Search Results (13,099)

Background: Dermatophilus congolensis, a Gram-positive actinomycete, is a well-known animal pathogen but a rare cause of human skin infections. Human dermatophilosis is an infection associated with tropical environments and animal contact that remains frequently underdiagnosed. Case Presentation: We report a case of recurrent folliculitis in a 34-year-old male Muay Thai fighter returning from Thailand to Spain. The patient presented with pustular lesions on his lower limbs following frequent leg shaving and close physical contact during training. Microbiological culture from skin swabs yielded beta-hemolytic colonies, identified as D. congolensis by MALDI-TOF MS. Identification was confirmed through Whole-Genome Sequencing (WGS), which also revealed an absence of antimicrobial resistance genes. Despite the lack of established EUCAST breakpoints, the isolate showed low MICs for most tested antibiotics. The patient was treated with doxycycline, although clinical follow-up was not possible due to travel. Conclusions: This case highlights D. congolensis as an emerging differential diagnosis for persistent folliculitis in travelers and athletes. Our findings suggest a potential horizontal transmission route through contact sports and fomites (e.g., mats) in high-humidity settings. Full article

This study proposes a reduced-complexity nonlinear model predictive control (NMPC) framework for high-performance path tracking of a four-wheel-drive (4WD) autonomous vehicle. A 4WD sports car equipped with four independent wheel motors is used as the test vehicle. Although the vehicle has four motors, the proposed NMPC directly optimizes the front-wheel steering command and the rear-left and rear-right wheel torque commands, while the front-wheel torques are generated using a gain-based virtual 4WD distribution law. Trajectory optimization (TRO) is performed offline to generate the reference racing line and velocity profile, while the online NMPC controller tracks the optimized reference trajectory using the front-wheel steering command and the rear-left and rear-right wheel torque commands as control inputs. This structure reduces the control complexity while maintaining the ability to improve traction utilization and yaw response. Under the investigated simulation conditions on the Shanghai International Circuit, the proposed reduced-dimensional NMPC with rear-dominant virtual 4WD torque distribution reduces the simulated lap time while maintaining bounded path-tracking errors and satisfying the track-boundary constraints. As the torque distribution gain K_r increases from 0 to 0.5, the lap time is reduced by approximately 10.3% (from 182.08 s to 163.30 s), while the maximum lateral tracking error remains below 0.33 m and the maximum heading-angle error remains below 2.95 deg for all stable cases. However, further increasing K_r beyond 0.5 leads to degraded tracking performance or loss of stable path following because excessive front-wheel longitudinal force reduces the available lateral tire force for steering. These results indicate that an appropriate torque distribution gain can improve corner-exit acceleration and overall lap-time performance, whereas excessive front torque assistance may degrade tracking accuracy and vehicle stability. Full article

Subway fire evacuations face severe challenges due to high passenger density, spatial unfamiliarity, and toxic smoke, which often render traditional static signage ineffective and cause chaotic congestion. To address this, we propose a drone-assisted evacuation strategy evaluated via a high-fidelity digital twin platform coupling PyroSim and AnyLogic. The developed human–fire-station interaction model integrates CO-induced physiological degradation and a binary logit model to capture bounded-rational decision-making and herding behaviors. Using the Suzhou Olympic Sports Centre Station as a case study, simulations reveal that spatial familiarity’s impact on spontaneous evacuation exhibits strict diminishing marginal returns. Under a realistic low-familiarity scenario (25%), unguided evacuation requires 312 s with severe bottlenecking. Drone guidance actively intercepts this chaos, slashing clearance time to 237 s—a 24.0% improvement in efficiency. Furthermore, aerial directives successfully transform panicked clusters into structured platoons, mitigating stampede risks and ensuring the safe egress of vulnerable demographics. This study provides robust quantitative evidence for integrating unmanned aerial systems into smart transit emergency management, serving as a high-fidelity virtual testbed for future evacuation drills. Full article

