Xinjiang is located in the arid region of northwestern China, and agriculture accounts for an absolute share of total water use. Resource-based, engineering, structural, and managed water shortages coexist. Therefore, it is of great significance to vigorously develop water conservation technology and improve the efficiency of water transmission and distribution in canal systems. This research aims at addressing the problems of difficult manual regulation and the overall optimization of the final canal system, low-water-resource utilization efficiency, and management efficiency. Taking the branch-double two-stage canal system of Dongfeng branch canal in Mangxiang, Jinghe irrigation district, as a case study, and the rotation irrigation group and irrigation duration as decision variables, canal distribution is modeled with the goal of minimizing seepage losses. The improved grey wolf algorithm combined with particle swarm optimization is used for the first time and compared with the traditional grey wolf algorithm, genetic particle swarm optimization fusion algorithm, and northern goshawk algorithm. The results show that (1) on the basis of meeting the water discharge capacity and water demand requirements of the canal system, the diversion time of the water distribution scheme obtained by using the improved grey wolf algorithm is shortened from 11 d to 8.91 d compared with the traditional empirical water distribution scheme. (2) The improved grey wolf algorithm converges to the optimal value within 10 generations compared to the remaining methods, and the total water leakage is reduced from 16.15 × 10⁴ m³ to 11.75 × 10⁴ m³. (3) The number of gate adjustments is reduced, and the canal gates are opened and closed at the same time within each rotational irrigation group. The grey wolf algorithm improved by its combination with particle swarm has stronger optimization ability and convergence, which can better meet the requirements of efficient water resource allocation in irrigation canal systems, as well as a high application value. Full article

This study aimed to develop a conceptual framework that integrates both consumer-specific and product-specific factors, with a particular focus on consumer value perceptions regarding recycled apparel and their impact on consumer attitudes and purchase intention. The framework combines the Perceived Consumer Value (PCV) with the Knowledge–Attitude–Behavior (KAB) model. To validate the proposed conceptual framework, an online survey was conducted with a purposive sample of 716 participants in China. Using structural equation modeling, the hypotheses of the conceptual model were tested. This study identified four dimensions of perceived value and environmental knowledge as significant factors that positively influenced customers’ attitudes toward purchasing recycled apparel. Notably, it was found that perceived quality value had a more pronounced effect on purchase intention than other factors. Interestingly, product knowledge did not demonstrate a significant impact on attitudes. By exploring this under-researched topic, this study provides new insights into consumer behavior in the context of sustainable fashion in a non-Western context. Full article

This paper presents a new type of hydraulic clutch operating by means of magnetorheological (MR) fluids and the results achieved from both theoretical analysis and experimental measurement. A hydraulic clutch system with MR working fluid and a rotating magnetic field located was designed. The clutch was based on the principle of using a rotating magnetic field created by an alternating current electromagnet to set the MR fluid in motion. To test the hydraulic clutch with a rotating magnetic field, MR fluids were produced by our laboratory, consisting of solid iron particles of various diameters mixed with a silicone oil. With MR working fluid and a rotating magnetic core was designed. The rheological properties of the MR fluids were assessed on the basis of tests carried out with a Brookfield DV2T rheometer equipped with a magnetic device for generating a magnetic field. The characteristics of the hydraulic clutch were tested on a specially built test stand. It was found that the torque transmitted by the clutch increased with the rotational speed of the magnetic field and with a lower rotational speed of the beaker in which the working fluid was placed. It was also found that the greatest torque occurred with the working fluid with the highest iron content. Based on the analysis of the structure and characteristics of the clutch in which the magnetic field is used, it has been shown that the design of the developed clutch is similar to that of an induction clutch, and its characteristics correspond to the characteristics of the eddy current clutch. Therefore, the proposed new clutch with MR fluid and rotating magnetic field can be applied to stationary power transmission systems in a manner similar to an eddy current clutch. Full article

