After spinal cord injury,impairment of the sensorimotor circuit can lead to dysfunction in the motor,sensory,proprioceptive,and autonomic nervous systems.Functional recovery is often hindered by constraints on the tim...After spinal cord injury,impairment of the sensorimotor circuit can lead to dysfunction in the motor,sensory,proprioceptive,and autonomic nervous systems.Functional recovery is often hindered by constraints on the timing of interventions,combined with the limitations of current methods.To address these challenges,various techniques have been developed to aid in the repair and reconstruction of neural circuits at different stages of injury.Notably,neuromodulation has garnered considerable attention for its potential to enhance nerve regeneration,provide neuroprotection,restore neurons,and regulate the neural reorganization of circuits within the cerebral cortex and corticospinal tract.To improve the effectiveness of these interventions,the implementation of multitarget early interventional neuromodulation strategies,such as electrical and magnetic stimulation,is recommended to enhance functional recovery across different phases of nerve injury.This review concisely outlines the challenges encountered following spinal cord injury,synthesizes existing neurostimulation techniques while emphasizing neuroprotection,repair,and regeneration of impaired connections,and advocates for multi-targeted,task-oriented,and timely interventions.展开更多
BACKGROUND:Hemiplegia,a prevalent stroke-related condition,is often studied for motor dysfunction;however,spasticity remains under-researched.Abnormal muscle tone significantly hinders hemiplegic patients’walking rec...BACKGROUND:Hemiplegia,a prevalent stroke-related condition,is often studied for motor dysfunction;however,spasticity remains under-researched.Abnormal muscle tone significantly hinders hemiplegic patients’walking recovery.OBJECTIVE:To determine whether early suspension-protected training with a personal assistant machine for stroke patients enhances walking ability and prevents muscle spasms.METHODS:Thirty-two early-stage stroke patients from Shenzhen University General Hospital and the China Rehabilitation Research Center were randomly assigned to the experimental group(n=16)and the control group(n=16).Both groups underwent 4 weeks of gait training under the suspension protection system for 30 minutes daily,5 days a week.The experimental group used the personal assistant machine during training.Three-dimensional gait analysis(using the Cortex motion capture system),Brunnstrom staging,Fugl-Meyer Assessment for lower limb motor function,Fugl-Meyer balance function,and the modified Ashworth Scale were evaluated within 1 week before the intervention and after 4 weeks of intervention.RESULTS AND CONCLUSION:After the 4-week intervention,all outcome measures showed significant changes in each group.The experimental group had a small but significant increase in the modified Ashworth Scale score(P<0.05,d=|0.15|),while the control group had a large significant increase(P<0.05,d=|1.48|).The experimental group demonstrated greater improvements in walking speed(16.5 to 38.44 cm/s,P<0.05,d=|4.01|),step frequency(46.44 to 64.94 steps/min,P<0.05,d=|2.32|),stride length(15.50 to 29.81 cm,P<0.05,d=|3.44|),and peak hip and knee flexion(d=|1.82|to|2.17|).After treatment,the experimental group showed significantly greater improvements than the control group in walking speed(38.44 vs.26.63 cm/s,P<0.05,d=|2.75|),stride length,peak hip and knee flexion(d=|1.31|to|1.45|),step frequency(64.94 vs.59.38 steps/min,P<0.05,d=|0.85|),and a reduced support phase(bilateral:24.31%vs.28.38%,P<0.05,d=|0.88|;non-paretic:66.19%vs.70.13%,P<0.05,d=|0.94|).For early hemiplegia,personal assistant machine-assisted gait training under the suspension protection system helps establish a correct gait pattern,prevents muscle spasms,and improves motor function.展开更多
Kiehl and colleagues1 utilized data from the Osteoarthritis Initiative(OAI)to address a clinically significant question:Is lifetime participation in strength training(ST)associated with improved trajectories of pain,f...Kiehl and colleagues1 utilized data from the Osteoarthritis Initiative(OAI)to address a clinically significant question:Is lifetime participation in strength training(ST)associated with improved trajectories of pain,function,and mobility in individuals with knee osteoarthritis(OA)?Among 3192 participants,those classified as“Lifelong ST”(n=142)demonstrated superior 4-year patient-reported outcomes and exhibited the lowest incidence of mobility disability(0.8%vs 2.3%–4.1%).Notably,they also maintained the fastest walking speeds at Year 4.展开更多
Background Obesity is a risk factor for developing cardiometabolic disease.Exercise training is pivotal in the treatment of obesity and is associated with reduced cardiovascular mortality.This study examined the effec...Background Obesity is a risk factor for developing cardiometabolic disease.Exercise training is pivotal in the treatment of obesity and is associated with reduced cardiovascular mortality.This study examined the effect of high-fat feeding on cardiac morphology and mitochondrial function,alongside the mitigating effects of voluntary exercise training.Methods Six-week-old male C57Bl/6 J mice commenced a high fat diet(HFD)or chow diet and were randomized to receive locked(sedentary)or unlocked(voluntary exercise training(VET))running wheels at 10 weeks of age.Mice were monitored until 30 weeks of age and euthanized for collection of tissues.Magnetic resonance imaging was performed to assess body composition,and echocardiography was performed to assess cardiac function.Results Compared with chow-fed animals,the HFD increased body weight and adiposity and decreased cardiolipins(CL)in the heart,which are required for maintaining adequate mitochondrial respiration.Importantly,VET reversed these effects and induced physiological cardiac hypertrophy.Cardiac mitochondrial respiratory chain analysis revealed decreased complexes II and IV activity following high fat feeding,while VET enhanced complex I activity,emphasizing the cardioprotective effect of exercise training in obesity.Conclusion This study uncovers mechanisms by which obesity and exercise impact cardiac mitochondrial health and suggests the mitochondria is a therapeutic target in obesity-related cardiovascular diseases.展开更多
Background This study compared knee osteoarthritis(OA)outcomes specific to pain,physical function,and quality of life in later life based on strength training(ST)participation over a lifetime.Methods Participants from...Background This study compared knee osteoarthritis(OA)outcomes specific to pain,physical function,and quality of life in later life based on strength training(ST)participation over a lifetime.Methods Participants from the Osteoarthritis Initiative(n=3192)were grouped by ST engagement during ages 12–18 years,19–34 years,35–49 years,and 50+years.Participants were categorized as:No ST(no ST at any point;61.7±9.0 years(mean±SD)),Some ST(engaged in ST during 1–3 life stages;58.9±8.7 years),and Lifelong ST(consistently engaged in ST across all life stages;55.6±8.1 years).Measures were collected at baseline and Year 4:Western Ontario and McMaster Universities Osteoarthritis Index Scores(WOMAC;pain,daily activities),Knee Injury and Osteoarthritis Outcome Score(KOOS;sports,recreation),Physical Activity Score for the Elderly(PASE),Short Form-12 Physical Component Score(SF-12 PCS),mobility disability,chair rise time,and walking speed(20 m and 400 m).Results At Year 4,the Lifelong ST group reported better WOMAC activity scores in the right knee along with better WOMAC pain,KOOS sports/recreation,and PASE scores compared to other groups(p<0.05).The Lifelong ST group had the lowest incidence of mobility disability of all groups(0.8%vs.2.3%–4.1%;p=0.015)and maintained the fastest walking speeds in Year 4.Conclusion For those with knee OA,ST throughout life may help preserve function and mobility,allowing for greater physical activity engagement while keeping pain levels relatively lower.展开更多
