Search Results (1,005)

Global aging is accelerating, with the proportion of the population aged 60 and above projected to reach 22% by 2050. In cold-region communities, the visual landscape environment is closely associated with the health of older adults, particularly showing associations with blood pressure (BP) and emotion states. However, associations between these factors across different landscape spaces and potential gender differences remain underexplored. This study utilized eye-tracking experiments to collect visual attention data from older adults in three types of cold-region community spaces: inter-building spaces, walkways and squares. The ground, buildings, trees, lawn, and the sky were identified as the primary Areas of Interest (AOIs). The Profile of Mood States (POMS) scale was used to assess emotion during walking experiments, revealing suggestive gender–environment interaction characteristics. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) were measured, and a Mann–Whitney U test indicated that DBP in community squares exhibited significant environmental dependency (U = 114.5, p = 0.004, r = 0.44). Hierarchical Linear Models (HLMs) revealed that, after controlling for individual differences, the number of fixation points on ground was independently associated (i.e., independent of measured individual characteristics) with elevated SBP ($\gamma =0.31, p=0.011$), while fixation on trees was associated with reduced SBP ($\gamma =-0.24, p=0.018$). Furthermore, gender moderation effects were observed: the association between ground fixation and SBP was stronger in females ($\gamma =0.18, p=0.022$), whereas the association between sports facilities and DBP was stronger in males ($\gamma =0.29, p=0.009$). Based on these findings, evidence-based design strategies are proposed, including the optimization of ground safety, gender-differentiated planting configurations, and targeted layouts for sports facilities. These results provide empirical support for age-friendly community design in cold regions. Full article

Mediterranean-type ecosystems (METs) occur on five continents and represent some of the most climatically constrained yet biologically rich regions on Earth. In these environments, legumes and their nitrogen-fixing rhizobial symbionts—including widely distributed genera such as Rhizobium, Bradyrhizobium, and Ensifer—play a pivotal role in sustaining plant productivity, nutrient cycling, and ecosystem resilience. This review synthesizes current knowledge on the environmental regulation of legume–Rhizobium symbiosis specifically within Mediterranean-type ecosystems, focusing on how nitrogen (N) and phosphorus (P) availability, light conditions, and carbon allocation trade-offs shape symbiotic performance across the five Mediterranean-type regions of the world (California, central Chile, the Cape Region of South Africa, southwestern Australia, and the Mediterranean Basin). By integrating physiological, ecological, and biogeochemical perspectives, we highlight how the shared features of these regions—strong seasonal drought, chronic nutrient limitation (particularly P in southwestern Australia and the Cape Region), recurrent fires, and exceptionally high plant diversity—constrain and, at the same time, favor the ecological success of symbiotic legumes. Throughout the review, we use case studies from key legume genera such as Lupinus in Chile and southwestern Australia, Virgilia and other Cape legumes in South Africa, Acacia in Australian kwongan and woodlands, and Medicago and Cytisus in the Mediterranean Basin and California to illustrate how general principles of legume–Rhizobium ecology manifest under Mediterranean-type climatic and edaphic constraints. Beyond summarizing established mechanisms, we critically examine the limitations of current metagenomic approaches, which often provide descriptive inventories of soil microbial communities without linking microbial composition to functional outcomes. We argue that advancing the field requires integrated, hypothesis-driven research that combines multi-omic tools with plant eco-physiology, soil nutrient dynamics, and temporal replication. Finally, we outline key priorities for future research, including the integration of functional ‘omics’, the study of microbiome interactions beyond rhizobia, the development of predictive models for Mediterranean-type ecosystems under climate change, and the application of symbiotic principles to restoration and agroecological management. By bridging molecular, physiological, and ecosystem perspectives, this review provides a conceptual framework for understanding and enhancing legume–Rhizobium symbiosis across five continents in a rapidly changing world. Full article

