Effects of different slopes on hip and ankle biomechanics of replaced and non-replaced limbs of patients with total knee arthroplasty during incline ramp walking.

Although knee biomechanics has been examined, hip and ankle biomechanics in incline ramp walking has not been explored for patients with total knee arthroplasty (TKA). The purpose of this study was to investigate the hip and ankle joint kinematic and kinetic biomechanics of different incline slopes for replaced limbs and non-replaced limbs in individuals with TKA compared to healthy controls. Twenty-five patients with TKR and ten healthy controls performed walking trials on four slope conditions of level (0°), 5°, 10° and 15° on a customized instrumented ramp system. A 3x4 (limb x slope) repeated analysis of variance was used to evaluate selected variables. The results showed a greater peak ankle dorsiflexion angle in the replaced limbs compared to healthy limbs. No significant interactions or limb main effect for other ankle and hip variables. The peak dorsiflexion angle, eversion angle and dorsiflexion moment were progressively higher in each comparison from level to 15°. The peak plantarflexion moment was also increased with each increase of slopes. Both the replaced and non-replaced limbs of patients with TKA had lower hip flexion moments than the healthy control limbs. Hip angle at contact and hip extension range of motion increased with each increase of slopes. Peak hip loading-response internal extension moment increased with each increase in slope and peak hip push-off internal flexion moment decreased with each increase of slope. Our results showed increased dorsiflexion in replaced limbs but no other compensations of hip and ankle joints of replaced limbs compared to non-replaced limbs and their healthy controls during incline walking, providing further support of using incline walking in rehabilitation for patients with TKA.

Study on the differences between Hoek-Brown parameters and equivalent Mohr-Coulomb parameters in the calculation slope critical acceleration and permanent displacement.

Mohr-Coulomb (MC) strength criterion has been widely used in many classical analytical expressions and numerical modeling due to its simple physical calculation, but the MC criterion is not suitable for describing the failure envelope of rock masses. In order to directly apply MC parameters to analytical expressions or numerical modeling in rock slope stability analysis, scholars established a criterion for converting Hoek-Brown (HB) parameters to equivalent MC parameters. However, the consistency of HB parameters and equivalent MC parameters in calculating critical acceleration of slope needs to be further explored and confirmed. Therefore, HB parameters are converted into equivalent MC parameters by considering the influence of slope angle (1# case and 2# case when slope angle is not considered and slope angle is considered respectively). Then, the lower-bound of finite element limit analysis is used for numerical modeling, and the results of calculating critical acceleration using HB parameters and equivalent MC parameters are compared, and the influence of related parameters on the calculation of critical acceleration is studied. Finally, the influence of different critical accelerations on the calculation of slope permanent displacement is further analyzed through numerical cases and engineering examples. The results show that: (1) In the 1# case, the critical acceleration obtained by the equivalent MC parameters are significantly larger than that obtained by the 2 #case and the HB parameters, and this difference becomes more obvious with the increase of slope angle. The critical acceleration obtained by the 2# case is very close to the HB parameters; (2) In the 1# case, slope height is inversely proportional to ΔAc (HB(Ac) - 1#(Ac)), and with the increase of slope height, ΔAc decreases, while in the 2# case, the difference of ΔAc (HB(Ac) - 2#(Ac)) is not significant; (3) In the 1# case, the sensitivity of the HB parameters to ΔAc is D > GSI > mi > σci, but in the 2# case, there is no sensitivity-related regularity; (4) The application of HB parameters and equivalent MC parameters in slope permanent displacement is studied through numerical cases and engineering examples, and the limitations of equivalent MC parameters in rock slope stability evaluation are revealed.

Guidelines for clinical evaluation of chronic kidney disease in early stages : AMED research on regulatory science of pharmaceuticals and medical devices.

