The growing importance of urban seismic resilience highlights the need for effective strategies to minimize earthquake-induced losses of building groups. Urban seismic capacity assessment requires rapid and accurate prediction of buildings’ seismic responses. However, in large urban building groups, the design information of many buildings is often difficult to obtain completely. In addition, post-earthquake interruption of economic activities will cause significant indirect losses to the city. Based on this background, this paper developed a convolutional neural network (CNN) model using structural characteristic parameters and ground motion parameters, by which the seismic response of structures in a building group can be rapidly predicted. On this basis, the repair priority of buildings was determined according to the repair efficiency value, and an optimal repair strategy considering indirect losses was proposed to minimize the post-earthquake indirect losses of building groups. Taking 908 buildings in Shanghai as an example, the effectiveness of the model is verified, and a comparison is made with the existing conventional repair strategies. Results showed that the proposed neural network accurately predicted the damage states of buildings. Compared with other existing strategies, the proposed optimal repair strategy effectively reduced the indirect economic loss. Further, the increased repair resources can reduce the indirect economic loss and repair time, but the reduction ratio decreases with the further increase of resource allocation.

Construction project work is a long process. During the implementation, various problems will inevitably be encountered. The most common problem is wasted materials. Waste materials are not only about wasted materials, but also wasted time and do not provide added value to the users of construction services. This study aims to provide answers to the factors causing material waste that are very dominant in the project to improve the quality of slum areas in Candikuning Village, Baturiti District, Tabanan Regency. This study ran for 7 (seven) days from July 29, 2025 to August 4, 2025. This study was carried out by distributing questionnaires to 32 contractor members who carried out the construction project in Candikuning. Data were analyzed using descriptive analysis through the results of the mean and standard deviation. This study provides answers to the most dominant factors in material waste in the project to improve the quality of slum areas in Candikuning Village, Baturiti District, Tabanan Regency. There are 3 (three) main factors that influence waste material, namely design changes (F5) where the mean score is 4.5 and the standard deviation is 0.57; waiting time for equipment repair (A3) with a mean of 4.44 and a standard deviation of 0.56; and complex image detailing (F4) with a value for the mean of 4.44 and a standard deviation of 0.67.

Risk-Stratified Timing of Thoracic Endovascular Aortic Repair for Complicated Type B Aortic Dissection with Acute Limb Ischemia.

Cost-effectiveness analysis of surgical repair versus observation of complex abdominal aortic aneurysms in elderly patients.

Optimal warranty policy with repair time threshold under repair-replacement warranty considering the expected total profit

This paper evaluates the availability of a symmetric bridge system composed of five identical repairable components. The system is modeled as a coherent structure that cannot be reduced to a pure series or parallel configuration. The failure and repair times of each component are assumed to follow the Weibull distribution. Five improvement techniques are considered: failure rate reduction, repair rate increase, hot, warm, and cold duplication. The availability equivalence factor is computed to compare the effectiveness of these methods. Simulation results are presented to distinguish among the improvement, revealing that cold duplication provides the highest improvement in system availability.

Knee dislocations (KDs) are potentially limb-threatening injuries characterized by complete displacement of the tibiofemoral articulation. Historically, most KDs resulted from high-energy trauma and sporting activities. However, KDs occurring in morbidly obese patients from low-energy falls, termed "ultra-low-velocity KDs," are becoming more common. Prompt evaluation and recognition are key to achieving a timely reduction and avoiding potentially devastating complications resulting from popliteal artery injury. A suspected KD should be monitored with serial examinations to assess the vascular status. Emergent vascular surgery consultation is indicated for limbs that have evidence of vascular compromise. KDs that cannot be reduced through closed means should be taken to the operating room emergently for open reduction. Temporary external fixation should be reserved for knees that remain subluxated or grossly unstable after reduction or bracing treatment, in cases with severe open wounds, associated extremity fractures that require stabilization, and in select cases requiring vascular intervention. Controversies in definitive management remain regarding timing of ligament stabilization, repair vs. reconstruction of injured ligaments, and single vs. staged treatment. Complications associated with KDs include vascular injuries with limb loss, arthrofibrosis, compartment syndrome, infection, heterotopic ossification, and nerve recovery challenges and recurrent laxity. Ongoing level 1 clinical trials are being conducted to determine optimal timing of both ligamentous reconstruction and postoperative rehabilitation. Despite the severity of these injuries, many patients are able to return to work and sport-related activities.

