Search Results (41,146)

Objectives: The aim of this study was to determine differences in injury types and frequencies between piston-based and band-based automated chest compression devices in patients with non-traumatic out-of-hospital cardiac arrest (OHCA) at a German cardiac arrest center. Methods: This retrospective single-center study assessed resuscitation-related injuries in OHCA patients using protocol-based early whole-body CT scans at hospital admission. CT scans were reviewed independently by two reviewers blinded to the compression device used. Between May 2015 and September 2021, all patients resuscitated from non-traumatic OHCA, treated with a mechanical chest compression device, and showing stable return of spontaneous circulation (ROSC) until CT examination according to the institutional standard operating procedure for all OHCA patients were included. Patients were categorized by compression device type, and group differences were analyzed using the Chi-square test and Mann–Whitney U test. In addition, patient-level incidences of rib fracture types were calculated, and risk ratios with corresponding 95% confidence intervals were used to compare rib fracture patterns between groups. A p-value of <0.05 was considered statistically significant. Results: Among 71 patients, 32 received band-based and 39 piston-based treatment. Both groups were comparable in resuscitation duration, body constitution, and gender ratio, although the band-based group was older. Thoracic injuries predominated, with rib fractures representing the most frequent injury pattern (64/71, 90.1%). The median number of rib fractures per patient was 10 (IQR 8–12) in the band-based group and 9 (IQR 7–12) in the piston-based group. The band-based group had significantly more liver lacerations (5/32, 15.6% vs. 0/39, 0%; p = 0.01) and displaced rib fractures (117 vs. 87; p = 0.046; patient-level RR = 1.43, 95% CI 1.06–1.93). Conclusions: In this observational study of a CT-based cohort of OHCA patients with stable ROSC, the band-based device was associated with significantly higher frequencies of liver lacerations and displaced rib fractures than the piston-based device. These findings should be interpreted as hypothesis-generating and may support further evaluation of device-specific injury profiles in future studies. Full article

This research investigates the influence of environmental regulation on subjective evaluations of video quality within the Quality of Experience (QoE) paradigm. This work presents a supplementary experiment conducted in a controlled laboratory setting, building on our previous crowdsourcing studies carried out in uncontrolled, web-based conditions using the Prolific platform. Both tests utilized the identical crowdsourcing platform and complied with the International Telecommunication Union Telecommunication (ITU-T) P.910 Recommendations, ensuring external validity and methodological consistency. Participants assessed a collection of processed video sequences (PVS) comprising 46 distinct video clips utilizing the 5-point Absolute Category Rating (ACR) scale, while their response times were documented in milliseconds as measures of cognitive exertion and decision delay. The comparison analysis employs nonparametric tests (Mann–Whitney U and Kolmogorov–Smirnov) and a hierarchical Linear Mixed-Effects Model (LMM) to examine disparities in reaction time distributions, rating consistency, and the incidence of outliers across both environments. The results indicate that controlled settings produce statistically significantly less response variability and enhanced data reliability, whereas uncontrolled settings encompass greater external diversity and real-world unpredictability. These findings offer significant insights into the balance between experimental control and external validity in crowdsourced video quality assessment, advancing the development of scalable approaches for Quality of Experience research. Full article

Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries, with increasing incidence linked to obesity and metabolic dysfunction. While early-stage EC is often curable, advanced and recurrent disease remains difficult to treat due to resistance and limited therapeutic options. Natural products derived from traditional Chinese medicine have attracted attention as complementary strategies in EC management. These compounds exhibit multi-target effects, including modulation of estrogen signaling, inhibition of proliferation, induction of apoptosis, and regulation of immune and inflammatory pathways. This review summarizes current evidence on natural products in EC, integrating preclinical findings, emerging clinical data, and mechanistic insights from molecular and systems biology approaches. Key challenges, including variability, bioavailability, and insufficient clinical validation, are discussed. Future directions emphasize the integration of natural products into precision oncology frameworks. Full article