Cranial cruciate ligament rupture is a common orthopedic condition in dogs, and tibial tuberosity advancement is a well-established surgical treatment. The aim of this retrospective study was to evaluate the short-term clinical and radiographic outcomes of a cageless tibial tuberosity advancement technique in small-breed dogs. Medical records of 63 dogs (77 stifles) treated using this technique were reviewed. Fixation was achieved using three construct types: a screw–pin construct (the majority of cases), a screw-only construct, or a screw combined with two pins. Due to small subgroup sizes, fixation-type outcomes were primarily analyzed descriptively. Clinical and radiographic evaluations were performed immediately after surgery and at eight weeks postoperatively. Clinical outcomes were graded based on limb function, and radiographic bone healing was scored using a standardized scale. Postoperative complications were recorded and analyzed in relation to patient and procedural variables. No intraoperative complications were observed, while postoperative complications occurred in 27% of dogs and were predominantly minor and implant-related. Lameness scores improved significantly over the follow-up period. All treated stifles demonstrated stable implants, maintained advancement, and satisfactory bone healing. The use of bone graft material appeared to be associated with fewer complications and more favorable clinical outcomes; however, this observation should be interpreted with caution given the retrospective and non-randomized design of the study. In this retrospective case series, cageless tibial tuberosity advancement using screw-based fixation (predominantly screw–pin constructs) was associated with favorable short-term clinical and radiographic outcomes. These findings should be considered preliminary and limited to short-term evaluation, given the retrospective design, absence of a control group, and relatively short follow-up period. Further prospective studies with larger populations, standardized outcome measures, and longer follow-up are warranted to confirm these findings. Full article

Background: Despite the frequent occurrence of ankle injuries, there is no consensus among orthopedic surgeons regarding the diagnosis and treatment of syndesmotic injuries. This study evaluates the clinical and radiological outcomes of three-cortex syndesmotic fixation in Weber type B/C lateral malleolus fractures (with or without medial malleolus involvement) associated with syndesmotic injury. Material and Method: This study analyzed thirty-six (36) patients with Weber type B/C lateral malleolus fractures treated between 2011 and 2022. All underwent open reduction and fixation with plates and screws for malleolar fractures, along with a 3.5 mm cortical syndesmosis fixation using three cortical engagements. Preoperative and postoperative radiological findings and final functional ankle assessments were reviewed. Intraclass correlation coefficients (ICC) were used to assess inter- and intra-observer agreement for tibiofibular clear space (TFCS), tibiofibular overlap (TFO), medial clear space (MCS), and anterior tibiofibular ratio (ATFR) measurements. The functional status of the ankle has been assessed using the American Orthopedic Foot and Ankle Society (AOFAS) scale. Results: The mean age of the patients was 50.56 ± 16.23 years, and the mean follow-up duration was 20.89 ± 24.93 months. Postoperative AOFAS scores averaged 91.08 ± 9.90. The inter-observer agreement for preoperative assessments was excellent across all parameters (ICC > 0.9). However, in the postoperative period, inter-observer agreement for ATFR measurement was poor (ICC < 0.5), while agreement for all other parameters remained excellent (ICC > 0.9). Intra-observer comparisons of preoperative (pre-op) and postoperative (post-op) measurements were poor across all parameters (ICC < 0.5); this can be attributed to the success of reduction, reflecting the positive directional change on all parameters. After an average follow-up of 20 months, four radiological parameters showed significant differences, indicating enhanced stability and reduced diastasis. Conclusions: Three-cortex syndesmotic screw fixation in Weber type B/C lateral malleolus fractures with syndesmotic injuries yielded excellent mid-term radiological and functional outcomes. Full article

