Search Results (516)

Work-related musculoskeletal disorders (WMSDs) are among the most prevalent occupational health issues, particularly affecting public transport drivers due to prolonged sitting, constrained postures, and poorly adaptable cabins. This study addresses the ergonomic risks associated with tram driving, aiming to evaluate biomechanical load and postural stress in relation to drivers’ anthropometric characteristics. A combined methodological approach was applied, integrating two standardized observational tools—RULA and REBA—with anthropometric modeling based on three representatives European morphotypes (SmallW, MidM, and TallM). ErgoFellow 3.0 software was used for digital posture evaluation, and lumbar moments at the L4/L5 vertebral level were calculated to estimate lumbar loading. The analysis was simulation-based, using digital human models, and no real subjects were involved. The results revealed uniform REBA (Rapid Entire Body Assessment) and RULA (Rapid Upper Limb Assessment) scores of 6 across all morphotypes, indicating moderate to high risk and a need for ergonomic intervention. Lumbar moments ranged from 51.35 Nm (SmallW) to 101.67 Nm (TallM), with the tallest model slightly exceeding the recommended ergonomic thresholds. These findings highlight a systemic mismatch between cabin design and user variability. In conclusion, ergonomic improvements such as adjustable seating, better control layout, and driver education are essential to reduce the risk of WMSDs. The study proposes a replicable methodology combining anthropometric, observational, and biomechanical tools for evaluating and improving transport workstation design. Full article

Background/Objectives: Discrepancies in diabetic retinopathy (DR) grading are well-documented, with retinal non-perfusion (RNP) quantification posing greater challenges. This study assessed intergrader agreement in DR evaluation, focusing on qualitative severity grading and quantitative RNP measurement. We aimed to improve agreement through structured consensus meetings. Methods: A retrospective analysis of 100 comparisons from 50 eyes (36 patients) was conducted. Two paired medical retina fellows graded ultra-widefield color fundus photographs (CFP) and fundus fluorescein angiography (FFA) images. CFP assessments included DR severity using the International Clinical Diabetic Retinopathy (ICDR) grading system, DR Severity Scale (DRSS), and predominantly peripheral lesions (PPL). FFA-based RNP was defined as capillary loss with grayscale matching the foveal avascular zone. Weekly adjudication by a senior specialist resolved discrepancies. Intergrader agreement was evaluated using Cohen’s kappa (qualitative DRSS) and intraclass correlation coefficients (ICC) (quantitative RNP). Bland–Altman analysis assessed bias and variability. Results: After eight consensus meetings, CFP grading agreement improved to excellent: kappa = 91% (ICDR DR severity), 89% (DRSS), and 89% (PPL). FFA-based PPL agreement reached 100%. For RNP, the non-perfusion index (NPI) showed moderate overall ICC (0.49), with regional ICCs ranging from 0.40 to 0.57 (highest in the nasal region, ICC = 0.57). Bland–Altman analysis revealed a mean NPI difference of 0.12 (limits: −0.11 to 0.35), indicating acceptable variability despite outliers. Conclusions: Structured consensus training achieved excellent intergrader agreement for DR severity and PPL grading, supporting the clinical reliability of ultra-widefield imaging. However, RNP measurement variability underscores the need for standardized protocols and automated tools to enhance reproducibility. This process is critical for developing robust AI-based screening systems. Full article

Background/Objectives: To identify the predictive biomarkers of treatment response following a switch to brolucizumab in patients with aflibercept-refractory neovascular age-related macular degeneration (nAMD). Methods: This retrospective study included 47 eyes of 44 patients with nAMD who were switched to brolucizumab; a two-year follow-up was completed for 37 eyes of 34 patients after the switch. The patients were classified into two groups based on the presence (fluid group) or absence (dry group) of retinal fluid at one and two years after switching, and their visual acuity, central retinal thickness, subfoveal choroidal thickness, injection interval, and dry macular rate were evaluated. Results: A dry macula was achieved for approximately 80% of patients at two years after the switch (p < 0.001), and the mean injection interval was significantly extended from 6.4 ± 1.8 weeks to 10.5 ± 2.6 weeks during the same period (p < 0.001). Both the mean central retinal thickness and subfoveal choroidal thickness showed a significant decrease at two years after the switch (p < 0.001 for both). A significantly higher proportion of patients in the Dry group exhibited punctate hyperfluorescence in the fellow eye (p < 0.001), and all patients in the dry group achieved a dry macula at two years. Conclusions: Switching to brolucizumab may be an effective treatment option for patients with aflibercept-refractory nAMD. Punctate hyperfluorescence may serve as a favorable prognostic factor following a switch to brolucizumab. Full article