Percutaneous left atrial appendage occlusion (LAAO) has become an established alternative to long-term oral anticoagulation for stroke prevention in patients with atrial fibrillation, with expanding indications beyond those with absolute contraindications to anticoagulation. Alongside its broader adoption, device-related thrombus (DRT) has emerged as a clinically relevant complication that directly compromises the protective intent of LAAO. This comprehensive narrative review synthesizes contemporary evidence on the incidence, mechanisms, predictors, clinical impact, and management of DRT. DRT is a multifactorial phenomenon that carries an annual incidence ranging from 1.75% to almost 5%, resulting from the interplay between post-implant flow dynamics, device engineering, endothelialization processes, procedural factors, and patient-specific prothrombotic features. Accumulating data from observational registries links DRT to increased risks of ischemic stroke, systemic embolism, major adverse cardiovascular events (MACE), and mortality. Although evidence is growing, optimal management regimens for both the prevention and treatment of DRT remain undefined. Moreover, a lack of standardization also affects diagnosis and imaging surveillance, mainly performed by transesophageal echocardiography or cardiac computed tomography. By integrating mechanistic insights, clinical predictors, device-specific considerations, and therapeutic evidence, this review highlights current knowledge gaps and proposes practical considerations to inform individualized risk stratification, surveillance, and management of DRT in contemporary LAAO practice. Full article

Background: Osteoporosis has a rising global incidence and social burden. Serum uric acid’s dual roles in oxidative stress and inflammation may influence bone health, but findings are inconsistent and require further research. This study aimed to evaluate the relationship between SUA levels and osteoporosis in a multicenter cohort obtained from different regions of Türkiye. Methods: This multi-center retrospective study included 3280 individuals, postmenopausal women and men aged 45 and older, from 16 centers in Türkiye. Individuals were excluded if they recently consumed alcohol, had severe renal dysfunction, certain hormonal or mineral disorders, specific medications, or certain menopausal statuses. Bone mineral density (BMD) at the hip and lumbar spine was measured using dual-energy X-ray absorptiometry (DXA), and participants were classified as normal or having osteopenia or osteoporosis based on T-score thresholds. Results: Overall, 34.8% were male, and 65.2% were female. For the lumbar spine, 36.8% had osteopenia, and 13.5% had osteoporosis; similarly, for the total hip, 40.8% had osteopenia, and 7.9% had osteoporosis. ROC analysis identified a threshold of 3.9 mg/dL serum uric acid (SUA) (AUC 0.374; p < 0.001), which was positively associated with both lumbar and total hip BMD. Osteoporosis rates were higher in patients with SUA < 3.9 mg/dL compared to those with SUA ≥ 3.9 mg/dL at the lumbar spine (29.1% vs. 14.2%, p < 0.001) and total hip sites (23.6% vs. 15.9%, p = 0.003). After adjustment for potential confounders, SUA was a significant independent predictor of osteoporosis in the lumbar spine (OR 0.70; p < 0.001) and the hip (OR 0.80; p < 0.001). Conclusions: Serum uric acid levels are inversely linked to bone mineral density and osteoporosis risk, indicating a potential role in bone health. However, due to study limitations, causal relationships remain unproven, and further research is needed. Full article

