Search Results (387)

Background: Large language models (LLMs) are being used by surgeons for education and reference yet concerns about hallucinations and reliability limit safe adoption. Retrieval-augmented generation (RAG) can offer a potential solution by grounding responses in a high-quality external database (e.g., medical textbooks) to enhance accuracy. However, performance tradeoffs across different RAG configurations—many of which exponentially increase computational cost—remain poorly characterized. Methods: In total, 120 lightweight, open-source RAG configurations were evaluated across 40 plastic surgery-focused question-answering tasks (20 single-hop, 20 multi-hop), spanning multiple subspecialties (4800 total evaluations). Configurations varied by base LLM (Phi-3-mini-128k-instruct vs. BioMistral-7B), embedding model, database size, chunk size, and query hop type. Performance was assessed using semantic similarity (Ragas) to physician-validated reference answers. Performance was analyzed using linear mixed-effects regression with query as a random effect and fixed and interaction effects selected via likelihood testing and AIC. Results: High performance was achievable using lightweight, open-source models. While BioMistral-7B had high mean sematic similarity under specific configurations (mean semantic similarity up to 0.786), Phi-3-mini-128k-instruct demonstrated more consistent performance across query complexity. Larger database sizes significantly improved semantic similarity, with the largest gain at intermediate sizes (e.g., size 5: +0.043, p = 0.001). Embedding choice had a strong effect, with bge-large-en-v1.5 improving performance (p = 0.0016) and Bio_ClinicalBERT markedly reducing it (p < 0.001). Multi-hop queries substantially reduced performance (p < 0.001), though this effect was attenuated for Phi-3-mini-128k-instruct via a strong model × hop-type interaction (p < 0.001). Conclusions: RAG systems for plastic surgery do not require large proprietary models, as performance depends on configuration choices and interaction effects rather than isolated components. With advancements, predictive modeling may enable resource-efficient, safe deployment of clinical RAG systems. Full article

Large Language Models (LLMs) have demonstrated superior abilities in complex tasks such as text generation, reasoning, and question answering. However, the explainability of LLMs becomes weak as the parameters and complexity of LLMs increase. Chains of Thought (CoTs) guide the model to perform step-by-step reasoning and effectively enhance its reasoning ability. The multi-step rationales verbalized in a CoT are widely regarded as the explanation of the model itself. This paper proposes an automated approach to testing the behavioral sensitivity of responses to self-cited evidence in CoTs from sufficiency and necessity perspectives under context intervention. Specifically, we intervene in the reasoning chain by changing the input context and measure the behavioral consistency as a proxy for the faithfulness of the CoT. We test the CoT rationales of mainstream open-source LLMs on multi-hop question-answering tasks. The experimental results show that the self-stated reasoning chain is insufficient and unnecessary. The CoT cannot fully explain the behavior of LLMs. Full article

Background and Objectives: Throughout the return-to-play process after anterior cruciate ligament reconstruction (ACLR), clearance criteria and limb symmetry indices (LSI) play an important role in clinical decision-making by helping evaluate patient readiness and informing safe activity progressions, with the goal of reducing re-injury risk. How clearance criteria are implemented in research studies to evaluate patient readiness, specifically in force plate jumping studies, is currently unknown. This scoping review was a focused examination of clearance criteria and limb symmetry indices in studies performing force plate-based jumping assessments with ACLR patients. The research questions guiding this scoping review were as follows: (1) What clearance criteria are reported in studies involving primary ACLR patients who participate in jumping assessments on force plates? (2) What LSI are reported in force plate studies, and what level of symmetry is deemed acceptable to allow for safe participation of ACLR patients who participate in jumping assessments of force plates? Materials and Methods: Nine databases were searched on 7 or 8 September 2024 for three concepts: ACLR, force plates, and movement properties. Inclusion criteria were as follows: (a) primary ACLR patients at least 6 months post-surgery; (b) performing a countermovement or drop jump; (c) collecting at least one kinetic parameter using a force plate. Clearance criteria was operationally defined as a time from surgery boundary, functional or performance-based testing criteria, medical evaluation, or completion/participation in a rehabilitation program. Results: Thirty-five studies were included. Time from surgery was the most frequently reported clearance criteria (26/35; 74.3%), followed by medical evaluation (18/35; 51.4%), and completion of rehabilitation (10/35; 28.6%). Use of LSI as clearance criteria was limited (5/35; 14.3%). Minimum required LSI ranged from 85 to 90% in quadriceps strength and hop testing. Conclusions: Clearance criteria varied by jump type and post-surgical time frame when the participant was tested. Standardized rehabilitation was common prior to 2 years post-surgery, whereas medical clearance was common after 2 years post-surgery. Single leg jumps typically required 2–3 clearance criteria, whereas double leg jumps required 1–2 clearance criteria. Limb symmetry indices were used in combination with two other clearance criteria in studies with single-leg countermovement or drop jumps. Improvements in clearance criteria and adverse event reporting may help improve patient safety and interpretation of findings across studies. Full article

