Search Results (34)

Background: For high-grade dislocation of the acromioclavicular (AC) joint, surgical treatment is widely recommended. This study aimed to evaluate the clinical and radiological outcomes after arthroscopic-assisted stabilization of acute high-grade AC joint dislocations using a low-profile suture button (LPSB) combined with percutaneous AC cerclage fixation. A secondary objective was to quantify clavicular tunnel widening (cTW) and explore its correlation with clinical and radiological outcomes. Methods: This retrospective study included 45 patients with acute Rockwood type V injuries treated with the LPSB technique and additional AC cerclage. Clinical outcomes were the Constant Score (CS), Subjective Shoulder Value (SSV), Taft Score (TF), AC Joint Instability Score (ACJI), and VAS for pain upon palpation. Radiological assessment included coracoclavicular (CC) distance and percentage deviations compared to the contralateral side, reclassified according to Rockwood, dynamic posterior translation (DPT), cTW measurements, and assessment of ossifications and AC joint osteoarthritis. Results: After 35.3 months, significant improvements were observed in CC distance and percentage deviation. A total of 27.3% were reclassified as Rockwood type III and 2.3% as type V. Initial overreduction persisted in 18.2%. DPT was observed in 34.1% of cases. The mean CS was 89.64, the SSV was 91.1, and the VAS was 0.8. cTW occurred only below the superior button and increased significantly over time, showing a negative correlation with the SSV but no correlation with any radiological outcome parameter. No implant-related revision surgery was reported. Conclusions: Arthroscopic-assisted stabilization of acute high-grade AC joint dislocations using the LPSB technique with AC cerclage fixation provides excellent clinical outcomes and high patient satisfaction, with minimal implant-related complications and no need for revision surgery due to implant issues. Although cTW occurs, its clinical impact appears limited within this procedure. Full article

Written language is a common component among the multimodal representations that help players construct meanings and guide actions in video games. However, how players process texts in video games remains underexplored. To address this, the current exploratory eye-tracking study examines how players processed subtitled instructions and resultant game performance. Sixty-four participants were recruited to play a videogame set in a foggy desert, where they were guided by subtitled instructions to locate, corral, and contain robot agents (targets). These instructions were manipulated into three modalities: visual-only (with subtitled instructions only), auditory only (with spoken instructions), and visual–auditory (with both subtitled and spoken instructions). The instructions were addressed to participants (as relevant subtitles) or their AI teammates (as irrelevant subtitles). Subtitle-level results of eye movements showed that participants primarily focused on the relevant subtitles, as evidenced by more fixations and higher dwell time percentages. Moreover, the word-level results indicate that participants showed lower skipping rates, more fixations, and higher dwell time percentages on words loaded with immediate action-related information, especially in the absence of audio. No significant differences were found in player performance across conditions. The findings of this study contribute to a better understanding of subtitle processing in video games and, more broadly, text processing in multimedia contexts. Implications for future research on digital literacy and computer-mediated text processing are discussed. Full article

