Background: Chronic lateral epicondylitis challenges the therapeutical approach; underlying mechanisms are incompletely understood; neuropathic pain and central and peripheral sensitization may explain the fact that botulinum toxin was found to play a role in pain and function management. Methods: We searched the literature for MeSH terms: lateral epicondylitis or synonyms and botulinum toxin. Results: We found 14 papers containing trials on botulinum toxin injection into the tendon or into the extensor muscles (particularly extensor carpi radialis brevis and extensor communis digitorum). We followed the administration pathways, doses, timing and side effects. Conclusion: With chronic course, the focus of the therapy shifts from the afflicted tendon to the inserting muscles, as muscle contracture may create a vicious loop to perpetuate and aggravate the disease. Doses, timing and side effects are discussed.

In order to master the structure state of subway shield tunnel, reduce the diseases and avoid the potential safety hazards, the lateral convergence deformation of subway shield tunnels should be predicted. For the non-stationarity small sample size of subway shield tunnel lateral convergence deformation value, the existing prediction models have poor performance in terms of accuracy and stability. In this paper, a lateral convergence model of subway shield tunnel based on Kalman algorithm is constructed based on Kalman filtering theory. The model is efficient, adaptive and robust, and can accurately predict the lateral convergence deformation of subway shield tunnel. Taking the horizontal diameter of 200 rings shield segment in the interval section of a subway tunnel as an example, it is proved that the residuals of the Kalman prediction model are small, the residual distribution conforms to the normal distribution, and the prediction effect is great. The model is suitable for the prediction of more than 5 periods of data, and the prediction accuracy of the model is improved with the increase of the number of data periods. In addition, the Kalman model is compared with GM(1,1) model and GM-Markov model, and RMSE and MAPE are introduced as evaluation indexes. The results show that the Kalman model has higher prediction accuracy and is more suitable for predicting the lateral convergence deformation of subway shield tunnel.

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.

Understanding the dynamic interaction between piles and surrounding soil under vehicular impacts is essential for effectively designing and optimizing soil-embedded vehicle barrier systems. The complex behavior of pile-soil systems under impact loading, attributed to the soil’s nonlinear behavior and large deformation experienced by both components, presents significant simulation challenges. Popular computation techniques, such as the Updated Lagrangian Finite Element Method (UL-FEM), encounter difficulties in scenarios marked by large soil deformation, e.g., impacts involving rigid piles. While mesh-free particle and discrete element methods offer another option, their computational demands for field-scale pile-soil impact simulations are considerable. We introduce the erosion method to bridge this gap by integrating UL-FEM with an erosion algorithm designed for simulating large soil deformations during vehicular impacts. Validation against established physical impact tests confirmed the method’s effectiveness for flexible and rigid pile failure mechanisms. Additionally, this method was used to investigate the effects of soil mesh density, soil domain sizes, and boundary conditions on the dynamic impact response of pile-soil systems. Our findings provide guidelines for optimal soil domain size, mesh density, and boundary conditions. This investigation sets the stage for improved, computationally efficient techniques for the pile-soil impact problem, leading to better pile designs for vehicular impacts.

Maxillary sinus augmentation with a lateral approach (MSA) is a well-established treatment. In this prospective study, we evaluated risk factors for postoperative bone-graft displacement and report the clinical application of long-term resorbable GMEM-B-2 (L-lactic acid/-caprolactone [P(LA/CL)]) as a barrier membrane to cover the open window in the lateral wall in MSA. Twenty-four patients underwent MSA according to the relevant criteria; CT data obtained before and 1 week (1W) and 5–6 months (5M) post-MSA, bone height changes, bone height reduction rates at 1W and 5M post-MSA, bone-graft displacement measurements, and risk factors were examined. All patients showed bone height increments (p < 0.005). However, no difference was observed between 1W and 5M post-MSA. Bone-graft displacement was observed in eight patients; the reduction rate from 1W to 5M post-MSA was 8.38% ± 4.88%. Sex, septa, maxillary sinus floor–palatal bone distance, and maxillary sinus floor–natural mouth distance were associated with bone-graft displacement (p < 0.05). Height from the maxillary sinus floor to the palatal bone and the sinus angle influenced the augmentation amount (p < 0.05). The L-lactic acid/ε-caprolactone [P(LA/CL)] membrane compared favourably with other membranes and may be useful as a barrier membrane for the MSA open window.