Background/Objectives: The objective of this study was to evaluate, for the first time, the effectiveness and safety of 4% icodextrin solution by detecting the incidence of adhesion-related morbidities (adhesion-related hospital readmissions, including reoperations) when used as an adhesion prophylactic agent during laparoscopic gynecologic surgery. Methods: The study was a single-arm, two-center, retrospective study. The incidence of hospital readmissions that were directly or possibly related to adhesions following the use of 4% icodextrin in laparoscopic gynecologic surgery, 2 years from the date of index surgery, was assessed either via chart review alone or, when found necessary, in combination with patient-completed questionnaires. Patient safety was evaluated through reported adverse events. The relationship between clinical events and the use of 4% icodextrin was assessed by investigators based on patient-level data. Results: After 149 patients were screened, the study finally included 123 patients; 4 (3.3%; 95% CI: 0.89%, 8.12%) had at least one reoperation or readmission that was directly or possibly related to adhesion within 2 years of index surgery. In the supplemental analysis (67 patients using chart and questionnaire data), this incidence rate was 10.4% (95% CI: 4.30%, 20.35%). No adverse events related to the use of 4% icodextrin were reported. Conclusions: This is the first study ever evaluating hospital readmission/reoperation rates after application of a specific adhesion prophylactic agent. The results indicate that 4% icodextrin is safe and effective when used as an intraperitoneal instillate for reduction in adhesions in gynecological laparoscopic procedures. It has a lower readmission and reoperation rate compared to meta-analysis data in the international literature. Full article

Background/Objectives: To compare the five-year efficacy and safety of the 63 µm (XEN63) vs. 45 µm (XEN45) XEN^® Gel Stent in patients with open-angle glaucoma (OAG). Methods: This retrospective matched (1:1) cohort study included adults with OAG who underwent standalone ab interno implantation of the XEN63 or the XEN45 between 2014 and 2021 at a tertiary referral center in Belgium. The primary outcome was IOP at five years. The secondary outcomes included surgical success, topical medication use, postoperative hypotony, complications and interventions. Results: Thirty eyes of 30 patients (15 XEN63 and 15 XEN45) were analyzed. The baseline characteristics were comparable. At five years, the mean IOP did not differ between the XEN63 and the XEN45 (11.5 vs. 11.0 mmHg; p = 0.54). The XEN63 demonstrated higher complete success rates than the XEN45 for both the IOP < 18 mmHg (10 vs. four eyes; p = 0.016) and <15 mmHg criteria (10 vs. three eyes; p = 0.003). The topical medication use was low and comparable (0.6 vs. 0.9 medications; p = 0.57). The numerical (13 vs. five eyes; p = 0.008) and symptomatic (six vs. two eyes; p = 0.2) hypotony were more frequent after the XEN63 implantation. The two eyes with XEN63 and none with XEN45 experienced clinically significant hypotony. The needling procedures and secondary glaucoma surgeries were more frequent after the XEN45. Conclusions: The XEN63 implantation was associated with higher long-term success rates and also with a higher incidence of early postoperative hypotony. These findings indicate a trade-off between efficacy and safety and suggest that careful patient selection and postoperative management are essential when considering larger lumen subconjunctival drainage devices. Full article

Background: The incidence and mortality rates of cancer among females aged 65 years or older in the Republic of Korea are increasing; however, the national cancer screening rate (50.4%) remains low. Therefore, this study aimed to identify predictors of participation in the National Cancer Screening Program (NCSP) among women aged 65 years or older using data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII, 2019–2021). Methods: This cross-sectional study utilized data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII, 2019–2021). Study variables were selected based on Andersen’s healthcare utilization model. Participation in the National Cancer Screening Program (NCSP) was defined as the dependent variable, and independent variables included predisposing, enabling, and need factors. Descriptive analyses were conducted to examine participants’ characteristics. Chi-square tests were used to assess differences in NCSP participation according to participant characteristics. Multivariable logistic regression analysis was conducted to identify factors associated with participation, with all independent variables simultaneously included in the model to adjust for potential confounding. A p-value of <0.05 was considered statistically significant. Results: A total of 2105 women aged 65 years or older were included in the analysis. Of the 2105 women aged 65 years or older, 1429 (67.9%) reported participation in cancer screening within the past two years. NCSP participation was significantly associated with being married (OR = 1.540; 95% CI: 1.263–1.879), being a middle school (OR = 1.357; 95% CI: 1.022–1.801) or college graduate or higher (OR = 2.012; 95% CI: 1.199–3.378), having private insurance (OR = 1.930; 95% CI: 1.573–2.368), average subjective health (OR = 1.332; 95% CI: 1.004–1.766), dyslipidemia (OR = 1.347; 95% CI: 1.110–1.636), and physical activity participation (OR = 1.252; 95% CI: 1.029–1.524). In contrast, urban residence, income level, being employed, medical coverage type, hypertension, diabetes, monthly drinking status and current smoking status were not statistically significantly correlated with NCSP participation. Conclusions: These findings highlight the need for tailored outreach strategies and health education programs targeting women aged 65 years and older to enhance participation in the NCSP and ultimately improve public health outcomes. Full article