Background/Objectives: The aim of our study was to document and analyze the long-term geometric alterations that occur in the infrarenal aorta and iliac arteries over time after a successful elective standard endovascular abdominal aneurysm repair (EVAR) as well as to investigate the potential relationship of aortoiliac remodeling with the long-term complications of EVAR. Methods: The prospectively collected clinical and computed tomography angiography (CTA) data from 168 patients treated with elective standard EVAR between 2013 and 2018 were retrospectively analyzed. Follow-up assessments were performed at 1, 24, and 60 months postoperatively. Primary anatomical variables included 11 measurements: total right and left aortoiliac lengths, infrarenal aortic length, right and left aortoiliac angles on the frontal CTA plane, right and left intra-iliac angles, inter-iliac angle, infrarenal aortic body angle on the sagittal CTA plane, and right and left aortoiliac angles on the sagittal CTA plane. Secondary variables were the mean percentage changes in anatomical measurements between the follow-up time intervals. The primary clinical endpoint was the occurrence of any complication related (ARC) to the index EVAR or reinterventions. Secondary endpoints included any graft migration (AM) observed in proximal aortic or distal iliac sealing zones, and failure of aneurysm sac regression (FSR) or an increase in sac diameter by >5 mm. Six different bifurcated endografts were used. For subgroup analysis, the primary differentiating feature among grafts was the presence or absence of suprarenal fixation with hooks. Results: Median follow-up was 77 months, with an interquartile range (IQR) of 24.0 months. Observed EVAR-related mortality was 2.4%. Twenty-seven (16.1%) ARC events occurred, and migration was detected in 21 (12.5%) patients, combined with endoleak in 20 of them. The incidence of FSR was 43.5%, and approximately a third of ARCs and AMs occurred after the 60th month of follow-up. Across all measured lengths and the inter-iliac angle on the frontal CTA plane, a significant increase was observed, while all other angles demonstrated a significant decrease over time. The pattern of aortoiliac remodeling followed a linear progression for the first 24 months, transitioning to either a quadratic or cubic trend by the 60-month mark. Linear regression analysis revealed that an excessive increase in length variables was significantly associated with lower AAA sac regression rates. Furthermore, multivariate analysis identified that suprarenal fixation with hooks was the only factor associated with a reduced likelihood of AMs and a five-fold decrease in FSRs. Conclusions: Despite a fully successful EVAR, significant aortoiliac geometrical remodeling is evident over time. Extensive remodeling of aortoiliac lengths appears to be associated with lower rates of AAA sac regression. Suprarenal proximal aortic fixation with hooks may serve as a protective mechanism, reducing the likelihood of long-term complications. Life-long follow-up remains an essential measure for early detection of long-term EVAR failures. Full article

Background: Optimal treatment for high-grade acromioclavicular (AC) joint dislocations is still not unanimous. Improving horizontal AC stability has been emphasized in recent years. Biomechanical studies and computer simulations have demonstrated that adequate horizontal stability could be restored with an additional AC fixation. We aim to prospectively investigate if AC augmentation leads to better clinical and radiological results. Methods: A total of 70 patients with a mean (± SD) age of 42 ± 11 years with acute AC joint dislocation Rockwood type IIIb and V were prospectively randomized into two equal groups. All patients underwent arthroscopically assisted stabilization using a double coracoclavicular (CC) suspensory system. Group N (No-augmentation group) had no additional fixation across the AC joint, while group T (tape-augmentation group) had additional fixation with tape. Patients were evaluated at 3, 6, and 12 months postoperatively. Primary clinical outcome measures included the Constant–Murley score and the Specific AC Score (SACS). Secondary outcome measures included the Subjective Shoulder Value (SSV), the Simple Shoulder Test (SST), the Disabilities of the Arm, Shoulder, and Hand (DASH) outcome measure, and the AC Joint Instability (ACJI) Score. Horizontal stability was radiologically measured with overlapping length (OL) and overlapping area (OA). Vertical alignment was measured with the CC distance. All radiological measurements were compared to the uninjured side and expressed in percentages as relative values. Results: There were no significant differences found between groups regarding the Constant score (p = 0.664), SACS (p = 0.518), or any other outcome measure at the one-year follow-up. Pain level (p = 0.635) and strength (p = 0.217) at the one-year mark also showed no significant differences. Clinical drawer testing for residual horizontal instability was non-significant (p = 0.061), but showed a tendency for a more stable AC joint in group T. The CC distance was smaller in group T at 6 and 12 months (p = 0.047 and p = 0.046, respectively). A two-way mixed factorial ANOVA test showed significantly lower CC differences for group T (p = 0.032); however, the gradual increase in CC distance was similar for both groups over time (p = 0.869). No significant differences were found in OL (p = 0.619) or OA (p = 0.236). Conclusions: The results of our study show that both CC stabilization with the double suspensory system alone and with additional AC fixation are effective surgical treatment options for acute AC joint dislocations, without any important clinical differences. CC distance similarly increased over one year in both groups but was better retained in the AC-augmented group, which showed a tendency toward a more stable fixation. Full article

