Search Results (17,036)

Background: Arthroscopic anterior cruciate ligament (ACL) reconstruction is widely recognised as the primary treatment for ACL injuries. However, with the increasing incidence of sports-related injuries and growing demand for rehabilitation services, conventional rehabilitation models—largely reliant on therapists’ experience and subjective assessment—are increasingly insufficient to meet the clinical need for precise and individualised rehabilitation programmes. This study aimed to evaluate the effectiveness of a rehabilitation protocol incorporating an artificial intelligence (AI)-based assessment and correction system on functional recovery following ACL reconstruction. Methods: Using convenience sampling, 80 patients undergoing ACL reconstruction between June to December 2024 were recruited for this randomised controlled trial. Participants were randomly assigned to either a control group (n = 40), which received conventional functional exercise training, or a trial group (n = 40), which received rehabilitation intervention guided by an AI-based assessment and correction system. Knee function scores (Lysholm score, IKDC score), Berg Balance Scale (BBS) scores, joint range of motion (ROM), and rehabilitation exercise compliance scores were collected and analysed 1, 2, 3, and 4 months postoperatively. Results: Compared with the control group, the trial group demonstrated significantly greater improvements in Lysholm score, IKDC score, BBS score, and active knee joint ROM (p < 0.05) at postoperative assessment points. Additionally, rehabilitation exercise adherence was significantly higher in the trial group compared to the control group (p < 0.05). Conclusions: Rehabilitation protocols integrating AI-based assessment and correction systems effectively enhance knee function recovery, joint mobility and balance ability following ACL reconstruction. Moreover, these protocols significantly improve rehabilitation exercise adherence, demonstrating superior efficacy compared to conventional rehabilitation approaches. This digital rehabilitation model represents an efficient and promising intervention for postoperative ACL rehabilitation. Full article

Type 2 diabetes is increasingly prevalent among children and adolescents with overweight or obesity, and although lifestyle interventions remain first-line preventive strategies, long-term adherence and effectiveness are often limited. Metformin has demonstrated efficacy in delaying type 2 diabetes onset in adults at high risk, but its preventive role in pediatric populations remains unclear. This systematic review and meta-analysis aims to evaluate the effectiveness of metformin, alone or in combination with lifestyle interventions, in preventing or delaying type 2 diabetes among children and adolescents with overweight or obesity. The protocol is registered in PROSPERO (CRD42024615622), MEDLINE (PubMed), Embase, Cochrane Library, Scopus, and Web of Science and will be searched from inception to June 2025. Eligible studies include randomized controlled trials, quasi-experimental studies, and prospective cohort studies involving individuals under 18 years of age. The primary outcome is incidence of type 2 diabetes, with secondary outcomes including fasting plasma glucose, HbA1c, insulin resistance, BMI z-score, adherence, and adverse events. Where appropriate, random-effects meta-analyses will be conducted. This review will synthesize current evidence on metformin for pediatric type 2 diabetes prevention and inform future preventive strategies and clinical decision-making. Full article

Antimicrobial resistance (AMR) continues to represent a significant global public health concern. Gram-negative bacilli (GNB) are the primary causative agents of severe nosocomial infections and possess a notable capacity to develop resistance mechanisms that restrict therapeutic options. The objective of this study was to characterize the antimicrobial susceptibility profiles of GNB isolated at a secondary-level hospital in Guadalajara, Mexico, with the aim of identifying predominant resistance patterns and the most effective therapeutic alternatives. A descriptive, retrospective, cross-sectional study was conducted using clinical isolates of Acinetobacter spp., Pseudomonas spp., Escherichia coli, Klebsiella spp., Morganella morganii, Proteus spp., and Enterobacter spp. collected during 2024. The identification and susceptibility testing were carried out using the VITEK^® 2 automated system, and the results were interpreted in accordance with CLSI guidelines. High resistance rates were observed in Acinetobacter spp. and Pseudomonas spp., particularly to carbapenems (>50% and >40%, respectively). Escherichia coli and Klebsiella spp. demonstrated resistance to third-generation cephalosporins and trimethoprim/sulfamethoxazole, exhibiting high susceptibility to amikacin and carbapenems (>90%). New-generation β-lactam/β-lactamase inhibitor combinations, such as ceftazidime/avibactam and ceftolozane/tazobactam, have demonstrated high efficacy against resistant strains. Overall, GNB isolates in this secondary-level hospital demonstrated elevated resistance levels, particularly to β-lactams and carbapenems, which pose a significant therapeutic challenge. Nevertheless, amikacin, carbapenems, and new-generation β-lactams persist as valuable therapeutic options. In order to contain the spread of multidrug-resistant organisms, it is imperative to strengthen local surveillance, optimize antibiotic stewardship, and reinforce infection control measures. Full article

