Search Results (103)

Background/Objectives: This prospective, randomised controlled trial aimed to evaluate whether using a real-time feedback device during basic life support (BLS) training for laypersons improves chest compression quality immediately after training and at the four-month follow-up. Methods: Participants were randomly assigned to a control group (standard BLS training) or an intervention group (BLS training with a real-time feedback device). All participants completed a standardised 2-h BLS course, followed by a 4-min practical assessment immediately after training and at the four-month follow-up. The primary outcomes were chest compression rate and depth, while the secondary outcomes were correct hand position, full chest recoil and flow fraction. These compression parameters were compared within and between groups at both time points. Results: Data from 101 participants were analysed. Both groups showed significantly decreased mean and adequate compression rates over time, but only the intervention group demonstrated significantly better performance at follow-up. The mean compression depth was approximately 5 cm in both groups; however, the proportion of adequate compression depth was low and did not differ significantly within or between groups. Correct hand position was consistently higher in the intervention group across both assessments. Full chest recoil improved in both groups, whereas flow fraction increased only in the control group. Conclusions: Incorporating real-time feedback devices into layperson BLS training leads to superior performance in selected chest compression parameters, particularly compression rate and hand position. Therefore, real-time feedback devices can be a valuable adjunct to standard BLS training to enhance skill retention over time. Full article

Background/Objectives: Cardiopulmonary resuscitation (CPR) skill assessments are susceptible to evaluator subjectivity, cognitive fatigue, and observational limitations. Although recent advances in multimodal artificial intelligence have increased the possibility of automated video-based assessment, its validity for clinical skill evaluation remains insufficiently examined. Methods: In this cross-sectional study, we enrolled 130 laypersons who underwent Basic Life Support training and skill testing. Twenty recordings were used for prompt development and 110 recordings were analyzed. Expert evaluators and GPT-4o independently assessed participants’ skills using a 12-item checklist. The manikin sensor data were the reference standard for the four chest compression metrics. Agreement was evaluated using Gwet’s agreement coefficient 1 (AC1) and intraclass correlation coefficient (2,1). Diagnostic accuracy, sensitivity, and specificity were compared using McNemar’s test. Results: Procedural items such as confirming cardiac arrest, calling 119, and requesting an automated external defibrillator showed a near-perfect agreement between experts and GPT-4o (AC1 > 0.8). However, the agreement was poor for the compression depth (AC1 = 0.374) and full chest recoil (AC1 = 0.355). Experts demonstrated high sensitivity (77.8–84.3%) but low specificity (24.6–47.8%), whereas GPT-4o showed low sensitivity (35.6–40.6%) but high specificity (69.2–76.1%). Conclusions: GPT-4o cannot serve as a standalone evaluator because of its inherent limitations in inferring three-dimensional spatial information from two-dimensional videos. However, its high agreement on procedural items and complementary error patterns with that of human evaluators on compression metrics suggests its potential as a decision support tool to mitigate expert leniency bias in CPR education. Full article

Background: Diabetic foot ulcers (DFUs) and lower extremity amputations are major contributors to morbidity and mortality in individuals with diabetes. Among patients undergoing active cancer treatment, the risks are compounded by immunosuppression, peripheral neuropathy, and vascular complications. Even minor foot infections or wounds in these patients can necessitate the suspension of cancer therapy, with potentially lifethreatening consequences. This study evaluated the impaqt of integrating symptom-focused patient education with coordinated podiatric care to reduce DFUs and amputations in this highrisk population with concurrent cancer and diabetes. Methods: A five-year retrospective review was conducted at a National Cancer Institute (NCl)designated comprehensive cancer center as part of the Novel Limb Preservation Initiative. The cohort included patients with Type II diabetes undergoing treatment for prostate, breast, colorectal, lymphoma, leukemia, thyroid, or lung cancers. Patients were assigned targeted educational modules based on self-reported diabetic foot symptoms. Podiatric care was individualized according to each patient's signs and symptoms, including routine diabetic foot examinations and close, timely monitoring when indicated. Results: The intervention yielded a DFU incidence of 2. 8% and an amputation rate of 0. 43%, both lower than national benchmarks. Enhanced patient engagement through diabetic foot symptom-focused education and earlier detection of foot complications-including diabetic foot ssues that may appear minor to laypersons-contributed to these improved outcomes. Conclusion: Integrating diabetic foot symptom-focused education with proactive podiatric monitoring significantly reduced DFUs and amputations in this high-risk population. This model, developed under the Novel Limb Preservation Initiative, offers a scalable strategy for broader implementation, particularly in high-risk communities, including Hispanic, African American, low socioeconomic, and rural populations across the United States. Full article