Background and Objectives: Although adult spinal deformity (ASD) surgery brought about the improvement of quality of life in patients, it accompanied with a high invasiveness of surgery and several complications. Specifically, mechanical complications of rod fracture, instrumentation failures, and pseudarthrosis are still unsolved issues. To better improve these problems, the oblique lateral interbody fusion at L5/S1 (OLIF51) was introduced since 2015 in my institution. The objective of this study was to compare the clinical and radiographic outcomes of anterior-posterior combined surgery for ASD between the use of OLIF51 versus transforaminal interbody fusion (TLIF) at L5/S1. Materials and Methods :A total of 117 ASD patients received anterior-posterior correction surgeries either use of OLIF51 (35 patients) or L5/S1 TLIF (82 patients). In both groups, L1-5 OLIF and minimally invasive posterior procedures of hybrid or circumferential MIS were employed. The sagittal and coronal spinal alignment and spino-pelvic parameters are recorded preoperatively and at follow-up. The quality of life parameters and visual analogue scale were evaluated as well as surgical complications at follow-up. Results: The average follow-up period was thirty months (13-84). The average fused segments were eight (4-12). The operation time and estimated blood loss were significantly smaller in OLIF51 that those in TLIF. The PI-LL mismatch, LLL, L5/S1 segmental lordosis, and L5 coronal tilt were significantly better in OLIF51 than TLIF. The complication rate was statistically equivalent between two groups. Conclusion: The introduction of OLIF51 for adult spine deformity surgery led to the decrease of operation time and estimated blood loss as well as the improvement of sagittal and coronal correction when compared to TLIF.

Leak of carbon dioxide (CO2) from conventional underground carbon storage reservoirs is an increasing concern. It is highly desirable to inject CO2 into low-temperature reservoirs so that CO2 can be locked inside the reservoir in solid state as CO2-hydrates. Marine gas hydrate reservoirs and surrounding water aquifers are attractive candidates for this purpose. However, the nature of low-permeability of these marine sediments hinders injection of CO2 in commercial scale due to the low-injectivity of wells with conventional completions. This study investigates injection of CO2 into the low-permeability marine reservoirs using a new type of well namely radial-lateral wells (RLW). An analytical model was developed for predicting CO2 injectivity of the RLW to assess well injectivity improvement. A case study and sensitivity analysis were performed with field data from the South China Sea. Result of analysis reveals that the injectivity of the RLW is nearly proportional to reservoir permeability, lateral wellbore length, and number of laterals. CO2 injection rate is predicted to be 19 tons/day to 250 tons/day, which is 3 to 15 times higher than the injectivity of frac-packed wells. It is feasible to inject CO2 into the low-permeability-low-temperature marine reservoirs at commercial flow rates. This work provides an analytical tool to predict CO2-injectivity of RLW in low-temperature marine reservoirs for leak-free CO2 storage.

The incidence of radiculopathy due to lumbar spinal stenosis has been on the increase in the aging population. However, patients aged 80 years hesitate to undergo conventional open surgery under general anesthesia because of the risk of postoperative morbidity and adverse events. Therefore, less invasive surgical alternatives are required for the elderly or medically handicapped patients. Transforaminal endoscopic lumbar lateral recess decompression (TELLRD) may be helpful for those patients. This study aimed to demonstrate the efficacy of TELLRD for treating radiculopathy in octogenarian patients. A total of 21 consecutive octogenarian patients with lumbar foraminal stenosis underwent TELLRD between January 2017 and January 2021. The inclusion criterion was unilateral radiculopathy, which stemmed from lumbar lateral recess stenosis. The pain source was verified using imaging studies and selective nerve blocks. Full-scale lateral canal decompression was performed using a percutaneous transforaminal endoscopic approach under local anesthesia. We found the pain scores and functional status improved significantly during the 24-month follow-up period. The clinical improvement rate was 95.24% (20 of 21 patients) with no systemic complication. In conclusion, endoscopic lateral recess decompression via the transforaminal approach is practical for octogenarian patients while reducing the medical risks of aggressive open surgery.

