Fracture Index Research Articles

The simpler modified fried frailty scale predicts 2-year mortality in older adults with heart failure: a pilot study

ObjectiveThe Simpler Modified Fried Frailty Scale (SMFFS) has recently been developed from the original Fried scale to ease its use in clinical practice, by transforming the items requiring measurements into the self-reported inquiries. Its predictive validity needs to be clarified, especially in populations with a high prevalence of frailty, such as patients with heart failure (HF). Primary aim of this study is to find out the prevalence of frailty in older patients with HF by using SMFFS and show its concordance with other frailty assessment tools. Secondary aim is to reveal whether SMFFS is useful to predict mortality in follow-up.MethodThis is a prospective, follow-up study including older adults (≥ 65 years) with HF. SMFFS was used to assess frailty phenotype and presence of ≥ 3 items was accepted as frailty. FRAIL scale, the Study of Osteoporosis Fractures (SOF) index, and Edmonton Frailty Scale (EFS) were alternatively used to study the correlation of SMFFS with different scales. Cox-regression analysis was performed to identify whether SMFFS-defined frailty could predict mortality in follow-up, with adjusting for a list of clinical characteristics and geriatric syndromes.FindingsAmong 101 patients with HF, 44 (42.8%) were female. Mean age was 75.8 ± 7.6 and frailty prevalence was 63.4% according to SMFFS. SMFFS showed a strong correlation with the other frailty scales. In a median follow-up of 759 days, cardiomegaly, increased pulmonary artery pressure (PAP) and frailty defined by SMFFS were the only predictors of mortality in older adults with HF after adjustments for age, falls in the previous year, undernutrition, probable sarcopenia, functional impairments, and quality of life [HR (95% CI) were 3.88 (1.05–14.3), 1.05 (1.01–1.09), and 10.96 (1.07–112.05) (p = 0.027); for older age, PAP, and frailty, respectively].ConclusionsAs a self-reported screening tool, SMFFS was independently associated with mortality in a median follow-up of two years. Frailty assessment recommended by the guidelines for risk stratification in patients with HF seems to be more effectively integrated into routine HF practice with the use of the easy and practical SMFFS. Further large scale studies are needed to support the predictive validity of SMFFS in older patients with HF.

Investigating the effect of nano-MoS2 on the fracture performance of asphalt pavement containing shear and tear cracks under aging and freeze–thaw conditions

ABSTRACT In this study, the fracture performance of edge cracks (under mode II) and oblique cracks (under mode III) was studied using reinforced asphalt mixtures with different ratios of nano-MoS2. An extensive laboratory program was presented in which three different conditions including untreated samples, samples treated by freezing and thawing process, and samples treated by aging mechanism were applied to estimate the short-term and long-term features. Finally, untreated and treated samples were fractured using the three-point fracture test at different temperatures. The outcomes of short-term performance indicators demonstrated that nano-MoS2 enhanced the fracture characteristics of pavement in both percentages. Therefore, the offered mixtures can perform better than the sample without additives in all three aspects of fracture resistance, toughness, and flexibility at various temperatures. Compared to the destructive cycles of freezing and thawing, which determined the critical fracture resistance and stiffness, the aging mechanism caused the fracture flexibility results to become crucial. This result revealed that in determining asphalt pavement fracture indices, all indices should be evaluated (medium and low temperatures). Finally, it can be suggested that the mixes strengthened with 0.6% and 0.3% nano-additive had the best short-term fracture performance against shear and tear loads, respectively.