Background/Objectives: High-quality cardiopulmonary resuscitation (CPR) is essential for improving clinical outcomes in patients experiencing cardiac arrest. Feedback devices designed to guide CPR must offer real-time feedback on chest compression quality for use by both medical personnel and laypersons. To describe the impact of using an infrared-based device to provide feedback on chest compression quality during CPR performed by healthcare personnel. Methods: A before-and-after study conducted in a simulated hospital from February 2019 to February 2020 evaluated the difference in the percentage of adequate chest compressions in depth and rate. This was assessed by comparing the number of adequate compressions to the total performed in one minute, both with and without the use of a feedback device. Results: A total of 90 participants were recruited, with an average age of 31.2 years (SD: 8.86), of which 60% (54/90) were women. In infants and schoolchildren/adults, high-quality compressions improved by 66% (85% vs. 19%; p < 0.001) and 54% (79% vs. 25%; p < 0.001), respectively, when guided by the GA compared to the control group. In participants without training and experience in CPR, the use of the Guardian Angel achieved high-quality compressions of 45% (10/22) and 66% (25/42), respectively, when evaluating depth for the schoolchildren/adults group. The use of the device during CPR, even in situations of moderate or severe fatigue, resulted in an improvement in high-quality compressions in terms of frequency, reaching 73% (16/22) in infants and 68% (15/22) in schoolchildren/adults. Conclusions: The Guardian Angel improves both the frequency and depth of compressions in participants without previous CPR experience or training. Additionally, the device demonstrated notable improvements in compression frequency, even in situations of moderate or severe fatigue. Full article

This study investigates how bio-inspired versus sustainability-focused framing influences lay evaluations of a specific bio-inspired building-technology scenario, testing the empirical validity of the so-called “biomimetic promise”. Employing a between-subjects experimental design ($N=582$), we examined assessments of a weather-responsive self-shading façade across bio-inspired, sustainable, and neutral framing conditions. We developed and validated the 12-item Perceived Bio-Inspiration Scale (PBS)—a novel standardized psychometric instrument designed to quantify lay recognition of biomimetic features across visual, intentional, and naturalistic dimensions. While results showed robust direct framing effects, we identified a significant negative spillover: emphasizing biological inspiration significantly reduced the technology’s perceived sustainability, while sustainability framing diminished its perceived bio-inspiration. These findings demonstrate, in this façade context, that laypersons evaluate bio-inspiration and sustainability as cognitively distinct and potentially competing constructs, indicating that “natural-is-better” bias is not universal across all technology domains. Consequently, merely invoking biological origins is insufficient to enhance a technology’s ecological appeal. To foster public trust, science communication should shift from abstract biological metaphors toward a performance-driven communication strategy that prioritizes the disclosure of verifiable life-cycle assessment and specific operational advantages over symbolic nature-based analogies. Full article