Background/Objectives: Recurrent oral ulcers (ROUs) are a common condition that significantly impacts patients’ quality of life. This pilot study was conducted to evaluate the feasibility and preliminary results of using non-thermal plasma (NTP) compared to low-level laser therapy (LLLT) and placebo to treat these ulcers. Methods: A prospective, controlled, randomised, parallel-group pilot study was conducted using a convenience sample of 50 patients with ROUs. Patients were randomly assigned (2:2:1) to one of three groups: NTP (n = 20), LLLT (n = 20), and placebo (n = 10). Feasibility and preliminary data acquisition were the primary goals. Exploratory outcomes included ulcer size reduction and safety profile. This was a single-blinded trial, where participants and outcome assessors were masked to group assignment. Ulcer size, pain perception, and time to complete healing were measured. For statistical analysis, ANOVA was used, with a p-value ≤ 0.05. Results: The groups were comparable at baseline. Exploratory results suggest that NTP demonstrated a promising trend in accelerating healing, with a mean healing time difference of 5.5 days compared to LLLT (2.5 ± 1.9 days vs. 8.0 ± 4.3 days) and 7.1 days compared to placebo (2.5 ± 1.9 days vs. 9.6 ± 5.3 days) (p < 0.001). Regarding pain, NTP provided significant and sustained relief. Patients in the NTP group were asymptomatic on day 2, unlike the LLLT and placebo groups, where pain persisted significantly (NTP VAS score at 1 h: 1.1 ± 2.1 vs. LLLT/Placebo VAS score at 1 h: 3.4 ± 2.4 and 7.3 ± 1.9, respectively) (p < 0.001). NTP was well tolerated, and no adverse events were reported. Conclusions: This pilot study suggests that NTP is a potentially safe and effective therapy for recurrent oral ulcers. Preliminary results indicate that it may accelerate healing and offer superior pain relief, warranting a large-scale clinical trial to confirm these findings. Full article

Diurnally asymmetric warming under global climate change is reshaping terrestrial ecosystems, with important implications for vegetation productivity, biodiversity, and carbon sequestration. However, the mechanisms underlying the delayed and differentiated vegetation responses to daytime and nighttime warming, particularly under interacting precipitation regimes, remain insufficiently understood, limiting accurate assessments of ecosystem resilience under future climate scenarios. Clarifying how vegetation responds dynamically to asymmetric temperature changes and precipitation, including their lagged effects, is therefore essential. Here, we analyzed the spatiotemporal evolution of growing-season Normalized Difference Vegetation Index (NDVI) across the Yellow River Basin from 2001 to 2022 using Theil–Sen median trend estimation and the Mann–Kendall test. We further quantified the lagged responses of NDVI to daytime maximum temperature (Tmax), nighttime minimum temperature (Tmin), and precipitation, and identified their dominant controls using partial correlation analysis and an XGBoost–SHAP framework. Results show that (1) growing-season climate in the YRB experienced pronounced diurnal warming asymmetry: Tmax, Tmin, and precipitation all increased, but Tmin rose substantially faster than Tmax. (2) NDVI exhibited an overall increasing trend, with declines confined to only 2.72% of the basin, mainly in Inner Mongolia, Ningxia, and Qinghai. (3) NDVI responded to Tmax, Tmin, and precipitation with distinct lag times, averaging 43, 16, and 42 days, respectively. (4) Lag times were strongly modulated by topography, soil properties, and hydro-climatic background. Specifically, Tmax lag time shortened with increasing elevation, soil silt content, and slope, while showing a decrease-then-increase pattern with potential evapotranspiration. Tmin lag time lengthened with elevation, soil sand content, and soil pH, but shortened with higher potential evapotranspiration. Precipitation lag time increased with soil silt content and net primary productivity, decreased with soil pH, and varied nonlinearly with elevation (decrease then increase). By explicitly linking diurnal warming asymmetry to vegetation response lags and their environmental controls, this study advances process-based understanding of climate–vegetation interactions in arid and semi-arid regions. The findings provide a transferable framework for improving ecosystem vulnerability assessments and informing adaptive vegetation management and conservation strategies under ongoing asymmetric warming. Full article

