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Dysphagia refers to swallowing difficulty, which impacts patients’ quality of life. Dysphagia influences clinical outcomes, including mortality rates and length of hospital stay of older hospitalized patients. Dysphagia may affect the current and future quality of life of these patients. However, its exact impact remains unclear. We aimed to clarify the impact of dysphagia on discharge to home in older patients in a rural rehabilitation unit. We conducted a secondary analysis using data from a retrospective cohort study including patients aged over 65 years who had been discharged from a community hospital rehabilitation unit in rural Japan. Data from the participants had been previously collected from April 2016 to March 2020. The primary outcome was home discharge. The average participant age was 82.1 (standard deviation, 10.8) years; 34.5% were men. Among medical conditions, brain stroke (44.3%) was the most frequent reason for admission; the most frequent orthopedic condition was femoral fracture (42.9%). The presence of dysphagia (odds ratio [OR] = 0.38, 95% confidence interval [CI]: 0.20–0.73), polypharmacy (OR = 0.5, 95% CI: 0.32–0.90), and admission for internal medicine diseases (OR = 0.44, 95% CI: 0.26–0.77) were negatively associated with home discharge. High motor domain scores of the Functional Independence Measure were positively associated with home discharge (OR = 1.07, 95% CI: 1.05–1.08). Dysphagia was negatively associated with home discharge as were polypharmacy and admission for internal medicine diseases and conditions. By clarifying effective interventions through interventional studies, including approaches to managing multimorbidity and polypharmacy through interprofessional collaboration, the health conditions of older patients in rural areas may be improved.

There have been significant advances in vehicle safety and road construction in all over the world and driver misbehaviours are still shown as one of the most important reasons of traffic accidents. When the current traffic accidents are examined, the negative effect of lane line quality and level of visibility related on the accidents comes to the forefront in underdeveloped and developing countries. In this study, the effect of lane line visibility level on drivers' lane utilization was investigated in detail. For this aim, a total of 17 different points in Türkiye were selected and the lateral positions of the vehicles on the road surface at these points were determined with the help of the screen scaling technique. In order to determine the level of lane line quality for an expert group and driver perspective, a face-to-face survey was conducted. From the analysis results, the lane line quality was determined low in urban and intercity roads, and the average maximum evaluation score was determined as 4.7 and the lowest score was determined as 1.42 where the best line quality was 5. This result showed that the level of lane line quality had significant differences at different points. Although, it was observed that the lateral position distributions in the examined points fit the normal distribution, the distribution of both the right/left wheels and their gravity center skewed to the right or left and deviated from the ideal conditions on road surfaces. It showed that the vehicles do not center the lanes exactly, but usually move close to the right or left edge of the lane. This situation also clearly revealed that the lane utilization disciplines of drivers are quite weak with the effect of the low lane line quality on road surfaces.

In this paper, a variety of 2D materials on the surface plasmon resonance sensor based on Al–Ni bimetallic layer are compared. Simulation results indicate that lateral position shift, which is calculated according to the real and imaginary parts of the refractive index of material, can be used as an effective parameter to optimize the sensitivity. By using the parameters for optimizing the SPR structures, the results show that the multiple layer models of Al(40 nm)–Ni(22 nm)–black phosphorus (BP)(1 L) and Al(40 nm)–Ni(22 nm)–blue phosphorus (BlueP)/WS2(1 L) exhibit average angular sensitivities of 507.0 °/RIU and 466 °/RIU in the refractive index range of 1.330–1.335, and maximum sensitivity of 542 °/RIU and 489 °/RIU at the refractive index of 1.333, respectively. We expect more applications can be explored based on the highly sensitive SPR sensor in different fields of optical sensing.

Study designRetrospective Case Series.ObjectivesThis study aims to determine complications, readmission, and revision surgery rates in patients undergoing single position surgery (SPS) for surgical treatment of traumatic and pathologic thoracolumbar fractures.MethodsA multi-center review of patients who underwent SPS in the lateral decubitus position (LSPS) for surgical management of traumatic or pathologic thoracolumbar fractures between January 2016 and May 2020 was conducted. Operative time, estimated blood loss (EBL), intraoperative complications, postoperative complications, readmissions, and revision surgeries were collected.ResultsA total of 12 patients with a mean age of 45 years (66.67% male) were included. The majority of patients underwent operative treatment for acute thoracolumbar trauma (66.67%) with a mean injury severity score (ISS) of 16.71. Mean operative time was 175.5 min, mean EBL of 816.67 cc. Five patients experienced a complication, two of which required revision surgery for additional decompression during the initial admission. All ambulatory patients were mobilized on postoperative day 1. The mean hospital length of stay (LOS) was 9.67 days.ConclusionThe results of this case series supports LSPS as a feasible alternative to the traditional combined anterior–posterior approach for surgical treatment of pathologic and thoracolumbar fractures. These results are similar to reductions in operative time, EBL, and LOS seen in the elective spine literature with LSPS.Level of EvidenceIV.

