Seismic strategy of non-seismically designed reinforced concrete columns retrofitted with steel rods.

This paper presents experimental results of combined cyclic load testing on a reinforced concrete (RC) column that was retrofitted with newly designed steel rods. The steel rods were installed around the column longitudinally and then anchored. The proposed steel rods utilize simple components and installation to enhance both the strength and ductility of RC columns. Cyclic lateral load tests were conducted on three specimens: one unreinforced specimen as reference, one specimen with the entire length of the column retrofitted, and one specimen with only the plastic hinge region of the column retrofitted. All specimens were tested under eccentric constant axial load and incrementally increasing lateral loading cycles with eccentricity. The implementation of steel rods resulted in significant improvement in ductility and an up to 60% increase in ultimate loading capacity.

Anterior variable angle locking neutralisation plate superiority over traditional tension band wiring for treating transverse patella fractures.

Purpose: This paper investigates the biomechanical benefits of using hybrid constructs that combine cannulated screws with tension band wiring (TBW) cerclage compared to cannulated screws with anterior Variable Angle locking neutralisation plates (VA LNP). These enhancements can bear heavier loads and maintain the repaired patella's integrity, in contrast to traditional methods. Method: Eighteen fresh-frozen human cadaver patellae were carefully fractured transversely at their midpoints using a saw. They were then divided into two groups of nine for subsequent utilisation. Fixation methods included Cannulated Screw Fixation added with either TBW or VA LNP Fixation Technique. Cyclic loading simulations (500 cycles) were conducted to mimic knee motion, tracking fracture displacement with Optotrak. After that, the constructs were secured over a servo-hydraulic testing machine to determine the load-to-failure on axial mode. Results: The average fracture displacement for the anterior neutralisation plate group was 0.09 ± 0.12 mm, compared to 0.77 ± 0.54 mm for the tension band wiring with cannulated screw group after 500 cyclic loading. This result is statistically significant (p = 0.004). The anterior neutralisation plate group exhibited a mean load-to-failure of 1359 ± 21.53 N, whereas the tension band wiring group showed 780.1 ± 22.62 N, resulting in a significant difference between the groups (p = 0.007). Conclusion: This research highlights the superior biomechanical advantage of VA LNP over TBW for treating simple transverse patella fractures with two cannulated screws. It also highlights how the TBW is still a valuable option considering the load-to-failure limit. Level of Evidence: Not Applicable.

Comparison of four confirmatory tests for the diagnosis of primary aldosteronism: Bayesian analysis in the absence of a gold standard.

BACKGROUND: Captopril challenge test (CCT), seated saline infusion test (SSIT), oral sodium loading test (OSLT) and fludrocortisone suppression test (FST) are widely used diagnostic tests for primary aldosteronism (PA). These tests differ in terms of safety and complexity. Whether the simpler tests (CCT and SSIT) are comparable in diagnostic performance to the more complex ones (FST and OSLT) is unclear. PURPOSE: To compare the diagnostic accuracy of the four tests. METHODS: This is a retrospective study of hypertensive patients who were screened for PA and completed at least one confirmatory test. The patients were divided into two cohorts: one including those who completed one to three tests was used for the estimation of sensitivity and specificity. The other including those who completed four tests was used for the comparison of accuracy. Bayesian method was used to obtain the sensitivity, specificity, and Youden index of each test. RESULTS: The study included 1011 hypertensive patients. Among them, 895 patients completed one to three tests (including 889 CCT, 605 FST, 611 SSIT and 69 OSLT), and 116 patients completed four tests. SSIT had the highest sensitivity of 0.82(95% CI 0.78-0.86) but the lowest specificity of 0.76(0.70-0.80). OSLT had the lowest sensitivity of 0.65(0.56-0.75) but the highest specificity of 0.91(0.82-0.96). The sensitivity and specificity were 0.78 (95% CI, 0.75-0.82), 0.82 (95% CI, 0.78-0.85), for CCT, and 0.77 (95% CI, 0.73-0.81), 0.87 (95% CI, 0.82-0.91) for FST, respectively. The Youden index was not significantly different among the four tests[0.60(0.55-0.65) for CCT; 0.58(0.51-0.64) for SSIT; (0.64(0.57-0.69) for FST; 0.56(0.43-0.67) for OSLT]. CONCLUSION: The accuracy of simpler tests is comparable to the more complex ones. Considering the safety and simplicity of CCT, it may be a reasonable first choice when confirming the diagnosis of PA.