Background/Objectives: Bond reliability is essential in orthodontic treatment, as temperature fluctuations in the oral environment can weaken adhesive interfaces and increase the risk of bracket failure. However, direct comparison of the long-term durability of commonly used orthodontic resin cements under thermocycling conditions is limited. Therefore, the present study aimed to evaluate and compare the shear bond strength (SBS) and failure modes of Transbond™ XT and Orthomite™ LC before and after thermal cycling (Tc). Methods: A total of 60 bovine enamel specimens were used in this study. Specimens were bonded with either Transbond XT or Orthomite LC under standardized conditions. SBS was measured at 24 h (Tc0) and after 5000 thermal cycles (Tc5000). Failure modes were classified as adhesive (A), enamel cohesive (B), or bracket cohesive (C) failure. Statistical analyses included the Mann–Whitney U test for SBS and Fisher’s exact test for failure mode distribution. Results: At Tc0, there was no significant difference in SBS between the two cements (p > 0.05). After Tc5000, Orthomite LC showed significantly higher SBS than Transbond XT (p = 0.00368). Failure mode analysis revealed that, after Tc, Transbond XT exhibited a higher incidence of adhesive failures (A), whereas Orthomite LC predominantly demonstrated bracket cohesive failures (C) (p = 0.00020). Conclusions: Orthomite LC demonstrated greater resistance to thermal cycling–induced bond degradation compared with Transbond XT, likely due to differences in resin monomer composition and interface stability. Full article

Transcatheter aortic valve implantation (TAVI) has become the preferred treatment for patients with symptomatic severe aortic valve stenosis. Newer-generation devices, increased operator experience, and improved patient selection have contributed to a reduction in complication rates. However, the occurrence of new-onset left bundle branch block (LBBB) after TAVI remains high, and currently it is the most common complication associated with the procedure. This review discusses the current understanding of new-onset LBBB, including its causes, incidence, clinical outcomes, and management strategies. Full article

City-scale augmented reality (AR) learning paths are outdoor, multi-stop educational routes delivered through mobile devices in public space. This paper examines the Art Nouveau Path, a mobile AR game (MARG) route in Aveiro, Portugal, as a deployable learning service. The focus is on implementation requirements and traceability rather than learning outcomes. The analysis combined profiling of eight points of interest (POIs) and 36 tasks, group-session logs from 118 sessions, and teacher-facing evidence from a validation workshop (T1-VAL, N = 30) and on-site observation (T2-OBS, N = 24). Open-text responses were segmented into meaning units and coded with an eight-determinant taxonomy, with good intercoder reliability (Krippendorff’s alpha = 0.83). Logs and the post-path questionnaire (S2-POST, N = 439) were used only to describe enactment feasibility and data integrity. The strongest determinants concerned onboarding and legibility, marker robustness and recovery, and curriculum alignment, together with safety and fallback needs. These signals were translated into 18 testable requirements linked to six transfer artefacts for enactment, maintenance, incident handling, and fallback. Overall, the study provides an implementation-oriented specification to support auditability, replication, and transfer in city-scale AR learning services. Full article

