Search Results (50)

Background: Previous reports suggest that patient age at the time of implant placement is not a factor in implant survival. However, analysis of data compiled for a previously published study on the effect of enamel matrix derivative (EMD), a frequently used biomaterial to aid bone regeneration, on peri-implantitis indicated that age and use of EMD may be a factor in implant survival. The current study further evaluated the existing database to determine the effect of age and EMD use on long term survival of implants. Methods: An existing database from a private periodontal specialty practice was evaluated for the effect of age at the time of implant placement on implant survival. In addition, all available clinical factors were evaluated, including the use of EMD at any point during site preparation or implant placement to determine any effect on implant survival. Results: Patient age at the time of implant placement had a negligible effect on implant survival for younger individuals. However, starting at 58 years of age, an increase in relative risk for implant loss was noted. When the patient age was divided into groups, it was determined that patients ≥ 58 and ≤68 years had a statistically significantly increased relative risk of implant loss (2.75), which was sharply reduced if EMD had been used (1.24). This trend was also noted to a lesser extent in patients older than 68 years. Conclusions: The risk of implant loss was elevated when implants were placed in older patients. This risk was reduced if EMD had been used at any point during implant site preparation or placement. Full article

Background/Objective: Worldwide, ~45% of hypertensives remain undiagnosed, and ~26% are adequately controlled. The active involvement of all healthcare professionals in diagnosing hypertension at primary health care units (PHCUs) is linked to better blood pressure (BP) control. There is currently no research examining the potential role of senior medical students in the diagnosis of hypertension. This study aimed to evaluate the contribution of final-year medical students’ active participation in the diagnosis of hypertension. The study also examined the prevalence and control of hypertension among health service users in Greek PHCUs. Methods: This is a cross-sectional convenience sample study. During clinical placement in PHC, sixth-year medical students received systematic training and performed BP measurements, according to the guidelines, in private, well-organized spaces. Adult patients and visitors were enlisted for BP measurements. The BP readings were provided to the participants so they could discuss any concerns about their BP with their physician. Statistical analysis was performed with SPSS. Categorical variables are presented as frequencies. Continuous variables were assessed for normality and, based on their distribution, are expressed as mean ± standard deviation or median (interquartile range). Appropriate tests were performed for the comparisons across groups (chi-square for the categorical variables, and two-sample t-test or Mann–Whitney test for continuous variables). A p-value < 0.05 was considered statistically significant. Results: In the present study, 124 medical students performed BP measurements in 68 PHCUs. BP was measured in 704 individuals, aged 61 (IQR: 48.0–73.0) years old; 58.8% were female, 68.3% of whom were patients. The prevalence of hypertension was 56.7%. The control rate was 44.9% (BP < 140 and 90 mmHg among all hypertensives), and the control rate under treatment was 61.0% (BP < 140 and 90 mmHg among treated hypertensives). The involvement of medical students contributed positively, increasing the diagnosis of hypertension in individuals who might not have their BP measured in routine clinical practice. Ninety-nine newly diagnosed hypertensives were detected. Students identified 220 uncontrolled hypertensives and 112 uncontrolled under-treated patients, who were then referred to the consultant physicians. Conclusions: Students played a critical role in diagnosing hypertension and identifying newly diagnosed hypertensive patients. Embracing interprofessional care in the diagnosis and management of hypertension is essential for achieving better outcomes for our patients. Engaging medical students in BP measurements is a practical and feasible approach to improve hypertension diagnosis and control, taking into consideration the increased workload of PHC physicians. While this action has important medical education implications, the impact on the knowledge level of medical students was not evaluated. Limitations of this study include the assessment of BP in one visit without home BP measurements or a second visit, lack of follow-up of newly diagnosed hypertensives, and the low average number of BP measurements per student. Full article