As core infrastructure of power transmission networks, power towers require high-precision 3D models, which are critical for intelligent inspection and digital twin applications of power transmission lines. Traditional reconstruction methods, such as LiDAR scanning and oblique photogrammetry, suffer from issues including high operational risks, low modeling efficiency, and loss of fine details. To address these limitations, this paper proposes a 3D Gaussian Splatting (3DGS)-based method for power tower 3D reconstruction to enhance reconstruction efficiency and detail preservation capability. First, a multi-view data acquisition scheme combining “unmanned aerial vehicle + oblique photogrammetry” was designed to capture RGB images acquired by Unmanned Aerial Vehicle (UAV) platforms, which are used as the primary input for 3D reconstruction. Second, a sparse point cloud was generated via Structure from Motion. Finally, based on 3DGS, Gaussian model initialization, differentiable rendering, and adaptive density control were performed to produce high-precision 3D models of power towers. Taking two typical power tower types as experimental subjects, comparisons were made with the oblique photogrammetry + ContextCapture method. Experimental results demonstrate that 3DGS not only achieves high model completeness (with the reconstructed model nearly indistinguishable from the original images) but also excels in preserving fine details such as angle steels and cables. Additionally, the final modeling time is reduced by over 70% compared to traditional oblique photogrammetry. 3DGS enables efficient and high-precision reconstruction of power tower 3D models, providing a reliable technical foundation for digital twin applications in power transmission lines. By significantly improving reconstruction efficiency and reducing operational costs, the proposed method supports sustainable power infrastructure inspection, asset lifecycle management, and energy-efficient digital twin applications. Full article

Contemporary environmental challenges necessitate the adoption of active learning methods within educational frameworks, particularly those that foster the development of environmental awareness among young people. The 2030 Agenda underscores the importance of project-based learning as a strategy for building the competencies required to achieve sustainable development goals. In this context, the attitudes and behavior of young people towards the environment serve as critical indicators of future social transformations within the sphere of sustainable development. The aim of this research was to determine whether project-based learning in geography, as opposed to traditional teaching methods, exerts a more pronounced influence on the formation of environmental values, attitudes, and pro-environmental behavior among students in their final year of primary school. The research was conducted using a convenience sample (n = 255) and employed pedagogical experimental surveys with parallel group designs. In the experimental group, project-based learning was implemented, whereas the control group continued with traditional teaching approaches. To assess environmental values and attitudes, the research employed a scale grounded in the EAATE framework, and pro-environmental behavior was evaluated using a measurement scale derived from the PEB and GEB scales. The obtained results are attributed to the influence of project-based learning. Although they cannot be generalized to the entire population, they indicate the potential of project-based learning as a more effective strategy in environmental education. Furthermore, these findings provide opportunities for further professional and scientific research in this area. Full article

Soil heavy metal contamination poses significant risks to ecological safety and human health, particularly in rapidly industrializing cities. Effectively identifying pollution sources is crucial for risk management and remediation. GIS coupled with data mining techniques, provide a powerful tool for quantifying and visualizing these sources. This study investigates the concentration, spatial distribution, and sources of heavy metals in urban soils of Bengbu City, an industrial and transportation hub in eastern China. A total of 139 surface soil samples from the urban core were analyzed for nine heavy metals. Using integrated GIS and PCA-APCS-MLR data mining techniques, we systematically determined their contamination characteristics and apportioned sources. The results identified widespread Hg enrichment, with concentrations exceeding background levels at all sampling sites, and a Cd exceedance rate of 28.06%, leading to a moderate ecological risk level overall. Spatial patterns revealed significant heterogeneity. Quantitative source apportionment identified four primary sources: industrial source (37.1%), which was the dominant origin of Cr, Cu, and Ni, primarily associated with precision manufacturing and metallurgical activities; mixed source (26.7%) governing the distribution of Mn, As, and Hg, mainly from coal combustion and the natural geological background; traffic source (22.3%) significantly contributing to Pb and Zn; and a specific cadmium source (13.9%) potentially originating from non-ferrous metal smelting, electroplating, and agricultural activities. These findings provide a critical scientific basis for targeted pollution control and sustainable land-use management in analogous industrial cities. Full article