I was 26 the first time I travelled to China,and even now,it feels like an unexpected chapter in my life.The opportunity came out of the blue.I learned,just a month before departure,that I had been selected for a one-...I was 26 the first time I travelled to China,and even now,it feels like an unexpected chapter in my life.The opportunity came out of the blue.I learned,just a month before departure,that I had been selected for a one-month professional training programme.The news ignited a wave of excitement.For nearly two weeks,I stayed up late into the night,imagining a country I had never seen,trying to picture what China might really be like,beyond the images in books,films and media.展开更多
Objective:To analyze the clinical effect of sensory integration training combined with cognitive training in the rehabilitation treatment of children with mental retardation.Methods:A total of 120 children with mental...Objective:To analyze the clinical effect of sensory integration training combined with cognitive training in the rehabilitation treatment of children with mental retardation.Methods:A total of 120 children with mental retardation who received rehabilitation intervention in our hospital from January 2022 to December 2025 were selected and divided into a control group and an experimental group,with 60 children in each group.The control group adopted a conventional rehabilitation training program;the experimental group adopted a combined sensory integration training and cognitive training program.The sensory integration ability,cognitive function,and daily living skills of children in the two groups were compared.Results:The sensory integration ability score of the experimental group(85.3±6.2)was significantly higher than that of the control group(72.1±7.5)(p<0.05);the cognitive function score(88.7±5.8)was significantly improved compared with that of the control group(76.4±6.9)(p<0.05);the daily living skills score(90.2±4.7)was significantly higher than that of the control group(80.5±5.3)(p<0.05).The social interaction ability of the experimental group reached 92.5%,which was significantly higher than that of the control group(81.3%)(p<0.05).Conclusion:Sensory integration training combined with cognitive training demonstrates favorable outcomes in the rehabilitation treatment of children with mental retardation,exhibiting a notable neurofunctional remodeling effect.It can optimize the multidimensional rehabilitation process,effectively enhance the comprehensive developmental potential of children,and hold significant clinical application value.展开更多
Aging is characterized by a progressive decline in physiological function,driven by intrinsic mechanisms(primary aging)and modifiable factors(secondary aging),ultimately leading to multimorbidity,disability,and mortal...Aging is characterized by a progressive decline in physiological function,driven by intrinsic mechanisms(primary aging)and modifiable factors(secondary aging),ultimately leading to multimorbidity,disability,and mortality.Mitochondrial dysfunction,a major hallmark of aging,plays a central role in the loss of muscle mass and strength observed in frailty and sarcopenia.With age,mitochondrial quality control processes,including biogenesis,mitophagy,and dynamics,become dysregulated,impairing energy metabolism and muscle homeostasis.Mitochondrial dysfunction correlates with clinical biomarkers of sarcopenia and frailty,such as the decrease in walking speed and muscle strength,making it a therapeutic target for mitohormesis-based strategies aimed at preserving functional capacity.Mitohormetic agents induce reversible mitochondrial stress,triggering adaptive responses that enhance function.Among these interventions,physical exercise,particularly endurance and resistance training(RT),has been reported to be among the most effective,as it may modulate mitochondrial biogenesis,dynamics,and mitophagy through increases in proliferator-activated receptor gamma coactivator 1-alpha(PGC-1α)and mitochondrial transcription factor A(TFAM)expression,mitochondrial deoxyribonucleic acid(mtDNA)copy number,and mitochondrial content.Chronic RT can also elevate fusion and fission markers,potentially as a compensatory mechanism to mitigate mitochondrial damage.Apart from exercise,mitohormetic compounds such as harmol and piceid are emerging as promising supplements in the aging field.By modulating mitochondrial bioenergetics and dynamics,they may complement lifestyle-based interventions to improve mitochondrial fitness and extend health span.展开更多
This paper studies the structural response of high-speed train wipers under the combined action of complex flow fields and scraping actions.The stress concentration areas are determined through simulation analysis,and...This paper studies the structural response of high-speed train wipers under the combined action of complex flow fields and scraping actions.The stress concentration areas are determined through simulation analysis,and the stress and aerodynamic load measurement points are reasonably arranged accordingly.The actual measurement is carried out in combination with the operating conditions of the existing lines.The stress variations and spectral characteristics of the train under different speed levels(80,160,180,200 km/h),tunnel entry and exit,and scraper action conditions were compared and analyzed.The stress amplification factors under tunnel intersection and scraper action were obtained,providing boundary conditions for the design of wipers for highspeed s.The research results show that the maximum stress of the wiper structure obtained through simulation calculation is concentrated at the connection of the wiper arm.Structural stress increases with the rise of speed grade.The stress increases by 1.11 times when the tunnel meets.When the scraper operates,the stress on the scraper arm increases by 4.1–7.6 times.Due to the broadband excitation effect of the aerodynamic load,the spectral energy of the structure is relatively high at the natural frequency,which excites the natural mode of the wiper.展开更多
