Search Results (3,640)

Background: Transcatheter aortic valve implantation (TAVI) is increasingly performed in fluoroscopy-intensive environments, raising concerns about occupational eye lens dose (equivalent dose to the eye lens, Hp (3)) and the risk of radiation-induced cataract, particularly after the reduction of recommended annual eye lens dose limits to 20 mSv. Purpose: To summarize evidence on eye lens radiation exposure during TAVI, identify procedural and occupational determinants, and review strategies to reduce exposure with a focus on imaging optimization. Methods: We performed a narrative review of observational and prospective studies reporting direct eye-level dose measurements or validated surrogate eye lens dose estimates (head-level, chest-level, or DAP-normalized) during TAVI and related structural heart procedures. This approach was chosen to provide a qualitative synthesis of the available evidence rather than a formal systematic review. Results: Reported operator eye lens doses typically ranged from 30 to 110 µSv per procedure, with higher exposure during transapical/transaortal access and among staff working close to the patient (e.g., anesthesiologists and circulating nurses). Additional shielding and lead-free drapes reduced normalized eye dose by approximately 25–40%, and RADPAD^® use reduced operator eye-level dose from 24.3 to 14.8 µSv per procedure (p = 0.008). At these levels, cumulative exposure may approach recommended regulatory limits after approximately 150–300 procedures, depending on role, access route, and shielding practices. Conclusion: In conclusion, Occupational eye lens exposure during TAVI is clinically relevant and strongly influenced by access route, staff positioning, and imaging-system use. Dose reduction should combine routine eye protection and dedicated eye-level dosimetry with imaging optimization (low pulse-rate fluoroscopy, minimized Digital-Subtraction-Angiography (DSA)/cine acquisitions, tight collimation, avoidance of unnecessary magnification, and correct positioning of ceiling-suspended shields and table skirts). Full article

Operable windows are critical for indoor environmental quality (IEQ) and occupant agency, yet their usability is increasingly compromised by conflicts between regulatory compliance and building performance. This study investigates the gap between geometrically compliant provisions and effectively operable windows through a comparative policy analysis of mandatory codes (Level 1), green rating systems (Level 2), and regenerative frameworks (Level 3). The findings identify a structural discrepancy termed the Geometric Trap: while minimum opening areas are legally required, mechanical ventilation often substitutes for natural access. In the United States, Japan, and Republic of Korea, explicit waivers permit full substitution, while in the United Kingdom, conditional constraints such as environmental noise limit practical operability. Germany, by contrast, maintains operable windows as an independent mandate, restricting substitution to defined environmental conditions. Although emerging green rating systems increasingly recognize resilience and adaptive comfort, operability remains optional. Regenerative standards, however, treat it as a prerequisite for occupant health. This study proposes a shift from static geometric compliance toward an Effective Opening Area framework that evaluates actual accessibility and usability, advancing a performance-based and occupant-centered regulatory perspective. Full article

Law enforcement officers experience substantial occupational stressors that increase vulnerability to food addiction and cardiovascular disease (CVD), which may be compounded by adverse local environments. This study examined associations among county-level environmental factors, food addiction, and cardiometabolic profiles among North Carolina law enforcement officers. Participants included 330 officers (mean age = 37.98 years; mean BMI = 30.53 kg/m²) who completed the Yale Food Addiction Scale 2.0 and underwent assessments of anthropometrics, blood pressure, blood lipids, and glucose. County-level Food Environment Index (FEI) scores and counts of fast-food restaurants, recreation and fitness facilities, and crime events were obtained from public data sources. Comparative analyses evaluated differences by county type and region, and BMI- and sex-adjusted regression models assessed associations among environmental factors, food addiction symptoms, and cardiometabolic profiles. Rural counties had significantly poorer FEI scores than suburban and urban counties, and rural officers reported the highest food addiction symptoms. Lower FEI scores were significantly associated with greater food addiction symptoms, which were, in turn, associated with higher adiposity and lower triglyceride levels. The findings support associations between food addiction and CVD risk, while underscoring potential influences of food environments on food addiction, warranting further investigation using more precise and up-to-date measures. Full article