The brewing process generates substantial by-products rich in potentially bioactive compounds (e.g., polyphenols and fermentation metabolites), providing a sustainable and appealing source of cosmetic ingredients. Oil-in-water (O/W) emulsions containing 20% (w/w) aqueous extracts from Bionda Triplo Malto beer, wort, and key brewing by-products (hops, yeast, and spent grain) were developed and evaluated using a combined in vitro–in vivo approach. Aqueous extracts were first screened on human immortalized dermal fibroblasts (BJ-5ta) at 0.25–1 mg/mL for cytocompatibility and antioxidant activity. Within this concentration range, no significant changes in cell viability or intracellular antioxidant capacity under UV stress were detected, suggesting cytocompatibility but limited inherent activity. When incorporated into O/W emulsions and tested at an active-equivalent concentration of 10 mg/mL, the formulations increased fibroblast metabolic activity and antioxidant response. In contrast, free extracts at 10 mg/mL showed concentration-dependent cytotoxicity for some matrices, with beer- and yeast-based emulsions demonstrating the strongest effects. The emulsions exhibited good physicochemical stability (pH ~5.7–6.2; viscosity 4750–5150 mPa·s), passed the ISO 11930:2012 challenge test, and were well tolerated in patch testing. In a double-blind, randomized split-forearm study on 50 healthy volunteers over 30 days, beer, yeast, and spent grain-based formulations improved skin parameters versus baseline. TEWL decreased (e.g., beer: 16.22 ± 5.12 to 10.77 ± 2.22 mg·m⁻²·h⁻¹; yeast: 16.29 ± 5.66 to 10.18 ± 1.08; spent grain: 14.45 ± 4.34 to 11.66 ± 2.28), hydration increased (beer: 35.15 ± 5.93 to 42.26 ± 3.78; yeast: 33.27 ± 4.87 to 42.92 ± 2.48; spent grain: 34.22 ± 5.19 to 41.16 ± 3.17, and elasticity improved for beer and yeast formulations (62.33 ± 3.27 to 70.24 ± 2.12 N/m) and yeast (61.21 ± 4.72 to 72.13 ± 5.55 N/m). Based on these findings, brewing-derived ingredients demonstrate potential as cosmetic actives, with formulation critically determining their clinical efficacy. Full article

Atopic dermatitis (AD) is associated with skin microbiota dysbiosis, particularly the overgrowth of Staphylococcus aureus (SA) and Staphylococcus epidermidis (SE), which contribute to inflammation and barrier disruption. Humulus lupulus (hop) extracts contain bioactive compounds with antimicrobial potential. This study aimed to evaluate, in vitro, the antimicrobial and anti-biofilm effects of hop extract, obtained from brewing industry waste, against SA and SE strains relevant to AD. The extract was produced using a food-grade ethanolic extraction, chemically characterised, and tested for antimicrobial activity and biofilm inhibition using standard in vitro assays. The extract contained humulone, lupulone, and xanthohumol and complied with microbiological quality requirements. The MIC was 0.129% (w/v) for both strains; the MLC was 0.515% for SA and 1.030% for SE. Biofilm inhibition was significant for SA at MIC, whereas SE required 5× MIC (p < 0.05). Humulus lupulus extracts obtained from brewing waste demonstrate effective antimicrobial and anti-biofilm activity, supporting their potential as sustainable agents for modulating skin microbiota in AD management. Full article

