Browse Articles

Immediate full weightbearing with additive cerclage improves early mobility after tibial shaft spiral fractures

Abstract In recent years, the trend in orthopedic and trauma surgery has shifted towards earlier mobilization with reduced weightbearing restrictions to enhance patient recovery. Tibial-shaft-spiral-fractures pose a challenge for early mobilization. This study examines the use of additive cerclages, which allow for immediate full-weightbearing, and compares it to the standard-of-care (SOC) treatment with partial-weightbearing. The primary aim was to evaluate mobility, return-to-daily-activities, and safety outcomes. This prospective multicenter study included 36 patients with tibial-shaft-spiral-fractures. Group1 ( n  = 20) received an additive cerclage and was permitted immediate full weightbearing-as-tolerated, while Group2 ( n  = 16) followed SOC with 20 kg partial weightbearing for 6 weeks. Gait analysis was performed at 1,3,6, and 12-weeks, as well as 6-months post-surgery, using the loadsol ® force-measuring device. Patient-reported outcomes, including pain levels, quality of life (EQ-5D), and return to daily activities, were assessed at these intervals. The results showed that immediate weightbearing as tolerated led to significantly faster mobilization. By week-3, 35% (7 of 20) of patients in Group1 were walking unassisted compared to 6.25% (1 of 16) in Group 2 ( p  = 0.04). By week 6, 75% (15 of 20) of patients in Group1 were walking without crutches, compared to 31.25% (5 of 16) in Group2 ( p  = 0.002). Gait speed and mobility were significantly improved in the cerclage group throughout the early postoperative period, with quality of life scores also higher during the early postoperative phase (gait speed week 3 2.57 ± 0.49 km/h vs. 2.16 ± 0.70 km/h, p  = 0.032; EQ-5D week 1 3.59 ± 0.85 vs. 3.05 ± 0.56, p  = 0.017). No significant differences in complications were observed between the groups. The use of additive cerclages for tibial-shaft-spiral-fractures is a safe and effective method that allows for immediate full-weightbearing, resulting in earlier mobilization and improved short-term quality of life. Trail registration number: DRKS00035464 ( www.drks.de ), Date of registration: 17/12/2024.

Quantum-resilient and adaptive multi-region data aggregation for IoMT using zero-knowledge proofs and edge intelligence

Mysterious cosmic ‘dots’ are baffling astronomers. What are they?

In vivo CRISPR screens identify modifiers of CAR T cell function in myeloma

Association of metabolic score for visceral fat (METS-VF) with lumbar spine bone mineral density in US adults

A data driven model based approach for medium-to-long-term electricity price forecasting in power markets

Snow droughts, deluge, and reservation systems interact to drive recreation access at Yosemite National Park

Abstract Changes in snow extremes can have important but as yet underexplored impacts on the 1.2-trillion dollar outdoor recreation industry, impacting essential ecosystem services. These hydroclimate conditions interact with reservation systems used by park managers to manage potential impacts to park resources and visitor experiences. Climate change extremes and associated hazards limit and enable access in different ways: snowpack from extreme wet years can prolong road closures at higher elevations, while extreme snow drought enables early season access. Few studies have attempted to assess and compare the influence of snow conditions and reservation systems among a population of visitors, as we do at Yosemite National Park. Roads were still closed into the 2023 peak season from a record extreme snow deluge, yet entry was unrestricted due to lack of a parkwide day use reservation system. This combination led to higher overall visitation levels but spatially constrained visitor mobility and resulted in more crowded conditions and traffic congestion. We assess the efficacy of the day use reservation system in limiting use by comparing differences from the annual mean and monthly volume and timing of visitors. Results show that annual use levels are influenced more by managed access than by climate extremes, and that results differ by overnight use types and traffic count locations with seasonal access limitations. These results demonstrate a novel aspect of the impacts of changing climate extremes with human use of natural resources and suggest that appropriately managed reservation systems are an essential tool for managing recreation resources in a changing climate.

Tuning of crystal structure and electronic band gap of the monoclinic Ga2O3 by simultaneous alloying with Al2O3 and In2O3

Does market access drive trade growth? Evidence from China

Against the backdrop of a turbulent global trade environment, high-quality development of foreign trade is an important driving force for the recovery and sustainable development of both China and other economies worldwide. This study investigates the influence of market access on the high-quality development of foreign trade, using panel data from 260 Chinese cities from 2014 to 2023. A fixed-effects model explores the nonlinear relationship, the transmission mechanisms of industrial structure advancement and economic agglomeration, and the moderating effect of industrial rationalization. The results reveal a significant positive U-shaped relationship: at low levels, market access improvements suppress trade quality, but beyond a critical threshold, the effect turns strongly positive. Mechanism analysis confirms that industrial structure advancement and economic agglomeration are key pathways through which market access promotes trade quality. Moreover, industrial rationalization exerts a moderating effect that reinforces the impact of market access. These findings enrich the understanding of foreign trade upgrading spatial drivers and highlight the nonlinear dynamics of market access in shaping trade quality.

