Search Results (44)

Background/Objectives: Anterior cruciate ligament reconstruction (ACLR) necessitates evidence-based rehabilitation strategies to optimize return-to-sport (RTS) outcomes, yet persistent re-injury rates and suboptimal performance persist despite standardized protocols. The purpose of this cross-sectional observational study is to examine the relationship between biomechanical, anthropometric, and temporal factors and return-to-sport outcomes. Methods: This cross-sectional study identifies biomechanical, anthropometric, and temporal determinants of RTS readiness in 81 recreational athletes post-ACLR. Outcome measures included anterior (A-SLH), lateral (L-SLH), and medial (M-SLH) single-leg hop for distance, single-leg sit-to-stand (SLSS), single-leg wall-sit hold (SLWS), and ACL-RSI. Statistical analyses employed Spearman’s correlations and multiple linear regression to determine the predictors of ACL-RSI. Results: There were significant correlations between RSI and Limb Symmetry Index (LSI) for L-SLH, M-SLH, SLSS, and SLWS (r = 0.27, r = 0.30, r = 0.44, r = 0.34, and p < 0.01, respectively). Among the functional outcome measures, multiple linear regression revealed that only SLWS significantly predicted ACL-RSI (β = 0.248, p = 0.037). Also, body weight (β = −0.233, p = 0.030) and postoperative duration (β = 0.292, p = 0.006) significantly predicted ACL-RSI. Conclusions: These findings challenge the primacy of limb symmetry indices alone, emphasizing the role of weight management, time-dependent neuromuscular adaptation, and multi-planar closed-chain strength in RTS decision-making. Clinically, rehabilitation frameworks should integrate personalized strategies targeting body composition and dynamic stability to mitigate asymmetric joint loading and enhance functional resilience. Full article

Burn injuries result in complex physiological and psychological sequelae, including hypermetabolism, muscle wasting, mobility impairment, scarring, and disrupted body image. While advances in acute care have improved survival, comprehensive rehabilitation strategies are critical for restoring function, appearance, and psychosocial well-being. Structured physical activity, including resistance and aerobic training, plays a central role in counteracting muscle atrophy, improving cardiovascular function, enhancing scar quality, and promoting psychological resilience and body image restoration. This narrative review synthesizes the current evidence on the effects of exercise-based interventions on post-burn recovery, highlighting their therapeutic mechanisms, clinical applications, and implementation challenges. In addition to physical training, emerging technologies such as virtual reality, aquatic therapy, and compression garments offer promising adjunctive benefits. Notably, artificial intelligence (AI) is gaining traction in burn rehabilitation through its integration into wearable biosensors and telehealth platforms that enable real-time monitoring, individualized feedback, and predictive modeling of recovery outcomes. These AI-driven tools have the potential to personalize exercise regimens, support remote care, and enhance scar assessment and wound tracking. Overall, the integration of exercise-based interventions with digital technologies represents a promising, multimodal approach to burn recovery. Future research should focus on optimizing exercise prescriptions, improving access to personalized rehabilitation tools, and advancing AI-enabled systems to support long-term recovery, functional independence, and positive self-perception among burn survivors. Full article

Quality and mechanical resilience are crucial for reducing losses in fruit production and for supporting food chains. Indeed, integrating empirical data with rheological models bridges gaps in fruit processing equipment design. Therefore, the objective of this research is to analyze the relationship between the mechanical and physical properties of seven economically important fruits—nectarine, kiwi, cherry, apple, peach, pear, and apricot—to assess their mechanical behavior and post-harvest quality. Standardized compression, creep, and puncture tests were conducted to establish mechanical parameters, such as rupture force, elasticity, and deformation energy. Physical characteristics including size, weight, density, and moisture content were also measured. The results indicated significant differences among the various categories of fruits; apples and pears were most suitable for mechanical harvesting and long storage periods, whereas cherries and apricots were least resistant and susceptible to injury. Correlations were high among the physical measurements, tissue firmness, and viscoelastic properties, thereby confirming structural properties’ contribution in influencing fruit quality and handling efficiency. The originality of this research is in its holistic examination of physical and mechanical properties under standardized testing conditions, thus offering an integrated framework for enhancing post-harvest operations. These findings offer practical insights for optimizing harvesting, packaging, transportation, and quality monitoring strategies based on fruit-specific mechanical profiles. Full article