Background: Restricted ankle dorsiflexion is common in basketball athletes and has been associated with altered lower-limb mechanics and reduced athletic performance. Although ankle joint mobilization is widely used to improve mobility, its effects on athletic performance remain unclear. The aim of this study was to examine whether adding posterior ankle joint mobilization to a structured exercise-based program incorporating eccentric strengthening and stretching improves ankle mobility and athletic performance in basketball athletes with restricted dorsiflexion. Primary outcomes were dorsiflexion range of motion (DF-ROM) and the Weight-Bearing Lunge Test (WBLT); secondary outcomes included jump performance, hop tests, Reactive Strength Index, Fatigue Index, and maximal isometric strength. Methods: In this randomized controlled trial, 38 basketball athletes (mean age 21.26 ± 2.52 years) with unilateral restricted ankle dorsiflexion were randomly allocated to an exercise-only group (n = 19) or to an exercise plus talocrural mobilization group (n = 19). The intervention lasted 5 weeks, with assessments performed at baseline, post-intervention, and at a 3-month follow-up. Results: Both groups improved ankle dorsiflexion; however, greater gains were observed in the intervention group for both dorsiflexion range of motion (DF-ROM; interaction p < 0.001; mean difference [MD] = 3.52° post-intervention and MD = 5.17° at follow-up) and the Weight-Bearing Lunge Test (WBLT; interaction p < 0.001; MD = 1.39 cm and MD = 1.34 cm, respectively). The intervention group showed superior improvements in countermovement jump and Triple Hop Test performance (both p < 0.001), as well as a small but statistically significant advantage in the Single Hop Test (p = 0.015). No between-group differences were found for the 6 m timed hop test, Reactive Strength Index, Fatigue Index, or maximal isometric strength (p > 0.05). Conclusions: Adding ankle joint mobilization to an eccentric strengthening and stretching program produced greater improvements in dorsiflexion and jump performance than exercise alone, without affecting speed, reactive ability, or maximal strength. Ankle mobilization may be a useful adjunct for improving functional mobility and selected performance outcomes in basketball athletes. Full article

Humulus lupulus L. (hops) is best known for its application in the brewing industry; however, growing scientific interest has revealed its high content of natural antioxidants, including flavonoids and polyphenols. These compounds exhibit pronounced anti-inflammatory activity, positioning hops as a promising plant-derived ingredient for cosmetic use. The present study evaluates the antioxidant properties of Humulus lupulus L. (HL) extract and cosmetic formulations loaded with hop-based active substances. Antioxidant capacity was determined using ABTS, Folin–Ciocâlteu, and FRAP methods. The hop extract showed limited free radical scavenging activity and reducing power; however, these results still confirm its antioxidant potential. Importantly, cosmetic emulsions enriched with the HL extract maintained substantial antioxidant activity, demonstrating successful incorporation and stability of the bioactive compounds within the formulations. Physicochemical stability tests, including pH monitoring and visual evaluation during storage, indicated good stability under different conditions. In vivo studies confirmed the effectiveness of cosmetics containing HL extracts as natural anti-irritant agents, demonstrated by a 10% reduction in erythema after a three-week application period. These findings provide evidence supporting the use of Humulus lupulus L. in the development of plant-based cosmetic products designed to improve the health of skin prone to irritation. Full article