The aim of this report is to evaluate the segmental rib index (RI) from T1-T12 spinal level in mild and moderate idiopathic scoliosis (IS) curves of thoracic, thoracolumbar and lumbar type by gender. The relationship of segmental RI to the frontal plane radiological deformity presented as the Cobb angle and to the posterior truncal surface deformity presented as the scoliometric readings of Angle of Trunk Rotation (ATR) in these patients is also assessed. Any statistical significant rela-tionship of these parameters would be very important for biomechanical relations of the rib cage (RC) deformity presented as the rib hump deformity (RHD) and the deformity in the spine and it would thus provide valuable information about scoliogeny. The segmental rib index (RI) is presented in 83 boys and girls with mild and moderate IS. The measurements include the scoliometric readings for truncal asymmetry (TA), the Cobb angle assessment and the segmental RI from T1-T12. The statistical package SPSS 23 was used for statistical analysis. The TA is documented and the Cobb angle is presented by gender and curve type. The segmental RI of thoracic, thoracolumbar and lumbar curves are presented for the first time. The correlations of the segmental RI to surface deformity presented as the rib hump deformity (RHD) in all IS patients and particularly in thoracic curves, to Cobb angle by gender and age and the comparison of the segmental RI index of asymmetric but not scoliotic children to the scoliotic peers by curve (in thoracic, thoracolumbar, lumbar curves) in boys and girls are presented. The findings emphasize the significant protagonistic role of the thoracic asymmetry in relation to the spinal deformity mainly in girls for the thoracic and in boys for the thoracolumbar curves. The cut-off point of age of the examined scoliotics is 14 years, that is when the RI shows stronger correlation with the spinal deformity, namely when the thoracic deformity is decisively effective to the developing thoracic spinal deformity, in terms of Cobb angle. In summary, the results of this study provide aetiological implications for IS, as far as the role of thorax is con-cerned.

Hemifacial spasm (HFS) is a rare disorder characterized by involuntary facial muscle contractions. The primary cause is mechanical compression of the facial nerve by nearby structures. Lateral spread response (LSR) is an abnormal muscle response observed during electromyogram (EMG) testing and is associated with HFS. Intraoperative monitoring of LSR is crucial during surgery to confirm successful decompression. Proper anesthesia and electrode positioning are important for accurate LSR monitoring. Stimulation parameters should be carefully adjusted to avoid artifacts. The disappearance of LSR during surgery is associated with short-term outcomes, but its persistence does not necessarily indicate poor long-term outcomes. LSR monitoring has both positive and negative prognostic value, and its predictive ability varies across studies. Early disappearance of LSR can occur before decompression and may indicate better clinical outcomes. Further research is needed to fully understand the implications of LSR monitoring in HFS surgery.

Background: Xenogenous bone has been proposed as an alternative to overcome the disadvantages of autogenous grafting. The aim of the present study was to study bone dynamics at inlay and onlay xenografts used for bone augmentation applying a ring technique. Methods: The bone at the lateral surface of the mandibular angle of 12 adult male New Zealand White rabbits was exposed bilaterally. The cortical layer received multiple perforations at one side of the mandible and a xenograft block of collagenated cancellous equine bone, 7 mm in diameter and 3 mm in width, was fixed on the prepared surface using an implant (onlay group). On the opposite side, a defect 7 mm in diameter and 3 mm in depth was prepared, the xenograft block was adapted to the defect and fixed with an implant (inlay group). Results: After ten weeks of healing, in the onlay grafts, new bone was mainly formed on the trabeculae surface, reaching in some specimens the most coronal regions of the block. In the inlay grafts, new bone was found arranged on the trabecular surfaces but also occupying the spaces among the trabeculae. The entrance of the defect was often found close at the top of the block by newly formed bone. A higher percentage of new bone was found in the inlay (19.0 ±9.3%) compared to the onlay (10.4 ±7.4%) groups (p=0.031). The mean gain in osseointegration at the implant in relation to the base of the original 3 mm deep defect was 0.95 ±1.05% at the onlay group and 0.78 ±0.71% at the inlay group (p=0.603). Conclusion: The inlay grafts exhibited a higher new bone percentage than the onlay grafts possibly due to the defect conformation that presented more sources for bone formation. The trabecular conformation and the composition of the grafts made possible the expression of the osteoconductive properties of the material used. This resulted, in several specimens, in growth of bone on the graft trabeculae toward the most superior regions in both groups, and in the closure of the coronal entrance of the defects in the inlay group.

Abstract Several studies have been conducted to strengthen weak road layers, regardless of whether they are un-der construction or are undergoing maintenance. Using substrates filled with different materials has proven effective for increasing the strength of these layers. In this study, I evaluated the coefficient of lateral soil pressure under various conditions when using reinforced and unreinforced piles filled with in-expensive material and the extent of their contribution to strengthening road layers. The results con-firmed that there was a difference in the coefficient of lateral soil pressure when the sand-filled piles were reinforced. The sand-filled piles were divided into several parts by arming. The maximum coeffi-cient of lateral soil pressure was 0.38 in the case of sand (1 mm) with reinforcement, whereas it was 0.29 in the same case without reinforcement as shown in Figure 1. The maximum coefficient of lateral soil pressure was 0.27 in the case of granite grain (2 mm) with reinforcement, whereas it was 0.17 in the same case without reinforcement. Moreover, the maximum lateral pressure coefficient was 0.26 in the case of granite grain (3 mm) with reinforcement, and it was 0.30 in the same case without reinforce-ment.