Background: This study aims to evaluate how surgical timing and the radiological characteristics of fragment blocks can affect the effectiveness of ligamentotaxis, in restoring the spinal canal area, and local kyphosis in adults with traumatic thoracolumbar A3 burst fractures without neurological impairment treated with percutaneous short-segment fixation. Methods: A retrospective observational study was conducted between January 2016 and December 2022 on neurologically intact adult patients with a single A3 thoracolumbar fracture. Data collected included demographics, injury mechanism, fracture level, and clinical and surgical details. Radiological assessments included spinal canal area, local kyphotic angle, anterior and posterior vertebral heights, and fragment block measurements. Results: Out of 101 treated patients, 9 met the criteria with a mean age of 52.22 years. Most fractures were at L1 (88.89%). All patients had moderate-to-severe pain (NRS 6.22 ± 1.09) at baseline. Five patients (55.55%) underwent surgery within 72 h, with a mean surgical time of 109.22 min. SCA and LKA values improved significantly in all patients post-surgery. Early surgical intervention (<72 h) correlated with greater improvements in spinal canal area (p = 0.016) and local kyphotic angle (p = 0.004). A significant association was found between spinal canal area improvement and the percentage ratio of fragment height to “normal” vertebral height (rho = 0.682; p = 0.043). Conclusions: Early (<72 h) short-segment percutaneous fixation is recommended for adults with high functional demands and moderate-to-severe axial pain due to single traumatic A3N0M0 thoracolumbar fracture. This “upfront” approach is associated with enhanced indirect decompression and better local kyphotic angle restoration. Considering the fragment morphology could also be important in surgical planning. Full article

Implementing greener approaches is a sustainable and eco-friendly methodology for nanocomposite synthesis. This work reports the sustainable fabrication of Fe-doped ZnS (Fe_0.3Zn_0.7S) nanocomposite and its broad-spectrum applications. The systematic characterization was carried out using several advanced analytical techniques. DLS, Zeta potential, SEM, XPS, and TEM performed morphological and size assessments of the engineered nanocomposite. Eventually, XRD provided valuable insights into the crystalline behavior of nanocomposite. The nanocomposites were then treated against the organic dye Safranin O, which displayed 93% degradation within an hour with the rate constant value of 0.0326 min⁻¹. Parameters influencing the percentage degradation, such as temperature, pH, etc., were also discussed. Moreover, an LCMS test was also conducted to evaluate the presence of reactive intermediates. Safranin O’s degradation was confirmed by identifying intermediate products, such as compounds with m/z values of 335.84, 321.81, 306.79, 292.77, and 257.32, which were indicative of progressive dye breakdown. Finally, the photocatalytic enactment examination verified that the prepared nanocomposite’s nitrogen fixation rate (38.96 µmolg⁻¹) was way greater (~4 times) than the pristine compound. In addition, prepared nanoparticles demonstrated a befitting ability to eliminate a wide range of threatening pathogenic fungi. The doping of Fe into ZnS further enhanced the inhibition against Fusarium oxysporum. Full article

Objectives: This study aimed to describe the outcomes of a staged procedure combining Descemet membrane endothelial keratoplasty (DMEK) and sutureless scleral fixation (SSF) of a one-piece intraocular lens (IOL) in a case series. Co-performing endothelial keratoplasty (EK) and SSF is associated with intraoperative and postoperative complications such as graft deployment difficulties, air migration, graft detachment, and IOL opacification or tilt, all of which are evaluated in this study. Methods: This is a retrospective observational case series. Clinical data were collected from eight eyes of eight patients who underwent DMEK for endothelial failure and had previously received an SSF with one-piece IOL following complete vitrectomy. During DMEK surgery, an air leak test was conducted to check for air migration into the posterior chamber. If instability was detected, pupilloplasty was performed. Intraoperative and postoperative data, including DMEK graft unfolding time, were collected. Corrected Distance Visual Acuity (CDVA), refraction, endothelial cell density (ECD), central corneal thickness (CCT), intraocular pressure (IOP), and complications were recorded over a 12-month follow-up period. Results: We performed pupilloplasty in four patients (50%). The median CDVA improved from preoperative 0.85 logMAR (range: 0.60 to 1.00) at baseline to 0.18 logMAR (range: 0.10 to 0.70, p = 0.012) at 12 months. The median refraction value changed significantly from −1.00 to −0.50 at 12 months. The median percentage reduction in ECD after 12 months was 33.4% (range 30 to 40). The median baseline CCT was 689 μm (range: 651 to 701) at baseline visit and 541.5 μm (range: 525 to 591, p = 0.008) at 12 months. The median IOP was reduced significantly during follow-up. The median graft unfolding time was 6 min (5 to 9). One patient required rebubbling for partial detachment on postoperative day one. No complications occurred within 12 months. Conclusions: The effective compartmentalization of the anterior and posterior chambers in vitrectomized eyes with an SSF one-piece IOL and pupilloplasty can facilitate critical steps of DMEK surgery in complex eyes. Additionally, the air leak test could prove useful in identifying the need for iris-lens diaphragm reconstruction. Full article