Comparative analysis of the effectiveness of instrumentation with manual stainless steel and NiTi files in the endodontic treatment

The aim of this study was to assess the effectiveness in instrumentation and the main differences between the manual systems K and M. Material and methods: Forty Type IV Vertucci standardized lower molars, considering the degree of curvature, were divided into 2 groups (n=10): M Files and K-File Files. After biomechanical preparation, the teeth were filled using the Tagger Hybrid technique. Digital radiographs were taken in the buccolingual and mesiodistal directions, and the quality of the filling was determined by three calibrated and blinded evaluators using a 4-point scoring system. The instrument fracture index was also recorded. The obtained data were subjected to Mann-Whitney tests (p<0.05). Results: In the analysis conducted by experienced professionals, a higher radiographic quality of obturation was observed in the M file group compared to the K-file group (p<0.05). Regarding the perception of undergraduate students regarding the difficulty of procedures, a greater difficulty was observed in preparing molars with K-Files compared to M Files (p<0.05). A higher percentage of fractured K-Files was observed compared to M Files. Conclusion: M Files provided less difficulty in preparing molars for undergraduate students, had a lower incidence of fracture, and favored better radiographic quality of obturation.

Analysis on Correlation Model Between Fracture Network Complexity and Gas-Well Production: A Case in the Y214 Block of Changning, China

The fracture network of the Y214 block in the Changning area of China is complex, and there are significant differences in the productivity of different shale gas wells. However, traditional machine learning models have problems such as missing key parameters, poor fitting effects and low prediction accuracy, which make it difficult to effectively evaluate the impact of crack network complexity on productivity. Therefore, the Pearson correlation coefficient was used to analyze the correlation between evaluation parameters, such as mineral content, horizontal stress difference, natural fractures and gas production. Combined with the improved particle swarm optimization (IPSO) algorithm and support vector machine (SVM) algorithm, a fracture network index (FNI) model was proposed to effectively evaluate the complexity of fracture networks, and the model was verified by comparing it with the performance evaluation results from the other two traditional models. Finally, the correlation between the fracture network index and the actual average daily gas production of different fracturing sections was calculated and analyzed. The results showed that the density of natural fractures was the key factor in controlling gas production (the Pearson correlation coefficient was 0.39), and the correlation between other factors was weak. In the process of fitting the actual data, the coefficient of determination, R², of the IPSO-SVM-FNI model training set increased by 8% and 24% compared with the two traditional models, and the fitting effect was greatly improved. In the prediction process based on actual data, the R² of the IPSO-SVM-FNI model test set was improved by 22% and 20% compared with the two traditional models, and the prediction accuracy was also significantly improved. The fracture index was concentrated, and its main distribution range was in the range of [0.2, 0.8]. The fracturing section with a higher FNI showed higher average daily gas production, and there was a significant positive correlation between fracture network complexity and gas production. Indeed, the research results provide some ideas and references for the evaluation of fracturing effects in shale reservoirs.

Frailty and Its Associated Factors in Patients With Atrial Fibrillation: A Cross-Sectional Study.

This study aimed to investigate the prevalence of frailty and its predictors among Taiwanese patients with atrial fibrillation (AF). A cross-sectional study was conducted, enrolling 188 AF patients aged over 20 years from a medical center in northern Taiwan. Participants were recruited from September 1 to December 30, 2022. Structured questionnaires were used to gather data on demographics, disease characteristics, Study of Osteoporotic Fractures Index, Short Portable Mental Status Questionnaire, Mini Nutritional Assessment Short-Form, Chinese Version Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale. Among Taiwanese AF patients, over two-thirds were at risk of frailty, with susceptibility increasing with age. Key potential predictors included sex, cognitive function, nutritional status, sleep quality, and depression, jointly explaining 47.6% of the variation, with nutritional status being the most significant. These findings underscore the importance of comprehensive assessment and management strategies to address frailty in AF patients and improve overall health outcomes.

Frailty transition and burden on mortality risk in middle-aged and older population: a prospective cohort study

The effect of frailty transition and burden on the risk of all-cause mortality in South Korea remains unclear. This study aimed to investigate the risk of all-cause mortality using the most recent frailty index (FI), changes in FI, and frailty burden. We analyzed data from the Korean Genome and Epidemiology Study (2013–2020). A total of 3,134 participants aged 53–87 years with a computable FI based on the osteoporotic fracture index during their initial visit. The FI was updated biennially during re-examinations and changes between the initial and last visits were categorized into four groups: (1) improved or maintained to non-frail, (2) worsened to pre-frail, (3) improved or maintained to pre-frail, and (4) worsened or maintained to frail. We used the Cox proportional hazards model, adjusted for age, sex, education, lifestyle factors, and diseases. During the follow-up, 218 participants died. Compared to those who were robust at the last visit, pre-frailty and frailty were associated with an increased risk of all-cause death. Of those who visited > 2 times, 62.3% improved or remained robust, and had a decreased risk of all-cause death. Those with > 63% of pre-frailty or frailty burden significantly higher risk of death, with > 60% increase compared to their non-frail counterparts. Maintaining or achieving robustness is associated with a decreased risk of mortality. To prevent premature death and extend healthy life expectancy, identifying biological aging through surrogate measures and implementing interventions to maintain or achieve a robust health status are needed.