Facial profile esthetics play a pivotal role in orthodontic diagnoses, treatment planning, and patient satisfaction; however, the perception of facial attractiveness is inherently subjective and varies according to professional expertise and sociocultural background. This study aimed to compare the perceived attractiveness of standardized sagittal facial profiles across skeletal Class I, II, and III patterns and to investigate the influence of professional training and sociodemographic variables on facial profile evaluations. It was hypothesized that straight facial profiles would be perceived as the most attractive across all observer groups, while deviations from the orthognathic profile would be rated as less attractive, with significant differences based on professional training and sociodemographic variables. This cross-sectional descriptive study included 509 participants, comprising orthodontists, orthodontic Ph.D. students, general dentists, specialist dentists, first- and fifth-year dental students, and laypersons. Seven standardized sagittal facial profile silhouettes (S1–S7) were digitally generated from a standardized lateral facial photograph and evaluated using a seven-point visual analog scale. Participants were also asked to identify the sagittal facial profile range (S8) they ideally preferred to possess. Intergroup comparisons were performed using non-parametric statistical tests (Mann–Whitney U and Kruskal–Wallis). The straight profile (S3) emerged as the most attractive and most frequently preferred across all participant groups, confirming its role as the dominant esthetic reference. Retrusive profiles, particularly bimaxillary retrusion (S2), mandibular retrognathism (S5), and maxillary retrusion (S6), were consistently rated as the least attractive. Significant differences in esthetic perceptions were observed according to the professional expertise, educational level, age, and nationality, whereas gender had no clinically meaningful effect. Orthodontic training was associated with increasingly critical evaluations, especially for protrusive and convex profiles, while laypersons demonstrated greater esthetic tolerance. Both anatomical characteristics and sociocultural experience shape the perception of facial profile esthetics. While the straight profile represents a widely shared aesthetic ideal, increasing orthodontic expertise accentuates discrepancies between professional standards and public preferences. These findings underscore the necessity of integrating patient-centered and culturally sensitive considerations into contemporary orthodontic treatment planning. Full article

Background/Objectives: This study investigated the relationship between time spent on social media and eating behaviours among young Australian adults. It also examined the types of content discussed and linguistic styles used by health and nutrition content creators on Instagram. Methods: Young adults (aged 18–30 years) who reported viewing social media for nutrition or health content were recruited to complete a self-administered, cross-sectional survey. Data on demographics, time spent on Instagram and TikTok, health content creators viewed, and responses to the Scale of Effects of Social Media on Eating Behaviours (SESMEB) were collected. Associations between time spent on Instagram and TikTok and SESMEB scores were analysed. Inductive content and thematic analysis were conducted on health-related posts from Instagram accounts viewed by study participants. Results: From the 57 participants who completed the demographic survey, 42 participants completed the full study including the SESMEB survey. There was no significant association between SESMEB score and time spent on Instagram (p = 0.38) or TikTok (p = 0.40). A total of 1420 Instagram posts from 71 distinct content creators were analysed. Health and fitness product endorsements or advertisements (56.3%), predominantly posted by laypersons (55.3%), were the most common type of post in the sample. The most common communication style was ‘expert advice’ (47.9%), with ‘informal language’ (85.9%) as the dominant linguistic style. Results from thematic analysis suggest health and nutrition information on social media is often presented to consumers in emotionally charged, stylised, or contradictory ways and requires users to sift through conflicting messages, aesthetics, and ideologies to construct their own understanding of health. Conclusions: This study suggests that young adults are primarily exposed to health and fitness product promotions from unqualified content creators on social media. Dietitians and nutrition professionals may need to consider adopting specific linguistic and communication styles to enhance the dissemination and engagement of credible nutrition information online. These findings have implications for improving digital health literacy and strengthening the impact of evidence-based nutrition messaging in digital environments. Full article

Background/Objectives: Early bystander CPR helps to restore perfusion and improves the likelihood of favorable survival and neurological outcome after out-of-hospital cardiac arrest (OHCA). One strategy to improve bystander CPR is the use of crowd-sourcing mobile CPR applications such as PulsePoint, which notifies bystanders of nearby OHCA. In 2019, PulsePoint was deployed in an urban county. Prior to its deployment, bystander CPR rates were 42.9% in this county. This descriptive analysis seeks to analyze bystander intervention after PulsePoint implementation in an urban county. Methods: This retrospective observational study included all PulsePoint activations in Alachua County from June 2020 to September 2023. Patient characteristics and survey data were extracted from EMS patient care reports, hospital electronic medical records, and Pulsepoint dispatch and responder data. Descriptive statistics were used to analyze patient and responder characteristics, PulsePoint activation circumstances, and patient care. Results: Of 225 PulsePoint activations, 95 (42.2%) were confirmed OHCA. Among these, 54 (56.8%) received bystander CPR prior to EMS arrival. Out of 15 prehospital defibrillations, laypersons defibrillated 9 patients (60.0%). There was an average of 3.3 eligible PulsePoint responders within a 0.25-mile radius of the OHCA victim. A majority of PulsePoint survey respondents were formally trained in CPR and automated defibrillator use. Conclusions: The data from our urban EMS experience demonstrate that bystander CPR rates were higher after PulsePoint deployment (56.8%) than before. Our bystander CPR rate was also higher than the national average. Full article