Unmanned Aerial Vehicles (UAVs) have made significant advancements in communication stability and security through techniques such as frequency hopping, signal spreading, and adaptive interference suppression. However, challenges remain in modeling spectrum competition, integrating expert knowledge, and predicting opponent behavior. To address these issues, we propose UAV-FPG (Unmanned Aerial Vehicle–Frequency Point Game), a game-theoretic environment model that simulates the dynamic interaction between interference and anti-interference strategies of opponent and ally UAVs in communication frequency bands. The model incorporates a prior expert knowledge base to optimize frequency selection and employs large language models for episode-level opponent trajectory generation and planning within UAV-FPG, serving as an operationally more challenging simulator adversary for stress-testing anti-jamming policies under our evaluation protocol. Experimental results highlight the effectiveness of integrating the expert knowledge base and the large language model: relative to fixed-path baselines, iterative feedback-conditioned LLM planning tends to generate more adaptive trajectories and achieve higher opponent rewards in UAV-FPG. These findings are confined to the proposed simulation environment and are not intended as general claims about real-world jamming capability or onboard planning performance. UAV-FPG provides a robust platform for advancing anti-jamming strategies and intelligent decision-making in UAV communication systems. Full article

Background: The purpose of this study was to examine the effects of an 8-week core training program on the lower-extremity, upper-extremity, and core strength of judokas. Methods: This study is based on a pre-test/post-test experimental design involving repeated measures and a control group. The study was conducted with the voluntary participation of 20 judo athletes (10 females and 10 males) aged between 18 and 22 years (mean age: 18.60 years; height: 163 cm; body weight: 59.40 kg; BMI: 22.30 kg/m²). Participants were divided into two groups: a control group that continued routine judo training and an experimental group that performed core training in addition to routine judo training. Participants performed Medial Push-Ups (MPUs) to assess upper-extremity muscle strength; sit-ups and Plank Tests (PTs) to assess core strength; five different Single-Leg Hop Tests (SLHTs) to assess lower-extremity muscle strength; and the Y Balance Test (YBT) to assess balance. These tests were conducted before and after the 8-week core training program. Results: PT performance improved significantly in both groups, with a significant group × time interaction (p < 0.001, η²p = 0.623), indicating greater improvement in the core training group compared to the control group. No significant interaction was observed for MPU and Sit-up tests; however, a significant main effect of time was detected for MPU (p = 0.032, η²p = 0.231), suggesting general improvements in both groups. For SLHT parameters, no significant group × time interactions were detected (p > 0.050); improvements were observed over time across groups. In balance performance, a significant group × time interaction was found only in the NDS postero-medial (PM) direction (p = 0.020, η²p = 0.267), whereas the other parameters demonstrated time-related improvements without between-group differences. Conclusions: Core stability training resulted in greater improvements in PT performance and influenced balance performance in the NDS PM direction. Improvements observed in other performance parameters appeared to be time-related rather than intervention-specific. Overall, core stability training may contribute to core endurance and certain aspects of lower-extremity function in judokas. Full article

The sport of orienteering requires athletes to reach specific points marked on a map (called “punching stations”) in the shortest possible time. Currently, the recording of athletes’ passages through the stations is performed offline. In addition to delays in generating intermediate and final rankings, this approach often leads to detection errors and potential cheating related to the lack of authentication of an athlete’s actual passage at a given station. This paper aims to define and design a system enabling three main functionalities: 1. real-time monitoring of athletes’ trajectories through a sensor network connected to control stations; 2. multi-modal authentication of athletes at each station; and 3. immutable certification of each athlete’s passage through blockchain-based recording. System performance is evaluated in terms of wireless network coverage and data collection efficiency across three representative environments: urban, rural, and forested areas. Results are obtained through a measurement campaign for two dedicated wireless technologies: ZigBee for local mesh network and LoRa for long-range links to connect local mesh networks to the cloud over the Internet, which is then accessed by the race organizers. Furthermore, two supporting subsystems are described, addressing athlete authentication and data integrity assurance, as well as a blockchain recording for the overall event management framework. Results are in terms of coverage distances for both technologies, proving highly effective across varied terrains. Field tests demonstrated significant communication capabilities, achieving distances of up to 1800 m in open spaces. Even in challenging, dense wooded environments, the system maintained reliable coverage, reaching transmission distances of up to 600 m. Local ZigBee links between punching stations achieved ranges between 70 and 150 m in forested areas. These findings validate the use of a wireless multi-hop network designed to minimize packet loss and ensure reliable data delivery in competitive scenarios. The feasibility is also investigated in terms of WSN performance, delay analysis and power consumption evaluation. Full article