Urban vitality is a key indicator for characterizing the quality of urban space and the operational status of urban functions. However, existing studies still have limitations in multidimensional vitality measurement at the block scale, the representation of hierarchical differences in cultural facilities, and the coupling coordination diagnosis of multidimensional vitality. This study takes 2504 blocks in the central urban area of Nanjing as the basic analytical units and integrates multi-source geospatial data, including VIIRS nighttime light data, Baidu Huiyan population heat data, POIs, road networks, and water systems, to construct a three-dimensional urban vitality evaluation system encompassing economic, social, and cultural vitality. A Composite Nighttime Light Index (CNLI) is constructed by geometrically fusing VIIRS nighttime light data with the kernel density of industry- and consumption-related POIs to reduce the impact of the spatial generalization of nighttime lights on block-scale economic vitality measurement. Meanwhile, population heat data and cultural POIs are used to characterize social vitality and cultural resource supply, respectively, and PCA, a coupling coordination model, and spatial autocorrelation analysis are combined to identify the spatial structure of multidimensional vitality and the dominant factors of disorder. External reference variables are also introduced to conduct convergent validity verification. The results indicate that the comprehensive vitality of Nanjing’s central urban area exhibits a distinct “core agglomeration–multi-node diffusion” structure. High-vitality zones are primarily concentrated in Xinjiekou, Confucius Temple, Hunan Road–Zhongyang Road, Longjiang, and the Nanjing Olympic Sports Center, with localized vitality patches forming at peripheral commercial and transportation nodes. Both comprehensive vitality and coupling coordination degree exhibit significant positive spatial autocorrelation, with Moran’s I values of 0.8089 and 0.8372, respectively. The disorder types show distinct quantitative differences and spatial differentiation. Among these, blocks with lagging cultural vitality are the most numerous; peripheral new towns and newly developed residential areas are more prone to cultural vitality lag; areas surrounding scenic spots, universities, and large ecological spaces tend to exhibit economic vitality lag; and less developed peripheral blocks primarily exhibit comprehensive disorder. Based on accessible multi-source geospatial data, this study constructs a block-scale framework for measuring multidimensional urban vitality and diagnosing coordination status. This framework can provide a reference for vitality identification, functional shortcoming diagnosis, and refined spatial governance in Nanjing’s central urban area, and offer a case reference for historic and cultural cities with similar spatial structures. Full article

Background: The Ankle-GO is a composite score integrating physical, functional, and psychological recovery after lateral ankle sprain (LAS). Its psychometric properties have been validated prospectively, but no large-scale data describe how it is used in routine practice. We aimed to characterise real-world usage patterns, score distributions, and the gap between intended and actual clinical use. Methods: Retrospective observational analysis of all Ankle-GO web-application sessions recorded between 1 February and 31 December 2024. Patients with at least one valid session and a single injured ankle were included. Quantitative variables were summarised as mean (SD) or median (IQR); proportions are reported with 95% Wilson confidence intervals (CIs). No inferential testing was performed. Results: Of 8988 registered patients, 6934 (77.1%) were analysed; 88.5% were assessed after ankle sprain (mean age 26.0 ± 10.0 years; 92.5% in France). Only 14.0% of sessions were follow-ups. Injured-ankle scores were consistently lower than contralateral scores and improved modestly across sessions. Notably, 20.4% (95% CI 19.4–21.4) of patients had already returned to sport before their first assessment. Conclusions: Real-world Ankle-GO implementation diverges substantially from its intended prospective use, defining clear priorities for future standardised, outcome-driven studies. Full article

This study was developed within the framework of the GOLL (Green Olympic Living Lab and Environment Change) project, promoted by the Municipality of Coimbra, Portugal. The project uses the Mário Mexia Multisport Pavilion (MMMP) and the Olympic Swimming Pools Complex (OSPC) as living lab case studies for sustainability-oriented sports infrastructure management. The study combines a review of best practices in sustainable sports facilities with an applied case study focusing on infrastructure characterisation and the identification of intervention requirements (InRs). The review addresses the environmental, economic, and social dimensions of sustainable sports facilities, including energy and water efficiency, digital technologies, renewable energy integration, waste management, mobility, certification systems, and user inclusion. The adopted methodology integrates a literature review, technical inspections, and the analysis of building systems and resource consumption. The findings highlight the significant potential for improving operational performance, resource efficiency, and overall sustainability by adopting more integrated maintenance and management approaches. However, practical implementation remains dependent on overcoming challenges related to costs, data integration, and stakeholder engagement. The paper also discusses the potential adoption of integrated maintenance approaches, including the potential adoption of tailored digital management solutions and certification schemes, which may support more structured and proactive management. Within the GOLL living lab environment, this contributes to more informed technical, operational, and policy decision-making for the sustainable rehabilitation and management of sports facilities. Full article