Research on Lateral Resistance Performance of Prestressed Cross-Laminated Timber-Concrete Composite Structures under Reciprocating Loads.

Cross-Laminated Timber (CLT) and concrete composite structures represent an architectural system that integrates the strengths of both materials. In this innovative configuration, the CLT and concrete collaborate synergistically, harnessing their individual merits to achieve enhanced structural performance and functionality. Specifically, the CLT offers a lightweight design, superior bending resistance, and immense engineering plasticity, while concrete boasts exceptional compressive strength and durability. This study investigates the mechanical performance of CLT-concrete composite structures through quasi-static reciprocating loading tests in three full-scale CLT shear wall samples. Designed with varying initial prestressing forces and dimensions of the CLT panel, the prestressed CLT-concrete structures demonstrated a reduced dependence on the steel nodes, resulting in an increase in yield load, yield displacement, and maximum load-carrying capacity. Maximum capacity increased by 39.8% and 33.7% under initial prestressing forces of 23 kN and 46 kN on steel strands. Failure occurred due to localized compressive failure on prestressed steel strands and anchor plates. ABAQUS finite element analysis established three refined models, revealing that the increased initial prestressing force moderately enhanced stiffness but reduced ductility under similar cross-sectional dimensions. Furthermore, under consistent CLT material, dimensions, prestressing force, and loading conditions, prestressed CLT-concrete structures exhibited a higher maximum load-bearing capacity than prestressed CLT-steel composite structures. This study proposes structural design recommendations based on experimental and simulation results, incorporating specific assumptions.

Sensitivity to change and responsiveness of provocative load tests among athletes with patellar tendinopathy.

BACKGROUND: Pain provocation tests are recommended for assessing pain severity and as an outcome measure for individuals with patellar tendinopathy. OBJECTIVE: To evaluate floor and ceiling effects, sensitivity to change, and responsiveness cut-offs of two provocative load tests among athletes with patellar tendinopathy. METHODS: Athletes (N = 41) performed six repetitions for the single leg decline squat (SLDS) and resisted knee extension (KE) at baseline and 12 weeks. Participants rated their pain during each test on a visual analog scale (VAS). Sensitivity to change was assessed by calculating effect size (ES) and the standardized response mean (SRM). The responsiveness cut-offs were assessed using a combination of anchor and distribution- based methods to determine the minimal clinically important difference (MCID) for each test. RESULTS: A floor or ceiling effect was observed in only a small number of participants for both tests except for KE, for which approximately one third of participants had a floor effect at week 12. There was higher sensitivity to change for SLDS (ES: 1.93/SRM: 1.43) compared with KE (ES:0.96/SRM: 1.09). The MCID corresponded to a decrease of 1.6 points for SLDS and 1.0 for KE, while the distribution-based method estimated 1.2 points for SLDS and 1.1 for KE. CONCLUSION: This study found moderate to high sensitivity to change and established MCID values for the SLDS and KE test in athletes with patellar tendinopathy before and after rehabilitation. Both tests may be useful as pain on loading outcomes as athletes progress with their rehabilitation, but the KE test results in higher floor effects and has lower sensitivity to change.

Time Course of Asymptomatic Stenosis in Multiple Lumbar Spinal Stenosis-Five-Year Results of Selective Decompression of Symptomatic Levels.