A novel method for evaluating shale gas preservation conditions in an area on a regional scale

The Youjiang Basin is the main area of the Middle Devonian shale gas resources in southern China, with complex geological conditions, diverse stratigraphic structures, low level of exploration and limited hydrocarbon geological data. In this study, a method is proposed for evaluating the regional shale gas preservation conditions, by which it is easy to obtain information (using available data from regional geological maps) and to process data (processed by computer software). This method was applied to the evaluation of the preservation conditions of the Middle Devonian shale gas in the Youjiang Basin. Information extracted from geologic maps includes exposed stratum, magmatic rock distribution, stratigraphic occurrence and surface fracture distribution. Evaluation criteria for three indexes (stratigraphy index, dip angle index and fracture index) were established to classify the preservation conditions into five types from good to bad. Based on the calculated values of comprehensive index (CI), the comprehensive evaluation each area: 11621.23 km2 for CI of 0.7–1.0, 37162.67 km2 for CI of 0.5–0.7, 57784.43 km2 for CI of 0.3–0.5, 69303.77 km2 for CI of 0.1–0.3, and 69303.77 km2 for CI of 0.0–0.1, accounting for 3.19%, 10.19%, 15.84%, 18.99% and 51.80% of the whole area, respectively. These results are highly consistent with the actual exploration discoveries, showing that in the northern and central parts of the Guizhong Basin, the southern part of the Xidamingshan Uplift, and the northern part of the Qiannan Basin, there are large areas with good shale gas preservation conditions.

A Step in the Right Direction. An Analysis of the Most Popular Online Ankle Fracture-Related Patient Education Materials

Category: Ankle; Trauma Introduction/Purpose: Due to the increasing accessibility of Internet access, it is becoming more and more important to ensure that the informational material available online for patient education is both accurate and readable to promote a greater degree of health literacy. This study sought to investigate the quality and readability of the most popular online resources for ankle fractures. Methods: After conducting a Google search using six terms related to ankle fractures, we collected the first 20 non-sponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI) instruments. Quality was evaluated using an author-created Ankle Fracture Index (AFI). Results: A total of 46 out of 120 articles met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 8.4 ± 0.5, 57.5 ± 3.2, and 10.5 ± 0.5, respectively. The average AFI score was 15.4 ± 1.4, corresponding to an “acceptable” quality rating. Almost 70% of articles (n = 32) were written at or below the recommended eighth grade reading level. Most articles discussed the need for imaging in diagnosis and treatment planning while neglecting to discuss the risks of surgery or potential future operations. Conclusion: Ankle fractures are a common injury among young and old patients alike. With a varied range of treatments available, patients are likely to perform their own Internet searches before arriving at the doctor’s office. Current, online patient education materials on ankle fractures diverge from the overall trend in orthopaedics by demonstrating an eight grade average reading grade level and an acceptable quality on content analysis. Further work should surround increasing information regarding risk factors, complications for surgery, and long-term recovery.