Reducing social exclusion through technology is a key challenge for sustainable development, particularly within the context of accessible tourism. This study, as part of the “MOUNTAINS WITHOUT BARRIERS” project, addresses this issue by aiming to identify optimal locations for specialized all-terrain wheelchair rental stations in mountainous regions. The primary purpose is to ensure these locations are seamlessly integrated with existing local transport systems, fostering genuine accessibility. A dedicated methodology was developed to analyze the spatial integration of the accessible trail network with the transport system in the Beskid Agglomeration. The analysis, conducted using Geographic Information System (GIS) tools, considers access via both individual transport and public transport, with a clear emphasis on prioritizing the latter to promote sustainable mobility patterns. Applying this approach, the study identified potential station locations that are not only conveniently situated at trailheads but are also highly accessible via public transport. The main finding indicates that strategic placement can significantly minimize the necessity for private car usage. Integrating tourism infrastructure with public transport is crucial for increasing the real-world accessibility of mountain areas for people with disabilities. Furthermore, the results and methodology provide valuable recommendations that can serve as a practical input for Sustainable Urban Mobility Plans (SUMP). Full article

Background: Single implants yield predictable survival and success using various treatment protocols. Innovations in design and surface texture improved survival and ensured crestal bone stability, crucial to avoiding biological complications. This study focuses on survival and peri-implant crestal bone remodeling during healing and function of single hybrid-surface implants (Machine Surface Coronal, MSc, Southern Implants Pty Ltd., Irene, South Africa), featuring a minimally rough coronal region and moderately rough body. The specific aims were firstly to compare the clinical outcome between 3 surgical protocols and secondly to assess whether the outcome is affected by macroscopic implant design. Methods: Clinical records of 120 consecutively placed single MSc-implants in private practice were scrutinized after 12–62 months in function. Implants were placed using one of three surgical protocols as selected by the surgeon based on clinical judgment and treatment indication: flap-healed surgery with healing abutment (HA), flapless surgery with HA, or immediate implant placement (IIP) with HA. Six different implant types, albeit with the same MSc-surface feature, were utilized, based on individual clinical indications. Radiographical crestal bone level changes over time were analyzed and effect of implant design, gender, smoking status and surgical protocol was explored. Results: 101 implants was available for analysis. Six implants failed prior to loading (5%); 30% in smokers versus 3.3% in non-smokers. Initial bone remodeling, due to biologic width formation, was 0.762 mm (SD 0.940) at time of loading and 0.933 mm (SD 1.057) after 2 years (p = 0.07). Steady state bone levels at final recall (12–62 months; mean 24) were irrespective of implant type (p = 0.51), surgical protocol (p = 0.10), gender (p = 0.557) or smoking habit (p = 0.27). 54% of the implants showed bone gain between loading and final, whereas only 3% had bone loss above 3 mm. Conclusions: Under daily clinical conditions, MSc-hybrid implants yield predictable clinical outcomes in line with contemporary implant systems, irrespective of implant length and diameter. A 5.9% early failure rate was found irrespective of smoking status, with no late failures. Failure rate dropped to 3.3% when smokers were excluded. Crestal bone remodeling at the time of loading, mimicking biologic width formation, as well as bone level changes over time, is indicative of a healthy peri-implant steady state irrespective of the surgical protocol. Full article

Background: Preschool bedroom television placement represents an established risk factor for negative psychological and behavioral outcomes in adolescence. Girls and boys have different risk factors for developmental psychopathology. It is unclear if childhood sport participation can act as a protective factor for the potential maladaptive behaviors associated with having a bedroom television in early childhood. Methods: This study aims to evaluate the impact of having a bedroom television in early childhood on later externalizing behaviors while examining the potential beneficial role of extracurricular sport participation in middle childhood using the Quebec Longitudinal Study of Child Development (Canada). We examine subsequent teacher-reported psycho-social outcomes by the end of sixth grade. Linear regression is used to examine the interaction between child-reported bedroom television placement (age 4 years) and parent-reported childhood sport participation trajectories (ages 6 to 10 years) in predicting behavioral outcomes at age 12 years. Results: For boys, extracurricular sport amplified the relationship between having a preschool bedroom television and subsequent physical aggression (b = 0.95, SE = 0.32, p < 0.001) and ADHD symptoms (b = 0.59, SE = 0.30, p ≤ 0.05), beyond individual and family characteristics. No interaction results were found for girls; however, consistent sport participation between ages 6 and 10 years resulted in a decrease in ADHD symptoms in girls (b = −0.329, SE = 0.102, p ≤ 0.001). Conclusion: Unexpectedly, for boys exposed to early bedroom television, consistently participating in extracurricular sport in childhood exacerbated long-term behavioral risks. Social unpreparedness from bedroom television placement countered the intended benefits of sport. This private access to screens might influence sedentary, unsupervised, isolated activity that increases the chances of viewing violence and reduces opportunities for social interaction. Full article