Background: Generative artificial intelligence (AI) applications have gained increasing popularity in recent years and are used by an ever-increasing number of people on a day-to-day basis. While the performance of the earlier-generation generative AI ChatGPT-3.5 in the context of ophthalmologic emergencies has been previously assessed, the purpose of this study is to analyze the performance of the newer-generation generative AIs DeepSeek R1 (Hangzhou DeepSeek Artificial Intelligence Co., Ltd., Hangzhou, China) and ChatGPT-4o (OpenAI Inc., San Francisco, CA, USA) in the context of diagnosis, triage and prehospital management of ophthalmological emergencies. Methods: Ten previously published fictional case vignettes representing queries in the English language of patients experiencing acute ophthalmological symptoms were entered into the generative AIs DeepSeek R1 and ChatGPT-4o. The interaction with the generative AIs followed a previously described structured interaction path. In a random order, each case vignette was entered into separate chats five times, producing a total of 50 answers from each generative AI. Each answer was analyzed according to a previously published manual. Results: We observed better values for DeepSeek R1 compared to ChatGPT-4o in terms of treatment accuracy (60% compared to 50%), the share of answers containing wrong (46% compared to 60%) or conflicting information (30% compared to 40%), the share of answers that correctly captured the overall severity of symptoms (98% compared to 78%), as well as the share of potentially harmful answers (38% compared to 50%). Moreover, DeepSeek R1 more frequently provided a single diagnosis (20% compared to 16%) and specific treatment advice (42% compared to 20%) than ChatGPT-4o. Both generative AIs showed a diagnostic accuracy of 100%, i.e., whenever they provided a single diagnosis, this was indeed the correct diagnosis. In terms of triage accuracy, ChatGPT-4o performed slightly better than DeepSeek R1 (73% compared to 66%). In contrast to DeepSeek R1, which never directed questions back at the user, ChatGPT-4o always did. The direction of questions at the user enables dialogues with ChatGPT-4o that more closely resemble the actual taking of a patient’s history. However, DeepSeek R1 seems to perform better compared to ChatGPT-4o in terms of several important content-related metrics and has been shown to be more cost-effective in other studies. Conclusions: Both newer-generation generative AIs constitute remarkable milestones in the development of generative artificial intelligence. However, since potentially harmful recommendations were observed with both models, we currently do not recommend their use as sole source of information on ophthalmological emergencies for laypersons. Full article

Accessible health information is essential to promote patient engagement and informed participation in clinical research. Brief summaries on ClinicalTrials.gov are indented for lay people; however they are often written at a reading level that is too advanced for the public. This study evaluated the performance of a Generative Artificial Intelligence (GAI)-powered tool—Pub2Post—in producing readable and complete layperson brief summaries for urologic oncology clinical trials. Twenty actively recruiting clinical trials on prostate, bladder, kidney, and testis cancers were retrieved from ClinicalTrials.gov. For each, a GAI-generated summary was produced and compared with its publicly available counterpart. Readability indices, grade-level indicators, and text metrics were analyzed alongside content inclusion across eight structural domains. GAI-generated summaries demonstrated markedly improved readability (mean FRES 73.3 ± 3.5 vs. 17.0 ± 13.1; p < 0.0001), aligning with the recommended middle-school reading level, and achieved 100% inclusion of guideline-defined content elements. GAI summaries exhibited simpler syntax and reduced lexical complexity, supporting improved comprehension. These findings suggest that GAI tools such as Pub2Post can generate patient-facing summaries that are both accessible and comprehensive. Full article