The Gas Production Characteristics of No. 3 Coal Seam Coalbed Methane Well in the Zhengbei Block and the Optimization of Favorable Development Areas

The characteristics and influencing factors of gas production in CBM wells are analyzed based on the field geological data and the productivity data of coalbed methane (CBM) wells in the Zhengbei block, and then the favorable areas are divided. The results show that the average gas production of No. 3 coal seam CBM wells in the study area is in the range of 0~1793 m3/d, with an average of 250.97 m3/d; 80% of the wells are less than 500 m3/d, and there are fewer wells above 1000 m3/d. The average gas production is positively correlated with gas content, critical desorption pressure, permeability, Young’s modulus, and Schlumberger ratio, and negatively correlated with fracture index, fault fractal dimension, Poisson’s ratio, and horizontal stress difference coefficient. The relationship between coal seam thickness and the minimum horizontal principal stress is not strong. The low-yield wells have the characteristics of multiple pump-stopping disturbances, unstable casing pressure control, overly rapid pressure reduction in the single-phase flow stage, sand and pulverized coal production, and high-yield water in the later stage during the drainage process. It may be caused by the small difference in compressive strength between the roof and floor and the coal seam, and the small difference in the Young’s modulus of the floor. The difference between the two high-yield wells is large, and the fracturing cracks are easily controlled in the coal seam and extend along the level. The production control factors from strong to weak are as follows: critical desorption pressure, permeability, Schlumberger ratio, fault fractal dimension, Young’s modulus, horizontal stress difference coefficient, minimum horizontal principal stress, gas content, Poisson’s ratio, fracture index, coal seam thickness. The type I development unit (development of favorable areas) of the Zhengbei block is interspersed with the north and south of the block on the plane, and the III development unit is mainly located in the east of the block and near the Z-56 well. The comprehensive index has a significant positive correlation with the gas production, and the prediction results are accurate.

Assessing the Clinical Effectiveness of an Exergame-Based Exercise Training Program Using Ring Fit Adventure to Prevent and Postpone Frailty and Sarcopenia Among Older Adults in Rural Long-Term Care Facilities: Randomized Controlled Trial.

Frailty and sarcopenia are geriatric syndromes of increasing concern and are associated with adverse health outcomes. They are more prevalent among long-term care facility (LTCF) users than among community dwellers. Exercise, especially multicomponent and progressive resistance training, is essential for managing these conditions. However, LTCFs, particularly in rural areas, face challenges in implementing structured exercise programs due to health care professional shortages. Moreover, older adults often become bored with repetitive exercise training and may lose interest over time. The Nintendo Switch Ring Fit Adventure (RFA) exergame is a novel exergame that combines resistance, aerobic, and balance exercises and offers a potential solution by boosting motivation in an immersive manner and reducing staff intervention needs. We aimed to evaluate the clinical effectiveness of an exergame-based exercise training program delivered via RFA (exergame-RFA) in improving muscle mass and functional performance among older adult LTCF users. This was a randomized controlled trial conducted from August 2022 to September 2023 and involved older adult LTCF users (aged ≥60 y) in rural southern Taiwan. Participants were randomized into an intervention group (exergame-RFA plus standard care) or a control group (standard care alone). The intervention, conducted seated with arm fit skills and trunk control exercises using the RFA, lasted 30 minutes twice weekly over 12 weeks. The primary outcomes measured were the Study of Osteoporotic Fractures index (serving as an indicator of frailty status) and the diagnostic criteria for sarcopenia (appendicular skeletal muscle mass index, handgrip strength, and gait speed). The secondary outcomes included functional performance (box and block test as well as maximum voluntary isometric contraction of the dominant upper extremity), muscle condition (muscle thickness measured using ultrasonography), activities of daily living (Kihon checklist), health-related quality of life (Short Form Health Survey-36), and cognitive function (brain health test). We used an intention-to-treat analysis, incorporating a simple imputation technique in statistical analysis. A mixed ANOVA, with time as a within-participant factor and intervention as a between-participant factor, was used to compare the training effects on outcomes. We recruited 96 individuals, of whom 60 (62%) underwent randomization. Of these 60 participants, 55 (92%) completed the study. Significant group×time interactions were observed in the intervention group in all primary outcomes (all P<.001, except P=.01 for handgrip strength) and most secondary outcomes, including maximum voluntary isometric contraction of the biceps (P=.004) and triceps brachii (P<.001) muscles, biceps muscle thickness measured using ultrasonography (P<.001), box and block test (P<.001), Kihon checklist (physical function: P=.01, mood status: P=.003, and total: P=.003), and brain health test (P<.001). The exergame-RFA intervention significantly improved muscle mass, strength, and functional performance among older adult users of rural LTCFs, offering a novel approach to addressing frailty and sarcopenia. ClinicalTrials.gov NCT05360667; https://clinicaltrials.gov/study/NCT05360667. RR2-10.3389/fmed.2022.1071409.