BACKGROUND: For the development of pharmaceutical products in kidney field, appropriate surrogate endpoints which can predict long-term prognosis are needed as an alternative to hard endpoints, such as end-stage kidney disease. Though international workshop has proposed estimated glomerular filtration rate (GFR) slope reduction of 0.5-1.0 mL/min/1.73 m /year and 30% decrease in albuminuria/proteinuria as surrogate endpoints in early and advanced chronic kidney disease (CKD), it was not clear whether these are applicable to Japanese patients. METHODS: We analyzed J-CKD-DB and CKD-JAC, Japanese databases/cohorts of CKD patients, and J-DREAMS, a Japanese database of patients with diabetes mellitus to investigate the applicability of eGFR slope and albuminuria/proteinuria to the Japanese population. Systematic review on those endpoints was also conducted including the results of clinical trials published after the above proposal. RESULTS: Our analysis showed an association between eGFR slope and the risk of end-stage kidney disease. A 30% decrease in albuminuria/proteinuria over 2 years corresponded to a 20% decrease in the risk of end-stage kidney disease patients with baseline UACR ≥ 30 mg/gCre or UPCR ≥ 0.15 g/gCre in the analysis of CKD-JAC, though this analysis was not performed on the other database/cohort. Those results suggested similar trends to those of the systematic review. CONCLUSION: The results suggested that eGFR slope and decreased albuminuria/proteinuria may be used as a surrogate endpoint in clinical trials for early CKD (including diabetic kidney disease) in Japanese population, though its validity and cutoff values must be carefully considered based on the latest evidence and other factors.

Evaluation of distal tibia slope in pilon fractures after surgical fixation.

INTRODUCTION: Alteration of sagittal alignment during fracture fixation directly impacts ankle motion in dorsiflexion and plantarflexion. Previously research measured the anterior distal tibia angle (ADTA) in a normal healthy population. The null hypothesis for this study is that ADTA is restored to normal range following unstable pilon fractures. The aim of this study is to identify the range of the ADTA in distal tibia fractures after surgical fixation, compared to a previously published normal population. MATERIAL AND METHODS: A retrospective review of operative distal tibia fractures (AO/OTA classification 43A and 43C - 43B were excluded due to lower likelihood of fracture changing the ADTA) was performed. ADTA on lateral radiograph was measured as the angle relative to the tibia shaft. RESULTS: 100 patients with post-operative radiographs that met inclusion criteria were analyzed. The average ADTA was 6.9° (⌠=4.62°) with a maximum slope of 19.2° (i.e. anterior orientation) and a minimum of -3.3° (i.e. posterior orientation). The uninjured population had an average ADTA of 6.0° (range -2.0°-14°, ⌠=3.0°). CONCLUSION: This analysis shows the average distal tibia sagittal alignment in the post-surgical group is similar to a normal, uninjured population. Large alterations in ADTA would directly impact the ankle in the plane of motion (i.e. negative ADTA would decrease ankle dorsiflexion). Considering ADTA as an objective intra-operative parameter optimizes sagittal plane alignment.

Mallard hindlimbs locomotion system respond to changes in sandy ground hardness and slope.

Mallards inhabit soft grounds such as mudflats, marshes, and beaches, demonstrating remarkable proficiency in traversing these grounds. This adeptness is closely linked to the adjustments in the operation of their hindlimbs. This study employs high-speed videography to observe postural adjustments during locomotion across mudflats. Analysis of spatiotemporal parameters of the hindlimbs reveals transient and continuous changes in joints (tarsometatarso-phalangeal joint (TMTPJ), intertarsal joint (ITJ), knee, and hip) during movement on different ground hardness and slope (horizontal and uphill). The results indicate that as the stride length of the mallard increases, its speed also increases. Additionally, the stance phase duration decreases, leading to a decrease in the duty factor. Reduced ground hardness and increased slope lead to delayed adjustment of the TMTPJ, ITJ, and knee. Mallards adjust their stride length by augmenting ITJ flexion on steeper slopes, while reduced hardness prompts a decrease in TMTPJ flexion at touch-down. Additionally, the hip undergoes two brief extensions during the stance phase, indicating its crucial role in posture adjustment and propulsion on uphill grounds. Overall, the hindlimb joints of the mallard function as a whole musculoskeletal system, with each joint employing a distinct strategy for adjusting to adapt to various ground conditions.

