Search Results (88)

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

Jurors and other legal decision-makers are often required to make judgments about the likely memory accuracy of another person. Legal systems tend to presume that decision-makers are well-placed to make such judgments (at least in the majority of cases) as a result of their own experiences with memory. However, existing research highlights weaknesses in our abilities to assess the memories of others and suggests that these weaknesses are not easily ameliorated through the provision of information. In this work we examine the accuracy of layperson assessments of “real” eyewitness identifications following observation of a mock crime. We examine whether novel instructions, characteristics and beliefs of assessors, and underlying reasoning strategies are associated with improved or impaired judgment accuracy. The results support prior research in demonstrating a tendency towards over-belief in the accuracy of identifications. They suggest that reliance on what witnesses have said rather than attempts to make inferences from their statements (e.g., in relation to the level of detail provided or non-verbal cues in testimony) is associated with greater accuracy in assessments and that some individual differences and beliefs about memory are also associated with greater accuracy. However, there was no evidence that the instructions tested were effective. We discuss the implications of results for procedure surrounding the evaluation of memory in the legal context. Full article

Background/Objectives: The increased availability of naloxone underscores the urgent need for scalable, effective training interventions. While current training modalities show promise, critical challenges persist, particularly regarding the development of interactive, self-efficacious platforms that mitigate anxiety in real-world overdose response, especially among laypersons. Therefore, this study aimed to develop and evaluate the usability and acceptability of a novel, self-paced mixed reality-based training tool (ReviveXR). Methods: ReviveXR was designed using the Apple Vision Pro spatial computing headset and Unity platform, employing mixed reality technology to facilitate interaction with virtual overdose scenarios while maintaining awareness of the physical environment. The intervention included a simulated tutorial and interactive modules on overdose response, rescue breathing, and chest compressions. Field testing was conducted in two rounds across various settings with a heterogeneous sample (N = 25), including individuals who use drugs, bystanders, first responders, and technology specialists. Data collection involved pre- and post-intervention surveys and qualitative interviews. Results: Participants demonstrated significant improvements in knowledge related to overdose recognition, naloxone administration, rescue breathing, and chest compressions. ReviveXR increased participants’ confidence and intent to help overdose victims while reducing uncertainty during overdose reversal. Participants were predominantly from rural areas and primarily identified as White and male. Qualitative feedback emphasized the platform’s heightened engagement, realism, patient responsiveness, and capacity to enhance knowledge acquisition and behavioral preparedness compared with conventional training approaches. Conclusions: ReviveXR offers a scalable, cost-effective, engaging alternative to traditional naloxone training programs, demonstrating strong feasibility across diverse environments and participants. ReviveXR holds considerable promise for expanding and enhancing community overdose response capacities and training healthcare professionals and first responders. Full article

This article explores the challenges associated with practicing Buddhist non-attachment as a layperson and whether its application in everyday life represents a puzzle. In Buddhism, practicing non-attachment implies becoming free of desires, as prescribed by Mahāyāna Buddhist philosophy in pursuit of liberation. This raises a critical challenge to form and maintain friendships in this increasingly competitive and demanding environment. To thrive, one must pursue beneficial goals to ensure a meaningful existence. A layperson, therefore, cannot entirely detach from their goals and aspirations without potentially abandoning the Buddhist path to enlightenment. Thus, non-attachment presents a dilemma for laypersons, creating a challenge in reconciling Buddhist philosophy with the realities of worldly existence. Full article

Service learning across medical schools is non-standardized and the skills that they learn can vary. Project HEART, a volunteer-based outreach program focused on teaching cardiovascular health and cardiopulmonary resuscitation (CPR) at public high schools, was implemented to encourage greater community engagement and equilibrate skill acquisition across different service projects. This pilot study characterized the benefits of providing service learning opportunities to first-year medical students. First-year medical students at a single institution were recruited to Project HEART. Following service sessions, all students completed a retrospective pre/post survey. They provided self-reported scores on a five-point Likert-type scale, grading their didactic and communication skills before and after the event. Subjective feelings of community engagement were also queried. Overall, 30 students were recruited across nine different community programs. Following participation, significantly increased confidence was seen in performing hands-only CPR (p < 0.001), public speaking (p = 0.003), teaching effectively (p < 0.001), and explaining medical terminology to laypersons (p < 0.001). Volunteers had an increased sense of community engagement (p < 0.001) and 17/30 students expressed greater consideration towards specializing in cardiology, primary care, or entering academia after participation. The study supported the proposal that service learning may promote self-determined altruism, positively influence perceptions of community stewardship, and have positive subjective benefits on medical student education. Full article