Background Intrinsic and extrinsic foot muscles contribute to foot and lower limb function.This knowledge provides opportunities to target these muscles in exercise and rehabilitation.However,a barrier is the limited ...Background Intrinsic and extrinsic foot muscles contribute to foot and lower limb function.This knowledge provides opportunities to target these muscles in exercise and rehabilitation.However,a barrier is the limited understanding of how prescribed exercises affect muscle activation and force output.This study examined muscle activation and torque production about the metatarsophalangeal joints of intrinsic and extrinsic foot muscles during common foot strengthening exercises.The secondary aim was to determine whether the addition of a postural change(leaning forward)or addition of mass can further increase muscle activation and torque.Methods Fifteen healthy participants(9 males,6 females;age=36.5±8.0 years,mean±SD)participated.Muscle activation was measured using fine-wire electromyography(EMG)electrodes for 2 intrinsic and 2 extrinsic muscles,and surface EMG electrodes for 4 superficial muscles.Metatarsophalangeal joint torque was measured using a custom toe dynamometer.Participants attended one 90-min session and performed 16 exercises.Five included the addition of leaning forward and 3 the addition of mass(20%of participant’s mass)to compare their effects on muscle activity and torque.Results Muscle activation and metatarsophalangeal joint torque varied considerably across exercises.Both the addition of leaning forward and the addition of mass increased muscle activation and metatarsophalangeal joint torque,with the addition of leaning forward producing a 35%median increase in torque about the metatarsophalangeal joints.Conclusion Many common exercises,despite high muscle activation,produce relatively low metatarsophalangeal joint torque,raising questions about their clinical value.Adding a forward lean significantly increases toe flexor muscle activity and torque,reaching levels greater than added mass and comparable to walking.展开更多
Purpose: Individuals with mild cognitive impairment (MCI) frequently experience negative emotions, which are closely correlated with an accelerated rate of cognitive decline and the subsequent transition to a state of...Purpose: Individuals with mild cognitive impairment (MCI) frequently experience negative emotions, which are closely correlated with an accelerated rate of cognitive decline and the subsequent transition to a state of dementia. Despite networked cognitive training has been demonstrated to enhance cognitive function in MCI, its effectiveness for negative emotions is still unknown. This review aimed to exam the influences of networked cognitive training on negative emotions and quality of life in people with MCI. Methods: Searches for eligible studies were conducted using PubMed, Web of Science, EMBASE, Cochrane Library, Psyc INFO, CNKI, Wanfang database, VIP database, and Sinomed. The retrieval time limit was set from their inception to 17 December 2025. The articles were reviewed and extracted by two researchers, and their quality was evaluated using the Cochrane risk-of-bias assessment tool. Subsequently, a meta-analysis was carried out utilizing RevMan 5.4 software. Results: The review comprised 13 randomized controlled trials with 626 individuals. The meta-analysis demonstrated that networked cognitive training significantly improved depression (SMD = -0.36;95% CI [-0.73, -0.00];p = .050), anxiety (SMD = -0.32;95% CI [-0.57, -0.06];p < .050), and quality of life (MD = 2.54;95% CI [0.98, 4.10];p < .001). In terms of the comparison of apathy, the effect of intervention was unclear. Conclusions: From these meta-analysis results, networked cognitive training may help patients for MCI with their anxiety, depression, and overall quality of life. However, because there are so few randomized controlled trials available, the evidence regarding apathy is still ambiguous. More thorough randomized controlled trials with larger samples are necessary to verify the significance of networked cognitive training on apathy and to consolidate the findings.展开更多
Digital twin technology brings more opportunities and challenges to chemical engineering in both academic and industry.A complex process could have multiple digitalization needs,including simulation,monitoring,operato...Digital twin technology brings more opportunities and challenges to chemical engineering in both academic and industry.A complex process could have multiple digitalization needs,including simulation,monitoring,operator training,etc.;thus,a hierarchical digital twin would be a comprehensive solution to that.In this study,a novel and general framework of the digital twin is proposed for operations in process industry.With the hierarchical structure,the framework can handle various tasks driven by different roles in process industry,including managers,engineers,and operators.To complete these tasks,the framework consists of three modules:OAS(Operation Analysis System),OMS(Operation Monitoring System),and OTS(Operator Training System).Each module focuses on one unique type of demand from the staff,as well as interactions among them enabling efficient data sharing.Based on the hierarchical framework,a digital twin system is applied for one complex industrial nitration process,which successfully enhances the operation efficiency and safety in several industrial scenarios with different demands.展开更多
Handedness is a fundamental behavioral trait in humans,with the majority exhibiting right-hand dominance.While its origins remain elusive,it is considered an innate genetic trait.This study demonstrates pawedness in m...Handedness is a fundamental behavioral trait in humans,with the majority exhibiting right-hand dominance.While its origins remain elusive,it is considered an innate genetic trait.This study demonstrates pawedness in mice(n=473),comparable to human handedness,as an acquired trait rapidly emerging after limited unilateral paw training.Notably,acquired right-pawedness demonstrates greater conservativeness compared to left-pawedness,as evidenced by stronger stability and greater resistance to reversal.This results in a population right-paw dominance under random training conditions.Moreover,acquired pawedness also exhibits sex differences,with the initial preference proving more malleable in females.These findings unveil the acquired features of pawedness in mice.By illuminating possible behavioral laterality commonalities across species,the study proposes a postnatal hypothesis for the origins of human handedness:it is not an innate genetic trait as traditionally believed,but rather an environmentally acquired stable behavior whose development is actively guided by genetic predispositions.展开更多
Stroke patients experience varying degrees of upper limb functional impairment.Although bilateral arm training can help stroke patients recover movement after stroke,little is known about the way in which the brain an...Stroke patients experience varying degrees of upper limb functional impairment.Although bilateral arm training can help stroke patients recover movement after stroke,little is known about the way in which the brain and muscles work together during this type of training.To address this,we conducted a cross-sectional study at The Seventh Affiliated Hospital,Sun Yat-sen University in China,where we observed the connection between brain and muscle activity during bilateral upper limb training in 21 stroke patients and 17 healthy controls.We used functional near-infrared spectroscopy and surface electromyography to measure changes in cerebral cortex oxygenation and upper limb muscle contraction signals,respectively.The results showed that,compared with the healthy control group,stroke patients had reduced functional connectivity and more irregular muscle activity in the affected flexor muscle during bilateral upper limb training.Moreover,we found a significant correlation between the surface electromyographic signal characteristics of upper limb muscles and cerebral oxygenation indicators of multiple brain regions in stroke patients.These findings indicate that bilateral upper limb training is an effective rehabilitation method that improves upper limb motor function in stroke patients by promoting brain functional connectivity and improving muscle activity patterns.展开更多