Elevating Oxygen Evolution using Iron Phthalocyanine Infused Vanillic acid Electrocatalyst.

Oxygen evolution reaction (OER) is the bottle neck step in  water splitting reaction towards the realization of hydrogen based clean energy production and storage.  Transition metal based N4 organics are explored extensively as oxygen electrocatalysts i.e., (OER) and oxygen reduction reaction (ORR) catalysts because of their ease of synthesis, tuneable properties, low cost and high performance with long term stability. Here, vanillic acid functionalized iron phthalocyanine (FeVAPc) was synthesised and characterised. The novel FeVAPc exhibited good thermal stability and was coated on Ni foam for OER studies. The scanning electron microscopy images showed net-work like surface morphology and the X-ray photoelectron spectroscopy indicated the presence of Fe in +3 oxidation state. The Ni/FeVAPc demonstrated excellent electrocatalytic activity for OER with overpotential of 312 mV at 10 mA.cm-2 current density in 1.0 M KOH . The designed  catalyst exhibited lesser Tafel slope value which is nearer to the benchmark catalyst, IrO2. The proposed catalyst exhibited good stability as phthalocyanines are highly stable and do not undergo decomposition even in strong acidic and basic corrosive media. Integration of FeVAPc onto  Ni foam resulted in higher mass activity, lower charge transfer resistance, high active surface area leading to enhanced conductivity and activity.

Diurnal cortisol profiles in autistic adolescents and young adults: Associations with social difficulties and internalizing mental health symptoms.

Several autism-related characteristics, such as social difficulties, may contribute to high perceived stress and increased exposure to stressful life events in some autistic individuals. Repeated exposure to stress might lead to the dysfunction of the hypothalamic-pituitary-adrenocortical-axis and be a vulnerability factor for developing mental health difficulties. Previous studies show contradictory findings on salivary cortisol in autism. In the current study, we investigated diurnal cortisol profiles in autistic adolescents and young adults, as well as their associations with social difficulties, stress exposure, and mental health symptoms. Autistic (n = 48, Mage = 17.6) and nonautistic (n = 51, Mage = 18.4) participants collected salivary cortisol at home six times a day for 2 days. Social difficulties, exposure to stressful life events/bullying, and mental health symptoms were assessed with questionnaires and clinical interviews. Similar diurnal cortisol slopes (DCS) and cortisol awakening responses were observed between the groups, but autistic participants showed higher total cortisol output (AUCG, area under the curve with respect to ground) during the day (b = 19.09, p = 0.009). In the autistic group, more severe social difficulties were associated with flatter DCS (b = 0.01, p = 0.007). Finally, cortisol alterations were associated with self-reported mental health symptoms, especially in autistic females in analyses uncorrected for multiple comparisons. In conclusion, our results do not indicate autism-related group-level alterations in most diurnal cortisol measures, but autistic youth showed higher total cortisol (AUCG) compared with nonautistic peers. More detailed investigation of interindividual variability in cortisol profiles within autistic people might give us important insights into vulnerability to developing stress-related mental health difficulties.

The influence of tibial length on radiographic posterior tibial slope measurement: How much tibia do we need?

