Search Results (221)

Background/Objectives: Intracranial hemorrhage (ICH) is a life-threatening condition that can be rapidly detected by non-contrast head computed tomography (NCCT). RAPID ICH is a deep learning (DL) tool for automatic ICH identification using NCCT. Our aim was to assess the real-world performance of RAPID ICH compared to that of a first-year radiology resident on consecutively acquired NCCTs from patients referred from the Emergency Department. Methods: This single-center retrospective cohort study included NCCTs acquired on the same CT scanner over three months. Exclusion criteria were motion or metallic artifacts that substantially degraded the NCCT quality and incomplete NCCTs. Two senior neuroradiologists conducted ground-truth labeling of the NCCTs regarding ICH presence in a binary manner. The first-year radiology resident assessed NCCTs for ICH presence and was blinded to the ground-truth labeling. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed for the RAPID ICH identifications and for the first-year radiology resident’s ICH identifications. Results: After applying exclusion criteria, 844 NCCTs remained. Ground-truth labeling found ICH in 63 NCCTs. RAPID ICH showed 87.3% sensitivity, 74% specificity, 21.3% PPV, and 98.6% NPV, while the first-year radiology resident achieved 95.2% sensitivity, 90.8% specificity, 45.5% PPV, and 99.6% NPV. There were 8 false-negative and 203 false-positive RAPID ICH identifications. Conclusions: RAPID ICH’s sensitivity and specificity were lower than in prior studies performed using RAPID ICH, and there was a high number of false-positive RAPID ICH identifications, limiting the generalizability of the assessed version of this DL tool. Testing DL tools by comparing them with radiologists of varying experience can provide valuable insights into their performance. Full article

Recent developments in higher education have transformed teaching–learning processes across disciplines, including structural mechanics in civil engineering programs. However, reports on innovative teaching practices in structural engineering are scattered, hindering their application in other contexts. This study consolidates and analyzes global research trends in structural mechanics education (from 2014 to 2023), complemented by insights obtained from surveys applied to students, instructors, and senior structural engineers in Colombia. The sample literature comprises 150 Scopus-indexed English articles analyzed with Bibliometrix. Eight guiding questions serve to characterize the literature, identify predominant pedagogical strategies, and outline future research directions. Results reveal limited collaboration networks, inconsistent keyword usage, and a strong concentration of U.S.-based authors and institutions. Most papers appear in engineering education journals, and the recurrent topics (active learning strategies, digital and virtual resources, and assessment methods) confirm the prevalence of experiential, student-centered approaches. Based on the findings, eight emerging areas should guide future research: sustainability, educational research, non-disciplinary competencies, digital resources, artificial intelligence, innovation, disciplinary competencies, and digital competencies. Also, it is recommended that engineering faculties focus efforts on clarifying competency frameworks, strengthening pedagogical and faculty development, investing in educational technologies and laboratory infrastructure, fostering collaborative networks, and enhancing the visibility of structural mechanics education research. Full article

Background: As pediatric head and neck cancer (pHNC) incidence increases, the development of new surgical oncology techniques to reduce morbidity are essential. Intraoperative navigation (iNav) represents the most translatable technology among both the model-comparative and integrative surgical navigation technologies to optimize surgical outcomes. Methods: A scoping review of the literature was performed according to PRISMA guidelines from 1970 to present (February 2025), investigating the use of iNav in cases of pHNC. Patient case details and authors’ perception of iNav’s utility were analyzed. A single-center retrospective case series review (September 2022 to September 2025) of the senior authors’ experience employing iNav in pHNC cases was also performed. Results: The scoping review identified twenty-seven cases of pHNC from sixteen studies that both utilized iNav and met the inclusion criteria. Many of the authors commented favorably on the utility of iNav technology, while concurrently agreeing upon its limitations. The case series review identified five cases of pHNC that met the inclusion criteria. This small case series revealed a 100% R0 resection rate with the use of iNav in four pHNC resections. The fifth case used iNav for biopsy site selection. Conclusions: The results of our scoping review as well as our institutional experience with this technology demonstrate its utility in guiding surgical approach, confirming depth of resection, and navigating marginal assessment. This study was limited by incidental and incomplete reporting of iNav’s clinical application to pHNC; several extensive institutional reports had to be excluded due to insufficiently detailed data linkage. Our review builds upon the existing pediatric surgical literature, anchoring the evidentiary justification for the application of iNav to pediatric head and neck surgery. Full article