Hip fractures are among the most serious health events in older adults, frequently leading to disability, loss of independence, and elevated mortality. In 2019, an estimated 9.6 million new cases occurred globally among adults aged ≥ 55 years, with an incidence rate of 681 per 100,000. Despite improved surgical care, one-year mortality remains high (15–30%), and fewer than half of survivors regain their pre-fracture functional status. Traditionally regarded as mechanical injuries, hip fractures are now increasingly recognized as systemic events reflecting and accelerating biological vulnerability and frailty progression. We synthesize evidence across biological, clinical, and social domains to explore the systemic implications of hip fracture, from the acute catabolic response and immune dysfunction to long-term functional decline. The concept of intrinsic capacity, introduced by the World Health Organization, offers a resilience-based framework to assess the multidimensional impact of hip fracture on physical, cognitive, and psychological function. We highlight the importance of orthogeriatric co-management, early surgical intervention, and integrated rehabilitation strategies tailored to the individual’s functional reserves and personal goals. Innovations such as digital health tools, biological aging biomarkers, and personalized surgical approaches represent promising avenues to enhance recovery and autonomy. Ultimately, we advocate for a shift toward interdisciplinary, capacity-oriented models of care that align with the goals of healthy aging and enable recovery that transcends survival, focusing instead on restoring function and quality of life. Full article

Vehicle collisions with street lighting poles generate extremely high impact forces, often resulting in serious injuries or fatalities. Therefore, enhancing the structural resilience of pole bases is a critical engineering objective. This study investigates a comprehensive dynamic analysis conducted with respect to base material behavior and energy absorption of GFRP lighting pole structures under impact loads. A finite element (FE) model of a 5 m-tall tapered GFRP pole with a steel base sleeve, base plate, and anchor bolts was developed. A 500 kg drop-weight impact at 400 mm above the base simulated vehicle collision conditions. The model was validated against experimental data, accurately reproducing the observed failure mode and peak force within 6%. Parametric analyses explored variations in pole diameter, wall thickness, base plate size and thickness, sleeve height, and anchor configuration. Results revealed that geometric parameters—particularly wall thickness and base plate dimensions—had the most significant influence on energy absorption. Doubling the wall thickness reduced normalized energy absorption by approximately 76%, while increases in base plate size and thickness reduced it by 35% and 26%, respectively. Material strength and anchor bolt configuration showed minimal impact. These findings underscore the importance of optimizing pole geometry to enhance crashworthiness. Controlled structural deformation improves energy dissipation, making geometry-focused design strategies more effective than simply increasing material strength. This work provides a foundation for designing safer roadside poles and highlights areas for further exploration in base configurations and connection systems. Full article

Background/Objectives: Prenatal hypoxia (PH) is a leading cause of nervous system disorders in early childhood and subsequently leads to a decline in the cognitive and mnemonic functions of the central nervous system (such as memory impairment, reduced learning ability, and information processing). It also increases anxiety and the risk of brain disorders in adulthood. Compensatory–adaptive mechanisms of the mother–placenta–fetus system, which enhance the fetus’s CNS resilience, are known, including the activation of endogenous neuroprotection in response to hypoxic brain injury through the pharmacological modulation of HSP₇₀. Methods: To evaluate the effect of HSP₇₀ modulators—Cerebrocurin, Angiolin, Tamoxifen, Glutaredoxin, Thiotriazoline, and HSF-1 (heat shock factor 1 protein), as well as Mildronate and Mexidol—on the motor skills, exploratory behaviors, psycho-emotional activities, learning, and memories of offspring after PH. Experimental PH was induced by daily intraperitoneal injections of sodium nitrite solution into pregnant female rats from the 16th to the 21st day of pregnancy at a dose of 50 mg/kg. The newborns received intraperitoneal injections of Angiolin (50 mg/kg), Thiotriazoline (50 mg/kg), Mexidol (100 mg/kg), Cerebrocurin (150 µL/kg), L-arginine (200 mg/kg), Glutaredoxin (200 µg/kg), HSF-1 (50 mg/kg), or Mildronate (50 mg/kg) for 30 days. At 1 month, the rats were tested in the open field test, and at 2 months, they were trained and tested for working and spatial memory in the radial maze. Results: Modeling PH led to persistent impairments in exploratory activity, psycho-emotional behavior, and a decrease in the cognitive–mnestic functions of the CNS. It was found that Angiolin and Cerebrocurin had the most pronounced effects on the indicators of exploratory activity and psycho-emotional status in 1-month-old animals after PH. They also exhibited the most significant cognitive-enhancing and memory-supporting effects during the training and evaluation of skill retention in the maze in 2-month-old offspring after PH. Conclusions: for the first time, we obtained experimental data on the effects of HSP₇₀ modulators on exploratory activity, psycho-emotional behavior, and cognitive–mnestic functions of the central nervous system in offspring following intrauterine hypoxia. Based on the results of this study, we identified the pharmacological agents Angiolin and Cerebrocurin as promising neuroprotective agents after perinatal hypoxia. Full article