Arid region ecosystems are among the most fragile ecological types worldwide. They depend heavily on limited water resources and are strongly influenced by intensive human activities, leading their ecosystem services to exhibit nonlinear and threshold responses to driving factors. Identifying the thresholds of ecosystem services under the combined influence of natural and socio-economic interactive drivers is of great significance for regional ecological risk warning and differentiated management. Taking the Tarim River Basin as a case study, this research establishes an integrated analytical framework that combines causal inference, interaction term construction, interpretable machine learning (XGBoost-SHAP), and piecewise linear regression. The framework is used to evaluate the variations in four types of ecosystem services in 2000, 2010, and 2023, to analyze the interactive effects of driving factors, and to identify their thresholds influencing ecosystem service functions. The results indicate that (1) different types of ecosystem service functions exhibited distinct trends from 2000 to 2023, with habitat quality and water yield showing declining tendencies, while soil conservation and Windbreak and sand fixation demonstrated gradual increases; (2) Causal Screening and interaction modeling revealed that the interaction between precipitation and population density (Pre × Pop) served as the key synergistic driver of changes in the four ecosystem service functions. Both the ecosystem services and the coupled natural–social driving processes exhibited pronounced nonlinear characteristics, with evident trend shifts occurring within specific threshold intervals. (3) The precise coupling thresholds of different ecosystem services under natural–social drivers were identified, intuitively revealing the coupling threshold characteristics of various ecosystem services; (4) The integration of causal inference with interpretable machine learning enhances the reliability of threshold identification, revealing the heterogeneous response mechanisms of different services and providing a quantitative basis for the zoning regulation and differentiated management of regional ecosystems. The findings offer a transferable methodological framework to support ecological governance in arid regions. Full article

Background: Beckwith–Wiedemann syndrome (BWS) is a rare congenital overgrowth disorder caused by genetic and epigenetic alterations on chromosome 11p15.5. While macroglossia, abdominal wall defects, and tumor predisposition are well recognized, hearing impairment has been sporadically reported. Objectives: The aim of this study is to review audiological features, surgical management, and rehabilitation in BWS, and we additionally present three cases with comprehensive longitudinal audiological follow-up. Methods: A systematic review of PubMed and Scopus was conducted according to PRISMA guidelines, including studies reporting audiological findings in patients with confirmed BWS. Studies without audiological data or reporting only normal-hearing patients were excluded. Data on hearing loss type, severity, genetics, clinical features, imaging, surgical interventions, and outcomes were extracted. A narrative synthesis was conducted; no meta-analysis was performed due to the heterogeneity and limited number of available studies. Data extraction was performed independently by two reviewers who independently screened titles, abstracts, and full texts, with disagreements resolved by discussion. In addition, three original case reports from our institution were included to further illustrate the clinical and rehabilitative variability of hearing impairment in BWS. Results: We identified 40 patients from the review, but only 12 of them reported audiological data (e.g., hearing thresholds, type of hearing loss, or diagnostic tests). Ossicular chain anomalies, particularly stapes fixation, were frequently observed. Surgical management improved hearing in selected cases, while bone conduction devices (BCD) or conventional amplification were effective alternatives when surgery was contraindicated. Genetic analyses revealed CDKN1C mutations or imprinting defects in nine patients. Conclusions: Hearing impairment in BWS is clinically relevant and often conductive, likely related to middle-ear anomalies. Early, multidisciplinary audiological evaluation—including imaging when indicated—and individualized rehabilitation can optimize auditory and communicative outcomes. The evidence is limited by the small number of studies and heterogeneous reporting of audiological outcomes. Full article

Background/Objectives: The optimal treatment strategy for periprosthetic femoral fractures (PFFs) around cementless femoral stems remains controversial, particularly for fractures in which stem stability is difficult to determine preoperatively. While revision arthroplasty is often recommended for unstable stems, open reduction and internal fixation (ORIF) continues to be widely used in clinical practice. This study aimed to evaluate mid- to long-term clinical outcomes, complications, and mortality of ORIF for PFFs around cementless stems. Methods: We retrospectively reviewed patients who underwent ORIF for PFFs around cementless femoral stems at a single tertiary referral center between March 2002 and March 2021. Clinical and radiographic outcomes, complications, reoperation, and mortality were assessed. Kaplan–Meier survival analysis was performed to estimate the survival rates for being free of revision and reoperation. Results: A total of 53 patients were included, with a mean follow-up of 4.4 years (range, 1.0 to 19.6). The mean age was 71.0 years, and 30 patients (56.6%) were female. Most fractures were Vancouver type B1 (84.9%). Radiographic union was achieved in 51 patients (96.2%), with a mean time to union of 20.5 weeks. The estimated revision-free survival was 98.1% (95% CI, 87.4–99.7%), and the reoperation-free survival rate was 94.3% (95% CI, 83.5–98.1%) at 5 years. The one- and five-year mortality rates were 5.7% and 22.6%, respectively. Conclusions: Open reduction and internal fixation for PFFs around cementless stems demonstrated acceptable mid- to long-term outcomes with comparable survivorship in selected patients. Although reoperations were not uncommon, mortality rates were comparable. ORIF may represent a reasonable treatment option in carefully selected patients, particularly those with high surgical risk. However, as the cohort was predominantly composed of B1 fractures, the findings should be interpreted primarily in the context of this fracture subtype. Full article