Balance is referred to as a state of equilibrium where forces of agonist and antagonistic muscles are equal. This is particularly relevant in the practice of Goju-Ryu Karate-Do, a martial art style with combinations of hard and soft techniques. Particularly, karate stances not only depend on technical aspects but also on the ability to achieve a centered posture. In this narrative review, we aim to integrate the existing knowledge about alignment parameters of the spine to various stances in Goju-Ryu Karate-Do to improve biomechanical understanding, allow technical modifications, and consequently enhance positive training experience. Balance is constantly challenged during the interplay of accelerated movements and subsequent controlled postures (Japanese: “Kamae”). This requires continuous neuromuscular coordination to maintain the body’s equilibrium. In particular, the body’s center of gravity, which is located around the second sacral vertebra in a standing position, needs to be kept within Dubousset’s “efficiency cone” for low energy consumption and minimal fatigue. This state is primarily maintained by aligning the spine, the pelvis, and the lower extremities, which is a result of complex biomechanical interactions of various spinopelvic parameters. Applying these concepts of Dubousset to stances in Goju-Ryu Karate-Do helps to explain why during the aging process or natural degeneration, technical modifications are needed to guarantee an optimal training experience in senior or disabled practitioners of Karate-Do. Biomechanical parameters of the spinopelvic axis are crucial in mastering the art of Goju-Ryu Karate-Do. Only with a balanced stance and an optimally situated center of gravity, a block or attack may be successful and movement strategies effective. However, technical modifications of stances must be considered in aged or disabled karateka to allow a sustained training experience. Full article

Background/Objectives: This study aimed to examine awareness and behaviors related to injury prevention in the home among community-dwelling older adults according to age and gender. Methods: In this cross-sectional descriptive study, 299 adults aged ≥65 years who visited 10 senior welfare centers in Korea were included. Data were collected through structured face-to-face interviews using a questionnaire assessing general characteristics, awareness, and behaviors related to home injury prevention. Descriptive statistics, the chi-squared test, independent t-test, and one-way analysis of variance were used for data analysis. Results: Levels of interest in home injuries and awareness of first aid differed significantly by age and gender. The possession of a home emergency kit and participation in regular health check-ups varied by age, while the intention to participate in injury-prevention education differed by gender. Overall, female participants demonstrated higher levels of injury-prevention behavior than male participants. Conclusions: Older adults showed lower awareness and practice of specific home injury–prevention strategies, while women exhibited greater awareness and preventive behaviors than men. These findings suggest that tailored home injury–prevention interventions that consider age and gender characteristics may yield more effective and positive outcomes. Full article

Background and Objectives: To evaluate the association of surgeon experience, simulation-based training, and hand dominance on drilling accuracy using a synthetic bone model, with the hypothesis that training improves resident performance and left-handed individuals show superior bilateral accuracy. Materials and Methods: A prospective observational study was conducted in the Orthopedic Surgery Division of a tertiary academic center. Drilling accuracy was assessed before and after a standardized simulation-based training program. Twenty-five orthopedic surgeons participated: 9 junior residents (≤3 years of training), 8 senior residents (>3 years), and 8 board-certified experts. All participants completed baseline assessments; only residents were evaluated immediately after training and at a 2-week follow-up. Results: Experts showed superior baseline accuracy, particularly with the non-dominant hand. Senior residents showed a significant overall effect of time on right-hand accuracy (F(2,14) = 5.85, p = 0.014); post hoc pairwise comparisons showed trends toward improvement from baseline to post-training (p = 0.06) and from post-training to 2-week follow-up (p = 0.105); Junior residents showed no significant changes. Left-handed participants consistently outperformed right-handed peers with their non-dominant hands (p = 0.034). Among residents, this pattern persisted across all sessions. At baseline, senior residents and experts had similar right-hand accuracy (p = 0.59), but senior residents performed worse with the left hand (p = 0.038). No significant differences were found between junior and senior residents in either hand across all time points, indicating that residency duration alone does not improve performance without targeted training. Conclusions: Drilling accuracy in orthopedic surgery is influenced by experience level, targeted training, and hand dominance. Experts show greater precision, and senior residents showed a significant overall effect of time on right-hand accuracy, with trends toward improvement following training, while junior residents may need different training strategies. Tailored educational interventions are needed to improve accuracy and ambidexterity across all training stages. Level of evidence: II. Full article