PURPOSE: The purpose of this study was to determine whether significant differences exist when comparing posterior tibial slope (PTS) measured using increasing lengths of the tibia to determine the anatomical axis. METHODS: Patients with full-length weight-bearing tibial radiographs were retrospectively identified from 2014 to 2022 at a single institution. Patients were excluded if there was any previous history of lower extremity fracture or osteotomy. The anatomical axis of the tibia was determined using the full length of tibial radiographs, and the "reference PTS" was measured using this axis. Using the same radiograph, the PTS was measured using four different anatomical axes at standardized tibial lengths. While the center of the proximal circle remained constant at 5-cm below the tibial plateau, the center of the distal circle was drawn at four points: a) overlapping circles; b) 10-cm distal to the tibial plateau; c) 15-cm distal to the tibial plateau; d) half the length of the tibia, measured from the tibial plateau to the tibial plafond. Bivariate correlation and frequency distribution analysis (measurements >2-degrees from reference PTS) were performed between the reference PTS and PTS measured at each of the four other lengths. RESULTS: A total of 154 patients (39.8 ± 17.4 years old, 44.2% male) were included in the final analysis. Measurements at each of the four tibial lengths were all significantly different from the reference PTS (p < 0.001). The correlation strength improved with increasing tibial length (overlapping: R = 0.681, 10-cm: R = 0.821, 15-cm: R = 0.937, and half-tibia: R = 0.963). The number of PTS measurements >2-degree absolute difference from the reference PTS decreased with increasing tibial length (overlapping: 40.3%, 10-cm: 24.0%, 15-cm: 26.0%, and half-tibia: 18.8%). CONCLUSION: Assessment of PTS is dependent on the length of the tibia utilized to obtain the anatomical axis. Accuracy and precision of PTS measurements improved with increasing length of tibia used to determine the anatomical axis. STUDY DESIGN: Case series.

Linearity and intermodulation distortion analysis of single and dual metal gate junctionless transistor.

Linearity and intermodulation distortion are very crucial parameters for RFICs design. Therefore, in this work, a detailed comparative analysis on linearity and intermodulation distortion of single metal (SMG) and double metal (DMG) double gate junction less transistor (JLT) is done using TCAD silvaco suite. Furthermore, the effects of temperature fluctuation, gate length variation, and gate material engineering on the linearity performance of both devices are also studied. A few significant figures of merit, including Voltage Intercept Point 2 (VIP2), Voltage Intercept Point 3 (VIP3), Third Order Intercept Power (IIP3), 1 dB Compression Point (P1dB), Third Order Intermodulation Distortion (IMD3), and the transconductance derivative parameters First Order Transconductance (gm1), Second Order Transconductance (gm2), and Third Order Transconductance (gm3) are used to assess the device linearity and intermodulation distortion of SMG and DMG JLT's. The findings show that higher VIP2, VIP3, IIP3, 1-dB compression point and lower gm3, IMD3 values are obtained for the SMG JLT device when compared to its counterpart DMG JLT. SMG JLT, which assures strong linearity and low distortion.

Analyzing results of cervical sagittal parameters in patients operated with polyetheretherketone cages without plate.

Study Design: This was a retrospective longitudinal observational study. Purpose: The purpose of this study was to analyze the results of cervical sagittal parameters on preoperative and postoperative lateral radiographs in anterior cervical discectomy and fusion (ACDF). ACDF is believed to change craniocervical parameters and thus cervical curvature using polyetheretherketone (PEEK) or titanium cages with or without self-locking as well as an anterior plate, the latter of which has not been shown to provide better clinical or radiological results. Overview of Literature: Cervical spondylotic myelopathy (CSM) is a common degenerative pathology that can affect one or more levels and treatment has varied over time trying to maintain sagittal parameters within acceptable values where the ACDF is the main treatment. Materials and Methods: The study was performed in patients with CSM who underwent anterior cervical discectomy, and their pre- and postoperative radiographs were analyzed using Surgimap software a few days before and 3 months after surgery. Results: Fifteen files were included in the study. Statistically significant sagittal balance variables were observed in cervical lordosis (CL) with an increase of 4.73° (P = 0.019) and T1 slope (T1S)-CL with a decrease of -5.93° (P = 0.007). Conclusions: CL and T1S-CL showed favorably modified values when performing ACDF using stand-alone PEEK cages without the need for self-blocking or an anterior plate.

Using the phase III slope of exhaled methane during a single breath DLCO test to assess ventilation heterogeneity.