The purpose of this article is to contextualize the world’s oldest art song directly associated with the railway-Travelling Song by the Russian composer Mikhail Glinka(1804-1857).The composer’s personal circumstance...The purpose of this article is to contextualize the world’s oldest art song directly associated with the railway-Travelling Song by the Russian composer Mikhail Glinka(1804-1857).The composer’s personal circumstances surrounding the creation of the song are examined,along with the historical and technical background of that era.While railways have always been associated with technological progress,new solutions for high-power engines,and the accuracy of arrival and departure timetables,the poetic and romantic side of train travel and railways in general has not yet received sufficient academic coverage.This essay is intended to partially fill this gap,though it rather outlines directions for possible development of its topical range.Each of the suggested reference points and stories is in itself an example of how the arts reflected the inspiration that cutting-edge technological advances of the period were exerting on artists,musicians,and other creative individuals.展开更多
We thank Power et al.1 for their interest in our review2 and for contributing to this important scientific discussion.We welcome their commentary and acknowledge the merit of continuing to scrutinize and refine interp...We thank Power et al.1 for their interest in our review2 and for contributing to this important scientific discussion.We welcome their commentary and acknowledge the merit of continuing to scrutinize and refine interpretations in this evolving field.Given that much research time and financial investment is being given to the study of the effects of eccentric training in both athletic and clinical contexts,it is incumbent on our field to demonstrate whether eccentric contractions are a key(or the key)stimulus for sarcomerogenesis(increases in serial sarcomere number(SSN)).展开更多
Background:This paper aimed to systematically review the literature regarding the effects of resistance training(RT)performed at longer-muscle length(LML)versus shorter-muscle length(SML)on proxy measurements for long...Background:This paper aimed to systematically review the literature regarding the effects of resistance training(RT)performed at longer-muscle length(LML)versus shorter-muscle length(SML)on proxy measurements for longitudinal hypertrophy.Methods:We included studies that satisfied the following criteria:(1)be a resistance training intervention with a comparison of LML vs SML-RT;(2)assess both fascicle length(FL)and muscle size pre-and post-intervention;(3)involve healthy adults aged≥18 years;(4)be published in an English-language journal,and;(5)have a minimum training intervention duration of 4 weeks.Three databases were searched in February 2024(Google Scholar,PubMed/Medline,Scopus)for relevant articles,alongside'forward'and'backward'citation searching of articles included and additions via authors'personal knowledge.The results of studies were described narratively,compared,and contrasted.Eight studies met the inclusion criteria,totaling a sample size of 120.Results:Our results suggest that both muscle size and fascicle length increases may be greater following LML-RT versus SML-RT,suggesting LML-RT may lead to greater longitudinal hypertrophy than SML-RT.Notably,evidence is largely mixed;no studies to date have attempted to estimate serial sarcomere number changes from LML versus SML-RT,and all but one study used linear extrapolation methods to estimate FL,which has questionable validity.Therefore,the structural adaptations underlying hypertrophy from LML-RT remain undetermined.Conclusion:In conclusion,results suggest that LML-RT may be superior to SML-RT for inducing muscle hypertrophy and,more specifically,longitudinal growth,though evidence is mixed.展开更多
Objectives:Postmenopausal women with stress urinary incontinence(SUI)exhibit low androgen expression.This study aimed to evaluate the efficacy and safety of vaginal androgen combined with pelvic floor muscle training(...Objectives:Postmenopausal women with stress urinary incontinence(SUI)exhibit low androgen expression.This study aimed to evaluate the efficacy and safety of vaginal androgen combined with pelvic floor muscle training(PFMT)in the treatment of SUI in postmenopausal women.Methods:Postmenopausal women with SUI were recruited from Hainan West Central Hospital between January 2024 and March 2025.Participants were randomly assigned in a double-blind manner to receive either vaginal androgen cream combined with PFMT(treatment group)or a visually identical placebo cream(without androgens)combined with PFMT(control group).The vaginal cream was applied to the vaginal wall at a dose of 0.5 g per application,twice weekly for a total of 10 applications,while PFMT was conducted for 8 weeks.The clinical efficacy and safety were compared between the two groups.Results:A total of 61 patients were finally enrolled,with 31 in the treatment group and 30 in the control group.At both 3-month and 6-month follow-ups,the treatment group demonstrated significantly lower values in daily pad usage(p<0.05),24-h pad test scores(p<0.05),and ICIQ-UI SF scores(p<0.05)compared to the control group.The improvement rate of urinary incontinence was significantly higher in the treatment group(p<0.05).Compared to baseline,the treatment group showed statistically significant reductions in all three outcome measures(all p<0.05).No severe adverse events were reported in either group during the treatment period.Conclusions:Androgen therapy combined with PFMT significantly improved the urinary incontinence remission rate in postmenopausal women with SUI,with no severe adverse effects observed.These findings suggest that androgen therapy may represent a novel therapeutic approach for SUI management in postmenopausal women.展开更多
Purpose-This study investigates the impact of flagship trains on high-speed railway capacity utilization and develops a brand value-oriented optimization framework that balances service quality enhancement with operat...Purpose-This study investigates the impact of flagship trains on high-speed railway capacity utilization and develops a brand value-oriented optimization framework that balances service quality enhancement with operational efficiency.Design/methodology/approach-A mathematical optimization model based on integer programming is developed,incorporating flagship train constraints into capacity optimization.Case studies compare scenarios with and without flagship train considerations using the Beijing-Shanghai High-Speed Railway data across 20 experimental groups.Findings-Operating flagship trains with hourly departure constraints results in an average decrease of 0.9 trains and an 8.4%reduction in capacity utilization rate.When scheduling 2 flagship trains within a 2-h timeframe,capacity utilization decreases from 86.43%to 83.73%,quantifying the trade-off between brand positioning and operational capacity.Originality/value-This research provides the first quantitative framework for brand value-oriented railway capacity optimization,establishing clear definitions for flagship trains and mathematical foundations for evaluating service quality versus efficiency trade-offs.The findings offer practical decision support for railway operators balancing competitive positioning with capacity maximization.展开更多
BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints...BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.展开更多
基金supported by the National Key Research and Development Program of China,No.2023YFC3603705(to DX)the National Natural Science Foundation of China,No.82302866(to YZ).
