BackgroundCardiovascular disease constitutes a leading cause of morbidity and mortality among women following menopause, with triglyceride (TG) dysregulation serving as a critical pathophysiological contributor. Despite accumulating evidence supporting the efficacy of structured exercise interventions, consensus regarding the optimal modality and “dose” required to maximize TG reduction in this demographic remains elusive.MethodsWe systematically searched PubMed, Scopus, The Cochrane Library, Web of Science, CNKI, Wanfang Database, Weipu Database, and Chinese Biomedical Database through December 2025. Eligible studies comprised randomized controlled trials (RCTs) enrolling postmenopausal women, comparing aerobic exercise (AE), combined exercise (CE), resistance training (RT), high-intensity interval training (HIIT), and control (CON). A random-effects model was employed for network meta-analysis (NMA), computing mean differences (MD) and 95% credible intervals (CrI). Treatment hierarchies were established via surface under the cumulative ranking curve (SUCRA). Exercise doses were standardized to metabolic equivalent task minutes per week (MET-min/week), and a dose-response meta-analytic framework was applied to characterize potential non-linear relationships between exercise volume and TG modification.Results51 RCTs encompassing 2,046 participants were included. Network meta-analysis demonstrated that HIIT (MD: −0.23 mmol/L, 95% CrI: −0.44 to −0.03), AE (MD: −0.20 mmol/L, 95% CrI: −0.27 to −0.13), and CE (MD: −0.17 mmol/L, 95% CrI: −0.31 to −0.03) significantly reduced TG relative to CON, whereas RT did not reach statistical significance (MD: −0.10 mmol/L, 95% CrI: −0.25 to 0.05). SUCRA rankings identified HIIT as the most efficacious intervention (79.44%), followed by AE (73.03%), CE (60.63%), and RT (34.16%), though the HIIT estimate was based on only three studies and is therefore uncertain. Dose-response modeling suggested a non-linear association between exercise volume and TG reduction, with tentative optimal therapeutic ranges: HIIT at 1,000–1,300 MET-min/week, AE at 830–1,000 MET-min/week, and CE at 830–1,200 MET-min/week, beyond which effects appeared to plateau.ConclusionsThis investigation provides preliminary evidence suggesting a non-linear dose-response relationship between exercise volume and TG reduction in postmenopausal women. HIIT demonstrated the highest relative efficacy in SUCRA rankings, though this conclusion is based on limited evidence and wide credible intervals. All active interventions produced clinically meaningful TG lowering within tentative dose ranges, but the observed non-linear pattern should be interpreted cautiously given the low-to-moderate certainty of evidence. These findings challenge the simplistic “more is better” paradigm and offer hypothesis-generating guidance for precision exercise prescription, pending confirmation by future high-quality RCTs.
IntroductionPreoperative estimation of non-gross-total resection (non-GTR), as defined on early postoperative magnetic resonance imaging (MRI), may support patient counseling and postoperative surveillance planning after surgery for nonfunctioning pituitary neuroendocrine tumors (NF-PitNETs). We evaluated whether a clinically informed, interpretable preoperative modeling strategy improved risk estimation compared with a reference strategy.MethodsWe retrospectively analyzed 354 first-surgery patients from a single center with a documented early postoperative MRI-based resection-status endpoint; 57 (16.1%) had non-GTR. A prespecified clinically informed logistic strategy extended a reference model based on routine preoperative clinical and MRI variables by adding transformed terms representing nonlinear tumor burden and invasion severity. Models underwent stratified repeated nested cross-validation with five outer folds repeated 20 times and four-fold inner tuning. Performance was evaluated using patient-level averaged held-out predictions.ResultsUnder model-specific tuning strategies, the clinically informed strategy showed little change in discrimination compared with the reference strategy (area under the receiver operating characteristic curve, 0.8054 vs. 0.8022; area under the precision-recall curve, 0.4603 vs. 0.4534), but had a lower Brier score (0.1100 vs. 0.1480) and calibration closer to ideal (intercept, 0.0256 vs. −0.3778; slope, 1.0209 vs. 2.5233). It also showed greater model-based net benefit across an exploratory threshold range of 0.05–0.50 and separated cohort-derived tertiles with observed non-GTR rates of 4.2%, 8.5%, and 35.6%. Postoperative pathological variables provided little incremental value.DiscussionThese findings represent single-center internal validation of complete modeling strategies. Because the strategies differed in both predictor representation and tuning objective, the calibration difference cannot be attributed to the transformed predictors alone. Independent external validation using standardized postoperative MRI, together with uniform-tuning and reduced-model sensitivity analyses, is required before application to counseling or surveillance planning.