Background: This pilot study examined differences in levels of obligatory exercise between two groups of adolescents: psychiatric patients diagnosed with eating disorders and youth engaged in qualified sports. Methods: The study included 45 adolescent psychiatric patients with eating disorders and 45 students training in sports departments (track and field, judo, gymnastics), aged 14–20 years. The sample comprised 50 women, 28 men, 10 non-binary participants, and two individuals who declined to identify their gender. The following instruments were used: the Eating Attitudes Test (EAT-26), Exercise Dependence Questionnaire (EDQ), Obligatory Exercise Questionnaire (OEQ), and Inventory of Physical Activity Objectives (IPAO). Between-group differences were analyzed using the Mann–Whitney U test. Most scales demonstrated acceptable internal consistency (Cronbach’s α > 0.70), although several scales showed lower reliability estimates. Results: Adolescents diagnosed with eating disorders showed significantly higher levels of problematic eating behaviours (rg = 0.94), exercise fixation (rg = 0.71), exercise commitment (rg = 0.33), withdrawal symptoms (rg = 0.52), exercise for weight control (rg = 0.83), and insight into problems (rg = 0.77) than athletes. In contrast, athletes reported higher levels of exercise for social (rg = 0.74) and health-related reasons (rg = 0.40). Effect sizes ranged from moderate to very large. These findings indicate marked differences in the psychological motives and compulsive characteristics of exercise between adolescents with eating disorders and athletes. Conclusions: This pilot study suggests that adolescents with eating disorders differ from athletes primarily in the psychological characteristics and motives underlying exercise rather than in exercise volume alone. These findings may help inform the assessment of problematic exercise in clinical practice, although they require confirmation in larger, adequately controlled studies. Full article

Background and Objectives: Accelerated rehabilitation after anterior cruciate ligament reconstruction (ACLR) is widely implemented, yet its definition and distinguishing characteristics remain inconsistently described in the literature. This scoping review examined how accelerated rehabilitation after ACLR is defined, described common protocol features, and identified elements distinguishing it from conventional rehabilitation. Materials and Methods: A scoping review was conducted using systematic searches of Medline (PubMed), Embase, and Web of Science from 1 April 1967 to 26 October 2025. Studies including patients aged 16 years or older who underwent primary ACLR that reported any form of accelerated rehabilitation or early progression relative to conventional protocols were eligible for inclusion. Results: Of 6002 screened records, 64 studies met the inclusion criteria. Accelerated rehabilitation was consistently characterized by early restoration of knee range of motion, early full weight-bearing, rapid gait normalization, early initiation of closed and open kinetic chain exercises, and avoidance of prolonged immobilization. However, definitions varied substantially across studies. Substantial heterogeneity was observed in progression timelines, bracing and crutch use, and return-to-sport criteria. Conclusions: Accelerated rehabilitation after ACLR appears to represent a brace-free, criterion-based, function-oriented approach emphasizing early restoration of knee extension, progressive loading, and individualized progression rather than simply shortened timelines. Establishing consensus definitions and standardized reporting is necessary to improve comparability across studies and facilitate translation into clinical practice. Full article

Background: Open fractures are traditionally associated with high-energy trauma, such as falls and traffic accidents, in healthy adults. However, the epidemiological characteristics of such injuries in children and adolescents remain incompletely defined. Most studies focus on long-bone injuries, while comprehensive epidemiological data across all anatomical regions are limited. This study aimed to analyze and provide an overview of age-dependent patterns of injury mechanisms and anatomical distribution in pediatric open fractures. Methods: This retrospective cohort study included all open fractures in patients aged 0–18 years treated at a level-I trauma center between 2002 and 2023. Demographic characteristics, injury mechanisms, anatomical distribution, treatment strategies, and complications were analyzed. Results: A total of 814 patients with 849 open fractures were included (mean age 10.5 ± 5.6 years; 67.7% male). Injury mechanisms differed significantly across age groups (p < 0.001), shifting from falls in infants and leisure-related injuries in younger children toward sports-related, traffic-related, and confrontation-related injuries in adolescents. Anatomical distribution also varied significantly with age (p < 0.001). Upper-extremity fractures predominated in younger children, whereas craniofacial fractures increased with age and became the leading anatomical region among adolescents aged 16–18 years (57.7%). Lower-extremity fractures also increased with age, although they accounted for a smaller proportion of fractures overall (14.4%). Across the entire cohort, open fractures most frequently involved the upper extremity (50.1%), followed by the craniofacial region (35.3%). Finger fractures represented the most common injury location (36.3%), followed by nasal fractures (20.6%). Most fractures were managed conservatively (66.8%), while 33.2% underwent surgical treatment. Complications were documented in 15.2% of patients, with surgical treatment required in 50.0% of these cases; septic complications mainly consisted of pin tract infections associated with external fixation. Persistent sequelae occurred in 4.9%, mainly including range-of-motion limitations and pain. Conclusion: Pediatric open fractures showed an age-dependent epidemiological pattern, with upper-extremity injuries predominating in younger children and craniofacial injuries increasing among adolescents. The substantial proportion of craniofacial and distal extremity fractures highlights the importance of considering the full anatomical spectrum of pediatric open fractures beyond long-bone injuries alone. Full article