Introduction: Facial aesthetics is an intricate domain bridging biology, psychology, and culture. It is influenced by evolutionary traits and societal norms, often driving demand for cosmetic treatments. While public perceptions of these interventions are widely studied, professional evaluations remain underexplored. This study examines differences in aesthetic judgement and treatment identification between healthcare professionals and laypeople, aiming to enhance clinical practice and research in facial aesthetics. Methods: A cross-sectional survey, administered via Microsoft Forms, assessed aesthetic evaluations from 88 participants, including professionals (e.g., dentists, dermatologists, and plastic surgeons) and laypeople. The survey comprised demographic questions, self-reported aesthetic assessment abilities, and visual evaluations of pre- and post-treatment images. Statistical analyses, including Fisher’s exact test and the Mann–Whitney U Test, evaluated associations between expertise level and judgments of facial beauty and treatment accuracy. Results: This study found no significant differences in subjective aesthetic improvement ratings between professionals and laypeople, suggesting that aesthetic judgments are inherently subjective. However, professionals demonstrated greater accuracy in identifying treatments in 3 of 7 cases (p < 0.05). Self-assessment revealed a critical disparity, with experts often underrating their skills compared to non-experts. Discussion: These findings highlight the interplay between expertise and subjectivity in aesthetic evaluations. While professional training enhances procedural recognition, biases influence judgement regardless of expertise. Incorporating standardised evaluation frameworks can refine aesthetic assessments across groups. Conclusions: This study underscores the value of expertise in treatment identification and advocates for standardised assessment methods to minimise bias, improve training, and support patient-centred aesthetic care. Full article

This study investigates whether or not laypersons perceive biomimetic buildings as more sustainable and acceptable, a notion termed the “biomimetic promise”. Employing an experimental design (N = 238), we examined assessments of three real-world biomimetic buildings at the University of Freiburg, namely the Fiber Pavilion in the Botanic Garden, the ceiling of the former zoology auditorium, and the Biomimetic Shell at the technical faculty. Participants were divided into two groups: one group was informed about the biomimetic nature of the buildings and the other group was not. Results showed no significant difference in perceived sustainability or acceptability between the two groups, favoring the hypothesis that there exists no “biomimetic bias”. Notably, with the exception of perceived sustainability comparing the pavilion and the auditorium, significant differences in assessments regarding sustainability and acceptability were observed between the buildings, emphasizing the importance of domain-specific factors in public judgments. These findings suggest that merely framing a technology as biomimetic does not inherently enhance its perceived sustainability or acceptability by laypersons. Instead, the study highlights the need for transparency and clear communication regarding sustainability benefits to gain societal acceptance of biomimetic technologies. Full article

Background: Layperson cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use are vital for improving survival rates after out-of-hospital cardiac arrest (OHCA), yet their application varies by community demographics. We evaluated the concerns and factors influencing willingness to perform CPR and use AEDs among laypersons in high-risk, low-resource communities. Methods: From April 2022 to March 2024, laypersons in Northern Manhattan’s Community District 12 completed surveys assessing their attitudes toward CPR and AED use before attending Hands-Only CPR training. Fisher’s Exact Test assessed differences in concerns and willingness to perform CPR and AED use across racial-ethnic groups and compared low-resource communities with high-resource groups consisting of non-clinical staff across eight ambulatory sites. Results: Among 669 participants from low-resource communities, 64% identified as Hispanic, 58% were under 40 years of age, and 67% were female. Significant knowledge gaps were identified: 62% had never learned CPR, and 77% were unfamiliar with AEDs. Top concerns about giving CPR included fear of incorrect performance (67%), causing harm (56%), and legal repercussions (53%). Willingness to perform CPR was most influenced by familiarity with the victim. The primary barrier to AED use was a lack of operational knowledge (66%). Non-Hispanic Black participants expressed significantly greater concerns than their Non-Hispanic White counterparts. Participants in high-resource settings (n = 309) showed higher training rates, albeit with similar apprehensions about CPR and AED use. Conclusions: Concerns regarding CPR and AED use stem from a lack of confidence and training, particularly predominant in certain racial-ethnic groups. Targeted, culturally sensitive community interventions could potentially address these barriers, enhance preparedness, and improve OHCA survival rates. Full article