文摘After spinal cord injury,impairment of the sensorimotor circuit can lead to dysfunction in the motor,sensory,proprioceptive,and autonomic nervous systems.Functional recovery is often hindered by constraints on the timing of interventions,combined with the limitations of current methods.To address these challenges,various techniques have been developed to aid in the repair and reconstruction of neural circuits at different stages of injury.Notably,neuromodulation has garnered considerable attention for its potential to enhance nerve regeneration,provide neuroprotection,restore neurons,and regulate the neural reorganization of circuits within the cerebral cortex and corticospinal tract.To improve the effectiveness of these interventions,the implementation of multitarget early interventional neuromodulation strategies,such as electrical and magnetic stimulation,is recommended to enhance functional recovery across different phases of nerve injury.This review concisely outlines the challenges encountered following spinal cord injury,synthesizes existing neurostimulation techniques while emphasizing neuroprotection,repair,and regeneration of impaired connections,and advocates for multi-targeted,task-oriented,and timely interventions.
文摘BACKGROUND:Hemiplegia,a prevalent stroke-related condition,is often studied for motor dysfunction;however,spasticity remains under-researched.Abnormal muscle tone significantly hinders hemiplegic patients’walking recovery.OBJECTIVE:To determine whether early suspension-protected training with a personal assistant machine for stroke patients enhances walking ability and prevents muscle spasms.METHODS:Thirty-two early-stage stroke patients from Shenzhen University General Hospital and the China Rehabilitation Research Center were randomly assigned to the experimental group(n=16)and the control group(n=16).Both groups underwent 4 weeks of gait training under the suspension protection system for 30 minutes daily,5 days a week.The experimental group used the personal assistant machine during training.Three-dimensional gait analysis(using the Cortex motion capture system),Brunnstrom staging,Fugl-Meyer Assessment for lower limb motor function,Fugl-Meyer balance function,and the modified Ashworth Scale were evaluated within 1 week before the intervention and after 4 weeks of intervention.RESULTS AND CONCLUSION:After the 4-week intervention,all outcome measures showed significant changes in each group.The experimental group had a small but significant increase in the modified Ashworth Scale score(P<0.05,d=|0.15|),while the control group had a large significant increase(P<0.05,d=|1.48|).The experimental group demonstrated greater improvements in walking speed(16.5 to 38.44 cm/s,P<0.05,d=|4.01|),step frequency(46.44 to 64.94 steps/min,P<0.05,d=|2.32|),stride length(15.50 to 29.81 cm,P<0.05,d=|3.44|),and peak hip and knee flexion(d=|1.82|to|2.17|).After treatment,the experimental group showed significantly greater improvements than the control group in walking speed(38.44 vs.26.63 cm/s,P<0.05,d=|2.75|),stride length,peak hip and knee flexion(d=|1.31|to|1.45|),step frequency(64.94 vs.59.38 steps/min,P<0.05,d=|0.85|),and a reduced support phase(bilateral:24.31%vs.28.38%,P<0.05,d=|0.88|;non-paretic:66.19%vs.70.13%,P<0.05,d=|0.94|).For early hemiplegia,personal assistant machine-assisted gait training under the suspension protection system helps establish a correct gait pattern,prevents muscle spasms,and improves motor function.
文摘Kiehl and colleagues1 utilized data from the Osteoarthritis Initiative(OAI)to address a clinically significant question:Is lifetime participation in strength training(ST)associated with improved trajectories of pain,function,and mobility in individuals with knee osteoarthritis(OA)?Among 3192 participants,those classified as“Lifelong ST”(n=142)demonstrated superior 4-year patient-reported outcomes and exhibited the lowest incidence of mobility disability(0.8%vs 2.3%–4.1%).Notably,they also maintained the fastest walking speeds at Year 4.
基金MAF is supported by an NHMRC Investigator Grant(APP1194141)Research in his laboratory was supported by project grants from the NHMRC(APP1042465,APP1041760,and APP1156511).
文摘Background Obesity is a risk factor for developing cardiometabolic disease.Exercise training is pivotal in the treatment of obesity and is associated with reduced cardiovascular mortality.This study examined the effect of high-fat feeding on cardiac morphology and mitochondrial function,alongside the mitigating effects of voluntary exercise training.Methods Six-week-old male C57Bl/6 J mice commenced a high fat diet(HFD)or chow diet and were randomized to receive locked(sedentary)or unlocked(voluntary exercise training(VET))running wheels at 10 weeks of age.Mice were monitored until 30 weeks of age and euthanized for collection of tissues.Magnetic resonance imaging was performed to assess body composition,and echocardiography was performed to assess cardiac function.Results Compared with chow-fed animals,the HFD increased body weight and adiposity and decreased cardiolipins(CL)in the heart,which are required for maintaining adequate mitochondrial respiration.Importantly,VET reversed these effects and induced physiological cardiac hypertrophy.Cardiac mitochondrial respiratory chain analysis revealed decreased complexes II and IV activity following high fat feeding,while VET enhanced complex I activity,emphasizing the cardioprotective effect of exercise training in obesity.Conclusion This study uncovers mechanisms by which obesity and exercise impact cardiac mitochondrial health and suggests the mitochondria is a therapeutic target in obesity-related cardiovascular diseases.