Background/Objectives: Primary cleft lip repair is a procedure to restore lip function and harmonious nasolabial appearance. However, the actual effects on nasolabial appearance have been insufficiently investigated. The aim of this study was therefore to critically review surgical results using well-validated objective and subjective methods and standardised outcome measures. Methods: A total of 26 non-syndromic patients with unilateral cleft lip +/− cleft palate were assessed retrospectively. Uniform 2D photographs of the nasolabial region were objectively analysed using SymNose software. The Cleft Aesthetic Rating Scale was employed for the subjective evaluation by a total of 255 observers with different backgrounds and experience levels in cleft surgery. Results: Significant positive correlation was identified between objective measurement of upper lip asymmetry and subjective assessment (p = 0.02). Furthermore, a significant difference emerged in the assessment of the nasolabial region depending on the rater’s professional background (p < 0.001). A major discrepancy was observed between the rating of maxillofacial consultants and those of laypersons and patients affected by cleft lip +/− cleft palate. Conclusions: The evaluation of attractiveness depends significantly on the professional background of the observer. The more interaction people have with individuals after cleft lip repair, the less they consider the aesthetics conspicuous. Achieving the highest possible postoperative nasolabial symmetry should be a main objective in primary cleft lip repair. Full article

(+)-Isocampholenic acid, prepared in two steps from (1S)-(+)-10-camphorsulfonic acid in 60% yield (on a scale of 172 mmol), served as the starting compound for the synthesis of small libraries of isocampholenic acid derivatives, comprising a total of 60 compounds, which are of interest due to their olfactory properties. Although isocampholenic acid derivatives are thermodynamically up to 5.9 kcal/mol less stable than endocyclic alkene isomers according to DFT calculation, only minor (up to 2%) isomerization to α-campholenic acid isomers was observed in most cases. The products were fully characterized, and their odor properties were preliminarily assessed by untrained laypersons. This study represents the first systematic exploration of the chemical space of isocampholenic acid. Novel derivatives with distinct odor profiles were discovered, and promising directions for future functionalization for fragrance development were identified. Full article

Background: The present study investigated the relation between dental inclination, colorimetric variation, and aesthetic perception according to the modification of incisor inclination. Smile aesthetics, shaped by morphological factors and patient perception, are vital for social attractiveness and treatment success. This study aimed to assess the effect of varying head tilt on the perceived colour of upper central incisors by simulating changes in torque of the tooth, as well as evaluate factors influencing the perception of an aesthetic smile, including morphological characteristics and gingival aesthetic parameters. Methods: The study was comprised of three stages: colour analysis, evaluation of micro- and mini-aesthetic smile features, and an image-based assessment to determine evaluator perceptions and overall smile attractiveness. A sample of 50 students with complete, lesion-free anterior dentition was analysed. To simulate the effect of orthodontic torque changes during colour analysis, subjects tilted their heads downward and upward, representing palatal and buccal crown torque, respectively. Standardized macro-intraoral photographs were captured under controlled lighting conditions using a DSLR camera stabilized on a tripod in the different positions: the neutral head position (p0), 15° upward (p + 15), and 15° downward (p − 15). Digital colour analysis was conducted in the CIELAB colour space (L*, a*, b*). In the next stage, focusing on micro- and mini-aesthetic evaluation, an additional 50 smiles were generated using artificial intelligence via the SmileCloud program—one digitally enhanced smile per subject—complementing the initial set of 50 spontaneous smiles. These 100 smile images were evaluated by 50 laypersons and 50 dentists using a visual analogue scale via an online questionnaire, in order to assess perceptions, determine smile attractiveness, and quantify gingival aesthetic parameters. Results: The statistically significant regression results are as follows: those for the L* values in all three head inclinations: downward (−15 degrees), upward (+15 degrees), and total tilting (−15 to +15 degrees), as well as for the a* values for downward tilting and the b* values for total tilting. When the head is tilted downwards, the central incisors are positioned retrusively, and the L* b* values reveal a darker and more yellowish appearance, whereas, with the head tilted upwards, the central incisors protrude, and L* a* values indicate a brighter and more greenish appear. In the evaluation stage of the smile aesthetics study, no significant differences were observed in the judgments between laypersons and dentists or between males and females. Smiles with a high or average anterior line, parallel arc, upward lip curvature, visible first/second premolars, a smile index of 5.08–5.87, and symmetry score of 1.04 were rated as more attractive. Significant asymmetries were observed between upper dental hemi-quadrants in gingival contour and interdental papilla height, highlighting subtle morphological variations relevant to smile aesthetics. Conclusions: Aesthetic assessment revealed that the findings suggest a measurable impact of head position on dental colour perception and aesthetic evaluation. Evaluator variables including profession and gender exerted negligible effects on aesthetic perception, whereas smile attractiveness features and gingival aesthetic parameters demonstrate significant clinical applicability in patient management. Full article