Background: In the diagnosis of lumbar spinal stenosis (LSS), finding stenosis with magnetic resonance imaging (MRI) does not always correlate with symptoms such as sciatica or intermittent claudication. We perform decompression surgery only for cases where the levels diagnosed from neurological findings are symptomatic, even if multiple stenoses are observed on MRI. The objective of this study was to examine the time course of asymptomatic stenosis in patients with LSS after they underwent decompression surgery for symptomatic stenosis. Materials and Methods: The participants in this study comprised 137 LSS patients who underwent single-level L4-5 decompression surgery from 2003 to 2013. The dural sac cross-sectional area at the L3-4 disc level was calculated based on preoperative MRI. A cross-sectional area less than 50 mm2 was defined as stenosis. The patients were grouped, according to additional spinal stenosis at the L3-4 level, into a double group (16 cases) with L3-4 stenosis, and a single group (121 cases) without L3-4 stenosis. Incidences of new-onset symptoms originating from L3-4 and additional L3-4-level surgery were examined. Results: Five years after surgery, 98 cases (72%) completed follow-up. During follow-up, 2 of 12 patients in the double group (16.7%) and 9 of 86 patients in the single group (10.5%) presented with new-onset symptoms originating from L3-4, showing no significant difference between groups. Additional L3-4 surgery was performed for one patient (8.3%) in the double group and three patients (3.5%) in the single group; again, no significant difference was shown. Conclusion: Patients with asymptomatic L3-4 stenosis on preoperative MRI were not prone to develop new symptoms or need additional L3-4-level surgery within 5 years after surgery when compared to patients without preoperative L3-4 stenosis. These results indicate that prophylactic decompression for asymptomatic levels is unnecessary.

Quetiapine and Valproic Acid-induced Central Hypothyroidism in a Patient with Autism Spectrum Disorder and Intractable Epilepsy: A Case Report.

OBJECTIVES: Patients with an autism spectrum disorder (ASD) are prone to disruptive behaviors and aggression. A typical antipsychotics are used to treat these difficult ASD conditions. Several psychotropic drugs have been linked to hypothyroidism. The clinical manifestation of hypothyroidism is indistinguishable from that of an antipsychotic's general adverse effect, which can lead to a delayed or missed diagnosis. Conversely, thyroid dysfunction can exhibit an impact on mood, anxiety, depression, and cognitive functions. CASE PRESENTATION: We present a case of central hypothyroidism caused by long-term use of valproic acid (VPA) and adding quetiapine to risperidone. The current case had a history of hyperprolactinemia and subclinical hypothyroidism caused by risperidone and VPA, respectively, before the administration of quetiapine. CONCLUSION: This is the first report of quetiapine-induced central hypothyroidism in a patient with ASD, as determined by a thyrotropin-releasing hormone (TRH) loading test. TRH loading test may be useful in elucidating the pathogenesis of hypothyroidism in patients receiving quetiapine and VPA. Thyroid function monitoring in patients taking quetiapine and VPA may provide an opportunity to begin replacement therapy.

Low-Cyclic Reversed Loading Tests on Full-Scale Precast Concrete Composite Wall Connected by Tooth Groove and Grouted Sleeve.

In this paper, a novel precast concrete composite wall connected by tooth groove and grouted sleeve was introduced, which is produced in factories by means of structure-insulation integrated prefabrication, and the prefabrication and assembly process were presented minutely. To verify the feasibility and reliability of this novel tooth groove and grouted sleeve connection method and explore the joint connection performance and the seismic performance of the precast concrete composite wall connected by tooth groove and grouted sleeve, low-cyclic reversed loading tests with an axial compressive ratio of 0.1 were performed on two full-scale precast concrete composite walls. Moreover, the failure mode, hysteretic curve, skeleton curve, stiffness degradation, displacement ductility, energy dissipation capacity, and reinforcement strain were comprehensively discussed. The research results showed that under the vertical axial load and low-cyclic reversed load, the distributed reinforcements in the wall panel only played a structural role, while the connecting reinforcements at horizontal joints can always effectively transfer stress without bond failure, and the tooth groove and grouted sleeve connection performance was reliable. In addition, the hysteretic curves of the precast concrete composite wall connected by tooth groove and grouted sleeve were full, showing good ductile deformation capacity and energy dissipation capacity. In general, the precast concrete composite wall connected by tooth groove and grouted sleeve not only possessed favorable seismic performance but also showed obvious advantages such as green energy saving, high assembly rate, and less on-site wet operation, which can be applied to practical engineering under reasonable design.