IntroductionThe hamstrings are essential for sports and daily activities, yet high stiffness and reduced flexibility increase injury risk. Existing relaxation techniques may be ineffective or impractical in clinical settings. This study investigated the immediate effects of radial extracorporeal shock wave therapy (rESWT) on hamstring stiffness and flexibility in individuals with hamstring tightness, providing preliminary evidence for its therapeutic potential for hamstring tightness.MethodsIn total, 131 participants with hamstring tightness were randomized to receive either active rESWT (n = 66) or sham control intervention (n = 65). Flexibility was assessed using the sit-and-reach test (SRT), active knee-extension test (AKE), and active straight leg raising test (ASLR), measured pre-intervention and 5 minutes post-intervention. Muscle stiffness was measured using MyotonPRO at 25% (upper), 50% (middle), and 75% (lower) of the line connecting the ischial tuberosity and the medial/lateral femoral epicondyles, evaluated pre-intervention, immediately post-intervention, and 5 minutes post-intervention.ResultsFor flexibility, the rESWT group demonstrated significant, large-effect improvements in SRT (|r| = 0.738) and ASLR (|r| = 0.848) performance, along with a reduction in knee-extension deficit (AKE, |d| = 1.584) (all PFDR < 0.001). The control group improved significantly only in SRT (PFDR = 0.008, moderate effect |r| = 0.350). Between-group comparisons revealed significantly greater improvements for rESWT in all three measures (all PFDR < 0.001; moderate-to-large effects: SRT |δ| = 0.373, AKE |d| = 1.858, ASLR |δ| = 0.683). Notably, post-intervention SRT raw scores reflecting final performance showed no significant between-group difference (PFDR = 0.091). Regarding muscle stiffness, significant group × time interactions with large effects occurred across all hamstring sits (all PFDR < 0.001, η² = 0.200-0.410). Both groups exhibited significantly reduced stiffness immediately post-intervention (all PFDR < 0.001); however, only the rESWT group maintained significant reductions at 5 minutes post-intervention (all PFDR < 0.001). The rESWT group exhibited significantly lower stiffness than the controls both immediately and 5 minutes after intervention at the 50%/75% semitendinosus and 75% biceps femoris (all PFDR < 0.05).ConclusionrESWT produces immediate and 5-minute short-term reductions in mid-to-lower hamstring stiffness and improves hamstring flexibility, suggesting potential for the immediate management of hamstring tightness.
IntroductionRodent models based on prenatal valproic acid (VPA) exposure are widely used to investigate autism spectrum disorder (ASD)-related neurobehavioral and biological alterations. Over the past two years, the rapid expansion of VPA-based research incorporating advanced molecular, neuroimaging, electrophysiological, and microbiota analyses has generated a substantial but fragmented body of evidence.MethodsThis systematic review aimed to synthesize findings from rodent studies published between January 2024 and November 2025 that employed prenatal VPA exposure, with particular emphasis on behavioral, neurobiological, inflammatory, microbiota–gut–brain axis, gene-expression, and histopathological outcomes. A structured search was conducted in PubMed, Scopus, Web of Science Core Collection, Embase, and PsycINFO, supplemented by manual screening in Google Scholar. Controlled vocabulary and free-text terms related to ASD, VPA, and rodent models were combined. Original in vivo studies administering VPA during gestation and reporting behavioral and/or biological outcomes were included. Because of substantial heterogeneity in VPA dose, administration route, gestational timing, species, strain, sex, and outcome domains, findings were synthesized narratively. Risk of bias was assessed using the SYRCLE risk-of-bias tool, and reporting completeness was evaluated using the ARRIVE 2.0 guidelines.ResultsSixty-six eligible prenatal VPA studies were included. Most administered a single intraperitoneal dose of 500 or 600 mg/kg around embryonic day 12–12.5. Across studies, prenatal VPA exposure was consistently associated with ASD-like phenotypes, including reduced sociability, impaired social novelty preference, repetitive behaviors, anxiety-like traits, and cognitive deficits. Frequently reported biological alterations included oxidative stress, neuroinflammation involving NF-κB and NLRP3 signaling, neurotransmitter dysregulation, impaired synaptic plasticity, microbiota-related changes, and region-specific brain abnormalities.DiscussionRecent prenatal VPA studies therefore extend beyond classical behavioral characterization by integrating neuroimmune, oxidative, microbiota-related, transcriptomic, electrophysiological, and histopathological findings. However, substantial methodological heterogeneity and incomplete reporting of randomization, blinding, animal-flow, and litter-level procedures limit cross-study comparability, reproducibility, and translational interpretation.