Modern mental fatigue detection methods include many parameters for evaluation. For example, many researchers use human subjective evaluation or driving parameters to assess this human condition. Development of a method for detecting the functional state of mental fatigue is an extremely important task. Despite the fact that human operator support systems are becoming more and more widespread, at the moment there is no open-source solution that can monitor this human state based on eye movement monitoring in real time and with high accuracy. Such a method allows the prevention of a large number of potential hazardous situations and accidents in critical industries (nuclear stations, transport systems, and air traffic control). This paper describes the developed method for mental fatigue detection based on human eye movements. We based our research on a developed earlier dataset that included captured eye-tracking data of human operators that implemented different tasks during the day. In the scope of the developed method, we propose a technique for the determination of the most relevant gaze characteristics for mental fatigue state detection. The developed method includes the following machine learning techniques for human state classification: random forest, decision tree, and multilayered perceptron. The experimental results showed that the most relevant characteristics are as follows: average velocity within the fixation area; average curvature of the gaze trajectory; minimum curvature of the gaze trajectory; minimum saccade length; percentage of fixations shorter than 150 ms; and proportion of time spent in fixations shorter than 150 milliseconds. The processing of eye movement data using the proposed method is performed in real time, with the maximum accuracy (0.85) and F1-score (0.80) reached using the random forest method. Full article

A scientific method for evaluating the design of interfaces is proposed to address the unique characteristics and user needs of infrequent-contact public service interfaces. This method is significant for enhancing service efficiency and promoting the sustainable development of public services. Current interface evaluation methods are limited in scope and often fail to meet actual user needs. To address this, this study focuses on virtual museums, examining users’ aesthetic psychology and cognitive behavior in terms of layout aesthetics and visual cognitive characteristics, aiming to explore the relationship between the two. Interface layout aesthetic values and user visual cognitive measurements were obtained by using computational aesthetics methods and eye-tracking experiments. These served as input data for a new model. An improved gray H-convex correlation model utilizing the ICRITIC method is proposed to examine the mapping relationship between interface layout aesthetics and visual cognitive features. The results demonstrate that our new model achieves over 90% accuracy, outperforming existing models. For virtual museum interfaces, symmetry and dominance significantly influence user visual cognition, with the most notable correlations found between density and gaze shift frequency, simplicity and mean pupil diameter, and order and gaze shift frequency. Additionally, fixation duration, fixation count, and mean pupil diameter were inversely correlated with interface layout aesthetics, whereas gaze shift frequency and gaze time percentage were positively correlated. Full article

Workload (WL) measurement is a crucial foundation for human–machine collaboration, particularly in high-stress multitasking environments such as manned vehicle operations during emergencies, where operators often experience High Workload (HWL) levels, increasing the risk of human error. To address this challenge, this study introduces a novel WL measurement method that combines Task Demand Load (TDL) and Subject Load Capacity (SLC) to quantitatively assess operator workload. This method was validated through experiments with 45 subjects using the Environmental Control and Atmospheric Regeneration (ECAR) system. The statistical results showed that as the designed WL levels increased, the Average Workload (AWL), the NASA-TLX score, and the work time percentage increased significantly, while the task accuracy and the fixation duration decreased significantly. These results also revealed the impact of WL levels on human responses (such as subjective feeling, work performance, and eye movement). In addition, very strong correlations were found between AWL measurements and NASA-TLX scores (r = 0.75, p < 0.01), task accuracy (r = −0.73, p < 0.01), and work time percentage (r = 0.97, p < 0.01). Overall, these results proved the effectiveness of the proposed method for measuring WL. On this basis, this study defined WL thresholds by integrating task accuracy with AWL calculations, providing a framework for the dynamic management of task allocation between humans and machines to maintain operators within optimal WL ranges. Full article