Comprehensive insight into gut microbiota and their interaction with fatty acid profiles in Channa striata during the spawning season

Innovative use of biowaste based cementitious grouts for semi-flexible pavement application and optimization using response surface methodology

This study investigates the potential usage of biowaste (i.e., bagasse ash) in cementitious grouts for semi-flexible pavement applications. Cementitious grouts were prepared by partially replacing cement with bagasse ash (5%, 10%, 15% and 20%) and at w/c ratios of 0.30 to 0.40. Flow cone apparatus was used to determine the flow properties of fresh cementitious grouts. The hardened specimens of cementitious grouts also were tested for compressive strength at curing ages of 7 and 28 days. Moreover, response surface methodology (RSM) was used to analyze the relationships between independent/input variables (bagasse ash and w/c ratio) and dependent/output variables (flow and compressive strength). Compressive strength tests revealed that 7-day strength ranged from 27 MPa to 41 MPa, while 28-day strength ranged from 35 MPa to 65 MPa. Results indicate that bagasse ash significantly influences the flowability and compressive strength of the cementitious grouts, with optimal performance achieved at a 15% replacement level and a 0.35 w/c ratio. The optimal combination achieved a flow value of 16 seconds, a 7-day compressive strength of 32 MPa, and a 28-day compressive strength of 49 MPa. Response surface methodology (RSM) confirmed these results, identifying an optimized mix composition of 16% bagasse ash and a 0.35 w/c ratio. The findings demonstrate the potential of bagasse ash as a sustainable alternative to cement, contributing to reduced environmental impact and improved material performance in semi-flexible pavements.

Steady-state entanglement generation via Casimir-Polder interactions

Coordinated control of acceleration slip regulation and active front steering for in-wheel motor driven electric vehicle based on dynamic slip ratio constraint

In-wheel motor driven electric vehicles are prone to issues such as wheel spin, vehicle sideslip, fishtailing, and steering instability when traveling on compacted snow surfaces. While traditional optimal slip ratio tracking aims to maximize longitudinal force, it significantly compromises lateral force reserves. Moreover, most existing longitudinal-lateral coordination strategies fail to actively constrain the slip ratio, unable to prevent the deterioration of road adhesion conditions. To address these challenges, this study proposes a coordinated control strategy integrating acceleration slip regulation (ASR) and active front steering (AFS) under dynamic slip ratio constraints. To maximize the preservation of tire lateral force margin for enhanced anti-sideslip capability, a dynamic slip ratio constraint control method is proposed. With the objectives of dynamically minimizing wheel slip ratio and maintaining driving stability, the non-dominated sorting genetic algorithm-II (NSGA-II) is employed to optimally distribute the total driving torque. Furthermore, to counteract undesired yaw moments caused by uneven road friction coefficients or torque distribution, an active front steering (AFS) compensation control strategy based on sliding mode control (SMC) is designed to track the ideal yaw rate and sideslip angle, thereby achieving efficient coordination between acceleration slip regulation and yaw stability control. Co-simulations under various conditions are conducted using the Matlab/Simulink-CarSim platform. The results demonstrate that the proposed strategy effectively suppresses wheel spin, reduces lateral path tracking errors, and improves both longitudinal and lateral stability of the vehicle. This study provides an effective solution for enhancing the active safety control of in-wheel motor driven electric vehicles operating in icy and snowy environments.

An approach for enhancing physical education analytics for college sports using AHP based MCDM algorithm integrated with MEREC method

LPD-YOLOv7-tiny: An enhanced lightweight YOLOv7-tiny model for real-time potato quality detection

To solve the problems of low detection accuracy, large model size and slow reasoning speed of existing potato quality detection models, this paper proposes LPD-YOLOv7-Tiny, a lightweight potato sprout and spoilage detection model based on YOLOv7-Tiny. The proposed model introduces MobileNetV3 small, BiFormer, SimAM, and the Focal-EIOU loss function. MobileNetV3 small greatly reduces the number of parameters and computational complexity of the model, BiFormer enhances the multi-scale feature fusion capability of the model, and the SimAM module effectively suppresses irrelevant information and strengthens local features. The Focal-EIOU loss function improves the model’s attention to difficult classification samples and enhances its bounding box regression capability. LPD-YOLOv7-Tiny achieves excellent detection performance on potatoes under complex background conditions: mAP is increased to 90.3%, the number of parameters is reduced to 5.8 MB, the number of computations is reduced to 10.1 G, and the inference speed is increased to 142.5 fps. Compared with mainstream detection models such as the YOLO Basic series, SSD and speed-RCNN, LPD-YOLOv7-Tiny achieves significantly improved performance in terms of detection accuracy, positioning capability and computational efficiency, indicating it has wide application potential in resource-constrained and high-precision scenarios.