Background: Traumatic injuries of the duodenum are generally rare but when they occur, they can result in serious complications. Inaccurate injury classification, delayed diagnosis, or late treatment can significantly raise morbidity and mortality. A multidisciplinary approach is often necessary. Mechanisms of injury: Isolated duodenal injuries are relatively uncommon due to the duodenum’s proximity to pancreas and major vascular structures. Duodenal injuries can result from blunt or penetrating trauma. Classification: The 2019 World Society of Emergency Surgery (WSES)-American Association for the Surgery of Trauma (AAST) guidelines recommend incorporating both the AAST-OIS grading and the patient’s hemodynamic status to stratify duodenal injuries into four categories: Minor injuries WSES class I, Moderate injuries WSES class II, Severe injuries WSES class III, and WSES class IV. Diagnosis: The diagnostic approach involves a combination of clinical assessment, laboratory investigations, radiological imaging and, in particular situations, surgery. Prompt diagnosis is critical because delays exceeding 24 h are associated with a higher incidence of postoperative complications and a significant rise in mortality. Contrast-enhanced abdominal computed tomography (CT) represents the gold standard for diagnosis in patients who are hemodynamically stable. Management: Duodenal trauma requires a multimodal approach that considers hemodynamic stability, the severity of the injury and the presence of associated lesions. Non-operative management (NOM) is reserved for hemodynamically stable patients with minor duodenal injuries without perforation (AAST I/WSES I), as well as all duodenal hematomas (WSES I–II/AAST I–II) in the absence of associated abdominal organ injuries requiring surgical intervention. All hemodynamically unstable patients, those with peritonitis, or with CT findings consistent with duodenal perforations or AAST grade III or higher injuries are candidates for emergency surgery. If intervention is required, primary repair should be the preferred option whenever feasible, while damage control surgery is the best choice in cases of hemodynamic instability, severe associated injuries, or complex duodenal lesions. Definitive reconstructive surgery should be postponed until the patient has been adequately resuscitated. The role of endoscopic techniques in the treatment of duodenal injuries and their complications is expanding. Conclusions: Duodenal trauma is burdened by potentially high mortality. Among the possible complications, duodenal fistula is the most common, followed by duodenal obstruction, bile duct fistula, abscess, and pancreatitis. The overall mortality rate for duodenal trauma persists to be significant with an average rate of 17%. Future prospective research needed to reduce the risk of complications following duodenal trauma. Full article

Aquaculture faces environmental challenges from sediment contamination by potentially toxic elements. This study investigated how aquaculture patterns and seasons jointly affect the distribution and ecological risks of these potentially toxic elements in sediments. By analyzing and comparing sediment samples from different aquaculture systems across seasons, we found that Mn (mean = 435.42 mg/kg) was the most abundant, followed by Zn (mean = 172.69 mg/kg), Cr (mean = 106.79 mg/kg), and Cu (mean = 63.44 mg/kg). Aquaculture patterns were the primary factor determining the composition of potentially toxic elements, followed by season. Fish farming tended to promote their accumulation in sediments, whereas the rice–crayfish co-culture model effectively reduced the enrichment of potentially toxic elements and their associated ecological risks. Therefore, optimizing aquaculture practices proves more effective in controlling these risks than managing seasonal variations. Moreover, total phosphorus was identified as a key driver of potentially toxic element accumulation in sediments. The results from the rice–crayfish co-culture system indicate that enhanced phosphorus management is crucial for mitigating such risks. Accordingly, it is necessary to develop systematic monitoring and integrated remediation strategies focused on priority metals and their main drivers. Full article

Designing and constructing heterojunctions has emerged as a pivotal strategy for improving the photocatalytic efficiency of semiconductors. In this study, we report the controlled synthesis of an Au/Zn₃In₂S₆ Schottky junction through a combination of hydrothermal and in situ photodeposition methods. The structural, morphological, and photoelectrochemical properties of the catalyst were meticulously characterized using a suite of techniques including X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), diffuse reflectance spectroscopy (DRS), X-ray photoelectron spectroscopy (XPS), photoelectrochemical (PEC) measurements, and electron spin resonance (ESR) spectroscopy. The optimized 3% Au/Zn₃In₂S₆ composite exhibited a remarkable enhancement in both photocatalytic activity and stability, achieving a 90.4% removal of bisphenol A (BPA) under UV–visible light irradiation within 100 min. The corresponding first-order reaction rate constant was approximately 1.366 h⁻¹, nearly 4.37 times greater than that of the pristine Zn₃In₂S₆. This substantial improvement can be attributed to several key factors, including increased BPA adsorption, enhanced light absorption, and the efficient charge separation facilitated by the Au/Zn₃In₂S₆ heterojunction. Photogenerated holes, superoxide radicals, and hydroxyl radicals were identified as the primary reactive species responsible for the BPA degradation. This work highlights the potential of metal-modified semiconductors for advanced photocatalytic applications, offering insights into the design of highly efficient materials for environmental remediation. Full article