In social networks like community Question-Answering (cQA) services, members interact with each other by asking and answering each other’s questions. This way they find counsel and solutions to very specific real-life situations. Thus, it is safe to say that community fellows log into this kind of social network with the goal of satisfying information needs that cannot be readily resolved via traditional web searches. And in order to expedite this process, these platforms also allow registered, and many times unregistered, internauts to browse their archives. As a means of encouraging fruitful interactions, these websites need to be efficient when displaying contextualized/personalized material and when connecting unresolved questions to people willing to help. Here, demographic factors (i.e., gender) together with frontier deep neural networks have proved to be instrumental in adequately overcoming these challenges. In fact, current approaches have demonstrated that it is perfectly plausible to achieve high gender classification rates by inspecting profile images or textual interactions. This work advances this body of knowledge by leveraging lexicalized dependency paths to control the level of abstraction across texts. Our qualitative results suggest that cost-efficient approaches exploit distilled frontier deep architectures (i.e., DistillRoBERTa) and coarse-grained semantic information embodied in the first three levels of the respective dependency tree. Our outcomes also indicate that relative/prepositional clauses conveying geographical locations, relationships, and finance yield a marginal contribution when they show up deep in dependency trees. Full article

Passengers’ trust in Shared Autonomous Vehicles (SAVs) can be affected by different factors, such as their attitudes toward new technologies and perceptions of the vehicles’ reputation. While the existing literature has begun to explore these issues, there is limited research investigating how industrial design in SAVs can enhance passengers’ trust levels. To address this gap, this study responds to the central question: How can passengers’ trust in the vehicle itself and in fellow passengers be enhanced through design intervention? This question conceptualises trust in the vehicle and trust in strangers as an integrated trust issue within the SAV context. To fill this gap, this study adopts a project-grounded methodology. The design work is guided by five trust principles: anthropomorphic design, a defensible space, system transparency, personalisation features, and a restorative environment. Drawing on insights from an auto-ethnography of current ride-sharing services, these principles are further explored and applied to identify design opportunities for both the physical and digital elements of SAVs. The final conceptual SAV design demonstrates how different design elements can be orchestrated to engender user trust. The outcome contributes to ongoing design practices and helps researchers and designers better understand trust design for SAVs. Full article

The prevalence of end-stage renal disease has surged significantly in recent decades, with an 88% increase reported in the United States between 2002 and 2022. Peritoneal dialysis and home hemodialysis offer numerous advantages over in-center hemodialysis, including improved quality of life, increased treatment flexibility, and reduced healthcare costs. Despite strong preferences among healthcare professionals and the documented benefits of home-based therapies, utilization remains limited in the U.S. One of the many factors that play a role in the underutilization of home therapies is inadequate training and perceived incompetence among nephrology fellows in initiating and managing home dialysis patients. Here in this article, we highlight the current educational gaps in home dialysis training and ways to overcome the barriers. There is a need for a multifaceted approach that includes home dialysis rotations and continuity clinics; a dedicated one-year Home Dialysis Fellowship; and continued medical education through didactics, symposiums, and conferences. Here we emphasize the need for structured, longitudinal programs that combine didactic learning with hands-on clinical in fellowship trainings and the importance of dedicated one-year fellowships in cultivating future leaders and experts in the field. By enhancing training pathways and expanding fellowship opportunities, nephrology education can better equip physicians to meet the growing demand for home dialysis, ultimately improving patient outcomes and advancing public health objectives. Full article