The Laboratory and Clinical Perspectives of Magnesium Imbalance.

Magnesium (Mg2+) is a predominantly intracellular cation that plays significant roles in various enzymatic, membrane, and structural body functions. As a calcium (Ca2+) antagonist, it is imperative for numerous neuromuscular activities. The imbalance of body Mg2+  concentration leads to clinical manifestations ranging from asymptomatic to severe life-threatening complications. Therefore, the contribution of Mg2+ measurement regarding various laboratory and clinical aspects cannot be ignored. Mg2+ is often described as the forgotten analyte. However, its close relationship with body potassium (K+), Ca2+, and phosphate homeostasis proves that Mg2+ imbalance could co-exist as the root cause or the consequence of other electrolyte disorders. Meanwhile, several preanalytical, analytical, and postanalytical aspects could influence Mg2+ measurement. This review highlights Mg2+ measurement's laboratory and clinical issues and some analyte disturbances associated with its imbalance. Understanding this basis could aid clinicians and laboratory professionals in Mg2+ result interpretation and patient management.

Investigation on Seismic Behavior of a Novel Precast Shear Wall System with Different Infill Wall Constructions.

Construction industrialization addresses various challenges in the traditional construction industry, enabling building structures to conserve resources and enhance energy efficiency while reducing emissions. Precast shear walls involve the factory-based production of components, followed by transportation to a construction site for assembly. The method of connecting these components is crucial for precast concrete shear wall systems. Common connection methods include lap-spliced connections, post-tensioned connections, welded connections, bolted connections, and sleeve connections. However, challenges such as construction precision and technology proficiency have limited their application. In response, a novel precast concrete shear wall system utilizing angle steel connectors has been proposed. These angle steel connectors enhance the shear resistance of horizontal joints between precast concrete shear walls and the foundation, providing provisional support for specimen positioning and installation. Presently, the seismic performance of this innovative precast shear wall system under the combined actions of cyclic horizontal loads and axial pressure or tension has been extensively investigated. In practical engineering applications, precast concrete shear wall systems are often accompanied by infill walls. However, there is limited research on the seismic performance of precast concrete shear wall systems with infill walls. To address this gap, this study designed and fabricated two novel precast concrete shear walls with different infill wall constructions. One specimen featured an infill wall composed of a single wall panel, while the other had an infill wall consisting of two panels. Pseudo-static tests were conducted on both specimens under constant axial compression. Subsequently, the seismic performance and force mechanism of the two specimens were compared with the novel precast concrete shear walls without infill walls. The test results demonstrated that the specimen with two infill wall panels exhibited superior overall performance compared to the one with a single continuous infill wall panel. Furthermore, it was observed that, during the loading process, the edge columns of specimens with infill walls provided the majority of the increased load-bearing capacity, while the infill walls made a limited contribution to the overall load-bearing capacity of the structures.

Pressure-Sensitive Capability of AgNPs Self-Sensing Cementitious Sensors.

Intelligent monitoring approaches for long-term, real-time digitalization in structural health monitoring (SHM) are currently attracting significant interest. Among these, self-sensing cementitious composites stand out due to their easy preparation, cost-effectiveness, and excellent compatibility with concrete structures. However, the current research faces challenges, such as excessive conductive filler, difficulties in filler dispersion, and insufficient stress sensitivity and instability. This study presents a novel approach to these challenges by fabricating self-sensing cementitious sensors using silver nanoparticles (AgNPs), a new type of conductive filler. The percolation threshold of AgNPs in these materials was determined to be 0.0066 wt%, marking a reduction of approximately 90% compared to traditional conductive fillers. Moreover, the absorbance test with a UV spectrophotometer showed that AgNPs were well dispersed in an aqueous solution, which is beneficial for the construction of conductive pathways. Through various cyclic loading tests, it was observed that the self-sensing cementitious sensors with AgNPs exhibited robust pressure-sensitive stability. Additionally, their stress sensitivity reached 11.736, a value significantly surpassing that of conventional fillers. Regarding the conductive mechanism, when encountering the intricate environment within the cementitious material, AgNPs can establish numerous conductive pathways, ensuring a stable response to stress due to their ample quantity. This study provides a significant contribution to addressing the existing challenges in self-sensing cementitious materials and offers a novel reference for further research in this domain.