How to elicit and harness regeneration is a major issue in wound healing. Skin injury in most amniotes leads to repair rather than regeneration, except in hair and feathers. Feather follicles are unique organs that undergo physiological cyclic renewal, supported by a dynamic stem cell niche. During normal feather cycling, growth-phase proximal follicle collar bulge stem cells adopt a ring configuration. At the resting and initiation phases, these stem cells descend to the dermal papilla to form papillary ectoderm and ascend to the proximal follicle in a new growth phase. Plucking resting-phase feathers accelerates papillary ectoderm cell activation. Plucking growth-phase feathers depletes collar bulge stem cells; however, a blastema reforms the collar bulge stem cells, expressing KRT15, LGR6, Sox9, integrin-α6, and tenascin C. Removing the follicle base and dermal papilla prevents feather regeneration. Yet, transplanting an exogenous dermal papilla to the follicle base can induce re-epithelialization from the lower follicle sheath, followed by feather regeneration. Thus, there is a stepwise regenerative strategy using stem cells located in the collar bulge, papillary ectoderm, and de-differentiated lower follicle sheath to generate new feathers after different levels of injuries. This adaptable regenerative mechanism is based on the hierarchy of stem cell regenerative capacity and underscores the remarkable resilience of feather follicle regenerative abilities. Full article

Design standards for manual handling equipment tend to measure maximal loads and moving forces using a smooth, flat, horizontal steel plate; yet, in everyday use, such equipment is used on floor coverings. Such test methods therefore overestimate the maximal loads acceptable for operators, which increases the risk of injury including the development of musculoskeletal disorders. This study presents a new approach for calculating the pushing force for manually handled equipment moving longitudinally on resilient floor coverings from the pushing force measured on a steel plate. This method combines corrective forces with the pushing force model presented in this study. Corrective force abaci, which describe corrective forces as functions of the hardness of the floor covering’s base foam, are provided for each type of tread and bearing in the cart’s wheels. These abaci have been elaborated from pushing force measurements obtained with 44 wheel designs (of varying diameters, treads and bearings) tested on five different floors on a custom-built test bench. A mean deviation between experimental results and model predictions of 5.1% is obtained for pushing forces. These results permit us to account for the real conditions in which manual handling equipment is used and help in reducing the incidence of musculoskeletal disorders. Full article

Background/Objectives: Rock climbing is a multifaceted athletic activity that requires both psychological and physiological resilience. This study aimed to examine the differences in psychological factors and fatigue predictors between novice and advanced climbers, with a focus on the interplay between experience and performance. Methods: The study included 60 participants categorized based on climbing experience (novice or advanced). Psychological and physiological assessments were conducted, including heart rate variability (HRV), grip strength, rate of force development (RFD), subjective perceived stress (SPS), and anxiety levels using validated questionnaires. Results: Advanced climbers exhibited lower anxiety levels and better sympathetic modulation compared to novices. Significant differences in HRV parameters, grip strength, and RFD were observed, reflecting the impact of experience on physiological responses. Advanced climbers demonstrated notable strength decreases post-climbing, supporting the utility of a force sensor on a 20 mm edge for assessing forearm fatigue. Correlations between cortisol levels, anxiety, and self-confidence during climbing were also identified. Conclusions: The findings highlight the importance of psychological and physiological factors in climbing performance. Forearm fatigue emerged as a critical predictor, suggesting that portable force sensors can optimize training and injury prevention. Insights from this study may enhance training protocols and improve real-time performance monitoring in climbers. Full article