IntroductionBenefiting from its radiation-free property and excellent soft-tissue contrast, magnetic resonance imaging (MRI) has become a crucial modality for prostate cancer diagnosis. However, automatic segmentation of prostate cancer lesions in MRI is still a challenging task due to the considerable variations in lesion morphology and scale, as well as the often indistinct boundaries between tumors and surrounding tissues. To address these challenges, we propose ACLA-Net, an attention-guided cross-level alignment network tailored for MRI-based prostate cancer lesion segmentation.MethodsSpecifically, ACLA-Net is built upon the U-Net architecture. To enhance the interaction and alignment of encoder features across different semantic levels, a cross-level feature alignment module (CLFAM) is introduced into the second, third, and fourth skip connections. Meanwhile, a spatial attention-guided fusion module (SAFM) is incorporated into the first skip connection to emphasize discriminative spatial cues and improve the fusion of shallow features. At the bottleneck stage, a SE-guided context aggregation module (SECAM) is employed to capture richer global contextual information and strengthen high-level semantic representation. Furthermore, the conventional double convolution blocks in the encoder are replaced with the SE-guided multi-kernel depthwise module (SEMKDM), which improves multi-scale feature extraction while reducing computational redundancy.Results and discussionTo evaluate the effectiveness and generalization ability of the proposed method, extensive experiments were conducted on two self-constructed prostate cancer MRI datasets, namely ProstateCancer-T2WI and ProstateCancer-ADC, as well as the public DDTI thyroid dataset. On ProstateCancer-T2WI, ACLA-Net achieved Dice, MCC, and Jaccard scores of 0.7798, 0.7782, and 0.6403, while on ProstateCancer-ADC, it obtained corresponding scores of 0.8332, 0.8328, and 0.7159. Furthermore, on the public DDTI dataset, ACLA-Net attained Dice, MCC, and Jaccard scores of 0.7752, 0.7438, and 0.6338. In addition, ablation studies were carried out to verify the effectiveness of each proposed module. The experimental results demonstrate that ACLA-Net achieves reliable segmentation performance on prostate cancer MRI and favorable generalization on the public dataset, suggesting its potential to provide useful support for lesion delineation and subsequent clinical assessment.
Tomicus yunnanensis, the most destructive pest in southwestern China, kills trees by predisposing the host for co-infestation by two sympatric species. Its survival relies largely on diverse capacities of its alimentary canal; thus, micro-computed tomography (micro-CT) and microscopic imaging reveal the morphology and topographical position of the gut, as well as the absence of sex-related differences in total length and regional organisation. The foregut, midgut, and hindgut account for 19.6%, 49.8%, and 30.6% of the total length, respectively. The crop is well developed and bears intimal spines, whereas the proventriculus is highly sclerotized, encircled by robust circular muscles and equipped with cuticular plates and teeth. The midgut is divided into anterior and posterior regions; only the latter possesses gastric caeca. The posterior midgut is structurally similar to the anterior midgut with respect to well-differentiated organelles, but exhibits longer microvilli and more abundant basal folds of the epithelial cells. A cryptonephridial system of six Malpighian tubules, arranged in two groups and attached distally to the anterior rectum, shows distinct proximal-distal structural differences. Epithelial folds forming microvillus-like structures, as well as microfibrils within the endocuticle, vary along the length of the hindgut. These findings are discussed in comparison with the alimentary canal of other Curculionidae (Coleoptera), with a particular focus on the Scolytinae.