Single-Leg Loading Test to Predict Time to Jog and Return to Sports after Acute Lateral Ankle Sprain in Competitive Athletes.

In a previous study, the utility of a single-leg loading (SLL) test after acute lateral ankle sprain (LAS) was reported. However, whether the severity level assessed by the SLL test is associated with the time to jog and return to sports (RTS) remains unclear. Therefore, this study aimed to examine whether the time to jog and RTS differ depending on the severity level. A total of 240 athletes after sustaining acute LAS were included in this study. The SLL test was performed at the first visit, and the patients were classified into four levels (Levels 1-4). The Steel-Dwass multiple comparison method and multiple regression analysis was performed to verify whether the SLL test can predict the time to jog and RTS. On examining the relationship between the severity levels assessed by the SLL test and time to jog and RTS, significant differences were found among almost all the severity levels. Moreover, the multiple regression analysis revealed that only the SLL test showed a significant correlation with both the time to jog and RTS. This study suggested that the time to jog and RTS can be predicted by conducting the SLL test for acute LAS and dividing the severity into four levels.

Neurotransmitters Disorders with Mild Hyperphenylalaninemia: The Ones That Should Not Be Missed.

Phenylalanine (PHE) is an essential amino acid. Dietary PHE converts to tyrosine by phenylalanine hydroxylase (PAH) activity. Phenylketonuria (PKU) is an autosomal-recessive disorder resulting from PAH enzyme deficiency. Elevations of PHE in plasma are classified based on the degree of enzyme deficiency into classic PKU (PHE≥1200 µmol/l), mild PKU (PHE>600 µmol/l and <1200 µmol/l), and non-PKU-hyperphenylalaninemia (HPA) or mild hyperphenylalaninemia (MHP) (PHE≤600 µmol/l). This is a single-center study of consecutive patients managed at the Pediatric Neurology Department and the outpatient clinic at Children's Welfare Teaching Hospital, Medical City, Baghdad, Iraq, from the 1st of October 2019 to the 1st of October 2020. Five patients were selected who were proven to have non-PKU-HPA (PHE<600 µmol/L) confirmed by the high-performance liquid chromatography analysis and assured to have sapropterin response by the sapropterin loading test which showed >30% decrease in PHE level. All patients presented with a neurological complaint, they were between three months and 15 years, and they were treated with sapropterin, Levodopa (L-Dopa), and 5-hydroxytryptamine (5-HT). The study included the demographic and clinical profile, biochemical response to sapropterin, and clinical response to treatment according to the development quotient. The five patients enrolled in this study had a gross motor developmental delay as their main symptom. One case also had a seizure and dystonia, another had a fluctuation of symptoms, four had a consanguineous marriage, and two had a family history of the same condition. Moreover, all cases had a higher than 30% decrease in PHE level by the tetrahydrobiopterin (BH4) loading test, and all of them showed significant clinical improvements after treatment except for one that showed only a moderate improvement. The BH4 therapy significantly enhanced dietary PHE tolerance and permitted a PHE-free medical formula to be discontinued in all patients with PHE within an achieved therapeutic target (120-300 µM]. MHP is not a mild disease as it may be related to neurotransmitter disorders. Sapropterin, L-DOPA, and 5-HT are always used for patients suspected of having neurotransmitter diseases, particularly those with MHP.

Use of Geopolymer and Carbon Fiber-Reinforced Polymer for Repairing Reinforced Concrete Deck Soffit.