High-precision dynamic positioning of highway vehicles is the foundation and prerequisite for achieving intelligent connected transportation. For the shortcomings of GNSS/INS combination and GNSS/INS/OD combination in tunnel vehicle positioning, this paper proposes a tunnel vehi-cle positioning method of GNSS/INS/OD combination based on lateral distance measurement and lane constraint. Firstly, lateral distance measurement of vehicles inside the tunnel is conducted based on laser radar point cloud data. Secondly, map matching positioning is performed based on lateral distance measurement, odometer, and lane markings. Experimental results demonstrate that for a 4.6 km tunnel, the average absolute error of lateral positioning is 0.294 meters, and the longitudinal positioning error is no more than 0.6 meters, which can effectively meet practical operational requirements.

The accompanying mechanical behavior during the flow of ore-rock dispersion is an important factor leading to the instability and failure of the orepass in the ore storage section. It is of great significance to accurately understand the instability characteristics of the well wall in the ore section, during the ore drawing process by understanding the flow characteristics and internal mechanical transfer mechanism of ore-rock dispersion. Using the discrete element method to analyze the flow characteristics, contact compactness, stress distribution characteristics and contact force probability distribution of the ore-rock dispersion, it realizes the quantitative characterization of the damage degree of ore-rock flow, and reveals the damage mechanism of mine storage wall. The results show that: (1) The friction between ore-rock particles, between ore-rock and well wall is an important reason for the change of the macroscopic flow form of ore-rock from “one” to “V” type. (2) The compactness and stress concentration of ores are increasing with the increase of storage depth, which is shown that with the increase of storage depth, the greater the probability of well wall instability. (3) The probability distribution of contact force strength between particles decreases exponentially in the whole process of ore drawing, in which the strong chain plays a major role in the stability of the dispersion system. (4) The number of overpressure and the overpressure coefficient can be used to quantitatively characterize the wall damage degree under the action of ore-rock flow. The dynamic side pressure decreases periodically in the form of exponential fluctuations, and the dynamic load formed by the ore-rock flow mainly played a role in the lower area of the ore storage section.

The article presents investigations of rail vehicle bogie of Y25 type. The Y25 bogie family is one of the most commonly used freight car bogie designs. In addition to several significant advantages characterising this design, it also has several disadvantages observed since the beginning of more than fifty years of operation in several types of cargo vehicles. One of these defects observed in real systems is "unsatisfactory running stability", particularly at long straight tracks. The article used commercial engineering software VI-Rail to create a model of the gondola car (type 412W Eaos) with two Y25 bogies. The car model was tested empty and loaded (maximum permissible load). Motion along straight and curved tracks with different radii values was analysed. The vehicle velocity was changed from a few m/s to the maximum values for which stable solutions of the model existed. For each route, a non-linear critical velocity was determined, defining the maximum operating velocity of the modelled car. The model solutions were recorded, while just one was selected to present the results - the first wheelset lateral displacement ylw. The opinion about the "imperfect running quality" in curved tracks was confirmed. The possible appearance of self-exciting wheelset vibrations in the modelled car's operating velocity range in the laden state was also observed. The research results on the impact of the bogie suspension parameters change on the vehicle model stability are presented. The crucial parameter in the bogie suspension was indicated. Reducing its value by several percent about the nominal value increases the critical velocity of the car to values higher than the maximum operating velocity of the modelled vehicle.

Efficient utilization of biomass requires conversion into forms that can be optimally applied in energy generation. Briquetting involves compaction of biomass into solid blocks that are more efficient than raw biomass and provides for ease of transport and handling. These are improved when the briquettes possess high shatter index and compressive strength. Due to difference in nature and composition, it is imperative to define optimum conditions for the production of quality and durable briquettes for individual biomass compacted into briquettes. This study studied the effects of process variables on the strength and durability of biomass briquettes produced using Abura sawdust. The lateral compressive strength and drop shatter index were investigated whilst varying the temperature (100-150 °C), pressure (9-15 MPa) and hold time (15-30 min). The compressive strength ranged between 2.06 and 5.15 MPa whilst the shatter index was between 50 and 600. The pressure was significant to the determination of the compressive strength (p < 0.1) and the shatter index (p < 0.05). Mechanical characteristics of the binderless Abura sawdust briquettes can be improved by optimizing the densification variables during the briquetting process when moderate pressures are used for compaction.