Background/Objectives: The aim of the study was to investigate the risk factors related to early implant failures in patients treated in a private implant clinic. Methods: The study was retrospectively conducted on 392 patients (mean age = 51.2 ± 15.4 years, 48.9% female and 51.1% male) who received 930 dental implants within the period from 2000 to 2020. Included patients had received at least one implant. Patients were excluded in case of incomplete dental records that did not contain the necessary information, including personal information (patient’s name, age, gender, history and current condition of systemic diseases) and treatment protocol record. No patients were excluded on the basis of systemic disease if it did not contraindicate dental implant surgery. Patient-related variables (age, gender, smoking, history of periodontitis, accompanying disease), surgical-related variables (surgical technique, bone augmentation, lateral sinus lift, internal sinus lift, immediate implant placement after tooth extraction, immediate mucosal grafting, insertion torque,) and implant-related variables (implant design, implant level, implant surface, site of implant placement, implants diameter, length and implants brand name) were recorded. Results: GEE analysis results showed that the implant-based failure rate before or at the abutment connection stage was 5.8%. Seven factors were identified associated with early implant failures: male gender, smoking, history of radiotherapy and chemotherapy, maxilla implant placement, non-submerged healing method, implant design and implant brand. Conclusions: In light of the results obtained, both patient-related variables (gender, smoking, history of radiotherapy and chemotherapy) and variables related to the type of implant, its position and the surgical technique used (maxilla implant placement, non-submerged healing method, implant design and implant brands) were found to be statistically correlated with early failures in this study. Full article

Shared cargo bike services hold significant potential for promoting sustainable urban mobility, yet their adoption remains limited—especially for private, everyday use. This study investigates how such systems can be more effectively integrated into urban transport by identifying key enablers and operationalizing them through a GIS-based multi-criteria analysis (MCA). Using a mixed-methods approach, expert interviews were conducted to explore success factors and barriers. Results highlight the dual function of shared cargo bikes: enabling occasional use while increasing long-term uptake by fostering trial and visibility. The study identifies both spatial and non-spatial enablers. Key spatial factors include high visibility, pedestrian flows, access to public transport and cycling networks, and placement in mixed-use areas. Non-spatial enablers include technical reliability, ease of use, strong visual identity, subsidies, and trial opportunities. The spatial enablers were operationalized into seven criteria in the MCA. Based on qualitative expert interviews and thematic analysis, the highest weights were assigned to visibility and pedestrian flows, followed by proximity to public transport and local centers, while lower weights were given to proximity to residences, population density, and access to cycle paths. The results offer guidance for station placement and demonstrate the role of shared cargo bikes in sustainable urban transport. Full article