Temporary architecture, as an expression of the concept of impermanence, offers adaptable and time-sensitive spatial interventions that promote community engagement and encourage experimentation within the urban environment. Beyond its physical and functional qualities, this architectural approach acts as a social mediator, fostering dialogue, networking, and the exchange of ideas between local communities and professionals, while contributing to the development of a socio-cultural common ground. This paper explores the Greenfeel Architecture wooden pavilion as a case study of small-scale architecture embedded within a landscape dedicated to urban agriculture and community-driven activities. The design process was guided by the need to balance functional requirements—providing shelter from the sun and rain and facilitating social interactions—with the protection of the existing vegetation and the enhancement of local biodiversity, with particular emphasis on supporting bee populations. In line with sustainable construction principles, the pavilion was built through the reuse of recovered materials, including used bricks for pavement, wooden slabs for the facade and roof, and several structural components sourced from previous building projects. Since its completion, the pavilion has acted as an urban acupuncture point within the surrounding area and has become a host for various outdoor activities and educational workshops aimed at diverse groups, including children, adults, professionals, and laypersons alike. The duality between the scale of the pavilion and the scale of its social, cultural, or ecological influence highlights the potential of temporary architecture to become a tool for both physical and socio-cultural sustainability in an urban environment. Full article

Background/Objectives: This study aimed to evaluate a regional implementation project for rural emergency care (RuralRescue) and to examine how its components and outcomes may support personalized approaches in emergency medicine. While not originally designed as a personalized medicine intervention, the project combined digital, educational, and organizational innovations that enable patient-specific adaptation of care processes. Methods: Conducted in the rural district of Vorpommern-Greifswald (Mecklenburg–Western Pomerania, Germany), the intervention included (1) standardized cardiopulmonary resuscitation (CPR) training for laypersons, (2) a geolocation-based first responder app for medically trained volunteers, and (3) integration of a tele-emergency physician (TEP) system with prehospital emergency medical services (EMSs). A multi-perspective pre–post evaluation covered medical, economic, and organizational dimensions. Primary and secondary outcomes included bystander CPR rates, responder arrival times, telemedical triage decisions, diagnostic concordance, hospital transport avoidance, economic simulations, workload, and technology acceptance. Results: Over 12,600 citizens were trained in CPR and the responder app supported early intervention in hundreds of cases. TEPs remotely assisted 3611 emergency calls, including delegated medication in 17.8% and hospital transport avoidance in 24.3% of cases. Return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) was achieved in 35.6% of cases with early CPR. Diagnostic concordance reached 84.9%, and documentation completeness 92%. Centralized coordination of TEP units reduced implementation costs by over 90%. Psychological evaluation indicated variable digital acceptance by role and experience. Conclusions: RuralRescue demonstrates that digitally supported, context-aware, and regionally integrated emergency care models can contribute significantly to personalized emergency medicine and can be cost-effective. The project highlights how intervention intensity, responder deployment, and treatment decisions can be tailored to patient needs, professional capacity, and regional structures—even in resource-limited rural areas. Full article