Background and Objectives: Eccentric hypertrophy (EH) represents a common physiological cardiac adaptation in athletes, particularly in endurance disciplines. However, the biological correlates underlying EH and potential sex-specific differences remain poorly understood. This study aimed to investigate clinical, echocardiographic, and biochemical determinants of EH in a large cohort of elite athletes. Materials and Methods: We evaluated 2522 elite athletes undergoing pre-participation screening for Olympic competitions. Athletes were classified according to cardiac geometry into EH or normal geometry (NG) based on echocardiographic parameters. Clinical, anthropometric, echocardiographic, and biochemical variables were compared between groups. Univariate and multivariable logistic regression analyses were performed to identify independent predictors of EH. Results: EH was present in 601 athletes (23.8%) and was more prevalent in endurance sports (51.1% vs. 14.3%, p < 0.0001). Athletes with EH showed greater cardiac chamber dimensions and mass, with preserved systolic and diastolic function. Several biomarkers differed between groups, including higher AST, ALT, CPK, eosinophils, and HDL, and lower creatinine and TSH in EH (all p < 0.01). Following multivariable analysis, lower creatinine (OR 0.28, 95% CI 0.14–0.52, p < 0.0001), higher AST (OR 1.02, 95% CI 1.02–1.03, p < 0.0001), and higher eosinophil count (OR 1.12, 95% CI 1.06–1.20, p < 0.0001) independently predicted EH. The model showed moderate discrimination (AUC 0.72). Sex-stratified analyses showed different biomarker associations with EH in men (creatinine and AST) and women (eosinophils and HDL), with similar model performance (AUC 0.71 vs. 0.73). Conclusions: EH in elite athletes is associated with distinct biological signatures reflecting multiple physiological pathways. Notably, sex-specific patterns emerge, suggesting different mechanisms underlying cardiac adaptation in male and female athletes. Full article

Background: Artificial intelligence (AI) is being increasingly used in educational and mental health contexts, yet many emotion-related applications still prioritize detection, classification, and automated feedback over contextual understanding. This study uses the Stanford AI Index Reports (2021–2025) as an exploratory discourse corpus to examine how prominent AI reports frame technology, application domains, and governance, and to consider what this framing implies for emotion regulation through sport and exercise in higher education. Methods: Across 1813 report pages, we applied BERTopic with multilingual sentence embeddings (paraphrase-multilingual-MiniLM-L12-v2), UMAP dimensionality reduction, HDBSCAN clustering, and class-based TF-IDF, followed by dynamic and hierarchical topic analysis and theory-informed synthesis. Of 22 topics generated, 13 relevant to the study focus were retained and validated through keyword inspection, representative-text review, and independent expert agreement. Results: The analysis indicated a three-layer structure: a technology core, an application-expansion layer, and an ethics-and-governance layer. Health and education themes grew most across reports, with medicine/health rising from 14 to 105 and school pathways from 3 to 105 segment occurrences between 2021 and 2025, whereas sport, exercise, embodied activity, and campus support appeared only indirectly. As prominence reflects raw frequency across five reports, trends are read descriptively. Conclusions: We propose a human–technology–environment framework comprising multimodal contextual profiling, autonomy-supportive task adaptation, feedback–reflection–practice loops, peer and campus support integration, and human-in-the-loop governance. The study does not test intervention effects; its contribution is conceptual and agenda-setting, clarifying a gap between mainstream AI discourse and the embodied, relational, and ecological conditions through which sport and exercise may support students’ emotion regulation. Full article