Introduction: Central line-associated bloodstream infections (CLABSIs) are a major cause of morbidity and mortality, yet health disparities in CLABSI incidence and outcomes remain understudied. This study evaluates these disparities and their impact on CLABSI rates, in-hospital mortality, hospital length of stay (LOS), and costs using the National Inpatient Sample (NIS) from 2016 to 2022. Methods: We conducted a retrospective analysis of adult hospitalizations using the NIS database that included central venous catheter placement and identified CLABSI using AHRQ’s Patient Safety Indicator 07. Primary outcomes included CLABSI incidence and in-hospital mortality; secondary outcomes were LOS and inflation-adjusted hospital costs. Outcomes were analyzed using logistic and lognormal regression models, focusing on demographic and clinical variables that included sex, race, socioeconomic status, and insurance type. Results: Among 11.5 million CVCs placed between 2016 and 2022, 6.56 million met CLABSI eligibility criteria, with 1 in 400 (0.25%) complicated by CLABSI. Blacks had 29.8% higher adjusted odds of CLABSI than Whites (p < 0.001), whereas Medicaid beneficiaries had 18.4% higher odds compared to those privately insured (p = 0.002). CLABSI was associated with a 97% increase in LOS and an 82% increase in hospital costs (both p < 0.001). In-hospital mortality was 13.3% and did not differ significantly by CLABSI status after adjustment. Discussion: Racial and socioeconomic disparities persist in CLABSI incidence and healthcare resource utilization, with Blacks and Medicaid beneficiaries at the highest risk. Although CLABSI rates returned to pre-pandemic levels in 2022, associated costs and LOS remained elevated. Further research and targeted prevention strategies are needed to reduce health disparities and improve patient outcomes. Full article

Background: Undergraduate nursing students (UNSs) often enter clinical training just as they are still mastering the emotional labor of the profession. In Nepal, where teaching hierarchies discourage upward dialogue and hospitals routinely struggle with overcrowding, supply shortages, and outward nurse migration, these learners confront a distinct, under-documented burden of psychological distress. Objective: This study examines how UNSs interpret, negotiate, and cope with the mental health challenges that arise at the intersection of cultural deference, resource scarcity, and migration-fueled uncertainty. Methods: A qualitative design employing reflexive thematic analysis (RTA), guided by the Reflexive Thematic Analysis Reporting Guidelines (RTARG), was used. Fifteen second-, third-, and fourth-year Bachelor of Science in Nursing students at a major urban tertiary institution in Nepal were purposively recruited via on-campus digital flyers and brief in-class announcements that directed students (by QR code) to a secure sign-up form. Participants then completed semi-structured interviews; audio files were transcribed verbatim and iteratively analyzed through an inductive, reflexive coding process to ensure methodological rigor. Results: Four themes portray a continuum from silenced struggle to systemic constraint. First, Shrouded Voices, Quiet Connections captures how students confide only in trusted peers, fearing that formal disclosure could be perceived as weakness or incompetence. Second, Performing Resilience: Masking Authentic Struggles describes the institutional narratives of “strong nurses” that drive students to suppress anxiety, adopting scripted positivity to satisfy assessment expectations. Third, Power, Hierarchy, and the Weight of Tradition reveals that strict authority gradients inhibit questions in classrooms and clinical placements, leaving stress unvoiced and unaddressed. Finally, Overshadowed by Systemic Realities shows how chronic understaffing, equipment shortages, and patient poverty compel students to prioritize patients’ hardships, normalizing self-neglect. Conclusions: Psychological distress among Nepalese UNSs is not an individual failing but a product of structural silence and resource poverty. Educators and policymakers must move beyond resilience-only rhetoric toward concrete reforms that dismantle punitive hierarchies, create confidential support avenues, and embed collaborative pedagogy. Institutional accountability—through regulated workloads, faculty-endorsed wellbeing forums, and systematic mentoring—can shift mental health care from a private struggle to a shared professional responsibility. Multi-site studies across low- and middle-income countries are now essential for testing such system-level interventions and building a globally resilient, compassionate nursing workforce. Full article