Objectives: It is generally accepted that the symmetry of the face plays a significant role in the visual perception of its attractiveness. Therefore, its objective assessment could be useful for individual therapy planning. However, there is an ongoing debate about whether completely symmetrical faces are less attractive than those with minor deviations. The aim of this study is to find thresholds of symmetry perception among faces with an increased spectrum of asymmetry values. Methods: The faces of 50 persons (25 men, 25 women) were digitized using a 3D scanner based on the fringe projection technique, and asymmetry values were calculated. In order to achieve a larger spectrum of asymmetry values, some of the surfaces were symmetrized or the symmetry was reduced. Afterward, an independent second group of 50 persons (13 medical professionals, 37 laypersons) rated “symmetry”, “attractiveness” and “health” using a visual analog scale (VAS). Results: Symmetry ratings and asymmetry value had a strong and monotonically decreasing association (rho = −0.78, p ˂ 0.001). Manipulated or naturally asymmetrical faces (n = 12) could not be well distinguished with regard to their symmetry (rho = −0.14, p = 0.67). The same applies to very symmetrical or symmetrized faces (n = 10, rho = −0.14, p = 0.67). Medical professionals rated the symmetry (p ˂ 0.001) and attractiveness (p ˂ 0.001) significantly higher than laypersons, while there was no significant difference in the health assessment (p = 0.24). Conclusions: It could be shown that there are indications of threshold values in the perception of facial symmetries, both in the direction of very symmetrical faces and in the direction of asymmetrical faces. There is no evidence that completely symmetrical faces are perceived as less attractive. Thus, in maxillofacial surgery, treatment should aim for the highest symmetry possible, although small deviations are not detrimental. Full article

Botulinum Neurotoxin A (BoNT/A) is a bacterial protein that has proven to be a valuable pharmaceutical in therapeutic indications and aesthetic medicine. One major concern is the formation of neutralizing antibodies (nAbs) to the core BoNT/A protein. These can interfere with the therapy, resulting in partial or complete antibody (Ab)-mediated secondary non-response (SNR) or immunoresistance. If titers of nAbs reach a level high enough that all injected BoNT/A molecules are neutralized, immunoresistance occurs. Studies have shown that continuation of treatment of neurology patients who had developed Ab-mediated partial SNR against complexing protein-containing (CPC-) BoNT/A was in some cases successful if patients were switched to complexing protein-free (CPF-) incobotulinumtoxinA (INCO). This seems to contradict the layperson’s basic immunological understanding that repeated injection with the same antigen BoNT/A should lead to an increase in antigen-specific antibody titers. As such, we strive to explain how immunological memory works in general, and based on this, we propose a working hypothesis for this paradoxical phenomenon observed in some, but not all, neurology patients with immunoresistance. A critical factor is the presence of potentially immune-stimulatory components in CPC-BoNT/A products that can act as immunologic adjuvants and activate not only naïve, but also memory B lymphocyte responses. Furthermore, we propose that continuous injection of a BoN/TA formulation with low immunogenicity, e.g., INCO, may be a viable option for aesthetic patients with existing nAbs. These concepts are supported by a real-world case example of a patient with immunoresistance whose nAb levels declined with corresponding resumption of clinical response despite regular INCO injections. Full article

While the positive effects of listening to music on mental health and well-being have been extensively studied, the effects of enjoying playing musical instruments have rarely been examined. Many tools have been developed to measure music listening; however, tools to measure the enjoyment of playing instruments have not yet been developed. This study aimed to develop and validate a tool to measure such enjoyment and to examine its relationship with subjective well-being and happiness. Primary information about the aforementioned enjoyment were collected from fourteen Chinese laypersons, five music graduates, and five music teachers using open-ended questions. Item and exploratory factor analyses were conducted using data from 361 Chinese adults, and the reliability and validity of the scale and the relationships between the variables were analyzed using data from 277 Chinese adults. The results revealed that the three-factor model for the enjoyment of playing instruments demonstrated excellent model fit, and satisfactory internal consistency, test–retest reliability, and criterion-related validity were demonstrated for the learning/social bonds, achievement/pride, and cognitive refreshment/stimulation subscales. All subscales of enjoyment were positively correlated with subjective well-being and happiness. This study highlights the usefulness of the Enjoyment of Playing Instruments Scale (EPIS) as a measure for research, educational, and clinical use, providing a rationale for using instrument playing as a therapeutic approach to promote subjective well-being. Full article

This investigation delves into the waterfront plant landscapes of traditional villages in Western Hunan, China, aiming to bolster sustainable ecological resource management, amplify ecological culture, and ameliorate environmental standards. Furthermore, it endeavors to furnish a theoretical scaffold for the meticulous construction and assessment of these landscapes. This study has illustrated the waterfront botanical landscapes of 32 traditional hamlets within the Xiangxi region, integrating prior research on the waterfront botanical regression model based on the Scenic Beauty Estimation (SBE) method. It established and investigated fifteen landscape factors pivotal to the aesthetic valorization of these village waterfronts. The study concocted a beauty quality evaluation model, unearthing a significant correlation (p < 0.01) across evaluations by students majoring in landscape architecture, expert landscape architects, and laypersons, thus underscoring a consensus in aesthetic judgments. A noteworthy correlation between the beauty value (Z-value) and the entropy weight value was elucidated through the equation EWM = −0.106 + 0.425ZSBE, showcasing the landscape quality’s variance among the studied villages. The formulated evaluation model accentuates the significance of seasonal variation, scale affinity, and a rich hierarchical structure. Full article

