced electromagnetic radiation (FEMR) in the vicinity of the Dead Sea Transform using the Angel-M1 instrument, which enables the recording of FEMR signals in a 3D manner. Results show both the possibility of estimating the sizes of micro-fractures that are the sources of the radiation, and of assessing the direction of their location to the measuring device and the range of magnitude Mw of the impending "events" (EQ's) associated with the present FEMR measurements. Moreover, the relation between the measured FEMR activity (the number of FEMR hits per unit time) and the FEMR event magnitudes shows consistency with the Gutenberg-Richter relationship for the region. Such measurements could therefore constitute a preliminary 'field reinforcement' towards an EMR valid method for a real earthquake forecast, which would provide much earlier warnings than the seismic ones. Obviously, the present observed FEMR measurements can only be used as an assessment of the stress concentration and micro-fracturing in the region since they relate to the very initial nucleation phase of a "virtual" (extremely low Richter scale value) earthquake, but they do provide the necessary feasibility test for a prediction method since all lab-measured FEMR features were confirmed also in the field.

A reliable finite element procedure to simulate shear-dominated ductile fracture in large-scale, thin-walled steel structures is still evolving due primarily to the challenges in determining the fracture criterion of steel materials under complex stress states. This paper aims to examine the accuracy of the modified Gurson-Tvergaard-Needleman (GTN) model considering the shear failure in simulating ductile fracture of steel plate structures under quasi-static punch loading. The modified GTN damage models are performed by ABAQUS user defined material subroutine (VUMAT). The void related parameters and shear damage parameters of Xue’s and N-H modified GTN models are calibrated from test specimens with various geometries corresponding to different stress triaxiality and shearing conditions. The damage evolution associated with the shearing of voids in the modified GTN models has strong influences on the stress triaxiality versus equivalent plastic strain under complex stress states, especially for the shear dominated loading conditions. Based on the original GTN model, Xue’s model, and N-H modified GTN model with calibrated material parameters, a numerical comparative study examines the ductile fracture of steel non-stiffened plate and stiffened plate under punch loading. Benchmarked against the experimental studies, the numerical simulations demonstrate that the shear driven void evolution in the modified GTN model imposes significant effects on the load-displacement responses, as well as the onset and extension of ductile fracture in steel plates under punch actions. The N-H modified model with calibrated shear damage parameters shows a better correlation with the ductile fractures in steel plates observed in the experiment, than the original GTN model and Xue’s modified GTN model. As a result of this study, the modified GTN model considering the shear failure can be applied for practical applications in the crashworthiness assessment of ship collision and grounding.

Al-6%Mg-Sc-Zr alloys with the total ratio of Sc + Zr = 0.32 wt.% make up the target of this research. The content of scandium and zirconium varied with an increment of 0.02%. The alloys were produced by induction casting. Their ultrafine-grained (UFG) microstructure was formed with Equal Channel Angular Pressing (ECAP). Such cast alloys have a homogeneous macrostructure formed by small equiaxed grains in the central part of the ingot and columnar crystals along the edges of the cross section. After ECAP, the average grain size in the alloy specimens is 0.5–1 µm. The average grain size does not depend on the ratio of Sc and Zr in these alloys. Superplasticity tests were performed at temperatures ranging from 300 to 500 °C and at a strain rate varying between 3.3·10-3 and 3.3·10-1 s-1. UFG Al-6%Mg-0.20%Sc-0.12%Zr and Al-6%Mg-0.18%Sc-0.14%Zr alloys exhibit the highest superplasticity. It was suggested that changes in Sc:Zr ratio affect spatial distribution and composition of the following precipitating particles: Al3Sc, Al3Zr, Al3(ScxZr1-x). An increase in Zr concentration is shown to reduce the susceptibility of UFG alloys to cavitation fracture.

The combined muscle-skeletal traumas (MST) are very frequent over the last few years. The emergency care try to save the life of the patient and to receive resuscitation treatment. The role of Trauma surgeon is to choose the right moment for surgery. Aim: To present the management of patient with combined height injury, fracture stabilization, partial foot amputation, local flaps, skin grafting and HIFU – thermotherapy as scar treatment. Materials and methods: 40 years old mail patient, injured after a fall from 8 meters in an elevator shaft. After resuscitation treatment to control the shock the Imaging results are: burst fracture of L3 with spinal canal stenosis, fracture of the sacral bone Denis I, fracture of the right humerus in the proximal third, Monteggia fracture of the left arm, fracture of the proximal third of the right tibia as well as comminuted fractures of both calves and of both heel bones. Results: After a few operations his final result was well healed bone fractures and a good quality soft tissue coverage allowing the patient a satisfactory quality of life. Conclusions: Combined traumas of the muscle- skeletal system are severe, serious and difficult to manage. The good outcome in their treatment requires a team approach between the different medical specialists.

Well placement optimization in a given geological setting for a fractured geothermal reservoir is a prerequisite for enhanced geothermal operations. High computational cost associated in the framework of fully coupled thermo-hydraulic-mechanical (THM) processes in a fractured reservoir simulation, makes the well positioning as a missing point in developing a field scale investigation. Here, in this study, we shed light on this topic through examining different injection-production well (doublet) position in a given real fracture network. Water and CO2 are used as working fluids for geothermal operations and importance of well positions are examined using coupled THM numerical simulations for both the fluids. Results of this study are examined through the thermal breakthrough time, mass flux and the energy extraction potential to assess the impact of well position in a two-dimensional reservoir framework. Almost ten times of the difference between the final amount of heat extraction is observed for different well position but with the same well spacing and geological characteristics. Furthermore, stress field is be a strong function of well position that is important with respect to the possibility of unwanted stress development. As part of the MEET project, this study recommends to perform similar well placement optimization study for each fracture set in a fully coupled THM manner before a field well drilling.

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

The current paper aims to study the impact properties of additively manufactured Maraging steel (1.2709) using laser powder bed fusion (PBF-L) processing. The specimens were manufactured using 3Dsystems ProX 300 equipment under constant specific power input, or Andrew Number. The interactions between the build strategy and parameters, such as Hatch spacing and Scan speed was, and the impact strength and fracture were investigated. The Impact energy anisotropy was also investigated parallel and perpendicular to the build direction. Instrumented impact testing was performed, and the fractography supported that the fusion zone geometry dictated the fracture behaviour. The influence from gaseous elements such as Nitrogen, Oxygen and Hydrogen was found insignificant at the levels found in the printed material.

Pore-fractures network play a key role in coalbed methane (CBM) accumulation and production, while the impacts of coal facies on the pore-fractures network performance are still poorly understood. In this work, the research on the pore-fracture occurrence of 38 collected coals from Sangjiang-Muling coal-bearing basins with multiple techniques including mercury intrusion porosimetry (MIP), micro-organic quantitative analysis, and optic microscopy, and its variation controlling of coal face were studied. The MIP curves of 38 selected coals indicating pore structures were subdivided into three typical types including type I of predominant micropores, type Ⅱ of predominant micropores and macropores with good connectivity and type Ⅲ of predominant micropores and macropores with poor connectivity. For coal facies, there are three various coal facies were distinguished, which include lake shore coastal wet forest swamp, the upper delta plain wet forest swamp, tidal flat wet forest swamp with Q-cluster analysis and tissue preservation index - gelification index (TPI-GI) and Wood index - groundwater influence index (WI -GWI). The results show there is positive relationship between tissue preservation index (TPI), wood index (WI) and mesopores (102nm-103nm), while a negative relationship between TPI, WI and macropores/fractures. In addition, groundwater level fluctuations can control the development of type C and D fractures, and the frequency of type C and D fractures shows an ascending trend with increasing GWI, which may be caused by the mineral hydration of the coal. Finally, from the perspective of the pore-fractures occurrence in CBM reservoirs, the wet forest swamp of upper delta plain is considered to be the optimization areas for Sanjiang-Mulinghe coal-bearing basins by a comparative study of various coal facies.

In recent years, the biomimetic potential of lignified or partially lignified fruit pericarps has moved into focus. For the transfer of functional principles into biomimetic applications, a profound understanding of the structural composition of the role models is important. The aim of this study was to qualitatively analyse and visualize the functional morphology of the coconut endocarp on several hierarchical levels, and to use these findings for a more precise evaluation of the toughening mechanisms in the endocarp. Eight hierarchical levels of the ripe coconut fruit were identified using different imaging techniques, including light and scanning electron microscopy as well as micro-computer-tomography. These range from the organ level of the fruit (H0) to the molecular composition (H7) of the endocarp components. A special focus was laid on the hierarchical levels of the endocarp (H3-H6). This investigation confirmed that all hierarchical levels influence the crack development in different ways and thus contribute to the pronounced fracture toughness of the coconut endocarp. By providing relevant morphological parameters at each hierarchical level with the associated toughening mechanisms, this lays the basis for transferring those properties into biomimetic technical applications.