Background: Maxillary sinus floor augmentation (MSFA) is commonly used to increase posterior maxillary bone volume prior to implant placement. Although generally successful, late complications can impact long-term outcomes. The purpose of the study was to estimate the incidence and timing of atypical late complications following (MSFA) using bovine xenohybrid bone grafts. The study also aimed to evaluate whether preoperative bone volume is associated with the risk of complications. Methods: This retrospective cohort study was conducted at the Center of Oral and Maxillofacial Surgery, Danube Private University, Krems-Stein, Austria, and included patients who underwent MSFA with bovine xenohybrid bone grafts and either simultaneous or staged implant placement between January 2020 and December 2023. Preoperative bone volume of the posterior maxilla measured via cone beam computed tomography (CBCT) in the planned implant insertion position. The primary endpoint was the time (days) from MSFA to the occurrence of a graft-related complication (defined as atypical if occurring more than 6 months after MSFA and not related to peri-implantitis) The covariates included subjects’ age, sex, the quantity of graft used for MSFA, timing of dental implant insertion (simultaneous vs. staged) and implant dimensions. Kaplan–Meier analysis and Cox proportional hazards regression were used to evaluate time-to-event data. Only one graft site per patient was analyzed. Results: Atypical complications occurred in 9 out of 47 patients (19.1%), with an average time to onset of 645 days. In a multivariable analysis, a lower preoperative bone volume was found to be an independent predictor of an increased risk of complications (hazard ratio [HR]: 0.972; 95% confidence interval [CI]: 0.925–1.021; p = 0.252). However, the quantity of graft used for MSFA was not found to be a predictor (p = 0.46). Conclusions: Within the limitations of a retrospective study, reduced native bone volume appears to increase the risk of atypical late complications following MSFA with bovine xenohybrid grafts. This makes closer clinical and radiologic follow-up of patients over a longer period very necessary. Full article

Background/Objectives: Out-of-hospital cardiac arrest (OHCA) remains a major public health challenge, with survival rates significantly dependent on early defibrillation. In Bialystok, Poland, the bystander usage rate of automated external defibrillators (AEDs) is extremely low, and the current distribution of public-access AEDs may not support optimal response times. The aim of this study was to identify an effective AED placement strategy using spatial analysis. Methods: We retrospectively analyzed 49,649 emergency dispatch records from 2018 to 2019, identifying 787 patients with OHCA within Bialystok’s city limits. After excluding ineligible records, 766 cases were geolocated and subjected to cluster analysis using the K-means algorithm. The goal was to determine optimal AED locations based on the geographic distribution of OHCA cases in both public and residential settings. Results: AEDs were used in only 0.51% of all cases of OHCA. Most cardiac arrests occurred in private homes (80.05% of cases). Cluster analysis identified 18 to 36 optimal AED locations, revealing significant mismatches with the current AED network. Notably, grocery store chain “PSS Spolem” emerged as an ideal AED deployment partner due to alignment with identified high-incidence clusters. Conclusions: The current AED distribution in Bialystok is inadequate for an effective response to OHCA. Geographic cluster analysis can significantly improve placement strategies. Priority should be given to residential areas and commonly accessed sites. Enhanced public education, a national AED registry, and improved accessibility are essential for increasing AED use and survival rates. Full article

This paper examines a previously unknown anonymous Hebrew letter inserted into a postwar edition of Shem HaGedolim, found in the library of the Jewish University in Budapest. The letter, composed in Győr in 1947, consists almost entirely of passages copied from Tiferet Chayim, a hagiographic genealogy of the Sanz Hasidic dynasty. Although derivative in content, the letter’s form and placement suggest it was not meant for transmission but instead served as a private act of mourning and historiographical preservation. By situating the letter within the broader context of post-Holocaust Jewish and Hasidic memory practices, including yizkor books, rabbinic memoirs, and grassroots commemorative writing, this study proposes that the document constitutes a “micro-yizkor”: a bibliographic ritual that aimed to re-inscribe lost tzaddikim into sacred memory. Drawing on theories of trauma, religious coping, and bereavement psychology, particularly the Two-Track Model of Bereavement, the paper examines the letter as both a therapeutic and historiographical gesture. The author’s meticulous copying, selective omissions, and personalized touches (such as modified honorifics and emotive phrases) reflect an attempt to maintain spiritual continuity in the wake of communal devastation. Engaging scholarship by Michal Shaul, Lior Becker, Gershon Greenberg, and others, the analysis demonstrates how citation, far from being a passive act, functions here as an instrument of resistance, memory, and redemptive reconstruction. The existence of such a document can also be examined through the lens of Maurice Rickards’ insights, particularly his characterization of the “compulsive note” as a salient form of ephemera, materials often inserted between the pages of books, which pose unique challenges for interpreting the time capsule their authors sought to construct. Ultimately, the paper argues that this modest and anonymous document offers a rare window into postwar Ultra-orthodox religious subjectivity. It challenges prevailing assumptions about Hasidic silence after the Holocaust and demonstarates how even derivative texts can serve as potent sites of historical testimony, spiritual resilience, and bibliographic mourning. The letter thus sheds light on a neglected form of Hasidic historiography, one authored not by professional historians, but by the broken-hearted, writing in the margins of sacred books. Full article