Evaluation of the Hydraulic Fracturing Tendencies of Consolidated Sandstone Reservoirs Based on the Catastrophe Theory

The evaluation of rock hydraulic fracturing tendency plays a crucial role in the selection of fracturing layers within reservoirs and the evaluation of post-compression capacity. The sandstone reservoirs in the Yihuang New Area have poor physical properties and are deeply buried. It is necessary to increase the production of oil and gas by hydraulic fracturing. Regarding the sandstones in the region, the following parameters were considered: combined compressive strength, bulk modulus, shear modulus, fracture index, horizontal-stress difference coefficient, and fracture toughness. In accordance with the catastrophe theory, a multi-level structure was established for the hydraulic fracturing-tendency evaluation of sandstone reservoirs, consisting of a target layer, a guide layer, and an indicator layer. A catastrophic model for evaluating the hydraulic fracturing tendency of sandstone reservoirs was established. The results are consistent with those obtained from the Analytic Hierarchy Process. However, the catastrophe theory significantly reduces subjective interference. The results indicate that when the hydraulic fracturing-tendency evaluation value is greater than 0.8, the reservoir can be fractured well; when the hydraulic fracturing-tendency evaluation value is between 0.7 and 0.8, the fracture reservoir is moderate; and when the hydraulic fracturing-tendency evaluation value is less than 0.7, the fractured reservoir is poor. The optimal fracture intervals for the Yi 70 well are 1320–1323 m, 1350–1355 m, and 1355–1360 m. The optimal fracture planes for the Yi 76 well are 1921–1925 m and 1925–1930 m. The optimal fracture planes for the Yi 10-1-26 well are 2487–2495 m, 2585–2587 m, and 2589–2591 m. The hydraulic fracturing-tendency model developed in this study has been applied to several well sections of sandstone reservoirs in the Yihuang New Area. Additionally, the model was compared with existing hydraulic fracturing-tendency evaluation models. The evaluation results are in agreement with the post-pressure capacity-monitoring data. The accuracy of the model presented in this study has been verified, as has its applicability to other sandstone reservoirs.

Experimental Investigation of Water Vapor Concentration on Fracture Properties of Asphalt Concrete.

The effect of moisture on the fracture resistance of asphalt concrete is a significant concern in pavement engineering. To investigate the effect of the water vapor concentration on the fracture properties of asphalt concrete, this study first designed a humidity conditioning program at the relative humidity (RH) levels of 2%, 50%, 80%, and 100% for the three types of asphalt concrete mixtures (AC-13C, AC-20C, and AC-25C).The finite element model was developed to simulate the water vapor diffusion and determine the duration of the conditioning period. The semi-circular bending (SCB) test was then performed at varying temperatures of 5 °C, 15 °C, and 25 °C to evaluate the fracture energy and tensile strength of the humidity-conditioned specimens. The test results showed that the increasing temperature and the RH levels resulted in a lower peak load but greater displacement of the mixtures. Both the fracture energy and tensile strength tended to diminish with the rising temperature. It was also found that moisture had a significant effect on the tensile strength and fracture energy of asphalt concrete. Specifically, as the RH level increased from 2% to 100% (i.e., the water vapor concentration rose from 0.35 g/m3 to 17.27 g/m3), the tensile strength of the three types of mixtures was reduced by 34.84% on average, which revealed that the water vapor led to the loss of adhesion and cohesion within the mixture. The genetic expression programming (GEP) model was developed to quantify the effect of water vapor concentrations and temperature on the fracture indices.