Polyolefin fibre reinforced concrete (PFRC) has become an attractive alternative to steel for the reinforcement of concrete elements mainly due to its chemical stability and the residual strengths that can be reached with lower weights. The use of polyolefin fibres can meet the requirements in the standards, although the main constitutive relations are based on the experience with steel fibres. Therefore, the structural contributions of the fibres should be assessed by inverse analysis. In this study, the fibre dosage has been fixed at 6kg/m³ and both self-compacting concrete and conventional concrete have been used to compare the influence of the positioning of the fibres. An idealized homogeneous distribution of the fibres with such fibres crossing from side to side of the specimen has been added to self-compacting concrete. The experimental results of three-point bending tests on notched specimens have been reproduced by using the cohesive crack approach. Hence, the constitutive relations were found. The significance of this research relies on the verification of the formulations found to build the constitutive relations. Moreover, with these results it is possible to establish the higher threshold of the performance of PFRC and the difficulties of limiting the first unloading branch typical of fracture tests of PFRC.

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.

Experimental quantification of retention factors related to post-fire strength as well as post-fire ductility of intentionally selected stainless steel grades applied in construction is the objective of research presented here. These steel grades are characterized by a two-phase austenitic-ferritic microstructure of the duplex type. In this context two mutually corresponding chromium-nickel-molybdenum steel grades have been subjected to analysis, namely X2CrNiMoN22-5-3 steel belonging to the standard duplex group (DSS 22% Cr) and X2CrMnNiN21-5-1 steel belonging to the lean duplex group (LDSS). The similarities and differences in the mechanical properties exhibited by these steel grades after effective cooling, following more or less prolonged simulated fire action conforming to several development scenarios, have been identified and indicated. The resistance of given steel grade to permanent structural changes induced by the heating program proved to be the critical factor determining these properties and resulting in many cases in increased susceptibility to brittle fracture.

Introduction: Despite more than one year passed since the first cases of SARS-CoV-2 were reported, there is still no consensus on the definition and clinical management of post-acute-COVID-19. The condition has heterogeneously been named as Chronic COVID syndrome, Post COVID-19 Syndrome, post-acute sequela of SARS-CoV-2 (PASC), and the more familiar long COVID. Method: In order to capture all relevant published studies, we undertook a multi-step search with no language restriction. The following four-step search strategy was utilized: First, a preliminary (limited) search was conducted on January 20, 2021, in Google Scholar and PubMed to identify the appropriate keywords. Then, on January 30, 2021, we adopted a search strategy of electronic databases from Cochrane Library, PsycINFO, PubMed, Embase, Scopus, and Web of sciences, using those keywords. Then, after duplicate removal, we screened all titles, abstracts, and full texts. This resulted in 66 eligible studies. Subsequently, after a forward and backward search of their references and citations an additional 54 publications were found, resulting in a total of 120 publications that formed the basis of the present analysis. The titles, abstracts, and full-texts of non-English articles were translated using Google Translate for further evaluation. We conducted our scoping review based on the PRISMA-ScR Checklist.Results: We found only one randomized clinical trial in our search. Of the 67 original studies, 22 were cohort and 28 were cross-sectional studies totaling 74.6% of the original studies. Of the total of 120 publications, 59 (49.1%) focused on signs and symptoms, 28 (23.3%) were focused on management, and 13 (10.8%) focused on pathophysiology. Ten (9%) publications focused on imaging studies. Ninety-one percent of the original investigations came from high and upper-middle-income countries, highlighting the scarcity of reports originating from low-income and lower-middle-income countries.Conclusion: The predominant symptoms among those with the so-called “Long COVID” were: fatigue, breathlessness, arthralgia, sleep difficulties, and chest pain. Recent reports also point to the risk of long-term sequela with cutaneous, respiratory, cardiovascular, musculoskeletal, mental health, neurologic, and renal involvement in those who survive the acute phase of the illness. The ambiguity and controversies in its definition have impaired proper recognition and management of those requiring additional support following the resolution of the acute phase of this infection. This has resulted in long-standing distress for the patients and their families. Our findings highlight the need for a multidisciplinary approach, support, and rehabilitation for these patients in terms of long-term mental and physical health.

Leaf springs are critical components for the railway vehicle safety in which they are installed. Although these components are produced in high-strength alloyed steel and designed to operate under cyclic loading conditions in the high-cyclic fatigue region, their failure is still possible to occur and hence lead to economic and human catastrophes. The aim of this document is precisely to characterise the mechanical crack growth behaviour of the 51CrV4 spring steel representative of leaf springs under cyclic conditions, that is, crack propagation in mode I. The common fatigue crack growth prediction models (Paris and Walker) considering the effect of stress ratio and parameters such as propagation threshold, critical stress intensity factor and crack closure ratio are also determined using statistical methods, which resulted in good approximations with respect to the experimental results. Lastly, the fracture surfaces under the different test conditions were analysed using SEM, with no significant differences to declare. As a result of this research work, it is expected that the developed properties and fatigue crack growth prediction models can assist design and maintenance engineers in understanding fatigue behaviour in the initiation and propagation phase of cracks in leaf springs for railway freight wagons.

An electrothermal analysis for barium titanate based ceramics is presented combining the Heywang–Jonker model for the electric resistivity with a heat dissipation mechanism based on natural convection and radiation in a one dimensional model on the device level with voltage as the control parameter. Both PTC and NTC effects are accounted for through the double Schottky barriers at the grain boundaries of the material. The problem formulated in this way admits uniform and non–uniform multiple steady state solutions that do not depend on the external circuit. The numerical bifurcation analysis reveals that the PTC effect gives rise to several multiplicites above the Curie point, whereas the NTC effect is responsible for the thermal runaway (temperature blowup). The thermal runaway phenomenon as a potential thermal shock could be among the possible reasons for the observed thermomechanical failures (delamination fracture). The theoretical results for the NTC regime and the thermal runaway are in agreement with experimental flash sintering results obtained for 3% and 8% yttria stabilized zirconia.

Abstract Background Context Pelvic ring fractures are becoming more common in the aging population and can prove to be fatal, having mortality rates between 10% and 16%. Stabilization of these fractures is challenging and often require immediate internal fixation. Therefore, it is necessary to have a biomechanical understanding of the different fixation techniques for pelvic ring fractures. Methods A previously validated three-dimensional finite element model of the lumbar spine, pelvis, and femur was used for this study. A unilateral pelvic ring fracture was simulated by resecting the left side of the sacrum and pelvis. Five different fixation techniques were used to stabilize the fracture. A compressive follower load and pure moment was applied to compare different biomechanical parameters including range of motion (contralateral sacroiliac joint, L1-S1 segment, L5-S1 segment), and stresses (L5-S1 nucleus stresses, instrument stresses) between different fixation techniques. Results Transiliac -trans sacral screw fixation at S1 and S2 showed the highest stabilization for horizontal and vertical displacement at the sacral fracture site and reduction of contralateral sacroiliac joint for bending and flexion range of motion by 165% and 121%, respectively. DTSF (Double transiliac rod and screw fixation) model showed highest stabilization in horizontal displacement at the pubic rami fracture site, while the L5_PF_W_CC (L5-Ilium posterior screw fixation with cross connectors) and L5_PF_WO_CC ( L5-Ilium posterior screw fixation without cross connectors) showed higher rod stresses, reduced L1-S1 (approximately 28%), and L5-S1 (approximately 90%) range of motion. Conclusions Longer sacral screw fixations were superior in stabilizing sacral and contralateral sacroiliac joint range of motion. Lumbopelvic fixations displayed a higher degree of stabilization in the horizontal displacement compared to vertical displacement of pubic rami fracture, while also indicating the highest rod stresses. When determining the surgical approach for pelvic ring fractures, patient-specific factors should be accounted for to weigh the advantages and disadvantages for each technique.

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.

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.

Steel fibers (SF) and polyolefin (PF) are widely used for shotcrete, especially in tunnelling. Both SF and PF and have shown to meet the standards in order to reduce or substitute the conventional steel mesh as reinforcement of concrete showing mechanical and productive advantages. This study sought the analysis and assessment of the mechanical properties of fiber reinforced shotcrete, comparing in-situ with laboratory results. This was performed with low and high fiber dosages of SF and PF as well as a combination of them (hybrid mixtures). A total of seven mixtures, two of steel, two of polyolefins, two hybrids and a control mixture were manufactured at laboratory and in situ. By performing tests according to EN 14651 and slabs according to EN 14488-5, it was possible to characterize the residual flexural strengths (fRj), and energy absorption capacity (E25mm) in slabs. In addition, a fracture surface analysis was performed, and the orientation factor was obtained. This allowed the authors to quantify the loss of residual strength on site and correlate it with the fiber content and positioning. Moreover, some relationships between beam and slab tests were found, allowing to correlate the most relevant type of tests in the field of fiber reinforced concrete.