This study presents the e[kent-im] model, a map-based crowdsourcing initiative that digitizes and safeguards urban memory and cultural heritage through community participation and digital tools. The model facilitates the collection, archiving, and dissemination of urban memories by fostering intergenerational knowledge transfer and encouraging civic engagement in heritage preservation. Implemented in the historical center of Kütahya/Türkiye, the project gathered 150 memories and stories from 12 senior participants aged 50–85, which were linked to 303 historical visuals sourced from personal archives. These materials were integrated into a custom-designed web and mobile interface (Mapotic Pro) enriched with metadata categories such as type, period, and location, enabling users to filter and navigate content effectively and watch the videos enriched with participant narratives. A digital city archive matrix was also developed to systematically organize the collected data and support the web-based platform. To assess the platform’s effectiveness, a pilot study with 15 young participants aged 18–28 was conducted. During a self-guided city tour, participants engaged with historical content on the platform and provided feedback through pre- and post-test evaluations. Results indicated heightened awareness of and interest in cultural heritage, demonstrating the model’s potential as both an interactive archive and a tool facilitating intergenerational heritage awareness. Overall, this study highlights the model’s adaptability, scalability, and capacity to bridge generational and technological divides. Full article

Screencasts, which are screen-capture videos, have been created by teachers delivering instruction or feedback, reflecting a teacher-centered model of learning. Based on the constructivist principle, this study explores an innovative attempt to position students as screencast creators, who must demonstrate their knowledge by and explain their work in the screencast. This innovative approach has the potential to promote authentic learning and reduce dependence on generative artificial intelligence (GenAI) tools for completing assignments. However, it is uncertain whether students will have positive attitudes towards this new form of assessment. From 2022 to 2025, the authors used screencasts as assessments in computer programming and English language subjects. Survey results were obtained from 203 university students and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results show that students generally hold positive attitudes toward creating screencasts, with perceived usefulness for future applications exerting the strongest influence on acceptance, followed by perceived performance benefits and ease of use. It is also found that gender, discipline, and study mode did not significantly alter these relationships, although senior students perceived screencast production as more effortful. These findings suggest that student-created screencasts can serve as an effective, student-centered alternative to traditional written assessments. The research results imply that student-created screencasts have the potential to help students develop their skills in an increasingly GenAI-pervasive academic environment. Full article

Background and Objectives: Unplanned return to the operating room (URTOR) is a sensitive indicator of surgical quality; however, data in neurosurgery are limited. This retrospective study analyzed patients who underwent URTOR following neurosurgical procedures over an eight-year period to define early and late patterns, identify underlying causes, and evaluate the distribution of cases according to surgeon experience. Materials and Methods: Records of 18,258 consecutive surgeries including both elective and emergency procedures in adult and pediatric patients, performed at a single center between 2010 and 2018 were retrospectively reviewed. Unplanned reoperations within 30 days of the index surgery were defined as URTOR; those occurring within ≤7 days were classified as “early,” and those occurring between 8 and 30 days were classified as “late.” Demographic data, surgical characteristics, causes of URTOR, and surgeons’ seniority were examined. Results: Among 18,258 neurosurgical procedures, 324 URTORs (1.8%) were identified. The median patient age was 38 years; 37% were children. Early URTOR comprised 59% and was primarily associated with hemorrhagic–vascular complications, whereas late URTOR accounted for 41% and was dominated by cerebrospinal fluid-related and infectious complications. Late events prevailed in significantly younger cases and were disproportionately followed by ventriculo–peritoneal shunt or endoscopic third ventriculostomy index operations. Junior surgeons performed 74% of later operations requiring URTOR versus 30% of early failures. Sex, weekday/weekend timing, and surgeons’ experience did not affect the overall URTOR classification categories. The median interval was six days. Conclusions: Centers worldwide have begun to examine URTOR rates, which are directly associated with hospital quality measurements. These results may inform targeted education and prevention by identifying patient groups at higher reoperation risk within a specific timeframe. Full article

