Purpose Chronic scapholunate interosseous ligament injuries contribute significantly to wrist instability. Surgical management remains challenging, with tendon graft-based reconstruction and dorsal capsulodesis being the most common techniques. This systematic review aimed to compare the clinical and radiographic outcomes of capsulodesis-based versus tendon graft techniques for chronic scapholunate ligament injuries. Methods This systematic review was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of PubMed, Web of Science, Scopus, and Cochrane Library identified eligible comparative studies. Studies comparing tendon graft techniques and dorsal capsulodesis for chronic scapholunate interosseous ligament injuries in adults were included. The Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool was used for quality assessment. Because of data heterogeneity and lack of consistent quantitative metrics (eg, means and standard deviations), a narrative synthesis of results was performed. Results Across six included studies encompassing 298 patients, tendon graft and tenodesis techniques demonstrated variable postoperative outcomes. Notable heterogeneity existed within the tendon graft/tenodesis category itself: modified Brunelli tenodesis outperformed the four-bone weave in pain relief (visual analog scale reduction 4.8 cm vs 3.2 cm), grip strength, range of motion (ROM) preservation (86% vs 60%), and Disabilities of the Arm, Shoulder, and Hand (DASH) score improvement (31.5 vs 14.2 points). Scapholunate intercarpal ligament similarly outperformed three-ligament tenodesis across grip strength, ROM (113° vs 82°), and patient-reported outcomes. Dorsal capsulodesis provided consistent pain relief, adequate ROM preservation, and lower surgical failure rates in most series, with no statistically significant differences in patient-reported outcome measures compared to tenodesis groups. Radiographic deterioration was observed across all surgical techniques over long-term follow-up without consistent correlation with clinical symptoms. Overall certainty of evidence was very low per Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment. Conclusions Neither tendon graft nor capsulodesis techniques demonstrated consistent superiority; outcome differences were more pronounced within technique subcategories than between groups, highlighting the need for standardized, high-quality prospective trials. Clinical relevance Tendon graft reconstruction and dorsal capsulodesis show comparable outcomes for chronic scapholunate ligament injury. Surgical choice should be individualized based on patient factors, injury characteristics, and surgeon expertise. Given the very low certainty of current evidence, standardized outcome reporting and further high-quality prospective studies are needed.
The electrification of cargo-handling equipment has become increasingly important for reducing the environmental impacts of port operations. However, selecting an appropriate electric reach stacker is a complex procurement decision involving multiple operational, environmental, and technical criteria, often evaluated using incomplete and heterogeneous performance data. This study develops an integrated spherical fuzzy Multi-Criteria Decision-Making (MCDM) framework to support this decision. The proposed framework combines Spherical Fuzzy Delphi (SF-Delphi), K-means clustering, and the Spherical Fuzzy Mixed Aggregation by COmprehensive Normalization Technique (SF-MACONT), which incorporates multiple normalization procedures. Methodologically, the study introduces a spherical fuzzy score function that explicitly accounts for hesitation when processing expert assessments. It also integrates criteria refinement, uncertainty modeling, alternative ranking, and robustness evaluation within an integrated decision-making framework. The applicability of the proposed approach is demonstrated through a real-world case study at a Mediterranean port in Türkiye. Drawing on manufacturer performance reports and expert evaluations, five electric reach stackers are assessed against 11 criteria. The results identify energy efficiency, carbon footprint, and compliance with emission standards as the most influential criteria, while Kalmar emerges as the preferred alternative. Sensitivity analysis, rank-reversal testing, and comparisons with state-of-the-art spherical fuzzy MCDM methods confirm that the resulting recommendation remains stable across the scenarios examined.