Carbonic anhydrases are mononuclear metalloenzymes catalyzing the reversible hydration of carbon dioxide in organisms belonging to all three domains of life. Although the mechanism of the catalytic reaction is similar, different families of carbonic anhydrases do not have a common ancestor nor do they exhibit significant resemblance in the amino acid sequence or the structure and composition of the metal-binding sites. Little is known about the physical principles determining the metal affinity and selectivity of the catalytic centers, and how well the native metal is protected from being dislodged by other metal species from the local environment. Here, we endeavor to shed light on these issues by studying (via a combination of density functional theory calculations and polarizable continuum model computations) the thermodynamic outcome of the competition between the native metal cation and its noncognate competitor in various metal-binding sites. Typical representatives of the competing cations from the cellular environments of the respective classes of carbonic anhydrases are considered. The calculations reveal how the Gibbs energy of the metal competition changes when varying the metal type, structure, composition, and solvent exposure of the active center. Physical principles governing metal competition in different carbonic anhydrase metal-binding sites are delineated. Full article

This study evaluated the biocontrol effect of isolated epiphytic yeasts (Papiliotrema terrestris, Hanseniaspora uvarum, and Rhodosporidium glutinis) against Botrytis cinerea and Alternaria alternata in blueberry fruits and its possible mechanisms. Our findings indicated that the three tested yeasts exerted a good biocontrol effect on postharvest diseases in blueberry, and that H. uvarum was the most effective. In addition, the three tested yeasts could improve the postharvest storage quality of blueberry fruits to some extent. H. uvarum demonstrated the strongest direct inhibitory effect on pathogens by suppressing spore germination, mycelial growth, and antifungal volatile organic compound (VOC) production. P. terrestris showed the highest extracellular lytic enzymes activities. It also had better adaptation to low temperature in fruit wounds at 4 °C. The biofilm formation capacity was suggested to be the main action mechanism of R. glutinis, which rapidly colonized fruit wounds at 20 °C. Several action mechanisms are employed by the superb biocontrol yeasts, while yeast strains possess distinctive characteristics and have substantially different action mechanisms. Full article

Purpose: Minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) serve as metrics to gauge orthopedic treatment efficacy based on anchoring questions that do not account for a patient’s satisfaction with their surgical outcome. This study evaluates if reaching MCID, SCB, or PASS values for American Shoulder and Elbow Surgeons score (ASES), Single Alpha Numeric Evaluation (SANE), Simple Shoulder Test (SST), and Visual Analog Score (VAS) for pain following arthroscopic rotator cuff repair (RCR) correlates with overall patient satisfaction. Methods: This was a single-institution, retrospective study of patients who underwent RCR from 2015 to 2019. Pre-operative and 2 year postoperative ASES, SANE, SST, and VAS scores were recorded. Patients underwent a survey to assess: (1) what is your overall satisfaction with your surgical outcome? (scale 1 to 10); (2) if you could go back in time, would you undergo this operation again? (yes/no); (3) for the same condition, would you recommend this operation to a friend or family member? (yes/no). Spearman correlation coefficients were run to assess relationship between reaching MCID, SCB, or PASS and satisfaction. Results: Ninety-two patients were included. Mean preoperative ASES was 51.1 ± 16.9, SANE was 43.3 ± 20.9, SST was 5.4 ± 2.9, and VAS was 4.6 ± 2.1. Mean 2 year ASES was 83.9 ± 18.5, SANE was 81.7 ± 27.0, SST was 9.8 ± 3.2, and VAS was 1.4 ± 1.9. Mean patient satisfaction was 9.0 ± 1.9; 89 (96.7%) patients would undergo surgery again and recommend surgery. Correlation for reaching PASS for SANE and satisfaction was moderate. Correlation coefficients were very weak for all other outcome metrics. Conclusions: Reaching MCID, SCB, and PASS in ASES, SANE, SST, or VAS following RCR did not correlate with a patient’s overall satisfaction or willingness to undergo surgery again or recommend surgery. Further investigation into the statistical credibility and overall clinical value of MCID, SCB, and PASS is necessary. Full article