Although lithium-ion batteries have extensively been used in various applications because of their high energy capacity, fracture and failure, the by-products of large strains and stresses caused by fast charging and discharging need yet to be addressed. The size effects on the mechanical behavior of the nano-sized structures are significant; however, the classical elasticity theory may not consider such effects. On the other hand, surface stress theory, as a robust and potential theory, is suitable in considering size effects in nano-scale structures. Therefore, in this paper, in order to involve the surface stress effects on the fracture behavior of Li-ion batteries, the following steps are taken. Firstly, a phase-field model is used to determine the evolution of the concentration profile. Subsequently, the stress distribution is obtained by using the surface stress theory combined with chemical equations for a planar electrode. Afterward, by using the weight function method for an edge crack in the plate, the stress intensity factor is derived for all time steps and possible crack lengths during the process. It is found that with increasing phase boundary thickness parameter or decreasing phase-separation phenomenon, the surface mechanics parameters become more influential. Furthermore, in the presence of positive surface stress, the diffusion-induced stress distribution decreases, which in turn reduces the stress intensity factor. In addition, in this paper, the two states of surface stress are compared either for elastic or total strain. Concerning stresses and concentrations, the results indicate a big difference at the beginning of the deintercalation process showing, in particular, 2% for stresses, but the differences diminish gradually.

Linear elastic fracture modeling coupled with empirical material tension data result in good quantitative agreement with experimental measurements of fracture failure for both brittle and tough epoxy nanocomposites. The nanocomposites comprise diglycidyl ethers of bisphenol A cured with O,O’ bis (2-aminopropylpropylene glycol) (Jeffamine D230) and doped with rubber nanoparticles of varying concentrations. Toughness, critical load, and critical displacement in quasi-static single edge-notched three-point bending are predicted accurately using both surface-based cohesive zone (CZS) and extended finite element (XFEM) methods implemented in Abaqus software. Fracture initiation within a crack is taken at the yield stress from uniaxial tension data. Prediction of fracture processes using a generalized truncated linear traction-separation law was significantly improved by considering the case of a linear softening function. There are no adjustable parameters in the XFEM model. The CZS model requires only optimization of the element displacement at fracture parameter. Thus, these continuum methods describe these materials in mode I fracture with a minimum number of independent parameters.

Manual measurement of rock discontinuities is time-consuming and subjective according to the experience of the surveyor. This work proposes a three-dimensional laser scanning-based method for the semi-automatic identification of rock discontinuities. Multisite cloud scanning is performed with real-time kinematic (RTK)-assisted orientation to estimate the rock fracturing degree; then, discontinuity orientations are extracted with the man–machine interactive method or automatic method. The proposed method was applied to actual examples to illustrate its accuracy at identifying rock discontinuities. The sensitivity of the identification accuracy to different parameters was investigated.

Intra-articular fractures are a major cause of post-traumatic osteoarthritis (PTOA). Despite adequate surgical treatment, the long-term risk for PTOA is high. Previous studies reported that joint injuries initiate an inflammatory cascade characterized by elevation of synovial pro-inflammatory cytokines, which can lead to cartilage degradation and PTOA development. This review summarizes the literature on the post-injury regulation of pro-inflammatory cytokines and the markers of cartilage destruction in patients suffering from intra-articular fractures. METHODS We searched Medline, Embase, and Cochrane databases (1960–February 2020) and included studies that were performed on human participants and included control groups. Two investigators assessed the quality of the included studies using Covidence and the Newcastle-Ottawa Scale. RESULTS Based on the surveyed literature, several synovial pro-inflammatory cytokines, including interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-12p70, interferon-y, and tumor necrosis factor-α, were significantly elevated in patients suffering from intra-articular fractures compared to control. A simultaneous elevation of anti-inflammatory cytokines such as IL-10 and IL-1RA was also observed. In contrast, IL-13, CTX-II, and aggrecan concentrations did not differ significantly between the compared cohorts. CONCLUSIONS Overall, intra-articular fractures are associated with an increase in inflammation-related synovial cytokines. However, more standardized studies which focus on the ratio of pro- and anti-inflammatory cytokines at different time points are needed.

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

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 objective of this research is to develop an experimental-theoretical analysis about the influence of the cooling medium and the geometry of the welding bead profile in fatigue life and associated parameters with structural integrity of welded joints. A welded joint with cruciform geometry is considered using SMAW, plates in structural steel ASTM A36 HR of 8 mm of thickness and E6013 electrode input. A three-dimensional computational model of the cruciform joint was created using the finite element method. For this model, the surface undulation of the cord and differentiation in the mechanical properties of the fusion zone were considered, the heat-affected zone (HAZ) and base material, respectively. In addition, an initial residual stress field which was established experimentally was considered. The results were a set of analytical expressions for the weld magnification factor Mk. It was found that values for the latter decrease markedly in function of the intensity of the cooling medium used in the post welding cooling phase, mainly due to the effect of the residual compressive stresses. The obtained models of behavior of the weld magnification factor are compared with the results from other researchers with some small differences, mainly due to the inclusion of the cooling effect of the post weld and the variation of the leg of the weld bead. The obtained analytical equations in the present research for Mk can be used in management models of life and structural integrity for this type of welded joint.

Large-span post-tensioned (PT) beams play a crucial role in maximizing the benefits of post-tensioning techniques. Bonded and unbonded systems are prevalent, with the latter being more widespread in the United States. While bonded systems are advantageous for creating long spans when multiple tendons are grouped in ducts, limited literature exists on their demolition. In a case study, this paper addresses the unique challenge of demolishing large-span bonded post-tensioned beams due to a building's functional change. Emphasizing insights for engineers, it explores the use of cutting and dismantling methods, considering the presence of prestressed cables. The demolition process is distinctive due to the presence of numerous pre-stressed cables along the beams, necessitating a specialized and cautious cutting approach. This is accomplished through the use of a drilling technique that selectively distresses the tendons, ensuring they are not all affected simultaneously. An intriguing observation discussed in this paper pertains to the occurrence of horizontal cracks accompanied by loud sounds following the drilling process, offering insights from the design perspective of PT systems. The paper details an innovative method for safely demolishing large-span bonded PT beams, using ground-penetrating radar and computer models to navigate structural complexities and ensure nearby structures' safety.

The pandemic was an enormous experience all over the world. The type of living, working and study were changed irreversibly. Facing the opportunity to establish old frames of education in universities is impossible. The adoption of new ways of teaching and assessments reveal their convenience and in the same way their weak points. In response to that stage, on 14 December 2022, the EU parliament accepted the "Digital Decade Policy Programme 2030", for the establishment of a digital transformation community (EU 2022). Trakia University had an online assessment system, quizzes for self-training, and final exams, developed in 2008 on Moodle virtual learning environment. During the pandemic, online exams and lectures were conducted using platforms like BigBlueButton in Moodle or Google Meets. The article gives the results of online exams before, during, and after the pandemic. The outcome, without doubt, displays the lowering knowledge level or performance during the social isolation due to COVID-19, and after, and the reasons are discussed. During the second year of the pandemic was mentioned also a high dropout of students. Now the situation is returning to the previous levels, before the pandemic, but the quality of education is not yet reached. The article values the grades results of session exams and has the intention to clarify the influence of the pandemic period on the excellence of high institution education.

The study aimed to evaluate the after-effects of the COVID-19 pandemic on the sleep quality and patterns of women across different cultural settings within Iraq, spanning the period of 2022. A cross-sectional survey was administered to a diverse cohort of women from multiple provinces in Iraq. The survey measured various parameters, including sleep duration, onset latency, and disturbances. The post-pandemic period has seen a notable decline in sleep quality among the female population. Contributing factors include psychological stress, lifestyle changes due to the pandemic, and ongoing socio-economic challenges. The impact on sleep quality exhibited variation across different cultural groups, indicating a significant cultural influence on the pandemic's psychological aftermath. The study concludes that the post-pandemic phase has adversely affected the sleep health of women in Iraq, with cultural factors playing a critical role in these changes. There is a pressing need for culturally sensitive public health strategies to address sleep disturbances and mitigate their long-term effects on women's health. Public health initiatives should be tailored to address the specific cultural contexts within Iraq to improve sleep health among women. Further research is warranted to explore the long-term consequences of disturbed sleep patterns and the effectiveness of different intervention strategies.

Background Posttraumatic stress disorder (PTSD) is a complex condition that represents a significant burden in terms of individual disability and societal costs. Despite decades of research investigating treatment options, PTSD remains a major cause of quality-of-life impairment. We hypothesized that patients with PTSD might benefit from peripheral somatosensory stimulation (PSS) therapy. Methods Six adult patients with clinically diagnosed PTSD were enrolled to undergo daily PSS therapy over a 4-week period. Patients completed two surveys evaluating satisfaction with treatment and overall well-being (Survey 1) and severity of PTSD symptoms (Survey 2). Survey 1 was completed weekly during the course of the study. Survey 2 was based on the 9-question National Stressful Events Survey PTSD Short Scale (NSESSS) and was completed as a baseline prior to initiation of therapy and then at the conclusion of the trial. All data were analyzed by an independent statistician. Results Six male patients were enrolled in the study; all completed the trial. All patients demonstrated a decrease in symptoms within one week of initiation of therapy. This benefit was sustained and appeared to further improve over the course of the trial. For Survey 1, the overall median scores demonstrated a significant time-dependent improvement across measurement times (p < 0.001). For Survey 2, patients had statistically significant improvements from baseline regarding feelings of being emotionally upset and being overly alert. Results from a cumulative link mixed model demonstrated that treatment yielded a 38.2-fold higher likelihood of transitioning from a higher PTSD score at baseline to a lower (improved) score at week 4. No adverse events were described by the patients. Conclusions PSS stimulation appeared to improve symptoms in all six patients with PTSD symptoms in this trial. Patients had unanimous and clinically meaningful improvement in overall PTSD symptoms with treatment. By week 4, all patients responded that they enjoyed the treatment and would like to keep their device. We suggest that further investigation into the potential usefulness of PSS therapy in patients with PTSD is warranted.