BackgroundPostpartum pelvic floor dysfunction (PFD) manifests as decreased pelvic floor muscle strength (PFMS), stress urinary incontinence (SUI), pelvic organ prolapse (POP), and impaired sexual function. Pelvic floor muscle training (PFMT) is the first-line therapy but often limited by poor muscle perception and adherence. Electrical stimulation (ES) and biofeedback (BF) may enhance outcomes, yet their combined effect with PFMT has not been systematically quantified.MethodsFollowing PRISMA 2020 guidelines, PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang, VIP, and SinoMed were searched to July 9, 2026. Randomized controlled trials (RCTs) comparing ES+BF+PFMT with PFMT alone were included. The population was restricted to women within 12 months postpartum. Outcomes were PFMS, SUI incidence, POP severity, and sexual function. Pooled mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CI) were calculated. Subgroup and sensitivity analyses were performed, publication bias was assessed for outcomes with at least 10 studies, and the certainty of evidence was evaluated using GRADE.ResultsTwenty-nine RCTs were included. ES+BF+PFMT significantly improved PFMS (MD = 0.85, 95% CI: 0.69–1.01), reduced SUI incidence (RR = 0.36, 95% CI: 0.26–0.49), lowered POP-Q stage (MD=−0.29, 95% CI: −0.39 to −0.20), and enhanced sexual function (MD = 4.38, 95% CI: 3.41–5.34). Exploratory subgroup analyses suggested that Kegel training duration may contribute to PFMS heterogeneity. GRADE assessment indicated moderate certainty for SUI incidence, low certainty for PFMS and sexual function, and very low certainty for POP severity.ConclusionsCompared with PFMT alone, ES+BF+PFMT may provide additional benefits for postpartum PFD rehabilitation within the first year, with the most consistent evidence observed for reducing SUI incidence. Potential benefits were also observed for PFMS and sexual function, whereas the POP-Q findings should be interpreted with particular caution because the certainty of evidence was very low. The generalizability of these findings is limited because all included studies were conducted in China.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251134152, identifier CRD420251134152.
Human spaceflight alters physiology in ways that can impact drug safety and efficacy, yet progress in this area has been hampered by a lack of integrated data. Our primary objective was to establish a Findable, Accessible, Interoperable, and Reproducible (FAIR) data curation framework by developing a novel database of pharmaceuticals used in spaceflight. This resource, compiled from publicly available literature, serves as a foundation for integrated pharmacological analysis. Using this resource, we demonstrate a data-driven framework for identifying pharmacologically-relevant, spaceflight-responsive genes by intersecting our drug catalog with available space-omics datasets. By focusing on the biological mechanisms perturbed by spaceflight, this approach provides a new avenue for pinpointing the most relevant changes within drug absorption, distribution, metabolism, and excretion (ADME) pathways. While necessarily limited by available tissue types, this work provides both the justification and a definitive starting point for spaceflight-guided pharmacogenomics. Ultimately, this establishes a foundational methodology to ensure the health and safety of future astronauts on long-duration missions to the Moon, Mars, and beyond.
Platelet function and count display robust circadian oscillations with a period of approximately 24 hours, governed by the core molecular clock and modulated by environmental factors such as light, diet, and stress. This review elaborates on three key aspects. First, platelet surface markers peak around 8–9 AM, whereas platelet count, ATP release, and aggregability reach their maximum between 3–8 PM. Mechanistically, the nuclear receptor Rev-erbα drives the morning surge in platelet reactivity and thrombosis via the OPHN-1/RhoA/ERM signaling pathway. Second, through their circadian rhythm, platelets actively participate in the pathogenesis of cardiovascular diseases, neurological disorders, and metabolic diseases. Third, circadian-targeting drugs including tasimelteon, ramelteon, agomelatine, SR9009, VTP-43742, and PF-670462 offer novel therapeutic strategies for rhythm-related disorders. This review highlights the circadian regulation of platelets as an emerging therapeutic target in human diseases.
With the increasing demand for personalized exercise guidance and real-time health assessment, sports health monitoring is shifting from single-index measurement toward continuous and objective human state assessment. Human bioimpedance, used in this review as an umbrella term for the complex electrical impedance measured in human tissues, has become an important physiological sensing approach owing to its portability, operational safety, and compatibility with wearable platforms. The measured impedance is decomposed into resistance and reactance, from which impedance magnitude and phase angle (PhA) are derived, whereas bioelectrical impedance analysis (BIA), bioimpedance spectroscopy (BIS), and electrical impedance myography (EIM) represent distinct analytical or regional assessment frameworks. These measurements can provide information related to body composition, fluid distribution, membrane-associated polarization, and local tissue status. This review summarizes recent advances in human bioimpedance for sports health monitoring, focusing on its physiological basis, impedance models, measurement principles, parameter interpretation, and applications in body composition, hydration, fatigue, muscle function, and multimodal monitoring. Existing studies indicate substantial potential for repeated and individualized assessment; however, practical use remains limited by measurement repeatability, motion artifacts, electrode–skin interface stability, model generalizability, and insufficient validation under dynamic conditions. Future research should strengthen standardized reporting, wearable acquisition, multisource data fusion, and physiologically grounded analytical methods.