Flow-accelerated corrosion (FAC) preferentially attacks the downstream heat-affected zone of the root-pass weld in steam pipe systems. A detailed characterization identifies the fusion boundary as the initiation location for the attack. Alloying elements are found depleted along the weld fusion boundary, and multiple welding thermal cycles and repetitive austenite-to-ferrite phase transformations result in an increased proportion of grains with Goss {110}<001> texture along the fusion boundary. The synergistic effects of chemical segregation and the Schmid factor may contribute to the preferential initiation of FAC cracks along the root weld fusion boundary, making it the weakest link for FAC attack in steam pipe girth welds. Full article

This paper explores two routes along which a pragmatic philosophical approach can contribute to reflections on agnosticism. The first of these approaches is developed in dialogue with William James, and it is oriented towards the needs and obligations of individuals and the extent to which agnosticism affects our abilities to lead strenuous lives. The second is developed in dialogue with Richard Rorty. It is oriented towards how agnosticisms can be adopted within particular vocabularies vis-a-vis other vocabularies as a pragmatically helpful strategy or skill. I discuss the extent to which these can contribute to philosophical reflection on agnosticism and propose that they show that the agnosticism debate would benefit from a broadened focus where epistemic and pragmatic considerations are better integrated than presently. This would enable us to discuss different types of agnosticism that come to the fore in various contexts and whether they prevent us or allow us to better handle concrete problems in our interactions with the world. Full article

The main hallmark in the development of both type 1 and type 2 diabetes is a decline in functional β-cell mass. This decline is predominantly attributed to β-cell death, although recent findings suggest that the loss of β-cell identity may also contribute to β-cell dysfunction. This phenomenon is characterized by a reduced expression of key markers associated with β-cell identity. This review delves into the insights gained from single-cell omics research specifically focused on β-cell identity. It highlights how single-cell omics based studies have uncovered an unexpected level of heterogeneity among β-cells and have facilitated the identification of distinct β-cell subpopulations through the discovery of cell surface markers, transcriptional regulators, the upregulation of stress-related genes, and alterations in chromatin activity. Furthermore, specific subsets of β-cells have been identified in diabetes, such as displaying an immature, dedifferentiated gene signature, expressing significantly lower insulin mRNA levels, and expressing increased β-cell precursor markers. Additionally, single-cell omics has increased insight into the detrimental effects of diabetes-associated conditions, including endoplasmic reticulum stress, oxidative stress, and inflammation, on β-cell identity. Lastly, this review outlines the factors that may influence the identification of β-cell subpopulations when designing and performing a single-cell omics experiment. Full article

Here, 0.3 wt.%Zr was introduced in an Al-4 wt.%Cu-0.5 wt.%Mn-0.1 wt.%Fe alloy to investigate its influence on the microstructure and mechanical properties of the alloy. The microstructures of both as-cast and T6-treated Al–Cu–Mn–Fe (ACMF) and Al–Cu–Mn–Fe–Zr (ACMFZ) alloys were analyzed. The intermetallic compounds formed through the casting procedure include Al₂Cu and Al₇Cu₂Fe, and the Al₂Cu phase dissolves into the matrix and re-precipitates as θ′ phase during the T6 process. The introduction of Zr results in the precipitation of L1₂-Al₃Zr nanometric precipitates after T6, while the θ′ precipitates in ACMFZ alloy are much finer than those in ACMF alloy. The L1₂-Al₃Zr precipitates were found coherently located with θ′, which was assumed beneficial for stabilizing the θ′ precipitates during the high-temperature tensile process. The tensile properties of ACMF and ACMFZ alloys at room temperature and elevated temperatures (200, 300, and 400 °C) were tested. Especially, the yield strength of ACMFZ alloys can reach 128 MPa and 65 MPa at 300 °C and 400 °C, respectively, which are 31% and 33% higher than those of ACMF alloys. The strengthening mechanisms of grain size, L1₂-Al₃Zr, and θ′ precipitates on the tensile properties were discussed. This work may be referred to for designing Al–Cu alloys for application in high-temperature fields. Full article