Background/Objectives: Loneliness and social isolation are common among older adults and linked to adverse health outcomes. Videoconferencing can support social connections, but the role of aging-in-place organizations (AIPOs), such as senior centers and Area Agencies on Aging, in facilitating adoption is poorly understood. This review examined how AIPOs use relational videoconferencing to promote social engagement among older adults. Methods: We applied a hybrid methodology combining a scoping review with latent topic modeling to contextualize and analyze the evidence base. Exploratory searches revealed limited literature specifically addressing AIPO involvement; therefore, we first conducted latent topic modeling of the broader literature on social videoconferencing among older adults to establish a thematic foundation for the subsequent PRISMA-guided scoping review. Thematic analysis of this broader corpus, identified through 2021 database searches, applied Latent Dirichlet Allocation (LDA) to a collection of peer-reviewed articles. Subsequent refinement of this corpus by removing non-primary research and non-AIPO records produced the narrower PRISMA subset used for the scoping review. The scoping review followed JBI guidelines and was based on database searches (EBSCOhost: MEDLINE, AgeLine, SocINDEX, Health Source: Nursing/Academic Edition, and Family & Society Studies Worldwide; ProQuest Social Science Premium Collection; and PubMed, including MEDLINE, PMC, and in-process content) for peer-reviewed studies published between 2011 and 2025. Inclusion criteria required primary research involving adults aged 65 years or older, use of videoconferencing technology for social engagement, and reference to AIPOs or analogous community-based aging services. The protocol was post-registered with the Open Science Framework. Results: The LDA analysis of 101 peer-reviewed articles identified six latent themes describing the broader research landscape: problem of isolation, character of socialization, physical health, technology as intervention, technology as social medium, and supportive environments. This thematic framework informed the scoping review, which screened 1908 records and retained 25 publications (representing 24 unique studies) explicitly referencing AIPO involvement in relational videoconferencing. Only one study predated COVID-19. Mapping these studies to the LDA-derived themes revealed the least consistent coverage to be in supportive environments and physical health, particularly among AIPOs other than senior or community centers. Conclusions: Relational videoconferencing has potential to sustain and expand older adults’ social connections, but evidence mapped through the scoping review shows that documentation of how AIPOs support adoption is sparse. The hybrid approach advances understanding of videoconferencing in aging contexts and identifies priorities for documenting, comparing, and refining AIPO practices to inform future interventions and policy. Full article

Background/objective: Online platforms for sharing prescription drug experiences are becoming increasingly available, yet their validity as measures of patient satisfaction remains unclear. This study aimed to evaluate the potential of an online drug review system, WePharm, as a proxy for treatment satisfaction among older adults taking antihypertensive medications. Methods: A cross-sectional survey using a convenience sample was conducted from February to July 2018 among patients aged 50–80 years recruited from four senior welfare centers and one community pharmacy in Seoul. Participants completed both an online review via WePharm and a paper-based Treatment Satisfaction Questionnaire for Medication (TSQM). Satisfaction attributes included drug efficacy, side effects, convenience, affordability, and willingness to recommend. Pearson correlation coefficients and ANOVA were used to examine concordance and associated factors. Results: A total of 313 participants were included. Online review scores were significantly correlated with TSQM scores across all domains as follows: effectiveness (r = 0.451), side effects (r = 0.363), convenience (r = 0.285), and overall satisfaction (r = 0.256), all p < 0.0001. Key factors associated with satisfaction included region, stage of hypertension, income, duration of antihypertensive use, and comorbidity count. Conclusions: Online patient medication reviews, as implemented in WePharm, demonstrated moderate correlation with validated treatment satisfaction measures. These findings support the potential utility of online drug review systems as complementary tools for capturing real-world patient experience and informing shared decision-making in clinical practice, and as these findings were from a convenience sample, further research is expected with the aim of improving generalizability. Full article

Objectives: The present study was conducted to examine the effects of a one-year multicomponent exercise training (MCET) program on the physical function and cardiovascular risk factors of community-dwelling older adults at risk of sarcopenic obesity. Methods: Data of 78 Brazilian community-dwelling older adults at risk of sarcopenic obesity, identified as the simultaneous presence of probable sarcopenia and overweight, were examined. The MCET program was performed twice a week over one year. Physical performance evaluations included (i) a timed “up-and-go” (TUG), (ii) one-leg stand, (iii) walking speed (WS) at normal pace and fast pace, (iv) a 5-time sit-to-stand (5STS) test, and (v) isometric handgrip strength (IHG). Cardiovascular risk factors involved blood pressure (BP) values and waist-to-hip ratio. Results: Significant improvements in balance and WS at a normal pace were observed following the MCET program, while no changes were noted in other physical performance markers. Additionally, a significant reduction in diastolic BP was recorded. Conclusions: Findings indicated significant improvements in mobility and balance, as well as a notable reduction in diastolic BP, among community-dwelling older adults at risk of sarcopenic obesity following a one-year MCET program. These improvements may play a critical role in reducing the risk of adverse outcomes such as falls, disability, cardiovascular events, hospitalization, and mortality. However, the quasi-experimental design of the present study, the absence of a control group, and other methodological limitations restrict the generalizability of the results. Future research using more rigorous study designs is necessary to confirm and expand upon these findings. Full article