Background/Objectives: Permanent cardiac pacemakers (PPMs) are small electronic implanted devices that regulate cardiac rhythm. Measurement of quality of life (QoL) serves as a powerful tool for gaining in-depth insights into pacing therapy and ultimately guiding patient-centered management strategies. The aim of the present study was to evaluate factors affecting QoL among PPM patients by applying the two generic questionnaires: SF-36 and EQ-5D-5L. Materials and Methods: A total of 120 patients with PPM were enrolled. QoL data were collected through interviews using the 36-Item Short Form Health Survey (SF-36) and the Euro QoL 5-Dimensions 5-Levels Health Questionnaire (EQ-5D-5L). Patients’ characteristics were also recorded. Results: The majority of participants were male (54.2%), retired (83.3%) residents in urban areas (75.5%), had a DDD pacemaker (82.5%), had rate response programmed on (77.5%), and had comorbidities (83.3%). Regarding QoL measured by SF-36, the Physical Component Summary Score (PCS) was significantly associated with programming rate response in their pacemaker (p = 0.046), comorbidities (p = 0.047), and the NYHA functional class (p = 0.047). The Mental Component Summary Score (MCS) was significantly associated with sex (p = 0.034), place of residence (p = 0.003), NYHA functional class (p = 0.001), and patients’ level of information about the device (p = 0.039). Patients’ QoL, as measured by the EQ-5D-5L, was significantly associated with sex (p = 0.001), age (p = 0.019), occupation (p = 0.040), pacing mode (p = 0.034), comorbidities (p = 0.019), NYHA functional class (p = 0.047), and level of information about the device (p = 0.005). Conclusions: NYHA functional class, comorbidities, and level of information as reported by patients were the factors associated with QoL, as shown by the two scales. All three factors guide a personalized care plan since NYHA class shows the burden of disease, comorbidities add to the complexity, and patient information determines the effectiveness of management. Full article

Background: Occupational noise-induced hearing loss (ONIHL) remains one of the most prevalent occupational diseases globally and in South Africa. Despite awareness and regulatory frameworks, consistent use of hearing protection devices (HPDs) is suboptimal in high-noise industries. Aim: To investigate patterns of HPD use and the factors influencing compliance among workers in an aluminium manufacturing company exposed to noise levels exceeding 85 dB(A). Methods: A cross-sectional survey was conducted with 115 workers, including 68.7% males and 31.3% females. Chi-square tests assessed associations between categorical variables, and logistic regression identified significant predictors of consistent HPD use. Results: Although 94.8% of workers were aware of the risks of hazardous noise, only 51.3% reported always using HPDs. Gender, education level, type of HPD, type and duration of noise exposure, and perceived susceptibility to hearing loss were significantly associated with consistent HPD use. Logistic regression revealed that gender, type of HPD, type of noise exposure, and perceived susceptibility significantly predicted consistent use. Conclusions: Despite high awareness and access to HPDs, consistent use remains moderate and is influenced by demographic, perceptual, device-related, and workplace factors. Findings highlight the need for targeted interventions, training, and workplace strategies to improve HPD compliance and prevent ONIHL. Full article

This paper presents a bench-top occupational power-assist robot aimed at reducing biomechanical effort during repetitive material handling. The prototype adopts a SCARA-like structure with three degrees of freedom and provides assistance on the vertical (z) axis through a three-phase brushless DC (BLDC) motor driven in field-oriented control with inner-loop current regulation. The user interacts with the robot through a single handle-mounted load cell. The measured interaction force is converted, via a calibration-based mapping, into a motor current reference that enforces a prescribed force-sharing ratio. In this way, the drive’s embedded current loop acts as the low-level torque regulator, and the system can share gravitational and inertial loads without additional environment force sensing or explicit high-level impedance/admittance dynamics. A coupled electro-mechanical model is derived and used to select the assistance gain and to verify feasibility in simulation. A pilot experimental campaign with eight participants and two payloads (0.5 kg and 1.5 kg) was carried out on sinusoidal and random tracking tasks. With assistance enabled, the operator contribution was reduced to about 15% of the total load, and the mean bicep brachii EMG amplitude decreased by about 60%, while tracking accuracy was generally preserved and often improved. Full article