Initial public offerings and mergers and acquisitions represent important opportunities for investors to exit and harvest their entrepreneurial success. Some firms are acquired shortly after their initial public offerings. This exit strategy is known as a double exit. In addition, issuing firms may choose to reincorporate in Delaware during their IPOs. In this study, we use hand-collected data from 1993 to 2020 to investigate whether and to what extent Delaware reincorporation may affect the M&As in the post-IPO stage. We use a Cox proportional hazard model to test the relation between Delaware reincorporation and the likelihood of being acquired for our sample IPOs. Recognizing that Delaware reincorporation is not a random decision, we adopt a Heckman switching regression method to estimate the relation between Delaware reincorporation and takeover premiums and announcement returns. We report that IPO firms choosing to reincorporate in Delaware experience a higher likelihood of being acquired compared to those IPO firms choosing to remain incorporated in their home states. We further document that IPO firms choosing to reincorporate in Delaware receive lower premiums in acquisitions, and experience lower abnormal returns on announcements. Full article

Estrogen plays an important role in osteoporosis prevention. We herein report the possible novel signaling pathway of 17β-estradiol (E2) in the matrix mineralization of MC3T3-E1, an osteoblast-like cell line. In the culture media-containing stripped serum, in which small lipophilic molecules such as steroid hormones including E2 were depleted, matrix mineralization was significantly reduced. However, the E2 treatment induced this. The E2 effects were suppressed by ICI182,780, the estrogen receptor (ER)α, and the ERβ antagonist, as well as their mRNA knockdown, whereas Raloxifene, an inhibitor of estrogen-induced transcription, and G15, a G-protein-coupled estrogen receptor (GPER) 1 inhibitor, had little or no effect. Furthermore, the E2-activated matrix mineralization was disrupted by PMA, a PKC activator, and SB202190, a p38 MAPK inhibitor, but not by wortmannin, a PI3K inhibitor. Matrix mineralization was also induced by the culture media from the E2-stimulated cell culture. This effect was hindered by PMA or heat treatment, but not by SB202190. These results indicate that E2 activates the p38 MAPK pathway via ERs independently from actions in the nucleus. Such activation may cause the secretion of certain signaling molecule(s), which inhibit the PKC pathway. Our study provides a novel pathway of E2 action that could be a therapeutic target to activate matrix mineralization under various diseases, including osteoporosis. Full article

Many Saudi students lack the motivation to pursue STEM careers due to their teachers’ limited experience and low efficacy in teaching science, technology, engineering, and mathematics (STEM). Teachers’ perceptions are central to efficient STEM education; however, little is known about the perceptions of teachers toward STEM education in Saudi Arabia. Therefore, this study attempted to identify the perceptions of secondary stage science teachers toward STEM education and their knowledge about the requirements for its implementation. The study also investigated whether there were statistically significant differences that could be attributed to teachers’ qualifications, years of experience, and specialization variables. A questionnaire was applied to 175 in-service science teachers. The results showed that the secondary stage science teachers had a medium level of positive perceptions toward STEM education and a high level of knowledge about the requirements for its implementation. It was also revealed that there were statistically significant differences in teachers’ perceptions due to their qualifications and years of experience, in favor of teachers with graduate degrees and with more years of experience, while there were no statistically significant differences due to teachers’ specialization. Based on the findings of this study, a number of recommendations on improving science teachers’ knowledge of STEM education and the requirements for its implementation are provided. Full article

