Active fault reactivation poses significant hazards, and understanding their near-surface structure is crucial for mitigating seismic risk. Along the Balakot-Bagh fault (BBF), the source of the 2005 Mw 7.6 Kashmir earthquake, geomorphic evidence is gradually eroded and sedimented. Traditional Electrical Resistivity Tomography (ERT) often produces smoothly varying tomograms that obscure sharp structural boundaries. This study introduces an integrated interpretation framework that combines geological mapping, high-resolution ERT imaging, and machine learning (ML) k-means clustering to improve characterization of the BBF's shallow deformation zone at Sar Pain (S1) and Naushahra (S2), Pakistan. Geological surveys at S1 document numerous NW-SE-trending coseismic rupture strands with vertical displacements of 0.1-3 m, defining an actively deforming damage zone, while at S2, no surface rupture is preserved due to thick alluvial cover. Inverted ERT models at both sites reveal low-resistivity anomalies associated with fractured, water-saturated materials and fault gouge; however, conventional inversions smooth sharp resistivity gradients, limiting structural interpretation. Applying k-means clustering as a post-inversion segmentation tool transforms continuous resistivity fields into discrete lithological and structural domains. The Elbow method is used to determine the optimal number of clusters to improve interpretability. The clustered models sharpen structural discontinuities, delineate fault cores and subsidiary strands at S1, and reveal concealed deformation at S2 where surface evidence is absent. This integrated interpretation framework significantly enhances the resolution and interpretability of near-surface fault architecture within a crustal-scale thrust system. The approach is particularly effective for imaging buried fault segments and has important implications for seismic hazard assessment and land-use planning.

BackgroundTennis elbow is a common musculoskeletal condition that causes discomfort and functional limitations in the wrist extensors. Manual therapy techniques including neural mobilization, Mulligan, and Maitland mobilization are commonly used to relieve pain and improve upper limb function, but their relative usefulness is unknown.ObjectiveTo compare between three manual therapy approaches (radial nerve mobilization, Mulligan and Maitland mobilization) to find their effectiveness when they were added to eccentric exercises in patients with tennis elbow. Study Design: Single-blinded, randomized, controlled trial.MethodsForty-five tennis elbow participants were randomly allocated into three groups (n = 15 each): Group A received radial nerve neural mobilization, Group B received Mulligan mobilization (MWM), and Group C received Maitland mobilization. Interventions were implemented over six weeks. Pain intensity, Pressure Pain Threshold (PPT), functional disability, and hand grip strength were measured before and after intervention.ResultsBetween-group comparison showed no statistically significant differences in post-treatment scores for Pain intensity (p = 0.10), PPT (p = 0.45), functional disability (p = 0.16), and grip strength (p = 0.75). However, the radial nerve neural mobilization group had a greater mean reduction in pain intensity (Pre- post: 4.6-1.8) and improved grip strength (Pre-post:26.65-31.14 kg) compared to the other groups; this difference is numerically greater but statistically insignificant.ConclusionsMaitland, Mulligan, and neural mobilization approaches are effective in reducing pain and enhancing upper limb function in patients with tennis elbow. Neural mobilization may provide numerically greater therapeutic benefits, but further research with larger sample size and long-term follow-up is needed.

The use of orthobiologic augmentation, including platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC), has gained increasing attention in rotator cuff repair; however, evidence supporting their combined use remains limited and inconsistent. This prospective randomized controlled study evaluated the clinical efficacy of PRP and combined PRP with BMAC (BMAC + PRP) following arthroscopic repair of large full-thickness rotator cuff tears (3-5 cm). A total of 93 patients were allocated into three groups: control (n = 33), PRP (n = 30), and BMAC + PRP (n = 30). Clinical outcomes were assessed using the American Shoulder and Elbow Surgeons (ASES) score (primary outcome), visual analogue scale (VAS), and Constant score at baseline, 3 months, and 6 months. To address baseline imbalances, propensity score-based overlap weighting (ATO) and weighted ANCOVA were performed. All groups demonstrated significant improvement in pain and functional outcomes over time. In unadjusted analyses, early differences were observed at 3 months; however, after adjustment using overlap weighting and baseline covariates, no statistically significant differences were observed between groups at 6 months for ASES, VAS, or Constant scores. Exploratory age-stratified analyses suggested potential trends toward improved outcomes in patients aged > 55 years in the BMAC + PRP group, although these findings were attenuated after adjustment and should be interpreted cautiously. These findings indicate that, despite theoretical biological complementarity, the addition of BMAC to PRP does not confer clinically meaningful short-term benefit after repair of large rotator cuff tears. The results challenge the assumption of additive efficacy in combined orthobiologic strategies and underscore the need for biologically stratified trials to identify patient subsets that may derive benefit. Longer-term and mechanistically integrated studies are required to define the role of combined biologic augmentation in tendon regeneration.Trial registration: The patients were registered in the institutional board registry of Hallym University Medical Center (registry number 138-82-02667). The study was registered with the International Standard Randomized Controlled Trial Number (ISRCTN) 69,088,783.

Simultaneous ipsilateral elbow and shoulder dislocations without associated fracture or other injury are extremely rare injuries. To date, there have been no such recorded injuries that include a posterior shoulder dislocation per a review of PubMed databases. This case involves an otherwise healthy 28-year-old male who sustained a simultaneous posterior left elbow dislocation with a posterior left shoulder dislocation without any other associated injury/fracture in a softball incident. Both joint dislocations were managed conservatively with bedside reduction of the elbow, followed by the shoulder and subsequent sling application. Given that the pain from the elbow can mask shoulder injuries, we recommend a high index of suspicion for concomitant injuries of adjacent structures when patients present with an elbow dislocation.