Obesity is characterized by a chronic low-grade inflammatory state that contributes to insulin resistance, type 2 diabetes, and metabolic syndrome. The gut microbiota has emerged as a critical mediator of this inflammatory process through multiple interconnected mechanisms including metabolic endotoxemia, short-chain fatty acid dysregulation, and intestinal barrier dysfunction. This review synthesizes current evidence on the structural and functional alterations of the gut microbiome in obesity, examines the mechanistic pathways linking dysbiosis to systemic inflammation, and critically evaluates therapeutic strategies aimed at restructuring the obese gut microbial community. We focus on three major intervention approaches: fecal microbiota transplantation, probiotic and prebiotic supplementation, and next-generation targeted microbial therapies. Analysis of clinical and preclinical studies reveals that successful microbial restructuring requires not only compositional shifts but also functional restoration of microbial metabolite production, particularly short-chain fatty acids. The evidence supports a model wherein obesity-associated dysbiosis perpetuates chronic inflammation through increased lipopolysaccharide translocation, reduced butyrate production, and compromised intestinal barrier integrity. Restoring microbial eubiosis through targeted interventions offers a promising avenue for resolving chronic low-grade inflammation and improving metabolic health outcomes in obese individuals.
BackgroundThe sit-to-stand (STS) task is a fundamental functional movement requiring substantial lower-limb joint torque and coordinated neuromuscular control. The knee joint plays a dominant role in generating extensor torque during the body elevation phase. However, existing exoskeleton assistive strategies often lack alignment with the temporal characteristics of joint mechanical demand, limiting their effectiveness.MethodsThirteen healthy male participants performed STS tasks under both non-assisted and exoskeleton-assisted conditions. A pressure-based motion intention recognition method was developed using anterior thigh pressure signals to detect movement onset. Three assistive torque levels (3.0 Nm, 4.5 Nm, and 6.0 Nm) were applied to the knee joint. Kinematic and kinetic data were collected using a motion capture system and force plates, and knee joint moment, power, and mechanical work were calculated to evaluate biomechanical changes.ResultsRecognition-performance analysis showed that the pressure-threshold algorithm identified the target pre-extension trigger in all six validation recordings, corresponding to a positive-event detection rate of 100% (6/6). The detected trigger occurred at 0.49 ± 0.05 of the pressure-rising phase, and the onset of assistive torque occurred within 0.072 s of knee-extension onset, advancing torque output by approximately 0.228 s compared with a kinematics-only trigger. Because the validation trials included intentional STS attempts only, specificity and overall classification accuracy against non-intention events were not estimated in the present study. Knee joint moment exhibited a clear phase-dependent pattern, characterized by a rapid increase following seat-off and a peak during the body elevation phase. Compared with the control condition, exoskeleton assistance significantly reduced mean and peak knee joint moment under the 4.5 Nm and 6.0 Nm conditions (p < 0.0167). Joint power and total mechanical work were also significantly reduced across assisted conditions. These reductions were observed in healthy young male participants performing a standardized laboratory STS task.ConclusionsIn healthy young male participants under controlled laboratory conditions, knee joint mechanical demand during STS was strongly phase-dependent, and assistance aligned with this temporal structure reduced knee joint loading. The pressure-based intention recognition method provided a practical approach for improving system responsiveness during this standardized task. However, these findings should be interpreted as preliminary biomechanical evidence obtained from healthy participants, rather than direct evidence of clinical efficacy. Further studies involving older adults, patients with functional impairments, and real-world testing conditions are required before clinical or rehabilitation applications can be inferred.
Allergic rhinitis (AR) is a prevalent chronic noninfectious inflammatory disorder. Emerging evidence suggests that the gut microbiota, as a central component of the human microecological system, plays an important role in the development and progression of AR through the gut–nasal axis. Chinese herbal medicine (CHM) has been shown to improve clinical symptoms and quality of life in patients with AR, and these therapeutic benefits may be related to its capacity to modulate gut microbial composition and activity. This review outlines the effects of CHM on the gut microbiota in AR and further explores the possible mechanisms involved.