This study aimed to assess the feasibility of utilizing geopolymer for repairing reinforced concrete beams. Three types of beam specimens were fabricated: benchmark specimens without any grooves, rectangular-grooved beams, and square-grooved beams. The repair materials employed included geopolymer material, and epoxy resin mortar, while carbon fiber sheets were used as reinforcement in select cases. The repair materials were applied to the rectangular and square-grooved specimens, with the carbon fiber sheets attached to the tension side of the specimens. To evaluate the flexural strength of the concrete specimens, a third-point loading test was conducted. The test results indicated that the geopolymer exhibited higher compressive strength and shrinkage rate compared to the epoxy resin mortar. Furthermore, the specimens reinforced with carbon fiber sheets demonstrated even greater strength than the benchmark specimens. In terms of flexural strength under cyclic third-point loading tests, the carbon fiber-reinforced specimens exhibited the ability to withstand over 200 cycles of repeated loading at 0.8 times the ultimate load. In contrast, the benchmark specimens could only withstand seven cycles. These findings highlight that the use of carbon fiber sheets not only enhances compressive strength but also improves resistance to cyclic loading.

Multiwall Rectangular Plates under Transverse Pressure-A Non-Linear Experimental and Numerical Study.

Large deflection of rectangular plates under transverse pressure is described by Föppl-von Kármán equations, which have only approximated solutions. One of these methods is the separation into a small deflection plate and a thin membrane described by a simple third order polynomial expression. The present study presents an analysis to obtain analytical expressions for its coefficients by using the plate's elastic properties and dimensions. To validate the non-linear relationship between the pressure and the lateral displacement of the multiwall plate, a vacuum chamber loading test is used to measure the plate's response, with a large number of plates and length-width combinations. In addition, to further validate the analytical expressions, several finite element analyses (FEA) were performed. It has been found that the polynomial expression fairly describes the measured and calculated deflections. This method allows the prediction of plate deflections under pressure as soon as the elastic properties and the dimensions are known.

Prevalence of primary aldosteronism in patients with concomitant hypertension and obstructive sleep apnea, baseline data of a cohort.

Obstructive sleep apnea (OSA) and primary aldosteronism (PA) often coexist in hypertension, whereas whether hypertensive patients with OSA should be screened for PA is controversial and whether gender, age, obesity and OSA severity should be considered is unexplored. We explored cross-sectionally prevalence and associated factors of PA in co-existent hypertension and OSA by considering gender, age, obesity and OSA severity. OSA was defined as AHI ≥5 events/h. PA diagnosis was defined, based on the 2016 Endocrine Society Guideline. We included 3306 patients with hypertension (2564 with OSA). PA prevalence was significantly higher in hypertensives with OSA than in those without OSA (13.2 vs 10.0%, P = 0.018). In gender-specific analysis, PA prevalence was significantly higher in hypertensive men with OSA, compared to non-OSA ones (13.8 vs 7.7%, P = 0.001). In further analysis, PA prevalence was significantly higher in hypertensive men with OSA aged <45 years (12.7 vs 7.0%), 45-59 years (16.6 vs 8.5%), and with overweight and obesity (14.1 vs 7.1%) than did their counterparts (P < 0.05). For OSA severity, men participants showed increased PA prevalence from non to moderate OSA and a decrease in the severe OSA group (7.7 vs 12.9 vs 15.1 vs 13.7%, P = 0.008). Young and middle age, moderate-severe OSA, weight, and blood pressure showed a positive independent association with PA presence in logistic regression. In conclusion, PA is prevalent in co-existent hypertension and OSA, indicating the need for PA screening. Studies are needed for women, older and lean population due to the smaller samples in this study.

A novel approach to evaluate the mechanical responses of elastin-like bioresorbable poly(glycolide-co-caprolactone) (PGCL) suture.