Infection is an uncommon side effect of arthroscopic surgery, and this percentage is higher in anterior cruciate ligament reconstruction (ACLR) surgery, where graft and fixation devices are used. Infections can not only lead to high re-admission rates and poor functional recovery of the knee but can also have a significant negative impact on the patient’s psychological and economic health, especially in athletes, as it can affect their sports career. It is important to be aware of the many risk factors, especially the manifestation of symptoms. These may sometimes be non-specific to the infectious pathology and common to other situations, such as the presence of a significant intra-articular hematoma. Septic arthritis after ACLR can occur at any time after surgery but typically presents acutely, while late manifestation is relatively rare. Diagnosis of infection is based on patient history, physical examination, laboratory parameters, and analysis of synovial fluid after joint aspiration, which is the gold standard for diagnosing post-operative infection. Once symptoms appear and the diagnosis seems certain, it is necessary to intervene quickly with arthroscopic debridement and long-term antibiotic treatment to try to save the graft and resolve the infectious situation to avoid graft failure and arthrofibrotic sequelae. The aim of this paper is to provide an overview of the epidemiology, pathogenesis, risk factors, clinical presentation, diagnostic evaluation, and current treatment guidelines of septic arthritis after ACLR surgery by analyzing recent literature, in particular meta-analyses and systematic reviews. Full article

This study examined the impact of using three types of in-store signage to educate consumers about packaging recyclability as well as to measure its effectiveness in increasing awareness of a store drop-off recycling method for packaged granola. A total of 67 shoppers were recruited and divided into two groups to shop for granola in a retail store. Group A was not exposed to signage near the granola, while Group B was exposed to the in-store signage comprising shelf strips and aisle invaders with How2Recycle educational information containing messaging about the store drop-off recycling. A store drop-off bin was positioned at the entrance of the testing environment for both groups. The results showed that Group B had a significantly higher total fixation duration (p = 0.02) and fixation count (p = 0.03) than Group A in response to the recycling instructions on the drop-off bin. When comparing the three methods of in-store signage—shelf strips, aisle invaders, and the printed store drop-off bin panels—the shelf strips performed the best with regard to total fixation duration (1.72 s) and fixation count (5.91 counts) and were noticed by the highest percentage of shoppers. The store drop-off bin panels had the best performance with regard to time to first fixation (0.12 s). The aisle invaders had the lowest performance in all three eye tracking key metrics and were noticed by the lowest percentage of participants. These responses illustrate shopper challenges related to plastic recycling. This study demonstrates that recycling information can be effectively provided through strategically positioned in-store signage, especially messaging on shelf strips. While consumers are open to the usage of Store Drop-off Bins, affirming customer knowledge of these processes is essential to develop new consumer recycling habits. Full article

(1) Background: Transvenous lead extraction (TLE) can become far more complex when unanticipated difficulties arise. The aim was to develop a simple scoring system that allows for the prediction of the difficulty and complexity of this significant procedure. (2) Methods: Based on analysis of 3741 TLE procedures with and without complicating factors (extended fluoroscopy time, need for second-line instruments, and advanced techniques and instruments), a five-point Complex Indicator of Difficulty of (TLE) Procedure (CID-TLEP) scale was developed. Two or more points on the CID-TLEP scale indicate a higher level of procedure complexity. (3) Results: Patient age below 51 years at first CIED implantation, number of abandoned leads, number of previous procedures, passive fixation and multiple leads to be extracted, and a ratio of dwell time of oldest lead to patient age during TLE of >0.13 are significant predictors of higher levels of lead extraction complexity. The ROC analysis demonstrates that a point total (being the sum of the odds ratios of the above variables) of >9.697 indicates a 21.83% higher probability of complex TLE (sensitivity 74.08%, specificity 74.46%). Finally, a logistic function was calculated, and we constructed a simple equation for lead extraction complexity that can predict the probability of a difficult procedure. The risk of complex extraction (as a percentage) is calculated as [1/(1 + 55.34 · 0.754^X)] · 100 (p < 0.001). (4) Conclusion: The LECOM score can effectively predict the risk of a difficult transvenous lead extraction procedure, and predicting the probability of a more complex procedure may help clinicians in planning lead removal and improving patient management. Full article