文摘Background This study compared knee osteoarthritis(OA)outcomes specific to pain,physical function,and quality of life in later life based on strength training(ST)participation over a lifetime.Methods Participants from the Osteoarthritis Initiative(n=3192)were grouped by ST engagement during ages 12–18 years,19–34 years,35–49 years,and 50+years.Participants were categorized as:No ST(no ST at any point;61.7±9.0 years(mean±SD)),Some ST(engaged in ST during 1–3 life stages;58.9±8.7 years),and Lifelong ST(consistently engaged in ST across all life stages;55.6±8.1 years).Measures were collected at baseline and Year 4:Western Ontario and McMaster Universities Osteoarthritis Index Scores(WOMAC;pain,daily activities),Knee Injury and Osteoarthritis Outcome Score(KOOS;sports,recreation),Physical Activity Score for the Elderly(PASE),Short Form-12 Physical Component Score(SF-12 PCS),mobility disability,chair rise time,and walking speed(20 m and 400 m).Results At Year 4,the Lifelong ST group reported better WOMAC activity scores in the right knee along with better WOMAC pain,KOOS sports/recreation,and PASE scores compared to other groups(p<0.05).The Lifelong ST group had the lowest incidence of mobility disability of all groups(0.8%vs.2.3%–4.1%;p=0.015)and maintained the fastest walking speeds in Year 4.Conclusion For those with knee OA,ST throughout life may help preserve function and mobility,allowing for greater physical activity engagement while keeping pain levels relatively lower.
文摘I was 26 the first time I travelled to China,and even now,it feels like an unexpected chapter in my life.The opportunity came out of the blue.I learned,just a month before departure,that I had been selected for a one-month professional training programme.The news ignited a wave of excitement.For nearly two weeks,I stayed up late into the night,imagining a country I had never seen,trying to picture what China might really be like,beyond the images in books,films and media.
基金Baoding Science and Technology Plan Project(Project No.:2541ZF307)。
文摘Objective:To analyze the clinical effect of sensory integration training combined with cognitive training in the rehabilitation treatment of children with mental retardation.Methods:A total of 120 children with mental retardation who received rehabilitation intervention in our hospital from January 2022 to December 2025 were selected and divided into a control group and an experimental group,with 60 children in each group.The control group adopted a conventional rehabilitation training program;the experimental group adopted a combined sensory integration training and cognitive training program.The sensory integration ability,cognitive function,and daily living skills of children in the two groups were compared.Results:The sensory integration ability score of the experimental group(85.3±6.2)was significantly higher than that of the control group(72.1±7.5)(p<0.05);the cognitive function score(88.7±5.8)was significantly improved compared with that of the control group(76.4±6.9)(p<0.05);the daily living skills score(90.2±4.7)was significantly higher than that of the control group(80.5±5.3)(p<0.05).The social interaction ability of the experimental group reached 92.5%,which was significantly higher than that of the control group(81.3%)(p<0.05).Conclusion:Sensory integration training combined with cognitive training demonstrates favorable outcomes in the rehabilitation treatment of children with mental retardation,exhibiting a notable neurofunctional remodeling effect.It can optimize the multidimensional rehabilitation process,effectively enhance the comprehensive developmental potential of children,and hold significant clinical application value.
基金Instituto de Salud CarlosⅢCB16/10/00435(CIBERFES)(PID2022-142470OB-I00)from the Spanish Ministry of Innovation and Science+3 种基金PROMETEO(CIPROM/2022/56)de"Consellería de Educación,Universidades,y Empleo de la Generalitat Valenciana"EU Funded H2020-DIABFRAIL-LATAM(Ref:825546)Red EXERNET-RED DE EJERCICIO FISICO Y SALUD(RED2022-134800-T)Agencia Estatal de Investigacion(Ministerio de Ciencias e Innovación)funded by Generalitat Valenciana and co-financed with FEDER funds(OP FEDER of Comunitat Valenciana 2014–2020).A.G-G(FPU22/02539)and S.S-R(PREP2022-000563)received a predoctoral grant financed by the Spanish Ministry of Universities.
文摘Aging is characterized by a progressive decline in physiological function,driven by intrinsic mechanisms(primary aging)and modifiable factors(secondary aging),ultimately leading to multimorbidity,disability,and mortality.Mitochondrial dysfunction,a major hallmark of aging,plays a central role in the loss of muscle mass and strength observed in frailty and sarcopenia.With age,mitochondrial quality control processes,including biogenesis,mitophagy,and dynamics,become dysregulated,impairing energy metabolism and muscle homeostasis.Mitochondrial dysfunction correlates with clinical biomarkers of sarcopenia and frailty,such as the decrease in walking speed and muscle strength,making it a therapeutic target for mitohormesis-based strategies aimed at preserving functional capacity.Mitohormetic agents induce reversible mitochondrial stress,triggering adaptive responses that enhance function.Among these interventions,physical exercise,particularly endurance and resistance training(RT),has been reported to be among the most effective,as it may modulate mitochondrial biogenesis,dynamics,and mitophagy through increases in proliferator-activated receptor gamma coactivator 1-alpha(PGC-1α)and mitochondrial transcription factor A(TFAM)expression,mitochondrial deoxyribonucleic acid(mtDNA)copy number,and mitochondrial content.Chronic RT can also elevate fusion and fission markers,potentially as a compensatory mechanism to mitigate mitochondrial damage.Apart from exercise,mitohormetic compounds such as harmol and piceid are emerging as promising supplements in the aging field.By modulating mitochondrial bioenergetics and dynamics,they may complement lifestyle-based interventions to improve mitochondrial fitness and extend health span.
文摘This paper studies the structural response of high-speed train wipers under the combined action of complex flow fields and scraping actions.The stress concentration areas are determined through simulation analysis,and the stress and aerodynamic load measurement points are reasonably arranged accordingly.The actual measurement is carried out in combination with the operating conditions of the existing lines.The stress variations and spectral characteristics of the train under different speed levels(80,160,180,200 km/h),tunnel entry and exit,and scraper action conditions were compared and analyzed.The stress amplification factors under tunnel intersection and scraper action were obtained,providing boundary conditions for the design of wipers for highspeed s.The research results show that the maximum stress of the wiper structure obtained through simulation calculation is concentrated at the connection of the wiper arm.Structural stress increases with the rise of speed grade.The stress increases by 1.11 times when the tunnel meets.When the scraper operates,the stress on the scraper arm increases by 4.1–7.6 times.Due to the broadband excitation effect of the aerodynamic load,the spectral energy of the structure is relatively high at the natural frequency,which excites the natural mode of the wiper.