Ultra-precision machining of silicon underpins semiconductor, optical and MEMS manufacturing, yet atomistic predictions remain highly sensitive to the interatomic potential employed. Here, seven popular interatomic potentials of silicon were benchmarked for thermal, cohesive, stacking-fault and tensile properties, with five carried through detailed dislocation and nanometric-cutting analyses and compared against TEM characterisation of ground silicon. The predicted responses vary markedly: apparent one-phase thermal-instability temperatures span 2309–3427 K, the unstable stacking-fault energies associated with the first {111} glide-set Shockley-partial displacement range from 1.918 to 2.948 J m−2, and Young's moduli vary from 65.06 to 99.93 GPa. Fitted dislocation-core energies, i.e., Ec(110) differ by almost a factor of six, from 0.1109 to 0.6398 eV Å−1. These differences translate into distinct stress-accommodation pathways during cutting. ABOP (Erhart and Albe) and classical Tersoff revealed localised deformation within narrow transformed/disordered subsurface regions, Stillinger–Weber activates transient dislocation-mediated plasticity, Screened ABOP promotes extensive disorder-mediated accommodation, and Kumagai exhibits an intermediate response. TEM observations of ground silicon revealed coexisting amorphisation, {111} stacking faults and partial-dislocation activity, supporting a mixed-mechanism picture of machining-induced damage. The results show that predictive atomistic simulations of silicon machining require mechanism-specific potential selection rather than validation against a single bulk property.
Dengue, an Aedes mosquito-borne viral infection, is on the rise with climate and demographic change. In 2023, WHO declared dengue its highest grade of emergency, following the largest number of cases and deaths in recorded history. This emergency highlighted the absence of safe and effective dengue-specific treatments as a gap in the product landscape for care for people with dengue. To accelerate development of dengue-specific treatments for wide implementation and access in all dengue-endemic countries, WHO conducted a landscape analysis of the dengue therapeutics pipeline and convened a global expert and public consultation to develop target product profiles for treatments for non-severe and severe dengue. These target product profiles provide strategic guidance for product developers, regulators, procurement agencies, and funders on the intended use, target populations, and key product characteristics of dengue-specific treatments required to meet public health needs, setting clear targets to drive development of dengue drugs accessible to those who need them the most.
Accurate simulation and projection of precipitation extremes are critical for climate adaptation planning. This study aims to evaluate the performance of the Coupled Model Intercomparison Project Phase 6 (CMIP6) Global Climate Models (GCMs) in simulating extreme precipitation and to project future changes in the Jemma subbasin. Daily precipitation data from seven meteorological stations in subtropical and temperate agroecological zones (AEZs) were used to evaluate CMIP6 GCM performance based on ten precipitation extreme indices. The top-performing GCMs were selected based on their skill assessed through the Comprehensive Rating Index (CRI). The GCMs were then used to project changes under three greenhouse gas emission scenarios (SSP24.5: medium emissions, SSP3-7.0: high emissions, and SSP5-8.5: very high emissions) for near (2030-2049), mid (2060-2079), and far future (2080-2099) periods relative to 1995-2014. The selected 8 GCMs demonstrated moderate skill, with CRI values ranging from 0.29 to 0.78 in the subtropical AEZ and 0.44 to 0.80 in the temperate AEZ. Indices such as Rx5day (multi-day maximum rainfall) and R10mm (heavy rainfall frequency) were captured more reliably than dry-spell metrics like consecutive dry days (CDD). Projections reveal notable variability in extreme precipitation across scenarios, periods, and AEZs. In the subtropical AEZ, R10mm and R20mm are projected to rise by 1.57 and 0.28 days/year, respectively, under SSP3-7.0 (near-term). Rx5day is expected to increase by 1.5 mm (SSP2-4.5, far-term) and 1.54 mm (SSP3-7.0, mid-term), while R95p (very wet day precipitation) rises by 7.51 mm (SSP3-7.0, near-term). In the temperate AEZ, mixed trends are observed: Rx1day increases by 0.88 mm (SSP5-8.5, far-term), Rx5day rises by 1.5 mm (SSP3-7.0, mid-term), but drops by 1.29 mm (SSP2-4.5, far-term). R95p generally trends upward, although a 5.36 mm decline occurs under SSP3-7.0 (near-term). Annual total wet-day rainfall (PRCPTOT) and SDII (simple daily intensity index) mostly increase, though occasional SDII declines suggest heightened uncertainty. The projected changes in precipitation extremes suggest increasing challenges for agricultural systems and water resource management, underscoring the need for climate-resilient planning in the Jemma sub-basin.