Post-traumatic stress disorder (PTSD) is a debilitating mental health disorder that causes significant dysfunction in individuals. Currently, there are many approved Pharmacotherapy and Psychotherapy treatment options for PTSD, but unfortunately, half of the patients do not respond to traditional therapies. In this article, we reviewed clinical trials and research on 3,4-methylenedioxymethamphetamine (MDMA) assisted Psychotherapy in PTSD patients, its pharmacokinetics and current treatment guidelines for PTSD. Based on the results of the efficacy of MDMA assisted Psychotherapy from six phases II Randomized controlled trials. MDMA-assisted Psychotherapy for PTSD has received the “Breakthrough Therapy” designation from the FDA. MDMA can potentially reduce PTSD symptoms even in treatment-resistant cases by increasing certain neurohormones, i.e. dopamine, serotonin, norepinephrine and oxytocin. It also modulates activities in the brain regions involved in fear and anxiety. Future research is needed to show whether the advantages outweigh the disadvantages and whether its use can be integrated into available treatment options for PTSD.

Aims: The aims of this meta-analysis were to assess: the prevalence of Post-Acute COVID-19 sequalae in HIV positive patients; average time of diagnosis; and meta-regress for possible moderators of PACS.Methods: A standard search strategy was used in PubMed, and then later modified according to each specific database to get the best relevant results. These included Medline indexed journals; PubMed Central; NCBI Bookshelf and publishers' Web sites in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. Search terms included “long COVID-19 or post-acute COVID-19 syndrome/sequalae”, “persons living with HIV or HIV. The criteria for inclusion were published clinical articles reporting HIV in association with long COVID-19, further, the average time to an event of post-acute COVID-19 sequelae among primary infected patients with COVID-19. Random-effects model was used. Rank Correlation and Egger's tests were used to ascertain publication bias. Sub-group, sensitivity and meta-regression analysis were conducted. A 95% confidence intervals were presented and a p-value < 0.05 was considered statistically significant. Review Manager 5.4 and comprehensive meta-analysis version 4 (CMA V4) were used for the analysis. The review/trial was PROSPERO registered (CRD42022328509).Results: A total of 43 studies reported post-acute COVID-19 syndrome. Of those, five reported post-acute COVID-19 sequalae in PLHIV. Prevalence of post-acute COVID-19 sequalae was 43.1% (95% CI 20.5% to 68.9%) in persons living with HIV (PLWH). The average time to PACS diagnosis was 4 months at 64% [0.64 (95% CI 0.230, 0.913) (P < 0.0000), I²= 93%] and at one year to PACS diagnosis was at 70 %, however with non-significant correlation (P > 0.05). On comorbidities, asthenia was associated with PACS at 17.6 % [0.176 (95% CI 0.067, 0.385) (P = 0.008), I²= 86%] while fatigue at 82%, however not related with PACS event incidence (P < 0.05). Americas, Asian and European regions showed PACS events rates of 82%, 43% and 19 % respectively (P<0.05) relative to HIV infection. Conclusion: PACS prevalence in PLWH was 43% occurring at an average time of 4 months at 64% and 70 % at 12 months however non-significant with PACS. Asthenia was significantly associated with PACS at 17.6 % while fatigue at 82%, however not related with PACS event incidence. Americas recorded the highest PACS event rates in PLWH.

In this review we extensively describe the main post-translational modifications that give rise to the multiple proteoforms characterized to date in the human salivary proteome and their potential role. Most of the data reported were obtained by our group in over twenty-five years of research carried out on human saliva mainly by applying a top-down strategy. At the beginning we describe the products generated by proteolytic cleavages, which can occur before and after secretion. In this section the most relevant families of salivary proteins are also described. Next, we report the current information concerning the human salivary phospho-proteome and the limited news available on sulfo-proteome. Three sections are dedicated to the description of the glycation and enzymatic glycosylation. Citrullination and N- and C- terminal PTMs and a miscellaneous of other modifications are described in the last two sections. Results highlighting the variation in the level of some proteoforms in local or systemic pathologies are also reviewed along the sections of manuscript to underline the impact and relevance of this information for the development of new diagnostic biomarkers useful in clinical practice.

Abstract Congenital rubella syndrome is a constellation of birth defects that can have devastating consequences, impacting approximately 100,000 births worldwide each year. The incidence is much lower in countries that routinely vaccinate their population. In the US, postnatal immunization of susceptible women is an important epidemiological strategy for the prevention of rubella. However, concerns that co-administration of Rubella vaccine with other immunoglobins (i.e., Rhogam) could comprise vaccine efficacy has produced warnings that can delay the administration of Rubella vaccination postpartum, leaving women susceptible in a subsequent pregnancy. We aimed to address whether co-administration of Rubella vaccine and Rhogam decreased antibody responses as compared to those receiving only Rubella vaccination. This retrospective cohort study utilized clinical data from 80 subjects who received Rubella vaccine and Rhogam after delivery and 43 subjects received Rubella vaccine alone. Maternal demographics, pregnancy complications and rubella status at the start of a subsequent pregnancy were recorded for analysis. Overall, the two cohorts had similar baseline characteristics; however, lower parity was noted in the participants having both Rubella vaccination and Rhogam. Based on maternal antibody IgG index for rubella during the next pregnancy, we observed that 88% of the Rhogam + Rubella vaccine group had positive titers, which was not significantly different than the 81% in the Rubella vaccine only cohort (p=0.36). In conclusion, no differences in the rubella immunity status in a subsequent pregnancy were observed in those mothers administered both Rubella vaccine and Rhogam concurrently. Given these findings, warnings against co-administration of Rubella vaccine in combination with other immunoglobulins should be discontinued.

(1) Background: High-grade cervical dysplasia is primarily caused by human papillomavirus (HPV) infection. Conservative surgery is the preferred treatment approach for this condition. The most commonly employed technique is the loop electrosurgical excision procedure (LEEP), which involves removing the affected portion of the cervix. Excisional treatments are often curative, and complications are typically rare and minor; (2) Methods: The loop electrosurgical excision procedure (LEEP) is the standard method used for conservative surgery in high-grade cervical dysplasia. It entails the excision of the specific area of the cervix where the abnormal cells are present. The procedure employs a wire loop carrying an electrical current to remove the affected tissue; (3) Results: Excisional treatments, such as LEEP, have shown to be effective in treating high-grade cervical dysplasia. They have a high success rate in eliminating abnormal cells and reducing the risk of cervical cancer. Complications associated with LEEP are infrequent and usually minor. Short-term complications may include bleeding, which can be managed easily. Long-term complications may involve cervical canal stenosis, which can impact fertility; (4) Conclusions: Conservative surgery, particularly the loop electrosurgical excision procedure (LEEP), is the preferred and effective treatment for high-grade cervical dysplasia caused by HPV infection. It offers a high cure rate with rare and minor complications. While short-term bleeding is a common occurrence, it is manageable. Long-term complications such as cervical canal stenosis may impact fertility. However, an extremely rare and possibly unique complication described in this case is the development of a vaginorectal fistula. This complication is likely due to indirect thermal injury resulting from compromised tissue. Further research is needed to better understand and prevent such complications.

Abstract: Gastroesophageal reflux disease (GERD), the inflammatory bowel disease (IBD), and mental health issues are significant public health concerns in globally. Although rising peaks observed post-COVID-19, there is a sever paucity in high quality data. Using descriptive analysis, we identified the frequency and associations of age- and gender, sport, genetic, and psychiatric consequences in the coexistence of GERD and IBD in 2067 participants 18 to &gt;60 years with mean age of 26.8 ± 12.9 years. Most were 18 -29 years old (66%, n=1364) of which majority were young Saudi females (72.4%, n=1496). Estimated 1099 (53.2%) were students, 428 (20.7%) were unemployed, and 540 (26.1%) were. The majority were Saudis (94.7%, n= 1957). Psychological syndromes anxiety (60.7%), stress (60.7%), and depression (60.6%) were most frequent; whereas, IBD (48.7%) and GERD (36.3%), respectively were the second and third. In 51 % respondents depression, anxiety, and stress occurred first while in 33.9%, and 24.3% IBD and GERD, respectively, were the first signs. In most respondents (59.2%, n=1178), these signs first appeared recently and 33.6% (n=669) reported occurrence during adult life, and only in 7.2% (n=144) the signs noticed during childhood (7.2%, n=144)). Aggravating factors were 32.9% (n=681) genetic and other factors of which 476 (69.9%) inherited IBD while 215(31.6%) and 175 ((25.7), respectively, inherited psychological (depression, anxiety, and stress) and GERD. However, only 18.3% sought treatment (n=378) and only 66 (3.2%) had colectomy or a colostomy bag. Little over half of the studied population (58.1%, n=1201) were active in outdoor. GERD or IBS and psychological factors (anxiety, depression, and stress), were significantly associated with age (P value =.001).; GERD with old age, IBD with mid-age 40-49 years, and psychological disorders among younger ages. Thus, while mental health issues predispose young millennial women to neurogastroenterological disorders, the IBD and GERD initiate psychological problems in old and mid-ages, respectively. Intriguingly, despite the significantly mosaic global genetic population structures, their lifestyles, and nutritional habits, the pattern of these disorders remains similar. Thus, this is potentially consistent with notion that the gut nerve cells are conserved and that the changes in gut dysbiosis of gut microbiome signatures are responsible. These findings have significant clinical implications in the patient treatment strategies and tailored educational and awareness programs in lifestyle medicine. Future microbiome studies would reveal more insight into the mechanisms of disorders.