文摘Background Intrinsic and extrinsic foot muscles contribute to foot and lower limb function.This knowledge provides opportunities to target these muscles in exercise and rehabilitation.However,a barrier is the limited understanding of how prescribed exercises affect muscle activation and force output.This study examined muscle activation and torque production about the metatarsophalangeal joints of intrinsic and extrinsic foot muscles during common foot strengthening exercises.The secondary aim was to determine whether the addition of a postural change(leaning forward)or addition of mass can further increase muscle activation and torque.Methods Fifteen healthy participants(9 males,6 females;age=36.5±8.0 years,mean±SD)participated.Muscle activation was measured using fine-wire electromyography(EMG)electrodes for 2 intrinsic and 2 extrinsic muscles,and surface EMG electrodes for 4 superficial muscles.Metatarsophalangeal joint torque was measured using a custom toe dynamometer.Participants attended one 90-min session and performed 16 exercises.Five included the addition of leaning forward and 3 the addition of mass(20%of participant’s mass)to compare their effects on muscle activity and torque.Results Muscle activation and metatarsophalangeal joint torque varied considerably across exercises.Both the addition of leaning forward and the addition of mass increased muscle activation and metatarsophalangeal joint torque,with the addition of leaning forward producing a 35%median increase in torque about the metatarsophalangeal joints.Conclusion Many common exercises,despite high muscle activation,produce relatively low metatarsophalangeal joint torque,raising questions about their clinical value.Adding a forward lean significantly increases toe flexor muscle activity and torque,reaching levels greater than added mass and comparable to walking.
文摘Purpose: Individuals with mild cognitive impairment (MCI) frequently experience negative emotions, which are closely correlated with an accelerated rate of cognitive decline and the subsequent transition to a state of dementia. Despite networked cognitive training has been demonstrated to enhance cognitive function in MCI, its effectiveness for negative emotions is still unknown. This review aimed to exam the influences of networked cognitive training on negative emotions and quality of life in people with MCI. Methods: Searches for eligible studies were conducted using PubMed, Web of Science, EMBASE, Cochrane Library, Psyc INFO, CNKI, Wanfang database, VIP database, and Sinomed. The retrieval time limit was set from their inception to 17 December 2025. The articles were reviewed and extracted by two researchers, and their quality was evaluated using the Cochrane risk-of-bias assessment tool. Subsequently, a meta-analysis was carried out utilizing RevMan 5.4 software. Results: The review comprised 13 randomized controlled trials with 626 individuals. The meta-analysis demonstrated that networked cognitive training significantly improved depression (SMD = -0.36;95% CI [-0.73, -0.00];p = .050), anxiety (SMD = -0.32;95% CI [-0.57, -0.06];p < .050), and quality of life (MD = 2.54;95% CI [0.98, 4.10];p < .001). In terms of the comparison of apathy, the effect of intervention was unclear. Conclusions: From these meta-analysis results, networked cognitive training may help patients for MCI with their anxiety, depression, and overall quality of life. However, because there are so few randomized controlled trials available, the evidence regarding apathy is still ambiguous. More thorough randomized controlled trials with larger samples are necessary to verify the significance of networked cognitive training on apathy and to consolidate the findings.
基金support of the“Pioneer”and“Leading Goose”Research&Development Program of Zhejiang(2024C01028)the State Key Laboratory of Industrial Control Technology,China(ICT2024C04)are gratefully acknowledged.
文摘Digital twin technology brings more opportunities and challenges to chemical engineering in both academic and industry.A complex process could have multiple digitalization needs,including simulation,monitoring,operator training,etc.;thus,a hierarchical digital twin would be a comprehensive solution to that.In this study,a novel and general framework of the digital twin is proposed for operations in process industry.With the hierarchical structure,the framework can handle various tasks driven by different roles in process industry,including managers,engineers,and operators.To complete these tasks,the framework consists of three modules:OAS(Operation Analysis System),OMS(Operation Monitoring System),and OTS(Operator Training System).Each module focuses on one unique type of demand from the staff,as well as interactions among them enabling efficient data sharing.Based on the hierarchical framework,a digital twin system is applied for one complex industrial nitration process,which successfully enhances the operation efficiency and safety in several industrial scenarios with different demands.
基金supported by grants from the National Natural Science Foundation of China,China(32470630 to Z.S.)the Scientific Foundation of the Institute of Psychology,Chinese Academy of Sciences,China(E2CX4115CX to J.W.)State Key Laboratory of Animal Biodiversity Conservation and Integrated Pest Management,China(SKLA2508 to Y.W.).
文摘Handedness is a fundamental behavioral trait in humans,with the majority exhibiting right-hand dominance.While its origins remain elusive,it is considered an innate genetic trait.This study demonstrates pawedness in mice(n=473),comparable to human handedness,as an acquired trait rapidly emerging after limited unilateral paw training.Notably,acquired right-pawedness demonstrates greater conservativeness compared to left-pawedness,as evidenced by stronger stability and greater resistance to reversal.This results in a population right-paw dominance under random training conditions.Moreover,acquired pawedness also exhibits sex differences,with the initial preference proving more malleable in females.These findings unveil the acquired features of pawedness in mice.By illuminating possible behavioral laterality commonalities across species,the study proposes a postnatal hypothesis for the origins of human handedness:it is not an innate genetic trait as traditionally believed,but rather an environmentally acquired stable behavior whose development is actively guided by genetic predispositions.