Material and texture decisions in bionic machinery installation art often remain intuition-dependent, limiting the reusability of empirical evidence for experience design. Building on the biomimetic content logic in biomimetic design theory, this study proposes a targeted framework—Texture Bionics—and operationalizes texture into four quantifiable perceptual dimensions: transparency, hardness, roughness, and surface texture, forming a controllable sample space of 12 plastic texture conditions. A case database encompassing 56 representative works (2000–present) was constructed to justify material selection; plastics were chosen for their tunable properties and feasibility for parameterized modulation. In a standardized viewing setup (≈500 lx illumination; 60 cm viewing distance), participants viewed a dynamic biomimetic mechanical wing module with interchangeable textured plastic surfaces. Subjective affect responses were captured using PAD ratings, and objective attention was assessed via wearable eye-tracking technology. Repeated-measures analyses showed robust main effects of texture on total fixation duration across all four dimensions, and selective effects on time to first fixation (significant/marginal for transparency, roughness, and surface texture but not hardness); pupillary response metrics provided no stable discrimination. PAD mappings further revealed functional “role types” (e.g., Key driver, Explore guide, Stable base), and a strong association between Arousal and inter-participant variability in fixation distribution, suggesting that high-arousal textures act as strategy amplifiers rather than uniformly increasing attention. Finally, findings were translated into an actionable Texture Design Toolkit using a three-question workflow—function label → attention goal → differentiation risk—to support evidence-based orchestration of installation narratives. Full article

Decision-making under time pressure has been associated with reduced deliberation and increased sensitivity to contextual cues such as framing. This study investigates how time pressure reshapes information processing in risky decision-making and which types of information receive greater attention when cognitive resources are constrained. Two experiments examined the combined effects of time pressure, spatial position, and presentation order on framing effects, integrating behavioral risk-choice measures with gaze-based indices of attention allocation. The results show that time pressure significantly reduces fixation counts and fixation durations, suggesting more restricted information search. Moreover, time pressure enhances frame-consistent risk preferences, with contextual presentation factors further shaping decision outcomes. Specifically, under time pressure and loss framing, stronger risk seeking emerged when the certain option was presented second. Overall, these findings suggest that time pressure not only amplifies framing effects in risky decision-making but also is associated with changes in attentional allocation patterns and increased reliance on contextual cues underlying framed choices. This study highlights how the temporal and spatial characteristics of information presentation shape decision processes under temporal constraint and provides theoretical and practical implications for decision-making under pressure. Full article

To investigate how knee joint protector design affects the biomechanical characteristics of knee motion under various activities, this pilot study (n = 5) examined how knee joint protector design modulates knee biomechanics across walking, jogging, squatting, and sit-to-stand tasks using optical motion capture and AnyBody musculoskeletal modeling (FullBody_GRFPrediction). We quantified knee flexion kinematics, model-estimated joint reaction forces and moments, and model-estimated muscle activity of eight lower-limb muscles under four conditions with different levels of structural constraint: no protector (Pro.off), a conventional sleeve-type protector (Pro.a), a segmented support protector (Pro.b), and a wrapping fixation protector (Pro.c). The biomechanical protective performance of the knee joint protector was task- and phase-dependent. The results showed that Pro.a optimized muscle activation. Pro.b increased sagittal-plane design but increased joint loading and muscle activity. Pro.c induced noticeable distal compensation along the kinetic chain. The findings revealed that protector effects were task-dependent. Dynamic tasks mainly affected coronal-plane stability parameters, whereas quasi-static tasks more clearly altered sagittal load distribution. In this study, biomechanical protective performance is defined as reduced knee joint loading without disproportionate increases in model-estimated muscle activity or excessive loss of functional knee flexion range. Under this definition, greater structural constraint did not consistently produce a more favorable biomechanical profile. These results provide a feasibility baseline for task-specific protector evaluation and motivate confirmatory studies with larger cohorts and experimental validation. This study provides theoretical and methodological insights to guide future design and optimization of knee joint protectors. Full article