The rapid development of quantum computing devices promises powerful machines with capabilities that solve a wide range of problems that traditional computers cannot. Therefore, quantum computers generate new threats at unprecedented speed and scale and specifically pose an enormous threat to encryption. Lattice-based cryptography is considered to be the rival to a quantum computer attack and the future of post-quantum cryptography. So, cryptographic protocols based on lattices have a variety of benefits, like security, efficiency, lower energy consumption, and speed. In this work, we study the most well-known lattice-based cryptosystems while a systematic evaluation and comparison is presented also, and focuses on their strengths and weaknesses.

Temperature is a critical factor that influences the proliferation of pathogens in hosts. The impact of temperature on pathogens is commonly explored in controlled and constant temperatures. Experiments under varying environmental temperature are becoming more frequent, however, testing every temperature scenario à la carte is unachievable. One example of this is the human pathogen Vibrio parahaemolyticus (Vp) in oysters. Here, a predictive model was developed for predicting the growth of Vp in oysters under varying ambient temperature. The model was fitted and evaluated against data from experiments studying growth and inactivation of Vp in oysters at eight constant temperatures. Once evaluated, Vp dynamics in oysters were estimated at different post-harvest varying temperature scenarios affected by water and air temperature, and different ice treatment timing. The model performed adequately under varying temperature, reflecting that (i) increasing temperature, particularly in hot summers, favors a rapid Vp growth in oysters, resulting in a very high risk of gastroenteritis in humans after consumption of a serving of raw oysters, (ii) pathogen inactivation due to day/night oscillations, and more evidently, due to ice treatments, (iii) ice treatment is much more effective limiting risk of illness when applied immediately onboard compared to dockside. The model results to be a promising tool for improving the understanding of the Vp-oyster system and support studies on public health impact of pathogenic Vp associated with raw oyster consumption. Although robust validation of the model predictions is needed, initial results and evaluation show the potential of the model to be easily modified to match similar systems where the temperature is a critical factor shaping the proliferation of pathogens in hosts.

Sepsis is a life-threatening condition with high hospital mortality. Elevated mortality has also been observed in patients after hospital discharge due to post-sepsis syndrome (PSS). The etiology of PSS is still not entirely known, but it involves inflammation. Plasma extracellular vesicles (EVs) are recognized as a unique mechanism of intercellular communication in inflammatory processes. It has been reported that EV microRNA (miRNA) production during the acute sepsis phase may persist until after disease resolution and is associated with PSS. We employed mass spectrometry and qPCR analysis to determine the protein and miRNA composition of plasma-derived EVs of 36 patients during sepsis-related hospitalization, immediately after ICU discharge (post-sepsis), and three, six, twelve, and up to 36 months post-sepsis. We determined that patients’ immune system cells were the primary EV source. Fifteen differentially expressed EV miRNAs (DEmiRs) were identified in samples from septic patients compared to the control group. Predictive analyses revealed that these DEmiRs could influence inflammation by modulating pathways mediated by NF-κB, STAT3, and TLR4 signaling activation. Thirteen miRNAs (-15b-5p,-16-5p,-20a-5p,-25-3p,-27a-3p,-29a-3p,-30d-5p,-93-5p,-146a-5p,-148a-3p,-191-5p,-195-5p,-223-3p) were downregulated in the death group compared to the survivor group, making them candidate prognostic markers of ICU survival. One year after ICU discharge, the expression of miR-21-5p and miR-195-5p were decreased in the survivor group. The miRNAs identified in the present study represent potential biomarkers for the survival prognosis of post-sepsis patients.

This study is a cross-sectional survey involving physicians around Indonesia aimed to explore physician hesitancy to treat COVID-19 patients after experiencing COVID-19 infection coupled with associated occupational risk factors. The questionnaire was distributed via contact information from the Indonesian Physician Association database. Out of 383 participants, 25.6% suffered from moderate symptoms of COVID-19 and 2.9% were admitted for critical care. Hesitancy to treat suspected, probable, or confirmed COVID-19 patients was found in 20.3% of physicians. A higher hesitancy rate was found in older physicians and those with less experience in treating COVID-19 patients. Specialist trainees and those who work in public hospitals were physicians with the lowest hesitancy in treating COVID-19 patients. There is a significant hesitancy in treating COVID-19 patients among physicians who have suffered from COVID-19 which calls for further action by management and policy makers.

Plastid gene expression involves many post-transcriptional maturation steps resulting in a complex transcriptome composed of multiple isoforms. Although short read RNA-seq has considerably improved our understanding of the molecular mechanisms controlling these processes, it is unable to sequence full-length transcripts. This information is however crucial when it comes to understand the interplay between the various steps of plastid gene expression. Here, the study of the Arabidopsis leaf plastid transcriptome using Nanopore sequencing showed that many splicing and editing events were not independent but co-occurring. For a given transcript, maturation events also appeared to be chronologically ordered with splicing happening after most sites are edited.

Background: Percutaneous coronary intervention (PCI) is known as a very rare possible trigger of pericarditis. Most frequently it develops after a latent period or early in case of periprocedural complications. In this report, we present an atypical early onset of pericarditis after the uncomplicated PCI. Case Summary: A 58-year-old man was admitted to the hospital for the PCI of the chronic total occlusion of left anterior descending (LAD) artery. An initial electrocardiogram (ECG) was unremarkable. PCI attempt was unsuccessful. There were no procedure related complications observed at the end of PCI attempt and patient was symptom free. Six hours after interventional procedure the patient complained of severe chest pain. The ECG demonstrated ST-segment elevation in anterior and lateral leads. Troponin I was mildly elevated but coronary angiogram did not reveal impairment of collateral blood flow to the LAD territory. Because of pericarditic chest pain, typical ECG findings and pericardial effusion with elevated C-reactive protein, the diagnosis of acute pericarditis was established, and a course of nonsteroidal anti-inflammatory drugs (NSAIDs) was initiated. Chest pain was relieved and ST-segment elevation almost completely returned to baseline after three days of treatment. The patient was discharged in stable condition without chest pain on the fourth day after symptom onset. Conclusions: Acute pericarditis is a rare complication of PCI. Despite the lack of specific clinical manifestation, post-traumatic pericarditis should be considered in patients with symptoms and signs of pericarditis and a prior history of iatrogenic injury or thoracic trauma.

The influence of post-processing conditions on the magnetic properties of amorphous and nanocrystalline microwires have been thoroughly analyzed, paying attention on the influence of magnetoelastic, induced and magnetocrystalline anisotropies on the hysteresis loops of Fe-, Ni- and Co-rich microwires. We showed that magnetic properties of glass-coated microwires can be tuned by the selection of appropriate chemical composition and geometry in as-prepared state or further considerably modified by appropriate post-processing, which consists of either annealing or glass-coated removal. Furthermore, stress-annealing or Joule heating can further effectively modify the magnetic properties of amorphous magnetic microwires owing to induced magnetic anisotropy. Devitrification of microwires can be useful for either magnetic softening or magnetic hardening of the microwires. Depending on the chemical composition of the metallic nucleus and on structural features (grain size, precipitating phases) nanocrystalline microwires can exhibit either soft magnetic properties or semi-hard magnetic properties. We demonstrated that the microwires with coercivities from 1 A/m to 40 kA/m can be prepared.

Blackberry is a fruit that has high nutritional value, a factor that has expanded its consumption worldwide. However, due to the fragility of the fruits and the high incidence of postharvest diseases, the fruits have a short shelf life. Thus, the objective of this study was to evaluate whether the application of coatings based on microfibrillated cellulose (NC) and lemongrass essential oil (EO) nanoparticles can prolong the shelf life of blackberry fruits after harvest. EO-coated blackberry fruits at nanocellulose concentrations were analyzed as follows: 0; 0.2; 0.4; 0.6 and 0.8%, in addition to the control treatment of which neither essential oil nor nanocellulose was used, for each treatment five repetitions were used. The fruits were analyzed soon after the application of the cover and at three and six days after storage. Fruit quality was assessed by soluble solids (SS), titratable acidity (TA), pH, fresh weight loss (FWL) and colorimetric parameters such as luminosity, hue angle and fruit peel chroma. Coating on EO (1000 ppm) blackberries combined with NC at concentrations of 0.2, 0.4 and 0.6% is promising in preserving blackberry fruits and reducing the process color reversal, up to six days of storage. The 0.4% NC + 1000 ppm EO conjugated coating showed no SS changes in blackberry fruits during the six days of storage.