Eriocheir sinensis, a key species in China’s freshwater aquaculture, is threatened by various diseases, which were verified to be closely associated with oxidative stress. This study aimed to investigate the response of E. sinensis to hydrogen peroxide (H₂O₂)-induced oxidative stress to understand the biological processes behind these diseases. Crabs were exposed to different concentrations of H₂O₂ and their antioxidant enzyme activities and gene expressions for defense and immunity were measured. Results showed that activities of antioxidant enzymes—specificallysuperoxide dismutase (SOD), catalase (CAT), total antioxidant capacity(T-AOC), glutathione (GSH), and glutathione peroxidase (GSH-Px)—varied with exposure concentration and duration, initially increasing then decreasing. Notably, SOD, GSH-Px, and T-AOC activities dropped below control levels at 96 h. Concurrently, oxidative damage markers, including malondialdehyde (MDA), H₂O₂, and 8-hydroxy-2′-deoxyguanosine (8-OHdG) levels, increased with exposure duration. The mRNA expression of SOD, CAT, and GSH-Px also showed an initial increase followed by a decrease, peaking at 72 h. The upregulation of phenoloxidaseloxidase (proPO) and peroxinectin (PX) was also detected, but proPO was suppressed under high levels of H₂O₂. Heat shock protein 70 (HSP70) expression gradually increased with higher H₂O₂ concentrations, whereas induced nitrogen monoxide synthase (iNOS) was upregulated but decreased at 96 h. These findings emphasize H₂O₂’s significant impact on the crab’s oxidative and immune responses, highlighting the importance of understanding cellular stress responses for disease prevention and therapy development. Full article

Gut microbiome-targeted interventions such as fecal transplant, prebiotics, probiotics, synbiotics, and antibiotic gut depletion are speculated to be of potential use in delaying the onset and progression of Parkinson’s disease by rebalancing the gut microbiome in the context of the gut–brain axis. Our study aims to organize recent findings regarding these interventions in Parkinson’s disease animal models to identify how they affect neuroinflammation and motor outcomes. A systematic literature search was applied in PubMed, Web of Science, Embase, and SCOPUS for gut microbiome-targeted non-dietary interventions. Studies that investigated gut-targeted interventions by using in vivo murine PD models to follow dopaminergic cell loss, motor tests, and neuroinflammatory markers as outcomes were considered to be eligible. A total of 1335 studies were identified in the databases, out of which 29 were found to be eligible. A narrative systematization of the resulting data was performed, and the effect direction for the outcomes was represented. Quality assessment using the SYRCLE risk of bias tool was also performed. Out of the 29 eligible studies, we found that a significant majority report that the intervention reduced the dopaminergic cell loss (82.76%, 95% CI [64.23%, 94.15%]) produced by the induction of the disease model. Also, most studies reported a reduction in microglial (87.5%, 95% CI [61.65%, 98.45%]) and astrocytic activation (84,62%, 95% CI [54.55%, 98.08%]) caused by the induction of the disease model. These results were also mirrored in the majority (96.4% 95% CI [81.65%, 99.91%]) of the studies reporting an increase in performance in behavioral motor tests. A significant limitation of the study was that insufficient information was found in the studies to assess specific causes of the risk of bias. These results show that non-dietary gut microbiome-targeted interventions can improve neuroinflammatory and motor outcomes in acute Parkinson’s disease animal models. Further studies are needed to clarify if these benefits transfer to the long-term pathogenesis of the disease, which is not yet fully understood. The study had no funding source, and the protocol was registered in the PROSPERO database with the ID number CRD42023461495. Full article

Abnormal viscosity is closely related to the occurrence of many diseases, such as cancer. Therefore, real-time detection of changes in viscosity in living cells is of great importance. Fluorescent molecular rotors play a critical role in detecting changes in cellular viscosity. Developing red emission viscosity probes with large Stokes shifts and high sensitivity and specificity remains an urgent and important topic. Herein, a novel viscosity-sensitive fluorescent probe (TCF-VIS1) with a large stokes shift and red emission was prepared based on the 2-dicyanomethylene-3-cyano-4,5,5-trimethyl-2,5-dihydrofuran (TCF) skeleton. Due to intramolecular rotation, the probe itself does not fluorescence at low viscosity. With the increase in viscosity, the rotation of TCF-VIS1 is limited, and its fluorescence is obviously enhanced. The probe has the advantages of simple preparation, large Stokes shift, good sensitivity and selectivity, and low cytotoxicity, which make it successfully used for viscosity detection in living cells. Moreover, TCF-VIS1 showed its potential for cancer diagnosis at the cell level and in tumor-bearing mice by detecting viscosity. Therefore, the probe is expected to enrich strategies for the detection of viscosity in biological systems and offer a potential tool for cancer diagnosis. Full article