This paper investigates religious encounters between Chinese and Senegalese Muslims in the relatively new Chinatown of Dakar. Chinese Muslims from Kaifeng City, Henan Province first arrived in Senegal in the 1990s following the Henan provincial state-owned construction company. They started a wholesale business mainly of clothing and shoes and brought their relatives and family members to Dakar. However, scholars studying the Chinese community in Dakar have largely ignored their Muslim identity and its significance. Moving beyond the conventional focus on tensions between Muslim and Chinese identities in the study of overseas Chinese Muslims, this paper turns to religious encounters in everyday life. Based on field research and interviews both in Dakar and Henan, this paper argues that for these Chinese Muslim businesspersons in Dakar, Islam as a shared religious identity sometimes provides opportunities to connect with their fellow Muslims in a foreign country. However, differences in religious practices can also lead to misconceptions between them and other Senegalese Muslims. This paper thus contributes to Islamic studies and the study of global China, particularly in relation to overseas Chinese Muslims, China–Africa encounters, and global Chinatowns. Full article

Bone repair and regeneration following an injury still present challenges worldwide. Three-dimensional (3D) scaffolds made from various materials are used for bone tissue engineering (BTE) applications. Polymers, minerals and nanotechnology are now being used in combination to achieve specific goals for BTE, including the delivery of antimicrobials through the scaffolds to prevent post-surgical infection. While several materials are utilised for BTE, natural polymers present a unique set of materials that can be manipulated to formulate scaffolds for BTE applications. They have been found to demonstrate higher biocompatibility, biodegradability and lower toxicity. Some even naturally mimic the bone microarchitecture, providing inherent structural support for BTE. Natural polymers may be simply classified as those from plant and animal sources. From both sources, there are different types of proteins, polysaccharides and other specialised materials that are already in use for research in BTE. Interestingly, these have the potential to revolutionise the field of BTE with a sustainable approach. In this review, we first discuss the different natural polymers used in BTE from plant sources, followed by animal sources. We then explore novel materials that are aimed at sustainable approaches, focusing on innovation from the last decade. In these sections, we outline studies of these materials with different types of bone cells, including bone marrow mesenchymal stromal cells (MSCs), which are the progenitors of bone. We finally outline the limitations, conclusions and future directions from our perspective in this dynamic field of polymers in BTE. With this review, we hope to bring together the updated existing knowledge and the potential future of innovation and sustainability in natural polymers for biomimetic BTE applications for fellow scientists, researchers and surgeons in the field. Full article

Background/Objectives: Non-ablative stereotactic body radiation therapy (SBRT) is commonly employed for locally advanced pancreatic cancer (LAPC) using computed tomography-guided radiotherapy (CTgRT) without online adaptive radiation therapy (oART). The safe delivery of ablative SBRT has been demonstrated using stereotactic magnetic resonance-guided online adaptive radiation therapy (SMART). We performed an in silico comparison of non-adapted CTgRT versus SMART to better understand the potential benefit of oART for ablative pancreatic SBRT. Methods: We retrospectively evaluated original and daily adapted SMART plans that were previously delivered for 20 consecutive LAPC cases (120 total plans across all patients) treated on a 0.35 T MR-linac prescribed to 50 Gy (gross disease) and 33 Gy (elective sites) simultaneously in five fractions. Six comparative CTgRT plans for each patient (one original, five daily treatment) were retrospectively generated with the same prescribed dose and planning parameters as the SMART plans assuming no oART availability. The impact of daily anatomic changes on CTgRT and SMART plans without oART was evaluated across each treatment day MRI scan acquired for SMART. Results: Ninety percent of cases involved the pancreatic head. No statistically significant differences were seen between CTgRT and SMART with respect to target coverage. Nearly all (96%) fractions planned on either CT or MRI platforms exceeded at least one GI organ at risk (OAR) constraint without oART. Significant differences favoring SMART over non-adaptive CTgRT were observed for the duodenum V35 Gy ≤ 0.5 cc (34.2 vs. 41.9 Gy, p = 0.0035) and duodenum V40 Gy ≤ 0.03 cc (37 vs. 52.5 Gy, p = 0.0006) constraints. Stomach V40 Gy trended towards significance favoring SMART (37 vs. 40.3 Gy, p = 0.057) while no significant differences were seen. Conclusions: This is the first study that quantifies the frequency and extent of GI OAR constraint violations that would occur during ablative five-fraction SBRT using SMART vs. CTgRT. GI OAR constraint violations are expected for most fractions without oART whereas all constraints can be achieved with oART. As such, these data suggest that oART should be required for ablative five-fraction pancreatic SBRT. Full article