Synergistic effects between reactions, reagents and catalysts can lead to minor heats of reaction and occur as an inherent result of multi-component reactions (MCRs) and their extensions. They enable syntheses to be performed at a low energy level and the number of synthesis steps to be drastically reduced in comparison with ‘classical’ two-component reactions. The very high potential for variability, diversity and complexity of MCRs additionally generates an extremely diverse range of products, thus bringing us closer to the aim of being able to produce tailor-made and extremely low-priced materials, drugs and libraries.

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.

The fatigue crack growth rate (FCGR) of aluminium alloys under the combined influence of temperature and humidity remains a relatively unexplored area, receiving limited attention due to its intricate nature and challenges in predicting the combined impact of these factors. The challenge was to investigate and address the specific mechanisms and interactions between temperature and humidity, as in coastal environment conditions, on the FCGR of aluminium alloy. The present study conducts a comprehensive investigation on the combined influence of temperature and humidity on the FCGR of Al6082 alloy. The fatigue pre-cracked compact tension specimens were corroded for 7 days and then subjected to various temperature and humidity conditions in a thermal chamber for 3 days to simulate coastal environments. The obtained data were analysed to determine the influence of temperature and humidity on the FCGR of Al6082 alloy. An empirical model was also established to predict fatigue life cycle values under these environmental conditions precisely. The correlation between FCGR and fracture toughness models was also examined. The Al6082 alloy exhibits a 34% increase in the Paris constant C, indicating reduced FCGR resistance due to elevated temperature and humidity levels. At the same time, fatigue, corrosion, moisture-assisted crack propagation, and hydrogen embrittlement lead to a 27% decrease in threshold fracture toughness. The developed model exhibited accurate predictions for fatigue life cycles, and the correlation between fracture toughness and FCGR showed less than 10% error, indicating a strong relationship between these parameters.

The surrounding rock during the coal mine excavation is prone to significant engineering disasters such as considerable deformation and rockbursts. Pressure release can improve the stress field of a deep rock mass and prevent the occurrence of dangers such as roadway collapse and coal and gas outbursts. This paper uses the ANSYS/LS-DYNA finite element software to simulate the crush area and fracture zone of a detonation charge with different diameters under in-situ stress. The stability of the surrounding rock was analyzed based on the impact stress and velocity, and was verified by field tests. The research results show that the blasting load primarily affects the damaged area near the borehole, while the in-situ stress affects the far-field crack propagation. The crack propagates in the direction of high surrounding rock pressure. When the uncoupling index is 1.5, the impact pressure of the 60 mm diameter cartridge is 8 times that of the 20 mm diameter cartridge. The impact speed can reach 2 times that of the 20 mm diameter cartridge. The high-energy event of the roof is transferred to the front of the working face, the distribution is no longer concentrated, and a better blasting pressure relief effect is achieved. The research results can help guide the prevention and control measures of rock bursts and other mining disasters.

In this paper, through high-temperature tensile tests of 55NiCrMoV7 steel, the high-temperature fracture behavior, microstructure evolution and carbide distribution characteristics of both thermal-mechanical coupling zone (fracture zone) and thermal stress zone (clamping zone) at different temperatures were studied. Intrinsic relationship between high temperature fracture and carbides types, distribution and size were revealed and evolution mechanism of microstructure near cracks in 55NiCrMoV7 hot-working die steel during high temperature deformation was clarified. Samples were stretched at different temperatures from 25 °C to 700 °C, and microscopic examinations were carried out by using SEM and TEM. The results showed that: With the increase of temperature, tensile strength and yield strength decreased, elongation and reduction of area increased, and fracture mode changed from brittle fracture to ductile fracture by transition temperature at about 400℃. During high temperature deformation, the grain dislocation density decreased, the tempered martensite decomposed, recovered, recrystallized, and then grain grew. M7C3 and M23C6 carbides precipitated and grew along the grain boundary, and a small amount of fine granular MC carbides were dispersed in the grain. The work done by the external force on the deformation zone would cause the temperature of it to be higher than tensile temperature, which provides thermodynamic conditions for the re-dissolution of small carbides near the fracture zone and the grain growth of large carbides, resulting in the decrease of small carbides and increase of large carbides in thermal-mechanical coupling zone.

Indirect fracturing from roof rock to coal using a horizontal well is a new and promising technology for coalbed methane surface exploitation in soft and low-permeability coal seams. In order to study the propagation law of hydraulic fracture across the coal-rock interface, a pore pressure cohesive element is used to establish a numerical model for indirect fracturing. Combined with practical engineering in 3# coal seam in Xinjing mine in China, the propagation behavior of hydraulic fracture across the coal-rock interface was researched, and the range of horizontal well position for indirect fracturing was determined. The results show that: (1) the pore pressure cohesive element can be used to simulate accurately the interaction between hydraulic fracture and natural fracture, and the propagation of hydraulic fracture across the coal-rock interface. (2) As the vertical distance between the horizontal well and coal-rock interface decreases, the breakdown pressure of perforation decreases; while the injection pressure increases when the hydraulic fracture crosses the coal-rock interface. (3) For the indirect fracturing engineering in 3# coal seam in Xinjing mine, the vertical distance between the horizontal well and coal-rock interface should not be larger than 2.0m to make the hydraulic fracture propagate into the coal seams.

Patients often need the use of their arms to assist with functional activities, but after bone disruption, pushing is frequently limited to less than 4.5 kg. No method exists to measure arm weight bearing objectively in clinical settings. This project aimed to design, construct, and test a walker for patients who need to limit arm force to prevent excessive bone stress during post-fracture (iatrogenic or traumatic) ossification. First, a qualitative study was conducted to obtain critiques of a Clinical Force Measuring (CFM) walker prototype from rehabilitation professionals. Key statements and phrases were coded that allowed “themes” to emerge from transcribed interviews, which guided device revisions. Next, a second CFM Walker prototype was designed based on the qualitative data and device criteria/constraints and finally tested. The result was fabrication of a new lightweight, streamlined, and cost-effective prototype walker with a simple visual display and auditory cue with upper limit alarms. Key features included attachments for medical equipment and thin film force-sensing resistors integrated into the walker handles that progressively activated 3 LEDs and a buzzer when arm force exceeded programmed thresholds. The innovative CFM Walker will help patients with restricted arm weight bearing, especially elderly adults, recover safer and faster in the future.

Beaches are among the habitats most frequented by migratory birds for breeding and/or wintering. However, threats such as human pressure and sea level rise can reduce the availability of these habitats for different species. The presence of alternative areas, such as salt pans and brackish habitats, is essential for many migratory shorebird populations. This study addresses the post-breeding dispersal of the Kentish plover (Charadrius alexandrinus) in the Iberian Peninsula by analysing C and N isotopes in feathers. The study was conducted at six locations along the Iberian coast, which were categorized in three areas: NW Atlantic coast, the Atlantic coast of Andalusia and the Mediterranean coast. Although linear mixed models did not reveal any significant effects of sex or coastal area on isotopic levels, the variability in the data suggests different habitat-use strategies in the post-reproductive period. Birds from the northwest of the Iberian Peninsula exhibit greater fidelity to a single habitat type, i.e. coastal beaches, while populations from the Mediterranean coast and the Atlantic coast of Andalusia show different individual dispersal strategies, occupying coastal habitats and freshwater wetlands. The lack of alternative habitats for the northwest Iberian population, the reduction in available habitat due to rising sea levels and human pressure together pose a serious threat to the survival of this species, already with an unfavourable conservation status.

Background: Traumatic events adversely affect the clinical course of obsessive-compulsive disorder (OCD). Our investigation explores the correlation between prolonged interpersonal trauma and the severity of symptoms related to obsessive-compulsive and anxiety disorders. Methods: The study follows a cross-sectional and observational design, employing the International Trauma Questionnaire (ITQ) to examine areas linked to interpersonal trauma, the Hamilton Anxiety Rating Scale (HAM-A), and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) to assess anxious and obsessive-compulsive symptoms, respectively. Descriptive analysis, analysis of variance (ANOVA), and logistic regression analyses were conducted. Results: We recruited 107 OCD-diagnosed patients, categorizing them into subgroups based on the presence or absence of complex post-traumatic stress disorder (cPTSD). The ANOVA revealed statistically significant differences between the two groups in the onset age of OCD (p=0.083), psychiatric familial history (p=0.023), HAM-A, and Y-BOCS (p=0.000). Logistic regression indicated a statistically significant association between the presence of cPTSD and Y-BOCS scores (p=0.000). Conclusion: The coexistence of cPTSD in OCD exacerbates obsessive-compulsive symptoms and increases the burden of anxiety. Further advancements in this field are crucial for mitigating the impact of early trauma on the trajectory of OCD and associated anxious symptoms.