文摘Stroke patients experience varying degrees of upper limb functional impairment.Although bilateral arm training can help stroke patients recover movement after stroke,little is known about the way in which the brain and muscles work together during this type of training.To address this,we conducted a cross-sectional study at The Seventh Affiliated Hospital,Sun Yat-sen University in China,where we observed the connection between brain and muscle activity during bilateral upper limb training in 21 stroke patients and 17 healthy controls.We used functional near-infrared spectroscopy and surface electromyography to measure changes in cerebral cortex oxygenation and upper limb muscle contraction signals,respectively.The results showed that,compared with the healthy control group,stroke patients had reduced functional connectivity and more irregular muscle activity in the affected flexor muscle during bilateral upper limb training.Moreover,we found a significant correlation between the surface electromyographic signal characteristics of upper limb muscles and cerebral oxygenation indicators of multiple brain regions in stroke patients.These findings indicate that bilateral upper limb training is an effective rehabilitation method that improves upper limb motor function in stroke patients by promoting brain functional connectivity and improving muscle activity patterns.
文摘The purpose of this article is to contextualize the world’s oldest art song directly associated with the railway-Travelling Song by the Russian composer Mikhail Glinka(1804-1857).The composer’s personal circumstances surrounding the creation of the song are examined,along with the historical and technical background of that era.While railways have always been associated with technological progress,new solutions for high-power engines,and the accuracy of arrival and departure timetables,the poetic and romantic side of train travel and railways in general has not yet received sufficient academic coverage.This essay is intended to partially fill this gap,though it rather outlines directions for possible development of its topical range.Each of the suggested reference points and stories is in itself an example of how the arts reflected the inspiration that cutting-edge technological advances of the period were exerting on artists,musicians,and other creative individuals.
文摘We thank Power et al.1 for their interest in our review2 and for contributing to this important scientific discussion.We welcome their commentary and acknowledge the merit of continuing to scrutinize and refine interpretations in this evolving field.Given that much research time and financial investment is being given to the study of the effects of eccentric training in both athletic and clinical contexts,it is incumbent on our field to demonstrate whether eccentric contractions are a key(or the key)stimulus for sarcomerogenesis(increases in serial sarcomere number(SSN)).
文摘Background:This paper aimed to systematically review the literature regarding the effects of resistance training(RT)performed at longer-muscle length(LML)versus shorter-muscle length(SML)on proxy measurements for longitudinal hypertrophy.Methods:We included studies that satisfied the following criteria:(1)be a resistance training intervention with a comparison of LML vs SML-RT;(2)assess both fascicle length(FL)and muscle size pre-and post-intervention;(3)involve healthy adults aged≥18 years;(4)be published in an English-language journal,and;(5)have a minimum training intervention duration of 4 weeks.Three databases were searched in February 2024(Google Scholar,PubMed/Medline,Scopus)for relevant articles,alongside'forward'and'backward'citation searching of articles included and additions via authors'personal knowledge.The results of studies were described narratively,compared,and contrasted.Eight studies met the inclusion criteria,totaling a sample size of 120.Results:Our results suggest that both muscle size and fascicle length increases may be greater following LML-RT versus SML-RT,suggesting LML-RT may lead to greater longitudinal hypertrophy than SML-RT.Notably,evidence is largely mixed;no studies to date have attempted to estimate serial sarcomere number changes from LML versus SML-RT,and all but one study used linear extrapolation methods to estimate FL,which has questionable validity.Therefore,the structural adaptations underlying hypertrophy from LML-RT remain undetermined.Conclusion:In conclusion,results suggest that LML-RT may be superior to SML-RT for inducing muscle hypertrophy and,more specifically,longitudinal growth,though evidence is mixed.
基金supported by Joint Program on Health Science&Technology Innovation of Hainan Province(WSJK2024QN093)Discipline Leader Development Program for Outstanding Talents of Hainan West Central Hospital.
文摘Objectives:Postmenopausal women with stress urinary incontinence(SUI)exhibit low androgen expression.This study aimed to evaluate the efficacy and safety of vaginal androgen combined with pelvic floor muscle training(PFMT)in the treatment of SUI in postmenopausal women.Methods:Postmenopausal women with SUI were recruited from Hainan West Central Hospital between January 2024 and March 2025.Participants were randomly assigned in a double-blind manner to receive either vaginal androgen cream combined with PFMT(treatment group)or a visually identical placebo cream(without androgens)combined with PFMT(control group).The vaginal cream was applied to the vaginal wall at a dose of 0.5 g per application,twice weekly for a total of 10 applications,while PFMT was conducted for 8 weeks.The clinical efficacy and safety were compared between the two groups.Results:A total of 61 patients were finally enrolled,with 31 in the treatment group and 30 in the control group.At both 3-month and 6-month follow-ups,the treatment group demonstrated significantly lower values in daily pad usage(p<0.05),24-h pad test scores(p<0.05),and ICIQ-UI SF scores(p<0.05)compared to the control group.The improvement rate of urinary incontinence was significantly higher in the treatment group(p<0.05).Compared to baseline,the treatment group showed statistically significant reductions in all three outcome measures(all p<0.05).No severe adverse events were reported in either group during the treatment period.Conclusions:Androgen therapy combined with PFMT significantly improved the urinary incontinence remission rate in postmenopausal women with SUI,with no severe adverse effects observed.These findings suggest that androgen therapy may represent a novel therapeutic approach for SUI management in postmenopausal women.
基金funded by the Science and Technology Research and Development Program Project of China Railway Group Co.,Ltd,grant number P2024X002the China Academy of Railway Sciences Corporation Limited,grant number 2024YJ154.
文摘Purpose-This study investigates the impact of flagship trains on high-speed railway capacity utilization and develops a brand value-oriented optimization framework that balances service quality enhancement with operational efficiency.Design/methodology/approach-A mathematical optimization model based on integer programming is developed,incorporating flagship train constraints into capacity optimization.Case studies compare scenarios with and without flagship train considerations using the Beijing-Shanghai High-Speed Railway data across 20 experimental groups.Findings-Operating flagship trains with hourly departure constraints results in an average decrease of 0.9 trains and an 8.4%reduction in capacity utilization rate.When scheduling 2 flagship trains within a 2-h timeframe,capacity utilization decreases from 86.43%to 83.73%,quantifying the trade-off between brand positioning and operational capacity.Originality/value-This research provides the first quantitative framework for brand value-oriented railway capacity optimization,establishing clear definitions for flagship trains and mathematical foundations for evaluating service quality versus efficiency trade-offs.The findings offer practical decision support for railway operators balancing competitive positioning with capacity maximization.
文摘BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.