BACKGROUND: The Phase III slope from a single breath nitrogen washout test provides information about ventilation heterogeneity (VH) in the lungs. PURPOSE: To determine if the Phase III slope from the exhaled tracer gas concentration during a standard, single breath DLCO test using rapid gas analysis provides similar information about VH. BASIC PROCEDURES: Retrospective analysis of clinical pulmonary function laboratory data including spirometry, lung volumes, and DLCO. The normalized Phase III slope from the exhaled CH4 concentration (SnCH4) was compared among different patterns of physiologic abnormality and with VA/TLC as an indicator of VH. MAIN FINDINGS: SnCH4 was the steepest in the group with "Obstruction and Low DLCO", with significant differences between this group and the "Normal", "Obstruction with Normal DLCO", "Mixed Obstruction and Restriction" and "Isolated Low DLCO" groups. SnCH4 was steeper in current and former smokers compared to non-smokers. Among the entire study sample, SnCH4 correlated with VA/TLC (Spearman rho = -0.56, p < 0.01) and remained a significant determinant of VA/TLC by regression modeling. PRINCIPAL CONCLUSIONS: The SnCH4 derived from a standard, single breath DLCO test using rapid gas analysis varied among distinct patterns of physiologic abnormalities and was associated with VA/TLC as a measure of VH.

Soft X-ray wavefront sensing at an ellipsoidal mirror shell.

A reliable `in situ' method for wavefront sensing in the soft X-ray domain is reported, developed for the characterization of rotationally symmetric optical elements, like an ellipsoidal mirror shell. In a laboratory setup, the mirror sample is irradiated by an electron-excited (4.4 keV), micrometre-sized (∼2 µm) fluorescence source (carbon Kα, 277 eV). Substantially, the three-dimensional intensity distribution I(r) is recorded by a CCD camera (2048 × 512 pixels of 13.5 µm) at two positions along the optical axis, symmetrically displaced by ±21-25% from the focus. The transport-of-intensity equation is interpreted in a geometrical sense from plane to plane and implemented as a ray tracing code, to retrieve the phase Φ(r) from the radial intensity gradient on a sub-pixel scale. For reasons of statistical reliability, five intra-/extra-focal CCD image pairs are evaluated and averaged to an annular two-dimensional map of the wavefront error {\cal W}. In units of the test wavelength (C Kα), an r.m.s. value \sigma_{\cal{W}} = ±10.9λ0 and a peak-to-valley amplitude of ±31.3λ0 are obtained. By means of the wavefront, the focus is first reconstructed with a result for its diameter of 38.4 µm, close to the direct experimental observation of 39.4 µm (FWHM). Secondly, figure and slope errors of the ellipsoid are characterized with an average of ±1.14 µm and ±8.8 arcsec (r.m.s.), respectively, the latter in reasonable agreement with the measured focal intensity distribution. The findings enable, amongst others, the precise alignment of axisymmetric X-ray mirrors or the design of a wavefront corrector for high-resolution X-ray science.

Combined Tibial Deflexion Osteotomy and Anterior Cruciate Ligament Reconstruction Improves Knee Function and Stability: A Systematic Review.

IMPORTANCE: Patients with excessive posterior tibial slope (PTS) may have higher risks of anterior cruciate ligament (ACL) reconstruction (ACL-R) failure, and clinical outcomes after revision ACL-R procedures are typically poor. OBJECTIVE: To perform a systematic review of the literature summarizing the clinical and radiological outcomes of the surgical treatment of ACL insufficiency in the setting of excessive PTS using a tibial deflexion osteotomy combined with ACL-R. EVIDENCE REVIEW: A systematic review of the literature was performed using PubMed, Cochrane Library, and OVID Medline databases from 1990 to present. Inclusion criteria were: studies of outcomes of isolated tibial deflexion osteotomies performed with primary or revision ACL-R in the English language. Data extracted included study demographic information, type of tibial deflexion osteotomy and concomitant procedures, radiological outcomes, patient reported outcome scores, and postoperative complications FINDINGS: Six studies, with 133 knees were identified. All included studies were retrospective case series, with a weighted mean follow-up of 3.39 years. In 106 of 133 (79.7%) knees, tibial deflexion osteotomy was performed concomitantly with an ACL-R, whereas in 27 of 133 (20.3%) knees the procedures were staged. 22, 45, and 66 of 133 knees (16.5%, 33.8%, and 49.6%) underwent primary, 1st revision, and 2nd or greater revision ACL-R, respectively. 3 of 133 (2.25%) knees demonstrated recurrent ACL graft failure at final follow-up. On average, PTS decreased from 15.2 degrees preoperatively to 7.1 degrees postoperatively. Mean International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores increased from 42.5, 46.4, and 4.2 preoperatively to 71.8, 89.0, and 6.7 postoperatively. CONCLUSIONS: The results of this review suggest that combined ACL-R and tibial deflexion osteotomy may be effective in decreasing PTS and improving knee function and stability. STUDY DESIGN: Systematic Review; Level of evidence 4.