Ventricular septal rupture (VSR) is a rare but devastating complication of acute myocardial infarction (MI), associated with high mortality despite advances in reperfusion therapy. However, contemporary data examining national trends in VSR outcomes and the evolving role of mechanical circulatory support (MCS) in this population remain limited. This study aimed to evaluate modern trends in VSR incidence, inpatient mortality, and MCS utilization among patients with MI using a nationally representative database. We analyzed the Nationwide Inpatient Sample from 2016 to 2021, identifying MI hospitalizations in adults ≥ 40 years. Outcomes included in-hospital mortality (primary), length of stay, adverse disposition, cardiogenic shock (CS), and MCS use (secondary). Of 5.4 million acute MI admissions, 2605 (0.05%) involved VSR. Patients with VSR experienced significantly higher mortality (49.9% vs. 8.6%), CS (70.1% vs. 6.7%), and greater reliance on MCS (ECMO 4.4% vs. 0.1%, IABP 47.6% vs. 3.2%, LVAD 15.9% vs. 1.2%; all p < 0.001). Regression analysis revealed increased odds of mortality (aOR 4.53, 95% CI 3.41-6.02), prolonged hospitalization, shock, adverse disposition, and MCS use. Across the study period, VSR incidence (0.03%-0.06%), mortality (43%-55%), and MCS rates (53%-68%) remained stable. Despite advances in cardiovascular care, VSR outcomes in the acute MI setting have not substantially improved. However, the incidence of this mechanical complication has decreased in the contemporary era of early reperfusion and advanced therapies as suggested by our cohort. Use of MCS with MI complicated by VSR remains high, and a nuanced approach for modality selection is necessary, especially in candidates for delayed repair. Trends in VSR incidence, mortality, and MCS remained stable throughout the study period. These findings underscore the persistent challenge in post-MI VSR management and emphasize the need for prospective randomized trials to define optimal repair timing and clarify whether MCS modality selection influences outcomes in this high-risk population.

To investigate the preventive effect of intravitreal injection on posterior segment magnetic intraocular foreign body (IOFB)-related endophthalmitis, the risk factors for endophthalmitis, and the prognostic factors of posterior segment magnetic IOFBs. Retrospective analysis of patients with posterior segment magnetic IOFBs admitted to Hebei Eye Hospital (2014-2022). Among them, 172 patients (2016-2022) received intravitreal antibiotics at the time of primary repair. Rates of endophthalmitis in this cohort were compared with those in a previous cohort admitted between 2014 and 2016(56 patients). In the previous cohort, patients received only primary repair. The cohort was predominantly male (94%), median age 39 years. the right eye was affected in 105 patients (45%). The incidence of endophthalmitis was 4.7% (8/172) and 13.6 % (8/59) in the recent and previous cohorts, respectively, with significant difference(P=0.043). Lens capsule rupture and IOFB > 2 mm were risk factors for magnetic IOFB-related endophthalmitis (P=0.024 and P=0.031, respectively). Lens capsule rupture (OR=2.872, 95% CI 1.487-5.548, P=0.002); vitreous hemorrhage(OR=2.010, 95%CI 1.064-3.796, P=0.031); retinal detachment (OR=3.745, 95%CI 1.758-7.979, P<0.001); choroidal detachment (OR=5.109, 95%CI 1.465-17.808, P=0.010) and IOFB>2mm(OR=1.914, 95%CI 1.025-3.574, P=0.042) were predictors of poor visual outcome. Prophylactic intravitreal antibiotics can reduce the incidence of endophthalmitis in posterior segment magnetic IOFB injuries. Lens capsular rupture and IOFB > 2 mm are risk factors for endophthalmitis. In addition, lens capsular rupture, vitreous hemorrhage, retinal detachment, choroidal detachment, and IOFB > 2 mm are associated with a poor prognosis. A good initial VA is associated with a good prognosis.