Reinforced concrete (RC) columns, vital components of urban infrastructure, are highly vulnerable to severe damage from contact explosions, posing significant threats to structural integrity and occupant safety. This study presents a rigorous experimental investigation into the dynamic blast response of RC columns and the efficacy of externally bonded Carbon Fiber Reinforced Polymer (CFRP) wraps as a retrofitting solution. Three series of scaled RC columns were subjected to controlled contact explosions using RDX charges of 50 g, 30 g, and 20 g. For each charge level, three configurations were tested: unretrofitted, single-layer unidirectional CFRP (hoop direction), and dual-layer orthogonal CFRP (hoop and longitudinal). A comprehensive instrumentation system, including high-speed cameras, accelerometers, and pressure transducers, captured blast overpressure, crack evolution, and dynamic acceleration. The results demonstrate that CFRP retrofitting substantially enhances blast resistance and structural performance. Peak accelerations were reduced by up to 68%, with the dual-layer configuration achieving the highest mitigation across all charge levels. In terms of damage control, a single CFRP layer reduced spalling height by 65%, while the dual-layer system achieved up to a 75% reduction. Damage depth was also mitigated by up to 60%, highlighting the superior energy dissipation and containment provided by multi-layered CFRP. These findings underscore CFRP’s significant potential as a robust, practical, and scalable retrofitting solution for enhancing the blast resilience of critical infrastructure, contributing directly to improved urban safety and structural protection in blast-prone environments. Full article

Background: Psychosocial well-being has been increasingly recognized as a relevant factor in cardiometabolic health; however, evidence linking Purpose in Life with type 2 diabetes risk across validated prediction tools remains limited. This study examined the association between Purpose in Life and estimated diabetes risk using three established risk scores. Methods: A cross-sectional analysis was performed in 93,077 Spanish working adults aged 18–69 years participating in routine occupational health assessments. Purpose in Life was measured with the 10-item Purpose in Life scale and categorized into high, moderate, and low levels. Estimated type 2 diabetes risk was evaluated using QDScore, FINDRISC, and CANRISK. Multivariable logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, occupational social class, smoking status, dietary pattern, physical activity, and body mass index. Results: Lower levels of Purpose in Life were consistently associated with greater likelihood of high estimated diabetes risk across all three instruments. Compared with participants reporting high Purpose in Life, those with low Purpose in Life showed increased odds of high-risk classification for QDScore (OR 2.38; 95% CI 2.19–2.57), FINDRISC (OR 2.49; 95% CI 2.08–2.89), and CANRISK (OR 2.79; 95% CI 2.50–3.09). Clear dose–response patterns were observed across Purpose in Life categories, and associations were similar in men and women as well as across lifestyle strata. Conclusions: Reduced Purpose in Life is strongly associated with higher estimated type 2 diabetes risk across multiple validated screening tools. Although causal direction cannot be inferred from this cross-sectional design, these findings suggest that psychosocial dimensions may provide complementary information for cardiometabolic risk assessment and prevention strategies. Full article

This study assessed the carbonation-related durability of an existing reinforced concrete building in Seoul scheduled for demolition to examine the level of durability performance commonly assumed for building structures. The compressive strength of concrete core specimens was compared with the estimated compressive strength derived from the rebound hammer, showing similar overall trends despite noticeable scatter, indicating that rebound testing can serve as a supplementary indicator when interpreted with caution. Carbonation depth measurements revealed that indoor locations tended to exhibit the greatest carbonation depths, likely reflecting higher CO₂ concentrations associated with occupancy and daily activities, as well as indoor ventilation and moisture conditions. For exterior walls, orientation affected carbonation progress; carbonation depths were greater on the southwest-facing wall than on the northwest-facing wall, suggesting that higher solar radiation may promote drying and facilitate CO₂ diffusion, thereby accelerating carbonation. When the carbonation rate coefficients were compared under similar compressive strength conditions, the southeast-facing wall exhibited a coefficient approximately 1.1 times greater than that of the northwest-facing wall. These results indicate that carbonation cannot be explained by strength alone and highlight the importance of incorporating exposure-related factors (e.g., solar radiation, drying, rainfall, and shielding) into carbonation behavior assessment. Full article