Background and Objectives: Patients with rheumatoid arthritis (RA) are found to have a higher risk of dental diseases. Although herbal medicines (HMs) have long been used to treat various conditions, few studies focus on its impact on dental diseases. In this longitudinal cohort study, we assessed the correlation between HM use and risk of dental diseases in RA groups. Materials and Methods: A total of 2359 persons with RA aged 20–80 who were free of dental diseases between 2001 and 2010 were retrospectively enrolled from nationwide register-based data. They were then classified into HMs and non-HMs groups based on whether they ever used combined HMs after RA onset. Incidence rate and hazard ratios (HRs) of dental diseases were estimated for both groups by the end of 2013 via fitting Cox proportional hazards model. Results: Incidence rate of dental disease was reported to be lower in the HMs group than in the non-HMs group (90.21 per 1000 person-years versus 106.94 per 1000 person-years, respectively). RA individuals treated with HMs showed a significantly lower risk of dental diseases, especially dental caries, pulpitis, periodontitis, and stomatitis. Among commonly prescribed formulas, eleven herbal products significantly associated with a lower risk of dental diseases, such as Hai-Piao-Xiao, Yan-Hu-Suo, Chuan-Niu-Xi, Mo-Yao, Olibanum, Bei-Mu, Mu-Gua, Gui-Zhi-Shao-Yao-Zhi-Mu-Tang, Shao-Yao-Gan-Cao-Tang, Xue-Fu-Zhu-Yu-Tang, and Ping-Wei-San. Conclusions: The addition of HMs treatment may have advantages to proactively prevent sequent risk of dental disorders for persons with rheumatic diseases. A deeper exploration focusing on pharmacological action is needed to provide more reliable evidence for the improvement of susceptible individuals’ oral hygiene. Full article

Photovoltaic systems deployed on large floating platforms in nearshore waters are strongly influenced by hydroelastic effects, nonlinear shallow-water waves, and variable bathymetry. This study develops a time-domain hydroelastic framework that couples the fully nonlinear non-hydrostatic wave model NHWAVE with a Rankine-source potential-flow solver and a discrete-module Cummins formulation. The wave model provides incident pressures and kinematics over uneven seabeds, while the potential-flow solver evaluates radiation and diffraction effects and transfers the resulting hydrodynamic coefficients into the time domain. Numerical simulations are carried out for a 600 m modular floating structure under regular waves over flat and sloped bathymetries with $tan\alpha =0.0133$, wave periods of 4–6 s, and wave heights of 0.3–1.0 m. The results show that bathymetric variation intensifies shoaling-induced excitation, modifies added-mass and damping distributions, increases the spatial non-uniformity of hydroelastic motions, and amplifies bending-moment RMS responses relative to the flat-bottom case. Additional comparisons between rigid-body and hydroelastic models show clear period-dependent redistribution of motions and bending demand. These results demonstrate that both local bathymetry and structural elasticity must be considered for the reliable analysis and design of nearshore floating photovoltaic systems and other large floating structures. Full article

Volatile organic compounds (VOCs) pose significant health risks. Photocatalytic oxidation offers a promising route for VOC purification under ambient conditions. Based on a review of over 80 studies, this article critically evaluates research progress on four semiconductor photocatalyst systems (TiO₂-based, g-C₃N₄-based, bismuth-based oxides, and MOFs) for VOC degradation. Unlike traditional descriptive reviews, this work establishes a quality-based filtering framework to distinguish studies reporting standardized photochemical parameters from those that do not. The analysis reveals a fundamental problem: the vast majority of reviewed studies lack essential parameters (incident photon flux, apparent quantum yield, or rigorous dark adsorption equilibrium), rendering cross-study comparisons invalid. Most literature relies on non-standardized metrics such as conversion percentages or rate constants per catalyst mass. While some high-quality studies report AQY, these remain a small fraction of the literature. Within individual studies under identical conditions, modification strategies enhance activity relative to controls, but relative efficiency (ζr) values are meaningful only within the same study and cannot be compared across setups. This review thus serves a dual purpose: to summarize modification strategies and to critically expose the lack of standardization. Future research must adopt unified reporting standards (photon flux, AQY, benchmarks under identical conditions) to transform the field into a reproducible, cumulative science. Full article