Shaking table test-based numerical study on post-buckling ULCF fracture behavior of partially concrete filled steel tubular piers

Steel structures may undergo local buckling deformation or ultra-low cycle fatigue (ULCF) fracture due to stress concentration under earthquake excitations, and the stress concentration may further develop after buckling deformation, thus leading to ULCF fracture. To investigate the post-buckling fracture behavior of partially concrete-filled steel tube (PCFST) piers under earthquake exactions, a new ULCF analysis method that integrates three fracture indexes of cyclic void growth model (CVGM) was proposed in this study based on a shaking table test of PCFST piers, and then the index for quantifying the buckling deformation of PCFST piers was developed to study the post-buckling ULCF mechanism. Finally, the effect of each design parameter on the ULCF fracture index was analyzed. The results indicate that all three indexes of CVGM can accurately predict the triggering time, crack location, and crack propagation of ULCF fracture after buckling. The failure mechanism of PCFST bridge piers experiencing post-buckling fracture is also revealed, i.e., under repeated lateral loads, the plastic hinge region at the pier bottom bulges, causing an expansion of the plastic region. Meanwhile, the cumulative rate of ULCF damage rapidly increases during the expansion process and slows down after the bulge reaches the maximum stable value until the cumulative damage value meets the fracture condition. In addition, the results of the parametric analyses indicate that the model with high ductility can undergo a greater number of cycles before localized instability failure, and thus is more likely to suffer ULCF fracture first.

Stress based fracture criteria for mixed-mode I/II delamination of unidirectional composite laminates

Mixed mode delamination is prone to occur in composite laminates subjected to complicated loading. In current study, the modified maximum principal stress (M-MPS) criterion and the modified maximum shear stress (M-MSS) criterion considering the effect of mode ratio on the critical distance are developed to predict the mixed mode delamination of unidirectional laminates. The accuracy of the proposed fracture criteria is validated by the comparison of the predicted fracture locus curve with extensive experimental data available in the literatures, a higher correlation is observed between the predicted results and the experimental data. Finally, comprehensive discussion on the capability of the proposed M-MPS and M-MSS criteria is conducted, a dimensionless parameter named fracture index composed of the difference of elastic properties and the difference of pure mode fracture toughness is proposed to reveal the fracture mechanisms of the unidirectional composites.

Groundwater vulnerability and risk assessment coupled with hydrogeochemical analysis in the Taza aquifer (Morocco)

This study assesses the vulnerability of aquifers to increased contamination, influenced by rapid peri-urbanization and deficient sanitary infrastructure. The research focuses on the Taza aquifer in northeastern Morocco, where we applied the DRASTIC and GOD models. We further enhanced the DRASTIC method by the addition of a Fracture Index (F) ‘’DRASTICF‘’ to incorporate the effects of tectonics and geological discontinuities on groundwater behavior. The vulnerability mapping was performed for two distinct dry and wet periods of 2016 and 2021 respectively. Moreover, the use of hydrogeochemical analysis of 22 groundwater samples helped to identify potential sources of pollution and to understand the hydrogeological process. The results indicate a dynamic in vulnerability between these two periods due to changes in the recharge parameter and groundwater depth. The comparison between obtained vulnerability maps and nitrate concentrations reveals vulnerable zones that closely resemble regions affected by nitrate pollution. This area is predominantly classified as of high vulnerability at 27 %, associated with an estimated pollution level of 36%. The findings underscore also the importance of integrating the fracture index into the assessment of aquifer vulnerability alongside the different models. This integration offers an enriched perspective for effectively managing risks associated with groundwater contamination. The risk maps of groundwater contamination were also established by overlapping the vulnerability map with the land use layer. The main hydrogeochemical facies determined in the Piper Diagram allowed classifying the waters as Ca–Mg–HCO3 type. The significant correlations indicated that groundwater mineralization in the study area originates from the dissolution of limestone and evaporated formations. The water quality within the study area shows substantial variability, ranging from excellent to unsuitable, primarily due to the leaching of fertilizers and wastewater.The different results can be very helpful to the farmers, and local authorities for better groundwater sustainable management.