Downy mildew of hops represents a serious disease affecting hops production in all growing regions. Disease management is primarily based on the application of fungicides at regular intervals based on a short-term forecasting methodology that is essential for evaluating the occurrence of theoretical infections. To enable a more reliable assessment of the pathogen’s presence in a given area, spore traps capturing airborne Pseudoperonospora humuli sporangia can be utilized. The use of quantitative real-time PCR (qRT-PCR) for the detection of sporangia collected by these traps allows for the elimination of laborious and time-consuming microscopic counting. Among four tested P. humuli-specific nuclear DNA sequences, an effective qRT-PCR detection method was developed based on the c127233.5e3 sequence. This detection approach was used for the quantification of sporangia from volumetric spore trap samples collected in situ under field conditions at three selected localities in Bohemia and Moravia during the 2021–2022 period. The obtained results were compared with the short-term forecasting method of the downy mildew (HDM) weather index (I) based on meteorological data. The overall course of the HDM weather index (I) closely correlated with the occurrence of sporangia: after reaching the maximum HDM weather index (I) value, the highest sporangium detection was observed with a time delay of 1–2 weeks at all the monitored sites. The results corresponded well with data obtained from volumetric spore traps in Germany, and the qRT-PCR method proved to be fully comparable to light microscopy. The combination of volumetric spore traps and qRT-PCR can significantly improve the precision of short-term forecasting systems for P. humuli infection, thereby enabling more efficient fungicide application programs in hops protection and contributing to a better understanding of the pathogen’s dispersal dynamics. Full article

This study examined fatigue- (within-group) and sex-related (between-group) differences in physical performance and muscle activation during physical assessments. Physically active college students (20 males, 20 females) completed side-hop and pelvic stability tests after a warm-up (T-1) and mobilization exercises (T0) and then following each with five 8 min runs at 70% of individualized peak velocity as the fatiguing protocol (T1–T5). No significant within-group performance differences were observed across tests (T0–T5). However, males completed more hops (p < 0.001) and had shorter ground contacts (p < 0.05) than females in the side-hop test with no significant sex-based stability differences. Electromyography data revealed reduced activation (p < 0.05) in various muscles (gastrocnemius, vastus medialis, biceps femoris, gluteus medius, gluteus maximus, erector spinae, obliquus abdominis) under fatigue (various timepoints between T1–T5) compared to baseline (T-1) across tests. Males displayed greater relative reductions in activation (p < 0.01) from pre-activation to ground contact in the gastrocnemius and biceps femoris during the side-hop test. Females exhibited reduced vastus medialis (p = 0.02) activation during the side-hop test and reduced biceps femoris (p = 0.04) activation during the pelvic stability test than males. Physical performance remained stable under fatigue, with sex-specific muscle recruitment strategies appearing as possible compensatory mechanisms. Full article

The transition to more sustainable models of production and consumption has encouraged the scientific community to seek innovative solutions that promote environmental responsibility and reduce waste. The cosmetic industry, in particular, has increasingly invested in natural and eco-friendly ingredients as alternatives to synthetic and environmentally harmful components. In this context, plant-derived bioactive compounds with antioxidant and anti-inflammatory potential have gained attention for their ability to enhance photoprotection and reduce the concentration of conventional ultraviolet (UV) filters in sunscreens. Humulus lupulus L. (hop), a plant traditionally used in the brewing industry, generates large amounts of organic waste after the beer production process, especially through the dry-hopping technique. Despite often being discarded, this residual biomass retains important secondary metabolites with high biological value. Our investigation researched the sustainable valorization of hop brewing residues as a source of bioactive compounds for the development of more natural photoprotective products. We performed HLPC-MS/MS analysis and confirmed the presence of α-acids in both pure and reused hop material extracts, while a xanthohumol-like prenylated flavonoid was tentatively detected exclusively in the extract obtained from reused hop extract. In vitro tests demonstrated that sunscreens containing extract obtained from reused material significantly increased the sun protection factor (SPF) without negatively altering the critical wavelength when water was used as the solvent. None of the samples developed higher UVAPF values compared to the control. Our investigation, to the best of our knowledge, constitutes the first successful proof of concept demonstrating the use of both pure (non-reused) and reused hop material extracts as functional photoprotective adjuvants in sunscreen formulations evaluated by a robust, standardized in vitro methodology. This work highlights the dual benefit of reducing industrial waste and developing more sustainable, consumer-friendly cosmetic products. Full article