PTFE Cuff Fenestration Reinforcement Demonstrates Low Endoleak Rates in PMEGs, Independent of Bridging Stent Type.

Cardioembolic stroke remains one of the most severe manifestations of cardiovascular disease, with atrial fibrillation (AF) responsible for a large proportion of ischemic cerebrovascular events. Stroke prevention strategies are currently dominated by oral anticoagulation guided by CHA2DS2-VASc scores, which emphasize age and comorbidities and therefore have limited applicability in younger patients with low conventional risk profiles. Although bleeding risk is routinely assessed using tools such as HAS-BLED, lifelong anticoagulation may still confer a substantial cumulative hemorrhagic burden over decades of treatment. The left atrial appendage (LAA) represents the primary anatomical source of thromboembolism in AF, yet current guidelines largely restrict surgical or percutaneous LAA exclusion to patients with AF who have contraindications to anticoagulation, reflecting a predominantly reactive approach. This Perspective advocates reconsideration of prophylactic surgical LAA exclusion at the time of open mitral valve repair in younger patients. Although early mitral repair limits atrial remodeling, it does not abolish lifetime AF risk, and post-operative or late-onset AF remains frequent. Moreover, residual or recurrent mitral regurgitation promotes progressive atrial dilation and fibrosis, increasing long-term thromboembolic risk even in patients initially in sinus rhythm. By integrating atrial remodeling, LAA morphology and function, residual mitral pathology, and the limitations of lifelong anticoagulation, a selective preventive framework emerges. An anatomical brain-heart prevention strategy may reduce lifetime cerebrovascular risk and improve long-term outcomes. While prospective data are needed, existing evidence supports individualized discussion of prophylactic LAA exclusion during mitral valve repair in selected young patients with structural atrial disease.

ABSTRACT This paper presents a novel yet practical friction‐based structural component design for low‐damage earthquake‐resistant structures. The proposed connection design is based on a conventional slotted‐bolted configuration with the novelty being the use of loose steel washer plates to establish the friction‐sliding interface. This design concept offers two key advantages: (1) The connection generates relatively constant sliding forces without the need for small geometric tolerances in the machined parts, and (2) the use of loose steel washer plates to establish the friction interface allows quick inspection and replacement of friction shims if needed. Eliminating the need for small geometric tolerances reduces the manufacturing cost and time. Reducing the inspection and potential repair time enhances the practicality of the connection in real applications and supports the long‐term functionality of earthquake‐resistant buildings equipped with it. To verify this design concept, a numerical simulation was first conducted to assess the expected kinematics and force‐displacement response. A comprehensive experimental characterization program was conducted, which consisted of component‐level connection tests and shaking table tests of a full‐scale three‐story re‐centering steel braced frame with sliding slabs, in which the proposed friction‐based connection was designed as the force‐limiting connection between the steel frame and the sliding slab. It is observed that the proposed connection exhibited a stable force‐displacement response and relatively low bolt load loss without enforcing small geometric tolerances when machining the parts of the connection. The replacement of the friction shim was performed after the completion of the shaking table test while the friction‐based connection remained installed on the frame specimen, which hence demonstrated the repairability of this connection.