Basic characterization of three kinds of bio-asphalt and research on the low-temperature performance of bio-asphalt mixtures

Bio-oil is a by-product of waste biomass treatment using high-pressure liquefaction, bio-enzymatic, or high-temperature thermal cracking techniques, and can alleviate the shortage of petroleum asphalt resources. This study investigated the production of bio-oil from selected raw materials, including corn stover, castor oil from castor beans, and epoxy vegetable oil from soybeans for the preparation of bio-asphalt. The properties and mechanisms of modification of the three modified bio-asphalts were explored by assessment of basic physical properties, gel permeation chromatography (GPC), temperature scanning (DSR), and thermogravimetric analysis, as well as Semi-Circular Bending (SCB), low-temperature bending, and fatigue tests. Bio-oil was found to improve the low-temperature cracking resistance of the asphalt mixtures, with the improvement further enhanced by changing the blending amount. The bio-oil was observed to negatively affect the low-temperature fatigue performance of the mixes, and the decrease in the n-value indicated that the bio-oil could make the asphalt mixtures less stress-sensitive under repeated loading, with improved anti-fatigue performance of bio-asphalt mixtures observed when the stress ratio was 0.5. Finally, the low-temperature cracking performance index of the corn stover bio-asphalt mixtures was correlated with the gray entropy. The use of the SCB fracture index was found to be more appropriate when using the semicircular bending test to characterize the low-temperature cracking performance of bio-asphalt mixtures.

Evaluation of fracture indices of warm mix asphalt (WMA) modified with nano-additive under pure shear and pure tear deformations

Cracks located on the road edge and curve are two pavement crack types that can reduce road safety. Providing a solution to control this type of crack can solve a large part of the concern in this case. This study innovatively bridges the research gap by evaluating the efficacy of nano-reduced graphene oxide powder (NRGOP) in enhancing the fracture resistance of warm mix asphalt (WMA) under various environmental conditions, a critical aspect previously unexplored in the pavement engineering literature. For this goal, asphalt mixtures containing different ratios of NRGOP were constructed. Then, a level of aging and damage induced by freeze–thaw were applied to the semicircular bend (SCB) and edge-notched disc bend (ENDB) specimens to understand how the changes in fracture strength, fracture crispiness, and fracture stiffness are under modes III and II (at + 15 °C and −15 °C). The finding revealed that the introduction of NRGOP increased the fracture properties of WMA mixtures, such as fracture energy (FEII or FEIII) and fracture toughness (KIIC or KIIIC), as well as fracture stiffness under pure shear and pure tear deformations. Laboratory findings at low temperatures showed that it is necessary to investigate KIIC and FEII for asphalt mixtures under non-conditions and freeze–thaw conditions. However, KIIC and FEIII were suggested for aging conditions. Therefore, in two-thirds of the results, FEII was critical, and in 100 % results, KIIIC was critical. At + 15 °C, KIIC and FEIII were more crucial for non-treated and freeze–thaw conditions, while KIIC and FEII were more critical for aging, respectively. Therefore, in two-thirds of the results, FEIII was critical, and in 100 % results, KIIC was critical. The results of this research provide insights to advance the socio-economics of pavements by controlling surface cracks in tropical and subtropical regions, which in turn increases ride quality, driver safety, and pavement maintenance costs.

Development and validation of machine learning models to predict frailty risk for elderly.