ObjectivesWhile an increasing number of studies highlight the significance of vitamin D supplementation for athletic performance, the effects of short-term high-dose vitamin D3 supplementation on exercise-induced inflammation remain unclear. This study aimed to evaluate the effects of 21 days of vitamin D3 supplementation (10,000 IU/day) on inflammatory biomarkers and maximal anaerobic performance in physically active men performing the 2 × Wingate Anaerobic Test (2xWAnT).MethodsThirty physically active men were randomly assigned in a double-blind manner to a vitamin D3 group (10,000 IU/day in vegetable oil; n = 15; aged 24.21 ± 4.35) or a placebo group (vegetable oil; n = 15; aged 23.15 ± 3.44). During the supplementation period, one participant from the vitamin D3 group and two from the placebo group were excluded because of non-compliance, leaving 27 participants for the final analyses (vitamin D3, n = 14; placebo, n = 13). Venous blood samples were collected at rest, immediately after, 3 h after, and 24 h after the 2xWAnT, before and after the 21-day intervention.ResultsResting 25(OH)D increased by +55.7% after supplementation in the vitamin D3 group. Wingate outcomes showed no differential effect of vitamin D3 versus placebo on anaerobic performance. At rest, vitamin D3 supplementation was associated with lower IL-1β and IL-6 concentrations and higher IL-10 concentrations. After the 2xWAnT, the vitamin D3 group showed an attenuated IL-1β response, lower IL-1RA concentrations during the post-exercise period, and higher IL-10 concentrations across the post-exercise period. In contrast, despite the pronounced exercise-induced increase in IL-6, the post-exercise time course of this biomarker did not differ between groups.ConclusionsTwenty-one days of vitamin D3 supplementation increased serum 25(OH)D concentrations but did not improve anaerobic performance. Supplementation was associated with changes in selected resting and post-WAnT inflammatory biomarkers, suggesting modulation of the biochemical inflammatory response to repeated supramaximal anaerobic exercise. Functional recovery outcomes were not assessed.
Prehospital pain management is challenging and is expected to become even more complex in future large-scale combat operations, where mass-casualty events and evacuation delay may be inevitable. An improved understanding of how analgesic drugs affect the physiological response of trauma patients can enhance treatment efficacy of combat casualties. We previously developed and validated a cardio-respiratory (CR) model for humans that accounts for vital-sign responses to hemorrhagic injuries, resuscitation with six fluid types, airway obstruction, and ketamine analgesia. Here, we extended the model to include the effect of fentanyl on vital signs by integrating existing fentanyl pharmacokinetic-pharmacodynamic models with the neuronal controller of the model. We calibrated and validated the extended model using experimental data from eight studies involving intravenous fentanyl administration (0.71–50.00 μg/kg) to healthy humans and swine with hemorrhagic injury. The model predictions reasonably captured the trend of the experimental data, with root mean square errors (RMSEs) between model predictions and measured data of 0.83 L/min for minute ventilation (MV), 1.20 mmHg for end-tidal carbon dioxide, 0.09 L for tidal volume, and 1.61 mmHg for mean arterial pressure, all of which were within 3–12% of their baseline values. For plasma fentanyl concentration, we obtained RMSEs of 0.79 μg/L in humans and 25.83 μg/L in swine. In simulations, we observed that as hemorrhage increased from 0 to 40% of blood volume, the fentanyl-induced decrease in MV increased from 19 to 34% of its baseline value prior to administration due to reduced fentanyl clearance. Similarly, in simulations of airway obstruction, the fentanyl-induced decrease in MV was 26% of its baseline value after a 100% obstruction compared to only 19% for a no-obstruction condition. Given that most combat casualties receive either fentanyl or ketamine for pain management, the ability to predict and quantify the physiological effects of these drugs will allow us to generate relevant synthetic datasets of diverse battlefield scenarios.