Immune cell function varies tremendously between individuals, posing a major challenge to emerging cellular immunotherapies. This report pursues the use of cell morphology as an indicator of high-level T cell function. Short-term spreading of T cells on planar, elastic surfaces was quantified by 11 morphological parameters and analyzed to identify effects of both intrinsic and extrinsic factors. Our findings identified morphological features that varied between T cells isolated from healthy donors and those from patients being treated for Chronic Lymphocytic Leukemia (CLL). This approach also identified differences between cell responses to substrates of different elastic modulus. Combining multiple features through a machine learning approach such as Decision Tree or Random Forest provided an effective means for identifying whether T cells came from healthy or CLL donors. Further development of this approach could lead to a rapid assay of T cell function to guide cellular immunotherapy. Full article

Deep convolutional neural networks (CNNs) can achieve good performance in image denoising due to their superiority in the extraction of structural information. However, they may ignore the relationships between pixels to limit effects for image denoising. Transformer, focusing on pixel to pixel relationships can effectively solve this problem. This article aims to make a CNN and Transformer complement each other in image denoising. In this study, we propose a dynamic network with Transformer for image denoising (DTNet), with a residual block (RB), a multi-head self-attention block (MSAB), and a multidimensional dynamic enhancement block (MDEB). Firstly, the RB not only utilizes a CNN but also lays the foundation for the combination with Transformer. Then, the MSAB adds positional encoding and applies multi-head self-attention, which enables the preservation of sequential positional information while employing the Transformer to obtain global information. Finally, the MDEB uses dimension enhancement and dynamic convolution to improve the adaptive ability. The experiments show that our DTNet is superior to some existing methods for image denoising. Full article

Systemic sclerosis (SSc) is a heterogeneous disease characterized by autoimmunity, vasculopathy, and fibrosis which affects the skin and internal organs. One key aspect of SSc vasculopathy is pulmonary arterial hypertension (SSc-PAH) which represents a leading cause of morbidity and mortality in patients with SSc. The pathogenesis of pulmonary hypertension is complex, with multiple vascular cell types, inflammation, and intracellular signaling pathways contributing to vascular pathology and remodeling. In this review, we focus on shared molecular features of pulmonary hypertension and those which make SSc-PAH a unique entity. We highlight advances in the understanding of the clinical and translational science pertinent to this disease. We first review clinical presentations and phenotypes, pathology, and novel biomarkers, and then highlight relevant animal models, key cellular and molecular pathways in pathogenesis, and explore emerging treatment strategies in SSc-PAH. Full article

Hybrid organic–inorganic perovskite solar cells (PSCs) are receiving huge attention owing to their marvelous advantages, such as low cost, high efficiency, and superior optoelectronics characteristics. Despite their promising potential, charge-carrier dynamics at the interfaces are still ambiguous, causing carrier recombination and hindering carrier transport, thus lowering the open-circuit voltages (V_oc) of PSCs. To unveil this ambiguous phenomenon, we intensively performed various optoelectronic measurements to investigate the impact of interfacial charge-carrier dynamics of PSCs under various light intensities. This is because the charge density can exhibit different mobility and charge transport properties depending on the characteristics of the charge transport layers. We explored the influence of the hole transport layer (HTL) by investigating charge transport properties using photoluminescence (PL) and time-resolved (TRPL) to unveil interfacial recombination phenomena and optoelectronic characteristics. We specifically investigated the impact of various thicknesses of HTLs, such as 2,2′,7,7′-tetrakis[N,N-di(4-methoxyphenyl)amino]-9,9′-spirobifluorene (spiro-OMeTAD), and poly(triaryl)amine (PTAA), on FA_0.83MA_0.17Pb(Br_0.05I_0.95)₃ perovskite films. The HTLs are coated on perovskite film by altering the HTL’s concentration and using F4-TCNQ and 4-tert-butylpyridine (tBP) and lithium bis(trifluoromethanesulfonyl)imide (LiTFSi) as dopants both for spiro-OMeTAD and PTAA. These HTLs diversified the charge concentration gradients in the absorption layer, thus leading to different recombination rates based on the employed laser intensities. At the same time, the generated charge carriers are rapidly transferred to the interface of the HTL/absorption layer and accumulate holes at the interface because of inefficient capacitance and mobility differences caused by differently doped HTL thicknesses. Notably, the charge concentration gradient is low at lower light intensities and did not accumulate holes at the HTL/absorption layer interface, even though they have high charge mobility. Therefore, this study highlights the importance of interfacial charge recombination and charge transport phenomena to achieve highly efficient and stable PSCs. Full article