Background: We designed a new non-locking six-strand suture technique (Li-Wee) as an evolution of our previous work. The aim of this study is to biomechanically compare repairs using this technique with FiberWire® 4-0 versus Prolene® 4-0. Methods: Thirty porcine flexor tendons were harvested for the experiments. A transverse cut was made in the middle of the tendons to allow for tendon repair. Repairs were made equally by using the Li-Wee technique with FiberWire® 4-0 and Prolene® 4-0. The ultimate tensile strength (UTS), load to 2 mm gap force, stiffness and repair times were measured under static testing. Furthermore, cyclic testing was performed on five specimens with the circumferential epitendinous suture from each repair group to evaluate their gap formation under cyclic loadings and final UTS. Results: The mean UTS of repairs using FiberWire® was 81.3 ± 10.3N while repairs done with Prolene® was 66.7 ± 8.3 N under static testing, and 98.7 ± 4.9 N for repairs using FiberWire® and 68.3 ± 10.4N for repairs using Prolene® under cyclic testing. Comparing FiberWire® and Prolene® repairs, the load to 2 mm gap force was 37.6 ± 8.4 N and 31.0 ± 10.9N; stiffness was 6.5 ± 0.9 N/m and 8.1 ± 1.0 N/m; repair times were 466 ± 45 s and 465 ± 62 s, respectively. A statistically significant difference was found between groups for UTS under both static and cyclic testing, as well as stiffness. Conclusions: This study has shown that six-strand non-locking Li-Wee flexor tendon repair using FiberWire® offers satisfactory repair strength, adequate stiffness and 2 mm gap force.

Background: In pediatric and adolescent patients with medial meniscal ramp lesions (MMRLs) undergoing anterior cruciate ligament reconstruction (ACLR), the presence of concomitant lateral meniscal tears (LMTs) are not well-characterized. Purpose: To describe the characteristics and surgical management of concomitant LMTs in pediatric and adolescent patients undergoing MMRL repair during primary ACLR. Study Design: Case series; Level of evidence, 4. Methods: Patients &lt;18 years old who underwent an MMRL repair during primary ACLR at 5 institutions from 2013 to 2025 were included. All MMRLs were diagnosed arthroscopically and defined as a partial or complete peripheral vertical/longitudinal tear of the posterior horn of the medial meniscus at or ≤3 mm from the meniscocapsular junction. The presence, location, and surgical management of arthroscopically identified concomitant LMTs were gathered from the operative reports. Lateral meniscus root tears (LMRTs) were categorized using the LaPrade classification. Patients with and without concomitant LMT at the time of MMRL repair during primary ACLR were compared. Results: In total, 189 pediatric and adolescent patients underwent an MMRL repair during primary ACLR at a mean age of 16.1 ± 1.4 years (range, 12.0-17.9 years). Concomitant LMTs were arthroscopically diagnosed in 122 (65%) patients, of which 38 (31%) were missed on the initial preoperative magnetic resonance imaging (MRI) report. Surgically, the majority of concomitant LMTs (67%) were treated with repair while 27% were treated with partial meniscectomy or observation (6%). LMTs were most frequently localized to the posterior horn (61%) or posterior root (27%). The most common LMT morphology was vertical/longitudinal (41%), followed by LMRTs (25%), complex nonroot tears (15%), radial tears (12%), and bucket-handle tears (4%). Of the 31 LMRTs identified, type 4 complex oblique root tears were most prevalent (65%), followed by type 2 complete radial root tears (26%), type 1 partial stable root tears (6%), and a type 5 bony root avulsion (3%). Significant risk factors associated with the presence of a concomitant LMT included male sex (odds ratio [OR], 1.9; 95% CI, 1.0-3.7; P = .044) and obesity (OR, 2.5; 95% CI, 1.0-6.1; P = .046). Conclusion: In this multicenter study, 65% of pediatric and adolescent patients undergoing MMRL repair during primary ACLR had a concomitant LMT and the majority were localized to the posterior horn and posterior root. As 31% of concomitant LMTs were missed on preoperative MRI, the posterior aspect of the lateral meniscus should be carefully evaluated at the time of surgery in pediatric patients with MMRLs. Nearly half of the concomitant LMTs identified in this cohort were LMRTs, complex tears, complete radial tears, or bucket-handle tears. Overall, surgeons should anticipate performing an additional lateral meniscal repair in nearly half of pediatric patients undergoing an MMRL repair during primary ACLR.

Aneurysm Risk Index as a Novel Method to Evaluate Abdominal Aortic Aneurysms: A Proof-of-Concept Study.