For the past three decades, Black Jews in France have made their presence manifest. These believers identify as African, West Indian, or biracial, and are either converts or native Jews. They may either assert their faith from within the institutions of French Jewry, or claim their Jewishness without practicing Judaism. They have widely different backgrounds, but share a common need for identity reconstruction. This paper aims to discuss this Africana minority within the broader French Jewish community, taking into account its relation to the majority. What is the positioning of Black Jews as French citizens or residents? How do they perceive themselves when reading the Torah and through the gaze of their fellow White Jews? What is their place within the global Jewish world? Such are the questions this paper will try to address, building on fifteen years of fieldwork in France and assessing their involvement in French Jewry and its impact with regard to participation, integration, legitimacy, and conflicts. Full article

Background and Objective: Despite growing emphasis on quality and safety in healthcare, there remains a limited understanding of how Quality Improvement and Patient Safety (QI/PS) training for health workers has evolved in response to global events like the COVID-19 pandemic and the WHO Global Patient Safety Action Plan. This rapid scoping review aimed to not only identify existing curricula but also uncover trends, innovation gaps, and global inequities in QI/PS education—providing timely insights for reshaping future training strategies. Methods: We searched MEDLINE and Scopus for English-language studies published between January 2020 and April 2024, describing QI and/or PS curricula across graduate, postgraduate, and continuing education levels. All healthcare worker groups were eligible, with no geographic limitations. Two reviewers conducted independent screening and data extraction; a third verified the results. Results: Among 3290 records, 74 curricula met inclusion criteria, with a majority originating from the US (58, 78.4%) and targeting physicians—especially residents and fellows (43/46, 93.5%). Only 27% of curricula were multidisciplinary. While traditional didactic (66.2%) and interactive (73%) approaches remained prevalent, curricula launched after 2020 introduced novel formats such as Massive Open Online Courses and gamification, with long-term programs uniformly leveraging web-based platforms. Common thematic content included Root Cause Analysis, Plan-Do-Study-Act cycles, QI tools, communication skills, and incident reporting. English-language peer-reviewed published literature indicated a marked lack of structured QI/PS training in Europe, Asia, and Africa. Conclusions: This review reveals both an uneven development and fragmentation in global QI/PS training efforts, alongside emerging opportunities catalyzed by digital transformation and pandemic-era innovation. The findings highlight a critical gap: while interest in QI/PS is growing, scalable, inclusive, and evidence-based curricula remain largely concentrated in a few high-income countries. By mapping these disparities and innovations, this review provides actionable direction for advancing more equitable and modern QI/PS education worldwide, whilst showcasing the need to systematically delve into QI/PS training in underrepresented regions. Full article

The African catfish, Clarias gariepinus, is among the most farmed fish species in Uganda’s rapidly growing aquaculture sub-sector. The enhanced growth performance, increased survival, and resilience to environmental stressors have driven a rising demand among farmers for improved African catfish broodstock and seed. Until recently, most studies of this species have focused on nutrition, physiology, and culture systems, with little known about the genetics, broodstock, and hatchery management of the cultured C. gariepinus populations. This knowledge gap has led to inbreeding depression, resulting in poor seed quality and reduced performance of the broodstock. To enhance catfish aquaculture production, a survey was conducted across multiple catfish hatcheries and farms in Uganda. Using semi-structured questionnaires, the study assessed broodstock management practices, hatchery propagation methods, the suitability of various populations, demographics, challenges, and prospects of hatchery operators. Responses were coded, and descriptive statistics such as frequency, percentages, and means were calculated. Results indicate that there are farmers who continue to source their broodstocks from the natural water bodies in addition to acquiring them from fellow farmers. The estimated effective population size (Ne) for the majority of the respondents was 133.33 and 178.22, with an average breeding coefficient of 0.4% and 0.3%, respectively. There is also a continuous use of shooters (fast-growing cannibalistic fish) by the farmers who hatch and select them to be used as broodstocks later, under the assumption that they have superior genetic traits. The reported hatchability rate was above 70%, with an average survival rate of 60% from larvae to fry. The study identified diseases, inadequate water supply, and electricity as the primary challenges for catfish breeding. While Uganda’s African catfish aquaculture industry is expanding rapidly, certain hatchery practices pose significant risks to its sustainability if not properly addressed. Full article