Poly(glycolide-co-caprolactone) (PGCL) has become a novice to the bioresorbable suture owing to the synergistic properties taken from the homo-polyglycolide (PGA) and polycaprolactone (PCL) such as excellent bioresorption and flexibility. In addition to under conventional monotonic loading, the understanding of mechanical responses of PGCL copolymers under complex loading conditions such as cyclic and stress relaxation is crucial for its application as a surgical suture. Consequently, the present work focuses on evaluating the mechanical responses of PGCL sutures under monotonic, cyclic, and stress relaxation loading conditions. Under monotonic loading, the stress-strain behavior of the PGCL suture was found to be non-linear with noticeable strain-rate dependence. Under cyclic loading, inelastic responses including stress-softening, hysteresis and permanent set were observed. During cyclic loading, both stress-softening and hysteresis were found to increase with the maximum strain. In multi-step stress relaxation, the PGCL sutures were observed to exhibit a strong viscoelastic response. In an attempt to describe the relationship between the stress-relaxation and strain-induced crystallization (SIC) occurring during the loading and relaxation processes, a schematic illustration of the conformational change of polymer chains in PGCL sutures was proposed in this work. Results showed that SIC was dependent on the strain level as well as the loading and relaxation durations. The inelastic phenomena observed in PGCL sutures can be thus correlated to the combined effect of stress relaxation and SIC.

Seismic Behavior of Concrete Columns Retrofitted with a Brace-Type Replaceable Steel Link.

This paper presents the results of a combined cyclic loading test on a single reinforced concrete column which was retrofitted with a newly proposed brace-type replaceable steel link. A total of four retrofitted reinforced concrete columns, with the length of the brace as a variable, were fabricated and tested. A companion column without retrofitting was used as the control specimen. The test results indicate that the proposed brace-type replaceable steel link can be effective in retrofitting the concrete columns, resulting in improvements in the strength, stiffness, and energy dissipation of columns. We observed that the maximum load increases by at least 87%, effective stiffness increases by 44%, and energy dissipation capacity increases by 91% when compared with non-retrofitted specimen.

The effect of surface treatments on the adhesive bond in all-ceramic dental crowns using four-point bending and dynamic loading tests.

The aim of this study was to determine the effect of sandblasting, grinding and plasma treatment on the adhesive bond strength between framework ceramic (Y-TZP) and veneering ceramic (feldspar ceramic). Therefore, four-point bending specimens (n = 180) were cut from densely sintered 3Y-TZP blanks. Subsequently, 80 of these samples received surface treatment by sandblasting and 80 samples by grinding. A reference group (20 samples) was not processed. Half of the specimens that received a surface treatment were additionally exposed to an oxygen plasma treatment. After processing, all specimens were manually veneered with feldspar ceramic and examined with a four-point bending test to evaluate the strain energy release rate G. The surface treatment parameters that achieved the highest and lowest G were transferred to real geometries of a posterior crown (n = 45). The crowns' ceramic framework was sandblasted and veneered by hand. The all-ceramic crowns were tested in a dynamic loading test and Wöhler curves were evaluated. Four-point bending samples blasted at an angle of 90° at 6 bar and a working distance of 1.5 cm without plasma treatment achieved the highest energy release rate. Samples blasted at an angle of 90° at 2 bar and a working distance of 1 cm with plasma treatment achieved the lowest energy release rate. Overall, plasma treatment did not improve bond strength. In the dynamic loading test, the group blasted with 2 bar showed the best results.

Influence of New Sleeve Composite on Fracture Behavior of Anterior Teeth with Flared Root Canals.

We evaluated the fracture strength and failure mode of non-ferrule teeth with flared root canals that were restored using new experimental sleeve composites. Fifty endodontically treated anterior teeth with flared root canals were restored with direct restorations utilizing different techniques. Group A had teeth (non-ferrule) restored using commercialized MI glass fiber post + Gradia Core as core build-up. Group B had teeth (non-ferrule) restored with commercialized i-TFC glass fiber post + sleeve system. In Group C, the teeth (non-ferrule) were restored with an experimental sleeve composite with commercialized MI glass fiber post and Gradia Core. Group D, teeth (non-ferrule), were restored using custom-made tapered E-glass filling post and Gradia Core. Group E, teeth (with ferrule), were restored with commercialized MI glass fiber post + Gradia Core. After core construction, all specimens underwent direct composite crown restoration and were loaded until fracture using a universal testing machine. Average fracture loads were compared, and the failure modes were observed. Group C exhibited significantly greater fracture strength than other groups (p < 0.05). Favorable fracture teeth ratio of group C was more than that of the other groups. Thus, the new experimental sleeve composite could be clinically useful for core construction of non-ferrule teeth.