Background and aims: For many surgical procedures, spinal anesthesia is a reliable and efficient anesthetic approach. Numerous drugs have been reported to be administered to intrathecal local anesthetics as adjuvants to increase the efficacy of spinal anesthesia. There is little evidence of the effect of intrathecal dexmedetomidine on pain scores and the consumption of analgesia postoperatively. Methods: After obtaining ethical approval, demographical and clinical data of patients who underwent surgical procedures under spinal anesthesia with intrathecal dexmedetomidine or fentanyl was collected and analyzed. Results: In this study with 96 patients, intrathecal dexmedetomidine (group D) resulted in significantly lower post-operative pain scores compared to intrathecal fentanyl (group F) (p=0.000). Across various surgical types, including Orthopedic, General, Urology, and Obs/Gyne procedures, group D consistently displayed reduced pain scores (p&lt;0.001). The number of patients who needed post-operative analgesia was significantly higher in group (F) than in group (D) (40 vs 23, p=0.002). Conclusion: Compared to fentanyl, intrathecal dexmedetomidine as an adjuvant to local anesthesia was found to lower post-operative pain scores and decrease the need for post-operative analgesia.

ICT and digital technology adoption, sustainable development, community empowerment and local wisdom and destinations uniqueness are keywords that will be further explored in the de-velopment of tourism villages in Kenderan as the most importance of tourism destinations de-velopment from the village level. Therefor this research is aimed at developing suitable model for post smart or wise tourism village through proposing Culture and Tradition Festival and the application of a circular economy. Circular economy development in tourism villages focuses on the application of sustainable production principles in the tourism value chain, namely in creating tourism experiences together with tourists (co-creation of experience) and integrated in a tourism system that supports environmental sustainability. This research is applied research conducted with a sequential mixed method research by conducting qualitative research through expert judgment and quantitative research by circulating questionnaire to tourists visiting Kenderan village, while the collected data is analyzed by Structural Equation Modelling to see the rela-tionship between variables. The results of this research show that creative event as the locality aspects of tourist village, digital competence, and sustainability practice are the building blocks of post smart tourism village, while digital competence and sustainable practice have significant mediating effect of locality on post smart tourism village. To make tourism village possesses sustainable competitive advantages, the village must explore and promote its locality aspects to differentiate its tourist village by identifying the valuable, rare, inimitable and non-substitutable tourism resources. The implication of this research is that to develop smart tourism destination wiser and distinctive, tourist village should explore their local values and resources, embed them into its tourism basic components and core resources, and co create, distribute, deliver and promote it to global market through technology adoption and global sustainability value.

Objective: To assess the recovery of voice in patients with unilateral vocal cord paralysis after thyroid surgery following treatment with nursing intervention combined with voice training. Methods: Thirty patients with unilateral vocal cord paralysis and hoarseness for 6-12 months post-thyroid surgery were selected. They first underwent two weeks of psychological and cognitive intervention, followed by a psychological resilience assessment, and then proceeded with 12 weeks of voice training. This training primarily included muscle relaxation exercises, breathing training, and phonation exercises. A comparative analysis was conducted on the patients' voice parameters before and after the training, including jitter, shimmer, maximum phonation time (MPT), noise to harmonic ratio (NHR), and the Voice Handicap Index (VHI) scores. Results: After psychological and cognitive intervention, scores for optimism, resilience, and self-strength among the 30 patients increased. Post-voice training, reductions were observed in jitter, shimmer, NHR, and VHI scores, the Maximum Phonation Time (MPT) increased compared to pre-training, with the difference being statistically significant (P<0.05). Conclusion: Nursing intervention combined with voice training can effectively improve voice quality in patients with unilateral vocal cord paralysis after thyroid surgery.

Background: Chronic post-surgical pain is a condition persisting at least three months after surgery. It is estimated that 25-60% of patients who underwent breast cancer removal surgery suffer from post-mastectomy pain syndrome and occurred anxiety, depression, sleep disturbance and catastrophizing. Physical activity can reduce the risk of chronic diseases and has a good impact on mood and cognitive function. Aim of this study was to evaluate the effects of physical activity on the intensity of pain, depression and anxiety in women underwent mastectomy for breast cancer removal. Methods: A prospective observational unicentric cohort study was performed. Patients were female underwent unilateral or bilateral mastectomy. Numerical Rating Scale (NRS), was used to assess pain intensity, Beck’s Depression Inventory (BDI) for depression and Generalized Anxiety Disorders-7 (GAD-7), for anxiety evaluation. Physical activity was assessed by International Physical activity questionnaire (IPAQ). Interleukin (IL)-17, IL-1β, cortisol, adrenocorticotropic hormone (ACTH) and brain-derived neurotrophic factor (BDNF) were also evaluated in the blood of patients. All the evaluation was assessed 3 and 6 months after the surgery. Results: Adequate physical activity reduced intensity of pain, depression and anxiety symptoms in women affected by post-mastectomy pain syndrome. Moreover, adequate active women, showed a reduction of biomarkers of inflammation, cortisol, ACTH and an increase of BDNF. Conclusions: Our results suggest that physical activity can improve quality of life, reducing intensity of pain, inflammatory markers and it can be useful in the reduction of associated anxiety and depression.

Keywords: Post-Stroke; Hyperbaric oxygen therapy; Sequelae; Feasibility; Out-patient.

Considering the importance of assessing the impacts resulting from a sport career, this study aimed at developing and validating a semi-structure interview guide suitable for quantifying the socio-demographic and epidemiological profile of former professional football players. Based on the theoretical frameworks and several methodological procedures, an interview guide was de-veloped, consisting of 3 areas of conceptual organization (A1. Biographical data; A2. Career data; and A3. Post-Career Transition data) and 8 data collection categories (C1. Personal data; C2. Pro-fessional data; C3. Socio-demographic pathway in the post-career; epidemiological pathway; C4. Epidemiological pathway; C5. Moment of leaving the career; C6. Socio-demographic pathway in post-career; C7. Epidemiological pathway in the post-career; and C8. Perceptions on post-career planning). The construction and validation of the interview guide following 4 steps: Ad hoc con-struction of the interview guide (step 1); Review of the interview guide by a panel of experts (step 2); Definition of procedures and protocol for the application of the interview (step 3); Application of the pilot study for face validation of the interview guide (step 4). Thus, in procedural terms, four stages were considered for the construction and validation of the interview guide, namely the Ad hoc construction of the interview guide (i), the review of the in-terview guide by a panel of experts (ii), definition of procedures and protocol for the application of the interview (iii), and the application of the pilot study for the face validation of the interview guide (iv). The results showed that the interview guide for the study of the impacts of the sports careers on the quality of life of Portuguese former football players shows reliability for the collec-tion of qualitative and quantitative information from the respective content analysis. The use of the interview guide characterizes the path of former player, providing information and knowledge on the socio-demographic and epidemiological impact factors resulting from their post-career (sports retirement).

This study intricately explores the evolving tapestry of Christmas celebrations in a post-pandemic era, where tradition delicately intertwines with technology. The literature review presents a global panorama of Christmas observances, delving into varied religious perspectives. Within this exploration, a Southeast Asian country discreetly initiates its festivities as early as September—a nuanced response to the profound significance of Christmas. Navigating the digital age, the paper dissects the impact of virtual gatherings, the surge in e-commerce, and digital church services on festive traditions. Employing diverse research methods, including thematic analysis, nuanced insights are synthesized from extensive literature reviews, interviews, and observations. Scrutinizing challenges posed by the digital divide, the erosion of personal connections in virtual gatherings, and sustainability concerns in online celebrations, the qualitative research methodology reveals the interplay between tradition and technology. The paper contemplates the future of Christmas in this transformative era, offering implications for future celebrations, technology developers, policymakers, and beyond. This endeavor invites contemplation on the dynamic interplay shaping the festive landscape and prompting reflection on future celebrations.

In conclusion, this qualitative exploration has unveiled the profound and essential impact of music on psychological well-being, especially in the post-pandemic world. Through in-depth literature reviews, informal interviews, and observations with thirty CAS participants from SMC, the researcher uncovered ten salient themes that collectively illustrate music's multifaceted role as a potent remedy. These findings showcase how music serves as an emotional outlet, a cognitive enhancer, and a source of inspiration. The emotional depth and spiritual resonance participants associate with music underscore its capacity to address diverse human needs, making it an indispensable tool in navigating the complexities of our post-pandemic reality. Moreover, the cognitive benefits observed, such as improved concentration and focus, are particularly pertinent in the context of remote work and education, highlighting music's necessity in our daily lives. Additionally, this study emphasizes the vital role of virtual music communities in fostering social connections, even amidst physical isolation, further underscoring the enduring relevance of music in these challenging times. This research contributes to the expanding knowledge of music's impact on well-being, offering a holistic perspective encompassing spiritual, emotional, social, and cognitive dimensions. It enriches existing music psychology theories and invites further exploration into the mechanisms underpinning music's diverse effects. These insights have practical implications for fields such as mental health, education, and remote work, where music can be utilized as an essential tool for stress reduction and emotional regulation. This is highlighted further in the Suggested songs that can help sought the mind, body, spirit and soul. Looking ahead, future research could delve deeper into the long-term impact of music engagement on well-being and explore the universality of music's benefits through cross-cultural studies. Overall, music, as illuminated by this study, stands as a timeless and indispensable companion, offering solace, inspiration, vitality, and connection in the face of any contemporary challenges.