Robot-assisted therapy (RT) is increasingly implemented in rehabilitation, yet evidence on its effectiveness in improving upper extremity function after cervical spinal cord injury (cSCI) remains limited. Therefore, this randomised crossover study aims to investigate the effects of unilateral RT compared to conventional unilateral occupational therapy (OT) on upper extremity function in individuals with cSCI. 40 participants with traumatic or non-traumatic cSCI (16–81 days post-injury, neurological level of injury: C1–T1) will be randomised (1:1), stratified by their predicted recovery profile, to receive 6 weeks of RT (ArmeoSpring) and 6 weeks of OT in random order, each 3 × 30 min/week in addition to the clinical routine therapy. Assessments are conducted before (t₀), between (t₁) and after both intervention blocks (t₂ and t₃). The primary outcome is the Quantitative Grasping Subtest of the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP-QtG); primary analysis uses a linear mixed model to estimate the treatment effect based on change scores. Recruitment is currently ongoing. This randomised crossover study allows the collection of a comprehensive dataset to generate knowledge about treatment effectiveness, enabling future individuals with cSCI to benefit from improved and individualised therapy schedules. Full article

Coordinated control of ramp metering, variable speed limits, and intersection signals is critical for mitigating congestion and enhancing efficiency at urban expressway–arterial interfaces. Existing strategies often operate in isolation, leading to fragmented responses and limited adaptability under heterogeneous traffic demands. This study develops a multi-agent reinforcement learning framework based on MADDPG to achieve cooperative decision-making across heterogeneous controllers. An asynchronous control cycle mechanism is designed to accommodate different temporal requirements of ramp meters, speed limits, and signal controllers, ensuring practical feasibility in real-time operations. A conflict-aware reward design further embeds density regulation, speed harmonization, and spillback prevention to stabilize flow dynamics. Simulation experiments on a calibrated urban network demonstrate that the proposed framework delays congestion onset, reduces shockwave propagation, and improves throughput compared with classical benchmarks. In particular, at the mainline merge, average travel time is reduced to 13.56 s (62.4% of VSL-only); at the ramp, occupancy is lowered to 6.4% (40.6% of ALINEA); and at the signalized approach, average delay decreases to 85.71 s (62.7% of actuated control). These results highlight the scalability and deployment potential of the proposed cooperative control approach for system-level traffic management in mixed traffic environments. Full article

Background/Objectives: A plethora of articles report the effectiveness of many different interventions for managing cerebral palsy (CP), but there are few long-term follow-up studies of children after an intervention designed to improve function in children with CP. This observational mixed-methods study examined the functional gains observed more than one year after toddlers completed a 48-week investigation that included 5 days per week for 12 weeks of occupational and physical therapy using the Perception-Action Approach (P-AA). The aim was to observe whether the functional gains made by the children continued to improve, plateaued, or declined at long-term follow-up. Methods: The sample was 23 children with a mild-to-moderate level of CP (Gross Motor Function Classification System I, II, or III) who completed the original study at least one year prior. The follow-up assessment included quantitative data using the Gross Motor Function Measure-66 (GMFM) and the Pediatric Evaluation of Disability Inventory-Functional Skills (PEDI-FS). Seventeen of 23 children were evaluated with both instruments. Qualitative data were collected from 14 of the 23 families who completed the PEDI-FS. Those families completed a survey with an open-ended questionnaire that assessed the caregivers’ perspectives about their children’s functioning and the impact of the intervention. Results: Findings from the quantitative data based on prognostic GMFM-66 developmental curves by age for children with CP: seven of the 17 children who had GMFM evaluations showed greater than expected improvement (all 5 with GMFCS II), four met the expected improvement, and six did not. Children with GMFCS II or III maintained their positions relative to the mean on the PEDI-FS mobility subset. Findings from the qualitative data revealed that some parents believed the intervention contributed to the changes in their children’s physical, mental, and social functioning. Many parents indicated that the study helped them overcome financial barriers related to accessing intensive therapies. Most parents reported that their child’s functioning was better than they expected when given the diagnosis of CP. Conclusions: Many months following an intense physical and occupational therapeutic intervention, based on predicted age-appropriate percentiles for motor function, roughly one-third of the children exceeded expectations, and one-third did not meet expectations. Despite the time invested in the intense protocol, caregivers felt the intervention was largely responsible for improvements in their children’s functioning. Full article