Early identification and intervention of the frailty of the elderly will help lighten the burden of social medical care and improve the quality of life of the elderly. Therefore, we used machine learning (ML) algorithm to develop models to predict frailty risk in the elderly. A prospective cohort study. We collected data on 6997 elderly people from Chinese Longitudinal Healthy Longevity Study wave 6-7 surveys (2011-2012, 2014). After the baseline survey in 1998 (wave 1), the project conducted follow-up surveys (wave 2-8) in 2000-2018. The osteoporotic fractures index was used to assess frailty. Four ML algorithms (random forest [RF], support vector machine, XGBoost and logistic regression [LR]) were used to develop models to identify the risk factors of frailty and predict the risk of frailty. Different ML models were used for the prediction of frailty risk in the elderly and frailty risk was trained on a cohort of 4385 elderly people with frailty (split into a training cohort [75%] and internal validation cohort [25%]). The best-performing model for each study outcome was tested in an external validation cohort of 6997 elderly people with frailty pooled from the surveys (wave 6-7). Model performance was assessed by receiver operating curve and F2-score. Among the four ML models, the F2-score values were similar (0.91 vs. 0.91 vs. 0.88 vs. 0.90), and the area under the curve (AUC) values of RF model was the highest (0.75), followed by LR model (0.74). In the final two models, the AUC values of RF and LR model were similar (0.77 vs. 0.76) and their accuracy was identical (87.4% vs. 87.4%). Our study developed a preliminary prediction model based on two different ML approaches to help predict frailty risk in the elderly. The presented models from this study can be used to inform healthcare providers to predict the frailty probability among older adults and maybe help guide the development of effective frailty risk management interventions. Detecting frailty at an early stage and implementing timely targeted interventions may help to improve the allocation of health care resources and to reduce frailty-related burden. Identifying risk factors for frailty could be beneficial to provide tailored and personalized care intervention for older adults to more accurately prevent or improve their frail conditions so as to improve their quality of life. The study has adhered to STROBE guidelines. No patient or public contribution.

Analysis of the Most Popular Online Ankle Fracture-Related Patient Education Materials.

Given the increasing accessibility of Internet access, it is critical to ensure that the informational material available online for patient education is both accurate and readable to promote a greater degree of health literacy. This study sought to investigate the quality and readability of the most popular online resources for ankle fractures. After conducting a Google search using 6 terms related to ankle fractures, we collected the first 20 nonsponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI) instruments. Quality was evaluated using custom created Ankle Fracture Index (AFI). A total of 46 of 120 articles met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 8.4 ± 0.5, 57.5 ± 3.2, and 10.5 ± 0.5, respectively. The average AFI score was 15.4 ± 1.4, corresponding to an "acceptable" quality rating. Almost 70% of articles (n = 32) were written at or below the recommended eighth-grade reading level. Most articles discussed the need for imaging in diagnosis and treatment planning while neglecting to discuss the risks of surgery or potential future operations. We found that online patient-facing materials on ankle fractures demonstrated an eighth-grade average reading grade level and an acceptable quality on content analysis. Further work should surround increasing information regarding risk factors, complications for surgery, and long-term recovery while ensuring that readability levels remain below at least the eighth-grade level.

Claims-Based Frailty Index and Its Relationship With Commonly Used Clinical Frailty Measures.

The relationship of claims-based frailty index (CFI), a validated measure to identify frail individuals using Medicare data, and frailty measures used in clinical practice has not yet been fully explored. We identified community-dwelling participants of the 2015 National Health and Aging Trends Study (NHATS) whose CFI scores could be calculated using linked Medicare claims. We calculated 9 commonly used clinical frailty measures from theirNHATS in-person examination: Study of Osteoporotic Fracture Index (SOF), FRAIL Scale, Frailty Phenotype, Clinical Frailty Scale (CFS), Vulnerable Elder Survey-13 (VES-13), Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), Edmonton Frail Scale (EFS), and 40-item Frailty Index (FI). Using equipercentile method, CFI scores were linked to clinical frailty measures. C-statistics and test characteristics of CFI to identify frailty asdefined by each clinical frailty measure were calculated. Of the 3963 older adults, 44.5% were ≥75 years, 59.4% were female, and 82.3% were non-Hispanic White. A CFI of 0.25 was equipercentile to the following clinical frailty measure scores: SOF 1.4, FRAIL 1.8, Phenotype 1.8, CFS 5.4, VES-13 5.7, TFI 4.6, GFI 5.0, EFS 6.0, and FI 0.26. The C-statistics of using CFI to identify frailty asdefined by each clinical measure were ≥0.70, except for CFS and VES-13. The optimal CFI cutpoints to identify frailty per clinical frailty measure ranged from 0.212 to 0.242, with sensitivity and specificity of 0.37-0.83 and 0.66-0.84, respectively. Understanding the relationship of CFI and commonly used clinical frailty measures can enhance the interpretability and potential utility of CFI.