ACE2 impact on the severity of COVID-19 is widely discussed but still controversial. To estimate its role in aspects of the main risk factors and comorbidities, we involved post-COVID-19 patients in Ternopil region (Ukraine). Recruitment period was July 2020 to December 2021. Medical records, treatment modalities and outcomes were recorded and analyzed. Serum human ACE2 protein was measured with Cusabio ELISA kits (Houston, TX, USA). Statistical analysis was performed with SPSS21.0 software (SPSS Inc., Chicago, IL, USA). The level of ACE2 serum protein was significantly higher (p < 0.001) in patients with mild symptoms compared to more severe course of disease, and inversely had changed from 1 to 90 days after recovery. In patients with mild COVID-19, ACE2 level significantly decreased over time, while among critical patients, it increased by 34.1percent. Such results could be explained by ACE2 shedding from tissues into circulation. Loss of the membrane-bound form of the enzyme decreases the virus entry into cells. Our studies did not identify any sex-related ACE2 serum levels correlation. The most common comorbidities were hypertension, cardiovascular diseases, respiratory diseases and diabetes mellitus. All comorbidities except respiratory diseases contribute to the severity of disease and correlate with ACE2 blood serum level.

The long-term laboratory aspects of the effects of COVID-19 on liver function are still not well understood. Therefore, this study aimed to evaluate the hepatic clinical-laboratory profile of patients with up to 20 months of long-term COVID-19. A total of 243 patients of both sexes aged 18 years or older hospitalised in the acute phase of COVID-19 were included in this study. Liver function analysis was performed. Changes were identified in the mean levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), gamma-glutamyl transferase (GGT), and ferritin. Inflammatory markers such as ferritin > 300 U/L were observed in the group that presented more changes in liver function markers (ALT, AST, and GGT). Age ≥ 60 years, male sex, AST > 25 U/L, and GGT ≥ 50 or 32 U/L were associated with ALT > 29 U/L. There was a correlation between ALT and AST, LDH, GGT, and ferritin. Our findings suggest that ALT and AST levels may be elevated in patients with long-term COVID, especially in those hospitalised in the acute phase. In addition, ALT > 29 U/L was associated with other markers of liver injury, such as LDH, GGT, and ferritin.

In the Valpolicella area (Verona - Italy) Vitis vinifera cv. Corvina is the main grape variety used to produce Amarone wine. Before starting the winemaking process, the Corvina grapes are stored in a withering (i.e., dehydrating) warehouse until about 30% of the berry weight is lost (WL). This practice is followed to have the chemical metabolites concentrate in the berry and enrich the Amarone wine in aroma and antioxidant compounds. In compliance with the guidelines and strict Amarone protocol set by the Consorzio of Amarone-Valpolicella, withering must be carried out by setting the grapes in a suitable environment, either under controlled relative air humidity (RH) conditions and wind speed (WS) – no temperature modification is to be applied – or, following the traditional methods, in open-air natural environmental conditions. In general, the two processes have different dehydration kinetics due to the different conditions in terms of temperature, RH, and WS, which affect the accumulation of sugars and organic acids and the biosynthesis of sec-ondary metabolites such as stilbenes and glycoside aroma precursors. For this study, the two grape-withering processes were carried out under controlled (C) and not-controlled (NC) condi-tions and the final compositions of the Corvina dried grapes were compared also to evaluate the effects on the organoleptic characteristics of Amarone wine. The findings highlighted differences between the two processes mainly in terms of the secondary metabolites of the dried grapes, which affect the organoleptic characteristics of Amarone wine.

Post-Shoah Christology is embedded in the unique relationship of Jews and Christians, especially Jesus’ Jewishness and the Jewish roots of Christianity, as well as Christian moral failures towards Jews before and during the Shoah. Essential for contemporary Christianity, a vibrant post-Shoah Christology confronts three main challenges, each demanding a different response. The first challenge is the reality that soon there will be no more first-generation witnesses to the Final Solution. Such is an inevitable challenge that has to be faced and prepared for. Religious pluralism is the second challenge, and includes a number of related threads, yet should ultimately be embraced. The third challenge is the (inevitable?) loss of memory, passion, and urgency, a willful forgetfulness by Christians towards the importance of the Jewish-Christian relationship, and especially, Christian failure in the Shoah. This challenge demands robust refutation and ongoing struggle. Before addressing these challenges, I will first further define and highlight the need for a post-Shoah Christology and will conclude this article with three general and three concrete hopes for a viable post-Shoah Christology.

Two ligands, 1, 3-bis(4-carboxyphenyl)imidazolium chloride and 4, 4՛-bipyridine, were employed to prepare nickel and zinc azolium based MOFs, 1 and 2 by the mixed ligand solvothermal approach. The positively charged azolium moieties in the imidazolium linker resulted in a charged environment in the as-synthesized frameworks. As a result, 1 and 2 demonstrated preferential adsorption of CO2 over methane molecules in the gas phase adsorption due to the higher quadruple moment of CO2, which interacts more with the positively charged frameworks. Besides, in aqueous media, 1 and 2 exhibited incredible adsorption efficiency for anionic dyes. In the following, MOF 1 was metallated at the carbene site of the azolium linker to generate the novel heterogeneous catalyst 1-Pd, which was successfully applied for Sonogashira and Suzuki-Miyaura coupling reactions without losing its activity after three cycles.

Post-mortem cardiac magnetic resonance (PMCMR) is an emerging tool supporting forensic medicine for the identification of the causes of cardiac death, as hypertrophic cardiomyopathy (HCM). We proposed a new method of PMCMR to diagnose HCM despite myocardial rigor mortis. Methods: we performed CMR in 49 HCM patients, 30 non-HCM hypertrophy and 32 healthy controls. In cine images, rigor mortis was simulated by the analysis of the cardiac phase corresponding to the 25% of diastole. Left ventricular mass, mean and standard deviation (SD) of WT, maximal WT, minimal WT and their difference, were compared for the identification of HCM. These parameters were validated at PMCMR, evaluating 8 hearts with HCM, 10 with coronary artery disease and 10 with non-cardiac death. Results: The SD of WT with a cut-off of > 2.4 had the highest accuracy to identify HCM (AUC 0.95, 95%CI 0.89-0.98). This was particularly evident in female population of HCM (AUC=0.998), with 100% specificity (95%CI 85-100%) and 96% sensitivity (95%CI 79-99%). Using this parameter, at PMCMR all the 8 patients with HCM were correctly identified with no false positive. Conclusions: PMCMR allows to identify HCM as cause of sudden death using the SD of WT >2.4 as diagnostic parameter.

n our previous paper, we showed that the so-called quantum entanglement also exists in classical mechanics. The inability to measure this classical entanglement was rationalized with the definition of a classical observer which collapses all entanglement into distinguishable states. It was shown that evidence for this primary coherence is Newton’s third law. However, in reformulating a "classical entanglement theory" we assumed the existence of Newton’s second law as an operator form where a force operator was introduced through a Hilbert space of force states. In this paper, we derive all related physical quantities and laws from basic quantum principles. We not only define a force operator but also derive the classical mechanic's laws and prove the necessity of entanglement to obtain Newton’s third law.

Data on pathologic changes of the 2019 novel coronavirus disease (COVID-19) are scarce. To gain knowledge about the pathology that may contribute to disease progression and fatality, we performed post-mortem needle core biopsies of lung, liver, and heart in four patients who died of COVID-19 pneumonia. The patients’ ages ranged from 59 to 81, including 3 males and 1 female. Each patient had at least one underlying disease, including immunocompromised status (chronic lymphocytic leukemia and renal transplantation) or other conditions (cirrhosis, hypertension, and diabetes). Time from disease onset to death ranged from 15 to 52 days. All patients had elevated white blood cell counts, with significant rise toward the end, and all had lymphocytopenia except for the patient with leukemia. Histologically, the main findings are in the lungs, including injury to the alveolar epithelial cells, hyaline membrane formation, and hyperplasia of type II pneumocytes, all components of diffuse alveolar damage. Consolidation by fibroblastic proliferation with extracellular matrix and fibrin forming clusters in airspaces is evident. In one patient, the consolidation consists of abundant intra-alveolar neutrophilic infiltration, consistent with superimposed bacterial bronchopneumonia. The liver exhibits mild lobular infiltration by small lymphocytes, and centrilobular sinusoidal dilation. Patchy necrosis is also seen. The heart shows only focal mild fibrosis and mild myocardial hypertrophy, changes likely related to the underlying conditions. In conclusion, the post-mortem examinations show advanced diffuse alveolar damage, as well as superimposed bacterial pneumonia in some patients. Changes in the liver and heart are likely secondary or related to the underlying diseases.