Metal Strip Implanted Tunneling Field-Effect Transistor Biosensor as a Label-Free Biosensor.

In this study, we design and simulate a metal implanted dielectrically modulated tunneling field-effect transistor (MI-DMTFET). In the ambipolar conduction state, the proposed structure works as an efficient sensor for the detection of a wide range of biomolecules. A metal strip (MS) is implanted above the drain-channel junction in the gate dielectric to improve the alignment of band gaps. Therefore, with the help of implanted metal work function engineering, the tunneling barrier gets lowered, which in turn increases the ambipolar current. An optimum metal-strip implant work function of 4.85 eV and a length of 1.5 nm have resulted in significantly improved performance of the proposed device. It has been observed that when the biomolecules with varying dielectric constants and charge densities are captured in the nanogap cavity, the ambipolar current of the biosensor changes, resulting in the detection of the biomolecules. Quantitative and comprehensive analyses of device parameters such as surface potential, electric field, band-to-band tunneling, subthreshold slope, and ION/IOFF ratio analysis have been performed. Rigorous comparative analyses of key performance-measuring parameters have been performed with a conventional sensor device. It has been found that the proposed device offers maximum sensitivity of 1220 under an ambipolar state at k = 12.

Supratubercle Anterior Closing Wedge Osteotomy: No Changes in Patellar Height and Significant Decreases in Anterior Tibial Translation at 6 Months Postoperatively.

BACKGROUND: Because of the increased prevalence of revision anterior cruciate ligament (ACL) reconstruction, there has been a desire to understand the role of posterior tibial slope on increased anterior tibial translation and increased ACL graft forces. One potential concern in supratubercle anterior closing wedge proximal tibial osteotomy (ACW-PTO) for decreasing the posterior tibial slope is the risk of altering the patellar height. PURPOSE: To radiographically assess changes in (1) patellar height, (2) anterior tibial translation, and (3) posterior tibial slope after supratubercle ACW-PTO. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Patients who underwent supratubercle ACW-PTO by a single surgeon between July 2019 and June 2023 were included. Standardized lateral knee weightbearing radiographs to assess patellar height (via the Caton-Deschamps index), anterior tibial translation of the lateral tibial plateau relative to the lateral femoral condyle, and posterior tibial slope were obtained at 4 time points (preoperatively and 1 day, 3 months, and 6 months postoperatively). Paired t test was used to compare differences between preoperative, 1-day, and 3- and 6-month values for patellar height as measured using the Caton-Deschamps index and for posterior tibial slope. Paired t test was also used to compare differences in the preoperative and 6-month postoperative values for anterior tibial translation. RESULTS: In 20 patients after ACW-PTO, the Caton-Deschamps index demonstrated a significant increase in patellar height on postoperative day 1 (P < .001) but no significant differences at 3 (P = .057) and 6 (P = .176) months postoperatively. Anterior tibial translation on standing lateral knee radiographs was significantly decreased by a mean of 8.9 mm from preoperatively to 6 months postoperatively (P < .001). Posterior tibial slope was significantly decreased by a mean of 11.2° from preoperatively to 6 months postoperatively (P < .001). CONCLUSION: Supratubercle ACW-PTO performed for ACL reconstruction failure in the setting of an increased posterior tibial slope did not induce significant changes in patellar height postoperatively. Furthermore, after ACW-PTO, there was a significant decrease in anterior tibial translation and posterior tibial slope.

Comparison of Clinical and Radiological Outcomes of Total Knee Arthroplasty in Osteoarthritic Patients.