Zone 2 thoracic endovascular aortic repair (TEVAR) frequently requires left subclavian artery (LSA) preservation to maintain vertebrobasilar and upper-extremity perfusion while obtaining a durable proximal seal. Dedicated single-branch endografts were developed to standardize this step and to facilitate a reproducible fully endovascular strategy. Two main device concepts currently shape this field: integrated unibody branch platforms, represented by Castor and the second-generation Cratos, and modular retrograde-branch systems, represented by the Gore TAG Thoracic Branch Endoprosthesis (TBE). The Castor/Cratos evidence base is broader and older, and is mainly centered on type B aortic dissection, with prospective multicenter and real-world data showing favorable branch patency and aortic remodeling. By contrast, TBE evidence is expanding rapidly and is supported by prospective midterm data in arch aneurysms as well as by increasingly large post-commercial series and comparative analyses across zones 0–2. Beyond outcomes, the two platforms differ substantially in branch directionality, potential contribution to proximal fixation, modularity, branch diameter range, proximal landing requirements, access profile, and regulatory/off-the-shelf availability, all of which have direct consequences for anatomical suitability in dissection, aneurysm disease, and trauma. This narrative review synthesizes current evidence and proposes an anatomy-first, pathology-aware framework for selecting between Castor/Cratos and TBE in totally endovascular zone 2 TEVAR with LSA revascularization. Full article

Background: Syndesmotic screw breakage is a well-recognized mechanical complication following ankle fracture fixation. Although several studies have investigated patient-related and technical factors associated with screw breakage, the temporal pattern of screw failure and implant survival remains less clearly defined. Therefore, this study aimed to evaluate one-year syndesmotic screw survival using time-to-event analysis and to identify factors associated with screw breakage. Materials and Methods: A total of 132 patients with unstable AO-Weber 44-B/C ankle fractures treated with syndesmotic screw fixation were retrospectively analyzed. Patients were followed for a minimum of 12 months or until screw breakage occurred. Screw survival was evaluated using Kaplan–Meier analysis and Cox proportional hazards regression was performed to identify factors associated with screw breakage. Demographic variables, fracture type, and screw-related parameters were analyzed. Receiver operating characteristic (ROC) analysis was used to assess the discriminative ability of age. Results: Screw breakage occurred in 31 patients (23.5%) during follow-up. Kaplan–Meier analysis demonstrated significantly lower screw survival in Weber C fractures compared with Weber B fractures (log-rank p < 0.001). Cox regression analysis identified younger age (HR: 0.965, 95% CI: 0.937–0.993, p = 0.016) and Weber C fracture type (HR: 1.811, 95% CI: 1.260–2.602, p = 0.001) as independent predictors of screw breakage. ROC analysis showed that age had moderate discriminative ability (AUC: 0.719, 95% CI: 0.612–0.816), with a cut-off value of 35.5 years. Conclusions: Younger age and Weber C fracture type are associated with an increased risk of syndesmotic screw breakage and Weber C fractures also demonstrating reduced screw survival. These findings may assist in patient counseling; however, the clinical implications of screw breakage remain uncertain. Full article