This paper investigates integrating a sensory data model for managing an existing 50-year-old building. A primary challenge in retrofitting older structures is the optimal deployment of high-quality sensors, systematic data acquisition, and subsequent data management. To address this, the study implemented a network of over 50 sensors connected via 270 m of wired infrastructure, deliberately avoiding wireless transmission to ensure data reliability. This configuration generates 5568 data points daily, which are archived on a dedicated server. The data is planned for integration into the Campus Geographical Information System (GIS), enabling private and public access. A methodology was employed, involving the strategic placement of sensors based on building use patterns, continuous data monitoring, and iterative sensor performance evaluation. The findings from the study indicate that integrating sensory data through this structured approach significantly enhances building management capabilities. Specifically, the results demonstrate improved energy efficiency and environmental performance, which is particularly relevant for public and educational facilities. The research highlights that a data-driven, monitoring-based management system can optimize operational functions and inform future retrofitting strategies for aging buildings. Full article

Technological innovation toward electrification and digitalization is revolutionizing aviation, paving the way for new aeronautical paradigms and novel modes to transport goods and people in urban and regional environments. Advanced Air Mobility (AAM) leverages vertical and digital mobility, driven by safe, quiet, sustainable, and cost-effective electric vertical takeoff and landing (VTOL) aircraft. A key enabler of this transformation is the development of vertiports—dedicated infrastructure designed for VTOL operations. Vertiports are pivotal in integrating AAM into multimodal transport networks, ensuring seamless connectivity with existing urban and regional transportation systems. Their design, placement, and operational framework are central to the success of AAM, influencing urban accessibility, safety, and public acceptance. These facilities should accommodate passenger and cargo operations, incorporating charging stations, takeoff and landing areas, and optimized traffic management systems. Public and private sectors are investing in vertiports, shaping the regulatory and technological landscape for widespread adoption. As cities prepare for the future of aerial mobility, vertiports will be the cornerstone of sustainable, efficient, and scalable air transportation. Full article

Electric and hybrid vehicles have become widespread in large cities due to the desire for environmentally friendly technologies, reduction of greenhouse gas emissions and fuel, and economic advantages over gasoline and diesel vehicles. In electric vehicles, overheating, vibration, or mechanical damage due to collision with an object or another vehicle can lead to the failure of lithium-ion batteries up to thermal runaway and fire. Therefore, the development of battery safety control systems is one of the most important factors contributing to the large-scale electrification of public and private transport. This review examines the design features of the location and management of the battery pack to achieve maximum safety and operational efficiency when using an electric vehicle. The power characteristics and life-cycles of various types of lithium-ion batteries depending on the chemical nature of their electrodes are considered, using the example of commercial vehicles’—Tesla, Nissan Leaf, Porsche Taycan, Zeekr, and Chevrolet Volt—strategic technologies for the placement and packaging of batteries, and battery cooling and monitoring systems (State of Health and State of Charge) are also discussed. In conclusion, the current challenges in the field are summarized and promising research directions are proposed. Full article