Synergistic bactericidal and anticancer potential of rubidium and silver-containing phosphate-based bioglasses

Changes in intraocular pressure before, during, and after playing Thai Traditional, Thai Folk, and Western wind instruments

Objectives To compare and evaluate intraocular pressure (IOP) during and after playing Thai traditional (TT), Thai folk (TF), and Western (WT) wind instruments. Methods Three types of wind instruments were used: Thai traditional, Thai folk, and Western, played by three groups of players according to an identical set of notes for 120 seconds. Five IOP measurements were performed before, during (37 and 101 seconds), and after (150 and 240 seconds) playing the instruments. Primary outcomes were differences in IOP between groups during the performance. Secondary outcomes were differences in IOP between groups after the performance. A mixed-effect model for repeated measures (MMRM) was used for statistical analysis. Results Thirty eyes from 15 participants were included, with mean (SD) baseline IOP of 13.3 (2.7), 12.3 (1.5), and 14.5 (2.4) mmHg in WT, TT, and TF groups ( P  = 0.53). No significant differences in overall IOP change were observed between TT (coefficient −1.2 mmHg; 95% CI −3.5 to 1.1, P  = 0.40) or TF (0.3; −2.1 to 2.8, 0.82) compared to WT group. During the performance (from baseline to 101 seconds), IOP increased significantly in WT (3.1, 0.6 to 5.7, 0.007) and TT groups (2.8, 0.2 to 5.3, 0.02), while TF group did not show a significant increase. However, no significant differences were found when comparing among the three groups. After the performance (150 seconds), mean IOP differences between groups were small and were not significantly different. Conclusions The three types of wind instruments demonstrated no significant differences in IOP elevation during or after performance. While a transient increase in IOP was observed during playing in all groups, IOP returned to baseline within 30 seconds after the performance.

The cognitive connectome in dementia with lewy bodies undergoes early alterations already at the mild cognitive impairment stage

Abstract Cognitive impairment is required to diagnose mild cognitive impairment with Lewy bodies (MCI-LB). However, associations of impairments across cognitive domains remain unclear. In this cross-sectional study, we investigated these associations by assessing the cognitive connectome of MCI-LB patients compared with healthy controls (HC), mild cognitive impairment due to Alzheimer’s disease (MCI-AD), and dementia with Lewy bodies (DLB). Using the National Alzheimer’s Coordinating Center database, we built cognitive connectomes for MCI-LB ( n  = 88), HC ( n  = 3703), MCI-AD ( n  = 1789), and DLB ( n  = 104) by correlating 24 cognitive measures. We compared global and nodal network measures of centrality (importance of cognitive measure), integration (communication across cognitive measures), and segregation (specialisation of cognitive measures) between groups. For global measures, MCI-LB showed lower segregation than HC, with no significant differences from MCI-AD, and lower integration) and higher segregation than DLB. For nodal measures, MCI-LB compared with HC and MCI-AD showed differences in executive and memory measures, respectively. MCI-LB showed several nodal differences compared with DLB, involving executive, processing speed/attention, and language measures. Our findings suggest that MCI-LB involves early changes in the cognitive connectome, particularly reduced segregation that becomes more pronounced at the DLB stage and shows overlap with MCI-AD, offering insights into cognitive impairment in MCI-LB.

Family support after a family member’s suicide: A qualitative exploration

Suicide bereavement presents unique challenges that shape how grief is experienced and supported within relational networks. Although family members often serve as a primary source of support, the interpersonal dynamics underlying such support remain understudied. This study explores how individuals bereaved by a family member’s suicide experience social support within the shared grief context of the family. Fifteen adults participated in semi-structured interviews conducted as part of a mixed-methods project in Germany, examining experiences and determinants of social support following suicide loss. Data were analyzed using qualitative content analysis, combining inductive and deductive coding. Two overarching themes were identified: (1) Contextual factors of family support , including grief reactions and coping patterns, shifts in family dynamics, and the distribution of support roles; and (2) Characteristics of family support , encompassing both supportive experiences—such as emotional closeness, open communication, and shared sense-making—and insufficient support—such as marginalization of grief and emotional neglect, often linked to pre-existing family strain. The availability and quality of support were influenced by protective buffering, relational withdrawal, discomfort surrounding suicide disclosure, and the reconfiguration of relationships after the loss. Extended family members played a significant role in assisting with childcare and relieving emotional burdens on grieving parents, although their support varied depending on attitudes toward suicide and levels of proactive engagement. Family support in suicide bereavement emerged as a dynamic process shaped by personal, relational, and sociocultural influences. These findings highlight the need for multilevel, integrative theoretical frameworks to capture the complexity of family support after suicide. This study underscores the value of systemic postvention strategies that foster emotional expression, shared sense-making, and stigma reduction, while recognizing that family may not be an accessible or supportive resource for all bereaved individuals.

Streptococcus pneumoniae infection is associated with matrix metalloproteinase-9 in lung cancer progression and brain metastases