A Serverless Pharmacogenomic Risk Dashboard: Translating Ensemble Models and Model-Based Scenario Rules to Clinical Decision Support.

Anterior cruciate ligament (ACL) has become one of the most common and easily damaged knee ligaments in sports and military training affecting young and active people. The extensive interest in ACL ruptures is related to the subsequent articular degeneration and severe dysfunction, resulting in skeletal muscle functional limitations not only in athletics but also in daily living. Thus, restoring lower limb motor function and stability has become the primary goal after ACL reconstruction. Moreover, the newest study has indicated that increased neural activity may reflect central neuroplastic strategies to preserve motor functionality after ACL reconstruction []. Postsurgical rehabilitation guidelines for the orthopedic clinician recommended a common treatments for ACL reconstruction patients []; Specifically, current rehabilitation strategies for ACL reconstruction primarily focus on physical therapy and strengthening exercises, but they often suffer from limited effectiveness in restoring full motor function. Previous studies have shown that neuroplastic changes are slow during early rehabilitation, and motor recovery can be hindered by poor central nervous system engagement. Hence, it is very urgent to find a safe, effective and easy conduct and alternative therapy. Transcranial direct-current stimulation (tDCS) is a well-established non-invasive neuromodulation technique that has shown promising results in improving motor function in various neurological and musculoskeletal conditions, including stroke, spinal cord injury, and knee osteoarthritis [, ]. Anodal stimulation over the primary motor cortex (M1) has been associated with increased cortical excitability, improved voluntary muscle activation, and enhanced motor learning through long-term potentiation-like mechanisms. In the context of ACL reconstruction, persistent quadriceps weakness and impaired proprioception have been linked to central nervous system hypoactivity and maladaptive plasticity []. Although direct evidence on the use of tDCS in ACL patients is limited, emerging studies have begun to explore its adjunctive role. For instance, Tohidirad et al. [] demonstrated that a battery-operated tDCS device, applied over the M1 with large electrodes(5 × 7 cm) at the intensity of 2 mA current for 20 min for 10 sessions, enhanced the effect of conventional physiotherapy (PT) on balance and muscle performance in athletes recovering from ACL injury. Their study showed that one month after treatment, the displacement of the center of pressure significantly decreased in the intervention group, indicating improved postural control, while no significant changes was observed in the control group. Additionally, the average power of flexor and extensor muscles increased in both groups, but the rise in the intervention group was significantly larger. These findings highlight the potential of combining a-tDCS with PT to induce lasting improvements in functional outcomes for ACL injury rehabilitation. For another, motor imagery based brain-computer interface (MI-BCI) neuro rehabilitation paradigms have emerged as a novel iatrotechnics on motor function and brain function recovery []. The MI-BCI was combined with tDCS offers a promising alternative by targeting neural reorganization and enhancing motor learning early in the recovery process, but this combined strategy that has not been fully explored in ACL rehabilitation. Building on these findings, our study explores the application of MI-BCI combined tDCS as a novel neuromodulation strategy in in a patient undergoing early post-ACL reconstruction rehabilitation. By monitoring changes in functional connectivity (FC) using resting-state fMRI, we aim to provide mechanistic insight into how such combined stimulation may facilitate neural plasticity and accelerate functional recovery.