BackgroundBlood lactate accumulation during exercise has traditionally been associated with reduced oxygen availability and an increased reliance on glycolytic metabolism. However, lactate production is influenced by multiple processes beyond oxygen availability. Previous pilot work demonstrated that a standardized controlled breathing intervention produced intermittent reductions in peripheral oxygen saturation comparable to intermittent hypoxic training, but its effects on blood lactate had not been investigated. This crossover study compared normobaric hypoxia (NH) and controlled breathing (CB). We hypothesized that both interventions would increase blood lactate accumulation relative to control.MethodsFifteen healthy adults completed three laboratory visits using a within-subject crossover design. Participants performed an identical 30-minute functional exercise protocol during control (CON), NH (15% inspired oxygen), and CB. Blood lactate was measured at rest, after 10, 20, and 30 minutes of exercise, and after 10 minutes of recovery. Blood lactate AUC, maximum blood lactate, average HR, peripheral oxygen saturation (SpO2), and ratings of perceived exertion (RPE) were assessed. Data were analyzed using linear mixed-effects models with Tukey-adjusted pairwise comparisons.ResultsContrary to hypothesis, NH and CB produced different metabolic responses despite reducing peripheral oxygen saturation. Blood lactate differed among conditions over time (condition × time interaction, p = 0.007), with CB demonstrating lower blood lactate than CON at 10, 20, 30 minutes, and recovery, and lower blood lactate than NH at 20 and 30 minutes. Maximum blood lactate (p = 0.002), blood lactate AUC (p < 0.001), and average HR (p < 0.001) were significantly lower during CB. NH produced greater reductions in peripheral oxygen saturation than CB, although both interventions reduced SpO2 relative to CON. RPE did not differ among conditions (p = 0.371).ConclusionsA standardized controlled breathing intervention was associated with lower blood lactate accumulation, cumulative lactate exposure, peak blood lactate concentration, and average HR despite significant reductions in peripheral oxygen saturation during moderate-intensity exercise. These exploratory findings suggest pulse oximetry-measured peripheral oxygen saturation may not fully predict metabolic responses to exercise. Because underlying mechanisms were not directly assessed, future mechanistic studies using direct measurements of skeletal muscle oxygenation, gas exchange, and metabolic regulation are warranted.
BackgroundBronchoalveolar lavage (BAL) may cause regional lung derecruitment during bronchoscopy. However, this effect may be underestimated by conventional oxygenation monitoring, especially under general anesthesia and mechanical ventilation. This study aimed to assess BAL-associated lung derecruitment using electrical impedance tomography (EIT) and to explore related clinical, radiological, and physiological factors.MethodsThis single-center retrospective observational study included adult patients who underwent BAL with periprocedural EIT monitoring between March 2024 and October 2025. EIT data were analyzed at three time points: before BAL, immediately after BAL, and after completion of the procedure. The primary outcome was residual end-expiratory lung impedance loss after BAL. Secondary outcomes included changes in defect score, global inhomogeneity index, center of ventilation, regional ventilation delay, respiratory mechanics, and oxygen saturation. Linear regression was used to identify factors associated with residual EELI loss.ResultsAmong 405 screened patients, 286 met the inclusion criteria, and 277 were finally analyzed. BAL was associated with a significant decrease in EELI and increases in defect score and global inhomogeneity index, indicating lung derecruitment and more heterogeneous ventilation distribution. Driving pressure increased and dynamic compliance decreased after BAL, while SpO2 showed no significant change. In multivariable analysis, preoperative atelectasis was independently associated with greater residual EELI loss, with an adjusted β coefficient of 1.71 (95% CI 0.41–3.00, P = 0.010). Baseline defect score was also independently associated with residual EELI loss, with an adjusted β coefficient of 0.51 (95% CI 0.07–0.95, P = 0.025). In contrast, total BAL instilled volume, number of BAL cycles, and bronchoscope insertion duration were not significantly associated with residual EELI loss.ConclusionsBAL was associated with immediate lung derecruitment and worsening of regional ventilation distribution under general anesthesia and mechanical ventilation, despite stable SpO2. Preoperative atelectasis and baseline regional ventilation defects were independently related to incomplete lung volume recovery after BAL. EIT may help identify patients at higher risk of BAL-associated lung derecruitment and support individualized respiratory management during bronchoscopy.