Background: Intraoperative neurophysiological monitoring (IONM) has become an invaluable tool for spinal deformity surgery. This study aims to present our experience of using transcranial motor evoked potential (Tc-MEP) as an IONM tool in adolescent idiopathic scoliosis patients undergoing navigation-assisted deformity correction and explore the potential risk factors associated with false-positive and true-positive IONM findings. Methods: A retrospective study was conducted in 103 patients (mean age 16.2 ± 4.0 years) undergoing corrective surgery for spinal deformity. All pediatric spinal deformity correction surgeries at the center were performed by a single senior spine surgeon, utilizing navigation and Tc-MEP to enhance the neurological safety profile. The sensitivity and the specificity of Tc-MEP were calculated. Results: Of the total cases, 87 patients (84.5%) exhibited no IONM signal alert and did not experience any postoperative neurological deficits, representing true negatives. There were no false-negative cases, which gives a negative predictive value of 100%. Significant IONM signal alerts were observed in 16 patients (15.5%), but only two patients (1.9%) experienced a postoperative motor deficit, representing true positives, which yielded a positive predictive value of 12.5%. Conclusions: This study demonstrated the sensitivity and specificity of Tc-MEP to be 100% and 86.3%, respectively, with a false-positive rate of 13.7%. Blood loss was the only factor significantly associated with IONM alerts, while age, gender, surgical duration, and anesthetic modality showed no significant differences. Full article

Objectives: We aimed to investigate whether AI assistance could improve the performance of pneumothorax detection on chest radiographs (CXR) by readers with varying experience from radiologists to the frontline healthcare providers, and whether AI assistance could diminish the potential confounders for readers’ detecting pneumothorax. Methods: In this retrospective, single-center, blinded, multi-reader diagnostic accuracy study, 125 CXRs were prepared from radiological information system (March 2024 to August 2024) for test. The 18 readers were composed of six groups, each had 3 persons: board-certified radiologists (Group-1), senior radiology residents (Group-2), junior radiology residents (Group-3), postgraduate year residents (Group-4), senior radiographers (Group-5), and junior radiographers (Group-6). They read the CXR independently twice, without and with AI assistance, at an interval of one month. We used receiver operating characteristic curve for performance analysis and generalized estimating equation (GEE) model for confounding factor analysis. Results: AI software alone achieved a high area under curve of 0.965 (95% CI: 0.926, 0.995). With AI assistance, the performance in all groups significantly improved (p < 0.01) especially the junior readers (the frontline healthcare providers, Group-3, 4, 6) and diminished the difference among all groups except some related to Group-1. GEE model showed that AI assistance, reader’s experience, and projection type interfere with the readers’ performance (all p < 0.05). Conclusions: AI assistance could improve the performance of pneumothorax detection by varying experience of readers, especially the frontline healthcare providers. The influence of confounders, such as reader’s experience, also be diminished by AI assistance. Full article

Artificial intelligence (AI) is increasingly embedded within organizational infrastructures, yet the foundational role of data in shaping AI outcomes remains underexplored. This study positions data at the center of complexity, uncertainty, and strategic decision-making in AI development, aligning with the emerging paradigm of data-centric AI (DCAI). Based on in-depth interviews with 74 senior AI and data professionals, the research examines how experts conceptualize and operationalize data throughout the AI lifecycle. A thematic analysis reveals five interconnected domains reflecting sociotechnical and organizational challenges—such as data quality, governance, contextualization, and alignment with business objectives. The study proposes a conceptual model depicting data as a dynamic infrastructure underpinning all AI phases, from collection to deployment and monitoring. Findings indicate that data-related issues, more than model sophistication, are the primary bottlenecks undermining system reliability, fairness, and accountability. Practically, this research advocates for increased investment in the development of intelligent systems designed to ensure high-quality data management. Theoretically, it reframes data as a site of labor and negotiation, challenging dominant model-centric narratives. By integrating empirical insights with normative concerns, this study contributes to the design of more trustworthy and ethically grounded AI systems within the DCAI framework. Full article