Many ailments can be diagnosed while they are asymptomatic, meaning that the patient has no signs or symptoms of a progressing disease. If caught in their initial stage of formation, these maladies can be effectively treated, leading to successful outcomes; curative therapies can halt illnesses from advancing, thus improving the quality of life, and long-term survival of the patient. Still cutting-edge upgrades in precision technologies are necessary for early, reliable, affordable, and rapid disease detection, but also are vital for the well-being of people and the future of global public health. The emerging role and utility of non-invasive and repeatable diagnostic test approaches for detection of health conditions has been liquid biopsies based on genomic biomarkers. As such, biological fluids permit any measurable molecular indicator or signature (e.g., proteins), to provide valuable information on individual’s wellness and/or disease. Among the bodily secretions used for non-invasive diagnostics is sputum, a complex viscous gel-like biopolymeric network, that has gained growing recognition as a rich source of biomarkers of airway infections, pulmonary diseases, and serves as a determinant to reveal other illnesses. As per the World Health Organization, the burden of respiratory conditions is exacerbated by factors, ranging from considerable subjection to air pollution and occupational contaminants, to tobacco smoking and second-hand smoke, in addition to poor socio-economic status. Due to the likely increase of these determinants, respiratory tract ailments are on the rise, affecting the health of many individuals, in addition to putting stress on healthcare facilities and services worldwide. We therefore highlight the need to use expectorated or induced sputum specimens as a routine sample source for testing valuable protein biomarkers to diagnose these chronic maladies, to predict inflammation and disease progression, as well as monitor the effectiveness of treatments. Further, we discuss the urgency for fast and reliable point-of-care methods to detect and quantify crucial protein biomarkers in sputum specimens, and limitations faced when dealing with their complex matrices.

Thyrotropin releasing hormone (TRH; pGlu-His-Pro-NH2) is an intercellular signal produced mainly by neurons. Among the multiple pharmacological effects of TRH, that on food-intake is not well understood. We review data that show that peripheral injection of TRH generally produces a transient anorexic effect, discuss the pathways that might initiate this effect, and explain its short half-life. In addition, central administration of TRH can produce anorexic or orexigenic effects, depending on the site of injection, that are likely due to interaction with TRH receptor 1. Anorexic effects are most notable when TRH is injected into the hypothalamus and the nucleus accumbens, while the orexigenic effect has only been detected by injection into the brain stem. Functional evidence suggests that TRH neurons that are prime candidate vectors for TRH action on food-intake include the caudal raphe nuclei projecting to the dorsal motor nucleus of the vagus, and possibly TRH neurons from the tuberal lateral hypothalamus projecting to the tuberomammillary nuclei. For other TRH neurons, the anatomical or physiological context and impact of TRH in each synaptic domain are still poorly understood. The manipulation of TRH expression in well-defined neuron types will facilitate the discovery of its role in food-intake control in each anatomical scene.

(1) Background: The lateral arm flap has been the very useful choice in the reconstruction of small- to medium-sized defects like hand, extremity, oral head and neck area reconstructions. Its versatile characteristics and surgical feasibility allow this flap to be widely applied, but the reconstructive potential in facial subunit after tumor ablative procedures has never been reported. In this study, we aimed to utilize the advantages of the flap to treat facial temple subunit defect reconstruction. (2) Methods: Between 2020 and 2023, 12 patients underwent temple reconstruction with lateral arm free flaps after malignant tumor wide excision. There were 7 women and 5 men, and the mean patient age was 60.6 years old. Among the patients with cancer, 6 had squamous cell carcinoma, 5 had basal cell carcinoma and 1 had myxofibrosarcoma. All the flaps were elevated under general anesthesia. Aloprostadil(PGE1, Eglandin®) were administered postoperatively. (3) Results: All the flap types were fasciocutaneous type with varied sizes from 3 × 4 to 5 × 7 cm (Average size of flap 22.7cm2) were utilized. The average pedicle length was 6.1cm. The versatility of the lateral arm flap enabled successful coverage of all cases with no specific complications. Good functional outcome and range of motion in the recipient arm were obtained after surgery. (4) Conclusion: The authors successfully verified the advantages of lateral arm flaps in the treatment of medium sized facial subunt temple defect reconstruction.