Background: Glioblastoma multiforme (GBM), the most aggressive primary brain malignancy in adults, is associated with poor prognosis and recurrence despite standard of care and newer immunotherapies. This warrants exploration of synergistic approaches such as combination immunotherapy for improved tumor control. Methods: We initiated a systematic review of articles from 2015–2025 in PubMed, Embase, Scopus, Cochrane, and Web of Science if they assessed immunotherapy for GBM. Results: We included 49 studies (n = 3002 patients) with no significant demographic differences across publications. Combination immunotherapy regimens demonstrated higher pooled ORRs in limited comparative analyses, though findings were driven by a small number of studies. Single-arm analysis for overall survival (OS), progression-free survival (PFS), treatment-related adverse events (TRAEs), and ORR showed no significant differences among the groups. However, treatment–control arm analysis showed pooled ORs of 9.51 for combination immunotherapies and 0.44 in the control group. Conclusions: Combining immunotherapeutics across mechanisms may potentiate immune response effectiveness against GBM. Full article

Severe mitral regurgitation (MR) is one of the most common valvular heart diseases and is frequently associated with advanced left ventricular (LV) systolic dysfunction. Transcatheter edge-to-edge repair (TEER) offers effective symptom relief but may induce abrupt hemodynamic changes leading to afterload mismatch and acute LV failure. Levosimendan may help mitigate this complication by improving contractility, yet evidence supporting its use in this setting is scarce. Therefore, the aim of this study was to systematically evaluate the evidence on the effects of Levosimendan in patients with severe MR and LV dysfunction undergoing TEER. We performed a comprehensive search of PubMed, Embase, Scopus, and Google Scholar. Primary outcomes were postprocedural LV ejection fraction (LVEF) and systolic pulmonary artery pressure (sPAP). Secondary outcomes included procedural success, procedure duration, and in-hospital complications. Five studies comprising 315 patients (n = 141 Levosimendan, n = 174 controls) met the inclusion criteria. Pooled analysis showed no significant difference in postprocedural LVEF between Levosimendan-treated patients and controls (mean difference 0.45%, 95% CI [−1.46–2.35] p = 0.65) and no significant change from baseline. Similarly, postprocedural sPAP did not differ significantly. Procedural success was higher with Levosimendan, and procedure duration was shorter. These hypothesis-generating findings highlight the need for larger, prospective randomized trials to clarify the role of Levosimendan in this setting. Full article

Background/Objectives: Evidence on pulmonary rehabilitation (PR) in paediatric post-COVID-19 condition (PPCC) is scarce. This study aimed to evaluate the association of a PR programme with changes in physical and mental health and quality of life in PPCC over a 12-month follow-up. Methods: A quasi-experimental pre–post single-arm study was conducted, with no control group, in PPCC patients attending an outpatient PR unit. The primary outcome was change in exercise capacity (6 min walk test, 6MWT). Secondary outcomes included inspiratory and peripheral muscle strength, quadriceps muscle morphology by ultrasound, fatigue, physical activity, quality of life, and psychiatric symptoms, assessed using validated paediatric instruments. Results: A total of 115 PPCC patients (mean age 13.3 years; 66.1% female) completed the PR. 6MWD distance increased from 509 ± 87 to 546 ± 86 (+37 m; p < 0.001; D: 0.50). Handgrip strength increased by 2.4 kg, maximal inspiratory pressure increased by 15 cmH₂O, physical activity increased by 2.4 points, fatigue score improved by 9.3 points, and quality of life improved by 11 points (all p < 0.001). Rectus femoris thickness increased by 0.56 mm (p = 0.005), psychiatric symptom scores decreased by 4.5 points (p < 0.001), and rectus femoris echo-intensity decreased (p = 0.003). Conclusions: Multidisciplinary PR appears feasible and potentially effective in improving physical function, psychological well-being, and quality of life in PPCC, supporting the need for evidence-based paediatric rehabilitation. Full article

The increasing demand for energy combined with depleting conventional energy sources has led to the evolution of distributed generation using renewable energy sources. Integrating these distributed generations with the existing grid is a complicated task, as it risks the stability and synchronisation of the system. Microgrids (MG) have evolved as a concrete solution for integrating these DGs into the existing system with the ability to operate in either grid-connected or islanded modes, thereby improving reliability and increasing grid functionality. However, owing to the intermittent nature of renewable energy sources, managing the energy balance and its coordination with the grid is a strenuous task. The hierarchical control structure paves the way for managing the dynamic performance of MGs, including economic aspects. However, this structure lacks the ability to provide effective solutions because of the increased complexity and system dynamics. The incorporation of artificial intelligence techniques for the control of MG has been gaining attention for the past decade to enhance its functionality and operation. Therefore, this paper presents a critical review of various artificial intelligence (AI) techniques that have been implemented for the hierarchical control of MGs and their significance, along with the basic control strategy. Full article