Functional ankle instability (FAI) is a common consequence of lateral ankle sprains, characterized by impaired sensorimotor control. While orthoses and localized vibration have shown individual benefits for FAI, their combined application in a wearable device has not been previously investigated. This pilot randomized trial compared the effects of a vibrotactile foot orthosis (VFO) and a vibrotactile ankle orthosis (VAO) on joint position sense (JPS) and postural control in individuals with FAI. Sixteen participants were randomized to receive either a VFO or a VAO, both delivering 30–50 Hz pulsed vibration in 20 min sessions, three times a week, for two weeks. Outcome measures included joint position sense (JPS) error (°), center of pressure (COP) velocity (mm/s), the Star Excursion Balance Test (SEBT), and the Six-Meter Hop Test (SMHT), which were assessed pre-intervention, immediately post-intervention, and after two weeks of use. The analysis showed a statistically significant interaction between time and intervention group for JPS error (p = 0.02, η² = 0.42). Specifically, the VFO group improved JPS significantly more than VAO at two weeks follow-up (MD = −1.75°, p = 0.005, d = −1.68). Both groups significantly reduced in anteroposterior COP velocity after two weeks (VFO: MD = 1, p = 0.003, d = 1.47; VAO: MD = 1.39, p ˂ 0.001, d = 2.05) with no between-group differences. No changes were observed in the SEBT or SMHT. Plantar-based vibrotactile stimulation was more effective than ankle-based stimulation in enhancing proprioceptive acuity in individuals with FAI. Both interventions improved static postural stability, supporting the potential of integrated vibrotactile orthoses in FAI rehabilitation. No major practical issues were reported during the intervention. Two participants experienced minor discomfort related to the electronic housing bulk in the first week, which was resolved by week two. No further complaints regarding device weight or usability were observed. Full article

Background: The study aimed to examine recovery time between sets (30 s vs. 2 min) during elastic band training for jumping, sprinting, COD, and repeated high-intensity efforts in young padel players. Methods: Twelve highly trained male padel players were allocated to one of the two groups randomly (short recovery [SRG] or long recovery [LRG]) and evaluated the triple hop test (3HJ), linear (10 m) and multidirectional (5 + 5 m sprint with a direction change of 45°) tests, and the repeated sprint ability (RSA) test after 3 weeks of training intervention. After 3 weeks, there was a 3-week washout period to cross both groups, and the participants then performed the opposite training program. Both groups performed two sets of four exercises, each with six repetitions, with an elastic band, recovering 30 s (SRG) or 2 min between exercises (LRG). Results: No between-training-program differences were established (p < 0.05). SRG showed a better trend in the 3HJ with the right (effect size (ES) = 0.85), while LRG showed small advantages in the 5 m and 10 m sprints (ES = 0.33 to 0.36). SRG also showed small to moderate improvements in COD on both sides (ES = 0.46 to 0.49), although period effects (p < 0.05) indicated the influence of familiarization. In RSA, LRG showed a slight tendency to improve the mean and the best time (ES = 0.24 to 0.41), while SRG showed an advantage in the percentage of decrement (ES = 0.54). Conclusions: SRG appeared more effective in horizontal jumping, COD, and fatigue resistance during the RSA test, whereas LRG may show small advantages in acceleration and RSA performance. Although the effects were mostly small and not statistically significant, the observed trends could have practical relevance for planning specific training programs focused on power, speed, and fatigue resistance in padel players. Full article