Background The knee is the joint most commonly affected by osteoarthritis, more than any other. Osteoarthritis is a progressive, long-term condition that leads to the deterioration of joint tissue and cartilage, resulting in pain and impairment. Total knee arthroplasty (TKA) is a successful intervention that improves functional capability, decreases pain, and enhances quality of life. We conducted this study to evaluate whether radiological parameters following TKA influence the clinical outcomes of patients with knee osteoarthritis. Methods The study was conducted on patients treated for knee osteoarthritis at the Department of Orthopedics, Rajindra Hospital and Government Medical College, Patiala, Punjab, in collaboration with the Department of Radiology over a period of 1.5 years. A total of 152 patients diagnosed with knee osteoarthritis were included in the study; all underwent TKA. Patients underwent clinical evaluation and were graded using the Knee Society Score (KSS) during follow-up examinations. Pain was evaluated using the Visual Analog Scale (VAS). Postoperative X-rays were obtained, and various angles, including the distal femoral angle (DFA), the proximal tibial angle (PTA), and the posterior slope angle (PSA), were measured. Patient follow-up was conducted at three days, three months, and six months. Subsequently, a comparison of the clinical and radiological outcomes of TKA was performed. Results In this study, a total of 152 patients participated, with the majority falling into the 61-70 age group. Of these patients, 40.13% were female and 59.87% were male. The average medial DFA was 94.05°, the average medial PTA was 89.31°, and the PSA was 6.6°. Patients with a medial DFA of 94.05° (±3), a medial PTA of 89.31° (±3), and a PSA of 6.6° (±3) were categorized into the normal group. Conclusion Patients with DFA, PTA, and PSA in the normal range demonstrate improved KSS and clinical outcomes.

Analysis of labour accidents caused by slope failure during slope cutting and application of a rapid checklist for risk management in Japan.

Slope failure during or immediately after slope-cutting can cause fatal accidents. This study analyses the characteristics of labour accidents caused by slope failure during slope-cutting in Japan and presents a countermeasure to prevent accidents caused by slope failure, such as the implementation of a slope guideline by MHLW. A case history conducted during slope-cutting and nailing was presented as an example of the application of the slope guideline to ensure safety. Furthermore, monitoring methods were implemented to gain a quantitative understanding of slope deformation. Geological conditions other than those assumed prior to excavation and small collapses attributed to groundwater are indications of landslide risk. The guideline's quick checklist reflects the slope condition or deformation, allowing the client, designer and contractor to discuss and agree on a quick solution to a problem. The case study confirmed the effectiveness of the slope guideline as a tool for sharing information during construction.

Infrared thermography reveals weathering hotspots at the Pozáry field laboratory.

Evaluating physical properties and mechanical parameters of rock slopes and their spatial variability is challenging, particularly at locations inaccessible for fieldwork. This obstacle can be bypassed by acquiring spatially-distributed field data indirectly. InfraRed Thermography (IRT) has emerged as a promising technology to statistically infer rock properties and inform slope stability models. Here, we explore the use of Cooling Rate Indices (CRIs) to quantify the thermal response of a granodiorite rock wall within the recently established Pozáry Test Site in Czechia. We observe distinct cooling patterns across different segments of the wall, compatible with the different degrees of weathering evaluated in the laboratory and suggested by IRT observations of cored samples. Our findings support previous examinations of the efficacy of this method and unveil correlations between cooling phases in the field and in the laboratory. We discuss the scale-dependency of the Informative Time Window (ITW) of the CRIs, noting that it may serve as a reference for conducting systematic IRT field surveys. We contend that our approach not only represents a viable and scientifically robust strategy for characterising rock slopes but also holds the potential for identifying unstable areas.

Effect of different lumbar-iliac fixation and sacral slope for Tile C1.3 pelvic fractures: a biomechanical study.