Background/Objectives: Omega-3 fatty acids (n-3), recognized for their anti-inflammatory and brain health benefits, are being studied to enhance cognitive function, aid physical recovery, and reduce injury rates among military service members (SMs). Given the unique demands faced by this tactical population, this systematic review aims to evaluate the evidence of n-3 to support physical and mental resilience and overall performance. Methods: This review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and includes articles that assessed n-3 status or implemented n-3 interventions in relation to physical and cognitive performance, recovery, and injury outcomes (2006 to 2024). Of the 1606 articles yielded in screening through Covidence, 755 were irrelevant, leaving 226 studies for full-text eligibility. Of those 226 studies, 165 studies were excluded, and 61 studies were included in this review. Results: The results highlighted evidence-based findings in five key areas where omega-3 fatty acids are being evaluated to benefit military service members. These key areas include cardiopulmonary function, exercise recovery, cognitive function, injury recovery, and strength and power. While existing research suggests promising benefits, the most significant evidence was seen with cardiopulmonary function, exercise recovery, and cognitive function. Conclusions: Current research is promising and shows potential benefits, but the results are inconclusive and inconsistent. Future research is needed to determine optimal n-3 status, dose, and possibly type of n-3 across the various performance outcomes. Understanding these gaps in research will be essential to creating evidence-based n-3 guidelines for optimal performance of SMs. Full article

Across the globe, landslides cause significant loss of life, injuries, and widespread damage to homes and infrastructure. Therefore, assessing and analyzing landslide hazards is crucial to human, environmental, cultural, economic, and social sustainability. This study utilizes ArcGIS 10.8 and Python 3.9 to create landslide databases for Niigata Prefecture (NIG), Iwate and Miyagi Prefectures (IWT-MYG), and Hokkaido (HKD), drawing on data obtained from the National Research Institute for Earth Science and Disaster Resilience, Japan. A distinguishing feature of this study is the application of a Convolutional Neural Network (CNN), which significantly outperforms traditional machine learning models in image-based pattern recognition by extracting contextual information from surrounding areas, a distinct advantage in image and pattern recognition tasks. Unlike conventional methods that often require manual feature selection and engineering, CNNs automate feature extraction, enabling a more nuanced understanding of complex patterns. By experimenting with CNN input window sizes ranging from 3 × 3 to 27 × 27 pixels and employing diverse sampling techniques, we demonstrate that larger windows enhance the model’s predictive accuracy by capturing a wider range of environmental interactions critical for effective landslide modeling. CNN models with 19 × 19 pixel windows typically yield the best overall performance, with CNN-19 achieving an AUC of 0.950, 0.982 and 0.969 for NIG, HKD, and IWT-MYG, respectively. Furthermore, we improve prediction reliability using oversampling and a random window-moving method. For instance, in the NIG region, the AUC of the oversampling CNN-19 is 0.983, while the downsampling AUC is 0.950). These techniques, less commonly applied in traditional machine learning approaches to landslide detection, help address the issue of data imbalance often seen in landslide datasets, where instances of landslides are far outnumbered by non-landslide occurrences. While challenges remain in enhancing the model’s generalization, this research makes significant progress in developing more robust and adaptable tools for landslide prediction, which are vital for ensuring environmental and societal resilience. Full article

The healthcare industry continues to experience high rates of burnout, turnover, and staffing shortages that erode quality care. Interventions that are feasible, engaging, and impactful are needed to improve cultures of support and mitigate harm from exposure to morally injurious events. This quality improvement project encompassed the methodical building, implementation, and testing of RECONN (Reflection and Connection), an organizational intervention designed by an interdisciplinary team to mitigate the impact of moral injury and to increase social support among nurses. This quality improvement project was conducted in a medical intensive care unit (MICU) in a rural, academic medical center. We employed an Evidence-Based Quality Improvement (EBQI) approach to design and implement the RECONN intervention while assessing the feasibility, acceptability, and preliminary effectiveness via surveys (n = 17). RECONN was found acceptable and appropriate by 70% of nurses who responded to surveys. Preliminary effectiveness data showed small to moderate effect sizes for improving social support, moral injury, loneliness, and emotional recovery. Further evaluation is warranted to establish the effectiveness and generalizability of RECONN to other healthcare settings. Full article