This study investigates the feasibility of using biodegradable secondary alcohol ethoxylate (SAE) non-ionic surfactant as a building block for the formation of reverse micelles, functioning as reactive dye carriers for the dyeing of cotton fabric in non-aqueous octane medium. Ten dyeing parameters were optimised, by a one-factor-at-a-time approach, namely: (i) effect of colour fixation agent; (ii) surfactant-to-water mole ratio; (iii) surfactant-to-co-surfactant mole ratio; (iv) volume of soda ash; (v) volume of dye; (vi) solvent-to-cotton ratio; (vii) dyeing temperature; (viii) dyeing time; (ix) fixation time; (x) soda-ash-to-cotton ratio. The colour properties, fastness properties and physical properties of SAE-dyed samples were experimentally compared with the conventional water-dyed samples. The optimised condition was found when SAE samples were dyed as follows: (a) 1:20 surfactant-to-water ratio; (b) 1:8 surfactant-to-co-surfactant ratio; (c) 10:1 solvent ratio; (d) 40 min dyeing time; (e) 60 min fixation time; and (f) 70 °C dyeing and fixation temperature. The results showed that SAE-dyed samples have better colour strength, lower reflectance percentage and comparable levelness, fastness and physical properties than that of water-dyed samples. SEM images revealed that the dyed cotton fibres had no severe surface damage caused by an SAE-based reverse micellar dyeing system. The TEM image depicts that the reverse micelle was of nanoscale, spherical-shaped and had a core–shell structure, validating the presence of reverse micelle as a reactive dye carrier and the potential of an SAE-based reverse micellar system for dyeing of cotton fabrics. Full article

The present study demonstrates the synthesis and application of Ag/ZnO powder films (thickness of 4 μm) as photocatalysts for natural sunlight and ultraviolet (UV, 315–400 nm) irradiation. The synthesis procedure is simple and eco-friendly, based on the photo-fixation of silver ions onto commercial ZnO powder via UV illumination for the first time. The photocatalytic efficiency of the newly developed films is evaluated through degradation of paracetamol in distilled and drinking water. Our experimental evidences show that the Ag/ZnO nanostructure films are more active than pristine ZnO films in the photodegradation process. Namely, the photocatalytic efficiency of the films modified with 10⁻² M concentration of silver ions achieve the highest degradation (D) percentages for paracetamol in both types of water (D_distilled = 80.97%, D_drinking = 82.5%) under natural sunlight. Under UV exposure, the degradation percentages are slightly lower but still higher than those achieved by pure ZnO films (D_distilled = 53.13%, D_drinking = 61.87%). It is found that the photocatalytic activity grows in direct proportion to the concentration of Ag⁺ ions: ZnO < Ag 10⁻⁴/ZnO < Ag 10⁻³/ZnO < Ag 10⁻²/ZnO. Scanning electron microscopy, X-ray diffraction, X-ray photoelectron spectroscopy, UV–vis diffuse reflectance and photoluminescence spectroscopy are used to characterize the as-prepared ZnO and Ag/ZnO nanostructures. The improved photocatalytic performance of the Ag/ZnO films is mostly attributed to the combination of excited electron transfer from ZnO to Ag and the inhibition of photogenerated electron–hole pair recombination. Furthermore, Ag/ZnO nanostructure films can retain their photocatalytic activity after three cycles of use, highlighting their potential practical application for the treatment of pharmaceutical wastewater in real-world scenarios where natural sunlight is often more readily available than artificial UV light. Full article