Background: Awkward postures are among the most prevalent ergonomic risk factors in occupational environments, including industrial settings. Conventional ergonomic risk assessments rarely address the relationship between sustained awkward postures and alterations in sagittal spinal curvatures. The primary objective of this study was to analyze the association between sagittal spinal posture parameters and exposure to awkward postures in male workers from the mattress manufacturing industry. The potential confounding effects of age, job seniority, body mass index (BMI), and physical activity level were also examined. Methods: An analytical cross-sectional study was conducted. Data collected included age, job seniority, anthropometric variables, and physical activity level. Sagittal spinal posture parameters—head alignment, thoracic kyphotic curvature, lumbar lordotic curvature, and pelvic tilt—were assessed using photogrammetry. Exposure to awkward postures was recorded according to occupational health surveillance criteria. Results: A total of 116 male workers were randomly selected. BMI showed a significant negative association with head alignment (p = 0.001), with a medium effect size (η² = 0.090). Lower BMI values (β = −0.517) were observed in association with a more posterior head position. In addition, participants not exposed to awkward postures presented, on average, a 6.479° lower thoracic kyphotic curvature angle compared with exposed workers (p = 0.050), indicating a greater kyphotic curvature among those exposed. Conclusions: In this sample, lower BMI was associated with a more posterior head position and improved alignment with the upper trunk. Furthermore, exposure to awkward postures was related to a modest increase in thoracic kyphotic curvature, suggesting postural adaptations to occupational demands. Full article

Rural shrinkage is increasingly expressed through changing residential mobility, housing under occupancy, and intermittent dwelling use, rather than a simple linear process of permanent outmigration and abandonment. Yet empirical measurement of occupancy dynamics and the service-mediated mechanisms shaping residence stability remains limited. This study proposes an evidence-driven and explainable assessment framework that links energy-informed occupancy dynamics with settlement building area and mechanism identification, using Fuyuan City as a case study. Daily electricity consumption time series from 2021 to 2024 are used to infer occupancy dynamics and detect behavioral signatures of long term residence, seasonal residence, return visits, and vacancy. Shape-based temporal clustering identifies six occupancy trajectories, revealing pronounced heterogeneity in mobility rhythms within the rural settlement system. Settlement vacancy-related built-environment changes are characterized from 2 m remote sensing imagery, using a trained YOLO-based building detection workflow, producing settlement-level total building area as a physical indicator of the development intensity. Integrating these behavioral measures with multi-source spatial factors, the mechanism model shows that development, governance, and environmental conditions influence residence stability primarily through service provision. Among service domains, education services exhibit the strongest direct association with long-term residence stability, while transport and daily life services show modest positive effects and healthcare presents a smaller positive effect. Development conditions positively promote all service types, whereas governance and environmental context display differentiated and, in some pathways, opposing effects across services. Overall, the framework enables interpretable monitoring of rural shrinkage dynamics by jointly quantifying occupancy trajectories, settlement morphology, and service-mediated pathways shaping residential outcomes. Full article

This study investigates the impact of occupational noise on the physical and mental health of 50 water pumping station operators in Lebanon. The research aimed to quantify noise exposure, assess its effects on hearing and psychological well-being, and identify contributing factors. To achieve this, this study employed several evaluation methods. Noise exposure was measured using a calibrated sound level meter to determine the average A-weighted sound pressure levels (dBA) at 52 stations, which were then compared to the 85 dBA recommended limit from the National Institute for Occupational Safety and Health (NIOSH). Physical health, specifically hearing ability, was assessed using a validated smartphone-based pure-tone audiometry application to measure hearing thresholds across multiple frequencies. The resulting data were used to calculate the pure-tone average (PTA) and classify hearing impairment according to the World Health Organization (WHO) standards. Psychological health was evaluated through a structured 14-item questionnaire developed for this study, covering self-reported impacts on stress, anxiety, sleep quality, concentration, communication, and emotional state. The results indicated a hazardous work environment, with the mean noise level across stations (86.67 dBA) significantly exceeding the NIOSH safety threshold. A high prevalence of hearing impairment was observed among operators, with 88% exhibiting impairment in the worse ear. A multiple linear regression analysis revealed that noise level, age, and duration of exposure were all statistically significant predictors, collectively explaining 62.3% of the variance in hearing impairment (F(3, 46) = 25.32, p < 0.001). The analysis further identified age as a key effect modifier; the duration of exposure was the dominant risk factor for younger workers, while the intensity of the noise level was more critical for older workers. Psychologically, workers reported a high prevalence of adverse effects, with sleep disturbances being the most common issue (reported by 75%), followed by emotional distress (67%) and anxiety (60%). This study also found a complete lack of hearing protection use and no formal training on noise hazards, highlighting significant gaps in occupational safety practices. Full article