With the advancement of healthy city development, optimizing the spatial allocation of urban parks has become a key issue in territorial spatial planning. However, existing studies mainly focus on accessibility and spatial equity, with limited attention to multidimensional suitability assessment and coordinated optimization based on public health needs. Taking Jinjiang City, Fujian Province, China, as a case study, this study used ArcGIS 10.8-based spatial analysis and multi-source geospatial data to classify urban park scenarios into eight categories based on public health needs: child-friendly, elderly wellness, rehabilitation and therapeutic, camping and leisure, cultural and creative, science education, scenic check-in, and outdoor sports. A four-dimensional framework integrating ecological, population vitality, accessibility, and health service function suitability was established to evaluate the suitability between park scenarios and public health needs. The results show that park scenarios exhibit significant spatial clustering with marked north–south and urban–rural disparities. Overall suitability is low, although high-density areas show better population–park matching, while health service facilities remain unevenly distributed. Based on multidimensional coordinated analysis, the 330 scenarios across 81 parks were classified into coordinated advantage, improvement, and potential zones, supporting differentiated spatial optimization and zonal governance. The proposed framework provides theoretical and practical support for health-oriented urban park planning and territorial spatial optimization. Full article

Background: COVID-19, a global pandemic, has had a profound impact on the world, overwhelming healthcare systems worldwide. These disruptions were associated with significant disparities in healthcare access to routine consultations and elective surgeries, adversely affecting patient health and altering injury patterns in emergency departments. This retrospective observational study aims to compare patient profiles and treatment during the pandemic compared to the pre-pandemic period. Methods: Patients admitted to the orthopaedic and traumatology department before, during, and after the COVID-19 pandemic. The full (unmatched) cohort comprised 8413 patients (6175 before, 1188 during, and 1050 after the pandemic). To ensure balanced comparisons, propensity score matching (1:2, based on age, sex, and comorbidities) was applied separately to the during- and after-pandemic groups, each matched against pre-pandemic controls. Collected information incorporated demographics, comorbidities, and injury circumstances. Results: After matching, the during-pandemic group (1188 patients) was compared with 2376 pre-pandemic controls, and the after-pandemic group (1050 patients) with 2100 pre-pandemic controls. A higher proportion of same-region re-injuries was observed during and after the pandemic, as well as higher medical leave during the pandemic and post-pandemic, and longer hospital stays of over 10 days during the pandemic and post-pandemic. Injury patterns changed, with an increase in lower leg injuries and a decrease in wrist injuries during the pandemic. Additionally, the proportion of open wounds was lower during the pandemic. Conclusions: The pandemic and post-pandemic periods were associated with marked changes in trauma care, including more conservative treatment, fewer surgeries, and longer hospital stays. Same-region re-injuries were more frequent and sports-related injuries less frequent—patterns that temporally coincided with the periods of repeated lockdowns. Notably, differences persisted into the post-pandemic period. Given the retrospective, observational design, these findings represent associations rather than causal effects. Full article

Background: Marathon running triggers a robust systemic inflammatory response. Whether habitual dietary fat composition modulates pre-race cytokine concentrations or the magnitude and recovery of the exercise-induced inflammatory response remains unknown. Methods: Thirty-one recreational marathon runners (58.1% female; mean age 38.4 ± 10.2 years) completed the Diet History Questionnaire III to assess habitual dietary fat intake—including chain-length-specific SFA, MFA, PFA, trans fatty acids, and CLA—over the preceding three months. Circulating IFN-γ, IL-1β, IL-4, IL-6, IL-10, and TNF-α were measured pre-race, immediately post-race, and 48 h post-race. Repeated measures ANOVA examined cytokine changes; multivariable regression models estimated fat–cytokine associations adjusted for 11 pre-specified covariates, with Benjamini–Hochberg FDR correction applied across all models. Results: IL-6 rose markedly post-race (p < 0.001, generalized η² = 0.615) before returning to pre-race levels by 48 h. IL-10 followed a similar trajectory (p < 0.001, generalized η² = 0.346). TNF-α showed a borderline non-significant trend (p = 0.056); IFN-γ, IL-1β, and IL-4 did not change significantly. MFA 20:1 was positively associated with IFN-γ concentrations at 48 h post-race (β = 13.66; 95% CI: 8.94, 18.38, p < 0.01, q = 0.04) and TNF-α (β = 9.14; 95% CI: 6.43, 11.86, p < 0.01, q = 0.02). Conclusions: Habitual intake of the long-chain monounsaturated fatty acid 20:1 was positively associated with IFN-γ and TNF-α at 48 h post-race. This pattern, emerging specifically at the 48 h post-race phase, suggests that the post-race period, once acute exercise-induced signaling has subsided, may be a window in which habitual dietary fat quality is most detectable in relation to circulating cytokines. Habitual fat quality may warrant consideration in future endurance recovery nutrition research. This exploratory finding calls for replication in larger cohorts. Full article