A shared commitment to standardising the process of hypothetically reconstructing lost buildings from the past has characterised academic research in recent years and can manifest at various stages of the reconstructive process and with different perspectives. This research specifically aims to establish a user-independent and traceable procedure that can be applied at the end of the reconstructive process to quantify the average level of uncertainty of 3D digital architectural models. The procedure consists of applying a set of mathematical formulas based on numerical values retrievable from a given scale of uncertainty and developed to simplify reuse and improve transparency in reconstructive 3D models. This effort to assess uncertainty in the most user-independent way possible will contribute to producing 3D models that are more comparable to each other and more transparent for academic researchers, professionals, and laypersons who wish to reuse them. Being able to calculate a univocal numerical value that gives information on the global average uncertainty of a certain reconstructive model is an additional synthetic way, together with the more visual false-colour scale of uncertainty, to help disseminate the work in a clear and transmissible way. However, since the hypothetical reconstructive process is a process based on personal interpretation, which inevitably requires a certain level of subjectivity, it is crucial to define a methodology to assess and communicate this subjectivity in a user-independent and reproducible way. Full article

Background and Objectives: Out-of-hospital cardiac arrest (OHCA) and survival is a pressing matter all around the world. Despite years of research and great strides and advancements, survival remains alarmingly low. The aim of this study was to measure the survival and characteristics of patients having an OHCA in Slovenia, with an in-depth look at how the bystanders affect the return of spontaneous circulation (ROSC) and survival of OHCA. Materials and Methods: In this observational cross-sectional prospective study, we enrolled patients between 1 September 2022 and 30 November 2022, with a follow-up period of 1 month. All OHCAs attended by the emergency medical services were included. Data were collected and analyzed according to the Utstein 2015 reporting template. Independent predictors of ROSC and 30-day survival or survival were explored using ridge regression. Results: ROSC was achieved in 41% of cases where resuscitation was attempted. The overall 30-day survival rate where resuscitation was attempted was 14%. In 13% of all cases where resuscitation was attempted, patients had a favorable neurological outcome. Using our prediction model, we found that defibrillation under 20 min and ventricular fibrillation as an initial rhythm improves survival, whilst no defibrillation and bystander full cardiopulmonary resuscitation negatively predicted survival. Conclusions: Slovenia has OHCA 30-day survival comparable to the rest of the European Union. The favorable neurological outcome is high. Our data show that bystanders do not significantly improve survival. This represents an untapped potential of general public education in cardiopulmonary resuscitation and automatic external defibrillator use. Following good practices from abroad and improving layperson CPR knowledge could further improve OHCA survival. Full article

The cultivation of the Chinese mitten crab (Eriocheir sinensis) is an important component of China’s aquaculture industry and also a field of concern worldwide. It focuses on the selection of high-quality, disease-free juvenile crabs. However, the early maturity rate of more than 18.2% and the mortality rate of more than 60% make it difficult to select suitable juveniles for adult culture. The juveniles exhibit subtle distinguishing features, and the methods for differentiating between sexes vary significantly; without training from professional breeders, it is challenging for laypersons to identify and select the appropriate juveniles. Therefore, we propose a task-aligned detection algorithm for identifying one-year-old precocious Chinese mitten crabs, named R-TNET. Initially, the required images were obtained by capturing key frames, and then they were annotated and preprocessed by professionals to build a training dataset. Subsequently, the ResNeXt network was selected as the backbone feature extraction network, with Convolutional Block Attention Modules (CBAMs) and a Deformable Convolution Network (DCN) embedded in its residual blocks to enhance its capability to extract complex features. Adaptive spatial feature fusion (ASFF) was then integrated into the feature fusion network to preserve the detailed features of small targets such as one-year-old precocious Chinese mitten crab juveniles. Finally, based on the detection head proposed by task-aligned one-stage object detection, the parameters of its anchor alignment metric were adjusted to detect, locate, and classify the crab juveniles. The experimental results showed that this method achieves a mean average precision (mAP) of 88.78% and an F1-score of 97.89%. This exceeded the best-performing mainstream object detection algorithm, YOLOv7, by 4.17% in mAP and 1.77% in the F1-score. Ultimately, in practical application scenarios, the algorithm effectively identified one-year-old precocious Chinese mitten crabs, providing technical support for the automated selection of high-quality crab juveniles in the cultivation process, thereby promoting the rapid development of aquaculture and agricultural intelligence in China. Full article