Escherichia coli O157:H7 is a recognized food-borne pathogen causing severe food poisoning at low doses. Bacteriophages (phages) are FDA-approved for use in food and are suggested as natural preservatives against specific pathogens. A novel phage must be identified and studied to develop a new natural preservative or antimicrobial agent against E. coli O157:H7. The phage SPEC13 displayed broad host range and was classified within the Ackermannviridae family based on its observed characteristics by a TEM and genome analysis. In 10 min, this phage achieves a remarkable 93% adsorption rate with the host. Its latency period then lasts about 20 min, after which it bursts, releasing an average of 139 ± 3 PFU/cell. It exhibited robustness within a pH range of 4 to 12, indicating resilience under diverse environmental circumstances. Furthermore, SPEC13 demonstrated stability at an ambient temperature up to 60 °C. A whole genome and phylogenetics analysis revealed that SPEC13 is a novel identified phage, lacking a lysogenic life cycle, antibiotic resistance genes, or genes associated with virulence, thereby presenting a promising biological agent for therapeutic application. Animal studies showed that SPEC13 effectively controlled the growth of harmful bacteria, resulting in a significant improvement in colon health, marked by reduced swelling (edema) and tissue damage (mucosal injury). The introduction of SPEC13 resulted in a substantial decrease in quantities of E. coli O157:H7, reducing the bacterial load to approximately 5 log CFU/g of feces. In conclusion, SPEC13 emerges as a promising inclusion in the array of phage therapy, offering a targeted and efficient approach for addressing bacterial infections. Full article

Moral injury is a psychological wound resulting from deep-rooted traumatic experiences that corrode an individual’s sense of humanity, ethical compass, and internal value system. Whether through witnessing a tragic event, inflicting injury on others, or failing to prevent a traumatic injury upon others, moral injury can have severe and detrimental psychological and psychosomatic outcomes that may last a lifetime. Post-traumatic experiences do not have to be a permanent affliction, however. From moral injury can come post-traumatic growth—the recovery from trauma in which personal betterment overshadows moral injury. Moral injury may lead to substantial personal growth, improved capacity and resilience. Based on these observations, it seems that from struggles and darkness, there can be positivity and hope. This review will summarize the current concepts of post-traumatic growth and consider potential mechanisms leading to resilience and recovery through post-traumatic growth. These considerations are gaining more importance in light of a growing number of existential threats, such as violent conflicts, natural disasters and global pandemics. Full article

Acute kidney injury (AKI) is a significant complication in burn patients, impacting outcomes substantially. This study explores the heterogeneity of AKI in burn patients by analyzing creatinine time-series data to identify distinct AKI clusters and evaluating routine biomarkers’ predictive values. A retrospective cohort analysis was performed on 2608 adult burn patients admitted to Hangang Sacred Heart Hospital’s Burn Intensive Care Unit (BICU) from July 2010 to December 2022. Patients were divided into four clusters based on creatinine trajectories, ranging from high-risk, severe cases to lower-risk, short-term care cases. Cluster A, characterized by high-risk, severe cases, showed the highest mortality and severity, with significant predictors being PT and TB. Cluster B, representing intermediate recovery cases, highlighted PT and albumin as useful predictors. Cluster C, a low-risk, high-resilience group, demonstrated predictive values for cystatin C and eGFR cys. Cluster D, comprising lower-risk, short-term care patients, indicated the importance of PT and lactate. Key biomarkers, including albumin, prothrombin time (PT), cystatin C, eGFR cys, and total bilirubin (TB), were identified as significant predictors of AKI development, varying across clusters. Diagnostic accuracy was assessed using area under the curve (AUC) metrics, reclassification metrics (NRI and IDI), and decision curve analysis. Cystatin C and eGFR cys consistently provided significant predictive value over creatinine, with AUC values significantly higher (p < 0.05) in each cluster. This study highlights the need for a tailored, biomarker-driven approach to AKI management in burn patients, advocating for the integration of diverse biomarkers in clinical practice to facilitate personalized treatment strategies. Future research should validate these biomarkers prospectively to confirm their clinical utility. Full article