Abstract With the rapid development of smart grids, the complexity and scale of power grid systems continue to increase, and traditional fault detection and repair methods have made it difficult to meet the high-reliability needs of modern power grids. This paper proposes a fault self-healing architecture for the Hongmeng-Grid hybrid system based on digital twin technology. This architecture realizes real-time monitoring, fault prediction and self-healing control of the power grid system through digital twin technology, significantly improving the operating efficiency and safety of the power grid. In the experimental part, we construct a large-scale power grid simulation model containing 100 nodes and introduce HarmonyOS as the control core. The effectiveness of the proposed architecture is verified by simulating different types of fault scenarios, including short circuits, overloads, equipment ageing, etc. The experimental results show that in the short-circuit fault scenario, the average fault detection time of the system is shortened from the traditional 5 min to 1.2 min, the fault repair time is reduced from 30 min to 5 min, and the overall fault handling efficiency is improved by 83%. In the equipment ageing failure scenario, the prediction accuracy rate of the system reaches 95%, effectively avoiding the chain reaction caused by equipment failure. Compared with the traditional power grid system without digital twin technology, it is found that the architecture proposed in this paper reduces the frequency of faults by 40% and significantly improves the system stability. This study not only provides a new solution for fault self-healing of smart grids but also lays a solid foundation for the intelligent development of power grids in the future.

The association of repair timing on outcomes following thoracic endovascular aortic repair for intramural hematoma.

This study analyzed the maintenance performance of heavy mobile equipment at a gold mine in Burkina Faso over a full year, from June 2024 to May 2025. The research tracked key performance indicators month by month for five equipment types: haul trucks, excavators, wheel loaders, graders, and dozers. The data came directly from the mine's maintenance records. We measured equipment availability, failure frequency, repair times, costs, and the balance between planned and emergency work. Results show a clear seasonal pattern. During the rainy season, equipment broke down more often, and repairs took longer. This caused a drop in equipment availability and higher operating costs. Haul trucks performed the worst, while graders and dozers were the most reliable. The study found that maintenance strategy shifts from planned preventive work in the dry season to reactive breakdown repairs in the rainy season. The study identifies specific failure causes like tire damage and hydraulic leaks that are most common during the rains. Based on the findings, we recommend concrete actions including a pre-rainy season maintenance program, better spare parts planning, and targeted technician training. These steps can help mines in similar climates improve equipment reliability and reduce costs.

The discrepancy between actual production process time and standard time is often occurs, because the calculation of production time does not take int account the repair time caused by defective products. The Graphical Evaluation and Review Technique (GERT) method is used to determine the production process time by considering repair time due to defective product. GERT is used to calculate the average and variance of the production time in stochastic work network and put into consideration the possibility of rework so that the completion time is close to the actual condition. The calculation results show a difference between the standard production time of the front spar component of 3,841.69 minutes/unit and the rear spar of 4,080.81 minutes/unit, while based on the GERT method the production time of the front spar is 4,657.77 minutes/unit and the rear spar is 4,406.01 minutes/unit.

This article focuses on the performance of a single-active-unit repairable industrial system with three different states of unit: active unit (N), partial failure unit (P), and complete failure unit (F). The system operates continuously, 24 hours a day, without interruption, except for two cases: a complete failure of the active unit or maintenance at partial failure (P). The system always has one service available, which is kept for maintenance and repair. In the case of complete failure, the faulty unit is replaced with a new one if the repair duration exceeds the maximum allowed time predefined. However, the nighttime replacement operations have a lot of challenges that may include limited availability of spare part suppliers or replacement must be performed at a higher cost since options are limited. In this paper, it is assumed that all the times in the system are negative exponentially distributed. The supplementary variable technique and Markov process theory have been employed to evaluate the reliability of the system. Further sensitivity and relative sensitivity analyses are performed on some system parameters in order to study the effect of these parameters on the proposed system. These results are presented with numerical examples that provide useful insights contributing to the enhancement of the systems efficiency and operational reliability.