Mitogen-activated protein kinase kinase kinases (MAPKKKs) play important roles in plant responses to abiotic stresses; however, the function of SiMAPKKK17 in mediating drought tolerance in foxtail millet remains unclear. In this study, the expression pattern, subcellular localization, and biological function of SiMAPKKK17 were investigated to clarify its role in the drought stress response. Tissue expression analysis showed that SiMAPKKK17 was expressed across developmental stages and in multiple organs, with the highest transcript level observed at the booting stage and comparatively higher expression in vegetative tissues, including roots, stems, and leaves. Subcellular localization analysis demonstrated that SiMAPKKK17 was localized to both the plasma membrane and the nucleus, suggesting potential involvement in membrane-associated signal transduction and nuclear regulatory processes. To evaluate its function, foxtail millet lines overexpressing SiMAPKKK17 were generated and subjected to drought stress. Compared with wild-type plants, the overexpression lines exhibited enhanced drought tolerance, as indicated by greener and more upright upper leaves, higher aboveground fresh weight, greater plant height, and larger leaf area under drought conditions. Transcriptome analysis of OE4 and WT plants under drought stress identified 3919 upregulated genes and 2965 downregulated genes in OE4 compared with WT. These differentially expressed genes were mainly enriched in chloroplast-related cellular components, as well as biological processes and metabolic pathways related to cellular amide metabolism, ion transport, carbon metabolism, photosynthesis, carbon fixation, purine metabolism, and amino acid biosynthesis. Taken together, these results indicate that SiMAPKKK17 acts as a positive regulator of drought tolerance in foxtail millet, potentially through modulation of photosynthesis- and metabolism-related pathways. This study provides evidence for the molecular mechanisms underlying drought tolerance in foxtail millet and identifies SiMAPKKK17 as a promising candidate gene for the development of drought-resistant cultivars. Full article

The Qinghai–Tibet Plateau is undergoing rapid warming and humidification, with altered precipitation regimes increasingly affecting soil nitrogen cycling and N₂O emissions. Denitrification—a key nitrogen transformation pathway—is particularly sensitive to these hydrological changes. Here, we investigated the response of nirK-type denitrifying microbial communities to altered precipitation in an alpine wetland on the northern shore of Qinghai Lake. Using a long-term precipitation manipulation platform with five gradients (ambient, ±25%, and ±50%), we integrated high-throughput sequencing with bioinformatics to systematically assess community shifts. Short-term precipitation treatments did not significantly alter alpha diversity, but markedly restructured community composition. Extreme wetting (+50%) increased within-group heterogeneity. At the phylum level, Proteobacteria remained dominant across all treatments, whereas extreme drought (−50%) suppressed Planctomycetes. At the genus level, Ochrobactrum was enriched under reduced precipitation, while Rhodopseudomonas increased under increased precipitation. Functional predictions indicated that reduced precipitation enhanced nitrogen fixation potential, whereas increased precipitation favored nitrate respiration. Soil pH and carbon fractions were the key environmental filters driving community variation. Ecological process analysis revealed that community assembly was entirely governed by deterministic processes, specifically variable selection. Together, these findings elucidate how precipitation shifts reconfigure the structure and functional potential of denitrifying microbial communities in alpine wetlands, primarily via changes in soil pH and moisture under variable selection. This work provides critical insights into microbial regulation of the nitrogen cycle on the Tibetan Plateau under ongoing climate change. Full article

Volcanic lava has a complete primary succession; the plant community composition can explain a great part of the variation of soil microbial diversity and community structure. Bacteria dominate the soil microbial communities in abundance and diversity, and they are important drivers of organic matter decomposition and nutrient cycling. With 16S rRNA Illumina Miseq sequencing techniques, we analyzed the soil bacterial communities and diversities associated with different vegetation types in Wudalianchi. Shrub soils had the highest pH, MC, TOC, TN, AP, AN and NN, whereas moss soils had the lowest. The Shannon, Ace, and Pd indices of bacteria showed significant differences in the different vegetation types (p < 0.05). Bacterial Ace, Shannon, and Simpson indices peaked in Herb and Shrub is highest. The Proteobacteria, Actinobacteriota, Acidobacteriota, Planctomycetota and Chloroflexota were the most abundant groups at phyla level. Bacterial community composition varied significantly across vegetation types (p < 0.05). At the family level, Pseudonocardiaceae predominated in moss soils. Redundancy analysis and correlation analysis revealed MC, pH, and TP as key environmental factors shaping bacterial communities. Functional predictions based on taxonomic data indicated that chemoheterotrophy and aerobic chemoheterotrophy were the predominant functional groups. In conclusion, although soil microbial composition and diversity differed markedly across vegetation types following volcanic eruptions, functional groups prioritized carbon fixation strategies. Full article