A principal strategic goal of the RCMI Coordinating Center (RCMI-CC) is to improve the health of minority populations and to reduce ethnic and geographic disparities in health by coordinating the development and facilitating the implementation of clinical research across the RCMI Consortium. To more effectively spur inter-institutional collaborative research, the RCMI-CC supports a Clinical Research Pilot Projects Program for hypothesis-driven clinical research projects proposed by postdoctoral fellows, early-career faculty and/or early-stage investigators from two or more RCMI U54 Centers. The purpose of this brief report is to summarize the Science Speed Dating sessions to facilitate cross-site collaboration at the RCMI Investigator Development Core (IDC) Workshop, held in conjunction with the 2024 RCMI Consortium National Conference. RCMI investigators and IDC Directors from 20 RCMI U54 Centers participated in two rounds of highly interactive small-group presentations of research ideas and resource needs in search of new collaborative and mentoring partnerships. Workshop participants expressed a high level of satisfaction with the speed-networking format and strongly agreed that the workshop was beneficial to their professional-development goals. Full article

Background/Objectives: The role of the vitreous in the effective lens position (ELP) is controversial in patients undergoing phacovitrectomy. The aim of this study was to compare the change in aqueous depth (AD), a surrogate of the ELP, in non-vitrectomized and vitrectomized fellow eyes. Methods: Post-hoc analysis of a prospective study conducted in OMIQ facilities (Barcelona, Spain) between 2021 and 2023. Patients with bilateral cataracts and a unilateral grade 2/3 epiretinal membrane underwent phacoemulsification in one eye and phacovitrectomy without endotamponade in the fellow eye. All eyes were implanted with an extended depth-of-focus intraocular lens after power calculation using the same biometer, technicians, formula, and surgeon. We compared the change in AD (mm and percentage) from baseline, and the role of vitrectomy without endotamponade on AD with a mixed-effects models. Results: We included 40 eyes (20 patients) with a mean age of 71.6 years, with 55% females. The mean change in AD was +1.51 (vitrectomized) and +1.42 mm (non-vitrectomized eyes), p = 0.33. The percent of change in AD was not different between groups (p ≥ 0.38) and phacovitrectomy had no effect on the change in AD on mixed-effects models (p > 0.10). Conclusions: The absence of the vitreous had a minimal influence on AD in these patients undergoing standard phacoemulsification or phacovitrectomy. Full article

Amblyopia, a neurodevelopmental disorder, is commonly assessed through amblyopic eye visual acuity (VA) deficits, but recent studies also highlight abnormalities in the fellow eye. This study quantified binocular and fellow/dominant eye VA in individuals with amblyopia and strabismus without amblyopia and examined factors influencing these measures, including fixation eye movement (FEM) abnormalities. Identifying which subsets of patients—such as those with nystagmus, concurrent strabismus, or greater fixation instability—exhibit more pronounced deficits in binocular visual acuity and binocular summation can enhance clinical decision-making by enabling tailored interventions and aiding patient counseling. Sixty-eight amblyopic, seventeen strabismic without amblyopia, and twenty-four control subjects were assessed using an adaptive psychophysical staircase procedure and high-resolution video-oculography to evaluate FEMs and fixation instability (FI). Binocular and fellow eye VA were significantly lower in amblyopia, regardless of type or nystagmus presence, whereas binocular and dominant eye VA in strabismus without amblyopia did not differ from the controls. Despite reduced binocular acuity, amblyopic and strabismic subjects exhibited binocular summation, with binocular VA exceeding fellow/dominant eye VA. Reduced binocular VA correlated with greater fellow eye VA deficits, diminished binocular summation, and increased FI in the amblyopic eye. Fellow eye VA deficits were linked to greater amblyopic eye VA deficits, an increased degree of anisometropia, higher FI, and stronger nystagmus correlation. These findings suggest amblyopia affects both visual sensory and motor systems, impacting binocular function and fixation stability, with potential consequences for everyday visuomotor tasks like reading. Full article