BackgroundTable tennis serve is the only technical action fully controlled by athletes during competition. Its biomechanical characteristics directly determine the coherence of the first three strokes, the initiation of active offense, and overall match performance. Conventional serve training relies predominantly on coaches’ empirical judgment and athletes’ subjective perception, which cannot satisfy the growing demand for refined optimization of multi-dimensional biomechanical parameters including spin, speed and placement.ObjectiveExisting studies remain limited in elucidating the coupling relationships among serve biomechanical parameters, establishing a comprehensive evaluation framework that balances competitive efficacy and motor executability, and deploying intelligent methods for individualized serve parameter optimization. This study aims to construct a data-driven multi-objective optimization framework for table tennis serve kinematic and performance parameters.MethodsFive core kinematic and serve-control variables were selected as decision parameters: racket face angle, ball contact height, hitting timing, swing velocity, and landing coordinates. A multi-objective evaluation model was developed, integrating spin intensity, ball speed, placement stability, return suppression effect and motor adjustment cost. An improved particle swarm optimization (PSO) algorithm embedded with dynamic inertia weight, constraint correction, non-dominated sorting and crowding distance mechanisms was applied to generate Pareto optimal solution sets and screen athlete-specific serve schemes. The calibration dataset included 42 athletes (1,512 trials), and the validation dataset included 18 athletes (648 trials). A separate serve–return block involved 18 independent receivers, and individualized recommendations were evaluated in a 4-week pre–post intervention.ResultsThe improved PSO-Pareto method outperformed conventional algorithms in convergence efficiency, solution set diversity and distribution uniformity. Six categories of Pareto-optimal serve schemes with distinct biomechanical and tactical orientations were identified. Individualized parameter recommendations showed descriptive improvements in overall serve quality, landing-point accuracy, return-suppression effect and third-stroke connection performance across different athlete types.ConclusionsThe proposed framework enables quantitative and individualized optimization of table tennis serve kinematic parameters based on measured movement and performance characteristics. It provides a methodological basis for data-driven and precision-oriented serve training, and offers a reference for biomechanical parameter optimization of other sport techniques.
Alveolar macrophages (AMs) are the lung’s phagocytic immune sentinels, programmed to maintain homeostasis while defending against inhaled pathogens. AM metabolism is shaped by both developmental origin and the alveolar microenvironment. Embryonically-derived AMs populate the lungs early in life and develop into long-lived, self-renewing cells displaying lipid-centered, oxidative metabolism that restrains inflammation and preserves alveolar structure. When infection or injury disrupts homeostasis, circulating monocytes are recruited to the airspace and differentiate into monocyte-derived AMs, which adopt a glycolytic, short-lived, pro-inflammatory phenotype. Thus, differences in origin and transcriptional programming create two metabolically distinct AM populations with divergent roles in lung immunity. The intracellular bacterial pathogens Mycobacterium tuberculosis, Coxiella burnetii, Legionella pneumophila, and Francisella tularensis exploit these metabolic programs to facilitate intracellular growth and disease progression. By modulating glycolysis, remodeling mitochondria, manipulating lipid handling, or redirecting host metabolites, these pathogens evade immune insults and create growth niches. In this review, we discuss mechanisms by which AM metabolism shapes the tissue environment and pulmonary immunity, and we showcase intracellular pathogens to understand pro-bacterial reprogramming of AM metabolism.
PurposeThis study applied statistical parametric mapping (SPM) to examine temporal differences in bilateral lower limb neuromuscular control and kinetics during unilateral countermovement jumps (CMJ) in speed climbers, and to explore their relationship with sport-specific performance.MethodsFourteen elite male climbers completed unilateral CMJs and a standard 15 m speed climb. Surface electromyography and vertical ground reaction force (vGRF) were synchronously recorded. Root mean square amplitudes, knee/ankle co-contraction indices (CCI), and time-varying vGRF curves were computed, alongside asymmetry indices. SPM assessed bilateral temporal differences across the CMJ cycle, while Pearson correlation evaluated links between asymmetry and climbing time.ResultsSPM results showed significantly higher activation of rectus femoris, biceps femoris, and tibialis anterior, as well as greater knee and ankle CCI in the left limb at specific phases (p < 0.05). vGRF exhibited phase-dependent asymmetry: the left leg produced greater force during rapid loading (30–32%), whereas the right leg showed higher output during the peak phase (90–94%). Climbing time was positively correlated with vGRF asymmetry (r = 0.61, p = 0.028), but not with CCI asymmetry (p > 0.05).ConclusionResults indicate clear functional differentiation. The left limb showed higher activation and co-contraction during braking, propulsion, and peak phases, primarily for stabilization. The right limb generated higher force during propulsion and peak phases, serving an explosive role. Notably, only vGRF asymmetry, and not neuromuscular asymmetry, was associated with performance. These findings suggest that training may prioritize balancing macroscopic kinetic output (i.e., reducing vGRF asymmetry) rather than pursuing inter-limb neuromuscular symmetry.