Background: Postoperative physical therapy emerges as a pivotal element of the rehabilitation process, aimed at enhancing functional recovery, managing pain, and mitigating the risk of further complications. The debate concerning the optimal timing of physical therapy intervention post-surgery remains unresolved; in particular, whether to initiate physical therapy immediately or to wait weeks is of particular interest. The aim of this study is to review the available literature regarding the optimal timing of physical therapy initiation and the outcomes obtained. Methods: This review was carried out in accordance with the Preferential Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. This search was carried out in February 2024. Only peer-reviewed articles were considered for inclusion. Results: Fourteen studies were included. The primary outcomes assessed in the included studies were the following: 12-week and 12-month low back pain, return to work, function and disability, psychological status, patient satisfaction, and complications associated with early physical therapy. A meta-analysis was performed concerning low back pain after lumbar discectomy at 12 weeks and 12 months and complications after early physical therapy after lumbar discectomy and lumbar interbody fusion. A significant difference was found between early and standard physical therapy in terms of low back pain at 12–18 months (p = 0.0062); no significant differences were found in terms of complications, both for discectomy and arthrodesis. Conclusions: This review indicates that employing early rehabilitation strategies for intervertebral disc disease could enhance results in terms of pain and disability without an enhanced risk of complications. Full article

Introduction: Vitamin B1 deficiency poses a significant risk of impaired consciousness, with manifestations ranging from anorexia and fatigue to severe neurological and cardiovascular disturbances. Wernicke’s encephalopathy, a neurological disorder stemming from vitamin B1 deficiency, presents as the triad of ophthalmoplegia, altered mental state, and cerebellar ataxia. However, these symptoms are not consistently present, complicating the diagnosis. In addition, subclinical vitamin B1 deficiency can progress unnoticed until severe complications arise. Studies indicate a high rate of undiagnosed cases, emphasizing the need for early detection and intervention. Case presentation: We present the case of a 65-year-old man in whom hyperlactatemia was incidentally detected, leading to the diagnosis of vitamin B1 deficiency. The patient, presenting with vertigo and vomiting, had been eating boxed lunches bought from convenience stores following the death of his wife 3 years earlier. Vertigo gradually improved with rest, but the persistence of hyperlactatemia prompted further investigation, revealing low vitamin B1 levels and high pyruvate levels. Treatment with dietary adjustments and supplements significantly improved his symptoms. Discussion: In this case, hyperlactatemia was found in a vertigo patient, revealing asymptomatic vitamin B1 deficiency. Elevated lactate is often linked with conditions like sepsis but can also stem from overlooked factors such as low vitamin B1 levels due to poor diet habits like consuming fried foods. Conclusion: This case highlights the importance of considering vitamin B1 deficiency in patients with unexplained hyperlactatemia, even in high-income countries. Early detection can prevent progression to the severe complications associated with Wernicke’s encephalopathy. Proactive measurement of lactate levels in at-risk populations may facilitate early diagnosis and intervention, ultimately improving patient outcomes. Full article