BACKGROUND: Lumbar-iliac fixation (LIF) is a common treatment for Tile C1.3 pelvic fractures, but different techniques, including L4-L5/L5 unilateral LIF (L4-L5/L5 ULIF), bilateral LIF (BLIF), and L4-L5/L5 triangular osteosynthesis (L4-L5/L5 TOS), still lack biomechanical evaluation. The sacral slope (SS) is key to the vertical shear of the sacrum but has not been investigated for its biomechanical role in lumbar-iliac fixation. The aim of this study is to evaluate the biomechanical effects of different LIF and SS on Tile C1.3 pelvic fracture under two-legged standing load in human cadavers. METHODS: Eight male fresh-frozen human lumbar-pelvic specimens were used in this study. Compressive force of 500 N was applied to the L4 vertebrae in the two-legged standing position of the pelvis. The Tile C1.3 pelvic fracture was prepared, and the posterior pelvic ring was fixed with L5 ULIF, L4-L5 ULIF, L5 TOS, L4-L5 TOS, and L4-L5 BLIF, respectively. Displacement and rotation of the anterior S1 foramen at 30° and 40° sacral slope (SS) were analyzed. RESULTS: The displacement of L4-L5/L5 TOS in the left-right and vertical direction, total displacement, and rotation in lateral bending decreased significantly, which is more pronounced at 40° SS. The difference in stability between L4-L5 and L5 ULIF was not significant. BLIF significantly limited left-right displacement. The ULIF vertical displacement at 40° SS was significantly higher than that at 30° SS. CONCLUSIONS: This study developed an in vitro two-legged standing pelvic model and demonstrated that TOS enhanced pelvic stability in the coronal plane and cephalad-caudal direction, and BLIF enhanced stability in the left-right direction. L4-L5 ULIF did not further improve the immediate stability, whereas TOS is required to increase the vertical stability at greater SS.

[The correct tibial slope? Comparison of measuring methods]. / Der korrekte tibiale Slope? Messmethoden im Vergleich.

INTRODUCTION: From a biomechanical point of view, the tibial slope plays a significant role in relation to the loading of the ligament structures in the knee joint. Currently, there are various methods of measurement for the tibial slope, which makes it difficult to compare the measurement results obtained. These differences can be decisive factors for the indication and the extent respectively of the correction of the tibial slope. The aim of this work is to present the differences in results between the measurement methods, and to compare these with the posterior tibial slope (PTS). METHODS: By means of a comparative analysis, six measurement techniques for the tibial slope were examined. Using six parameters (correlation coefficient, range, deviation of the average slope value, correction coefficient, difference in the corrected measurements, range of the corrected measurements), these results were compared with the PTS. In this prospective study, the PTS was measured in 107 (49 male, 58 female, age 42.6 ± 23.4 years) strictly lateral plain radiological projections of the tibia with the talocrural joint in comparison with the measurement methods according to Han, Brazier, Moore and Harvey, Pietrini and LaPrade and a supratuberosity measurement. RESULTS: The posterior slope was observed at a mean value of 6.9° (±â€¯8.6°). Compared with the PTS, tibial slope values were increased in 55.5 % of all measurements examined and decreased in 42.4 %. In 2 % the values were identical to those of PTS. The deviations observed were significant at up to +2.9° (±â€¯1.7°) and -2.3° (±â€¯1.5°) respectively in comparison with the measured PTS (p < 0.001). 25.9 % of the results showed a slope value more than 2°too high and 17.6 % one less than -2° too low. Thus, in 43 % of the results clinically relevant results that were too high or too low were observed for the tibial slope compared with the PTS (p < 0.001). The correlation analyses showed very high linear connections with PTS (p < 0.001) for all methods, from r2 = 0.88 (in Moore and Harvey) up to r2 = 0.98 (in Han). The ranges varied between 13.90° (Moore and Harvey) and 18.30° (Han). CONCLUSION: Depending on the measurement method, the slope values obtained should be individually evaluated, in order to draw the correct clinical conclusions. In principle, the radiological assessment of the whole lower leg is essential, so that concomitant pathologies in the area of the entire tibia can be detected. In everyday clinical practice, the measurement according to Han et al., and thus a shorter X­ray projection, makes it possible to draw optimal conclusions about the PTS. LOE: Prospective diagnostic study, Level II.