Performance decrement associated with sleep deprivation is a leading contributor to traffic accidents and fatalities. While current research has focused on eye blink parameters as physiological indicators of driver drowsiness, little is understood of how gaze behaviour alters as a result of sleep deprivation. In particular, the effect of sleep deprivation on gaze entropy has not been previously examined. In this randomised, repeated measures study, 9 (4 male, 5 female) healthy participants completed two driving sessions in a fully instrumented vehicle (1 after a night of sleep deprivation and 1 after normal sleep) on a closed track, during which eye movement activity and lane departure events were recorded. Following sleep deprivation, the rate of fixations reduced while blink rate and duration as well as saccade amplitude increased. In addition, stationary and transition entropy of gaze also increased following sleep deprivation as well as with amount of time driven. An increase in stationary gaze entropy in particular was associated with higher odds of a lane departure event occurrence. These results highlight how fatigue induced by sleep deprivation and time-on-task effects can impair drivers’ visual awareness through disruption of gaze distribution and scanning patterns.

In order to control the adverse effect of vehicles overloading infrastructure and traffic safety, weight-in-motion (WIM)-related research has drawn growing attention. To address the high cost of current piezoelectric sensors in installation and maintenance, a study on developing a low-cost piezoceramic sensing system is presented in this paper. The proposed system features distributed monitoring and integrated packaging, for calculating vehicle’s dynamic load and its wheel position. Results from the laboratory tests show that the total output of the sensing system increases linearly with the increase of the peak load when the loading amplitude is 5–25 kN (equivalent to the half-axis load of 20–100 kN); when the loading frequency is between 15 Hz and 19 Hz (equivalent to a speed of 17.8–23.2 km/h), the total output of the system fluctuates around a value of 1.305 V. Combined with finite-element simulation, the system can locate load lateral position with a resolution of 120 mm. Due to the protection packaging, the peak load transferred to the sensing units is approximately 4.36% of the applied peak load. The study indicates the proposed system can provide a promising low-cost, reliable and practical alternative for current WIM systems.

There is still no definite answer regarding the most advantageous patient positioning during total hip replacement (THR). We compared whether patient position (lateral vs supine) incur a difference on hospital length of stay (LOS) after primary THR. This retrospective cohort study included primary THR patients at a single tertiary center (2017-2022). THR patients prepared in the lateral decubitus position were compared to those in the supine position. Propensity score matching at a 1:4 ratio was applied to minimize selection bias. Matching covariates included age, sex, body weight, comorbidities (hypertension, diabetes), anesthesia time, and intraoperative tranexamic acid use. After matching, 990 patients were analyzed (792 lateral; 198 supine). In supine group, the median LOS (5 days, IQR: 4-6) was shorter than the lateral group (5 days, IQR: 5-6; <0.001). More supine patients were discharged before day 5 (45.5% vs 22.7%, <0.001). Multivariate analysis revealed supine position as the strongest protective factor against long hospitalization (OR: 0.32, 95% CI: 0.23-0.46, <0.001). Other notable predictors of long LOS included ASA ≥III (OR: 1.74), longer anaesthesia duration (OR: 1.78), and higher IV fluid administration (OR: 1.08). Patient positioning did not notably predict blood transfusion risk (OR: 1.32, =0.144). THR patients in supine positioning have a substantial reduction in hospital LOS compared to patients in lateral decubitus positioning, with supine position providing a 68% reduction in risk of long hospitalization. The two groups showed no difference in blood transfusion requirements.

Vehicle load is crucial for road design, maintenance, and expansion, while vehicle speed and lateral position are essential for traffic management and driving safety. This paper introduces a method for collecting vehicle speed, lateral position, and load information using roadside Micro-Electromechanical Systems (MEMS) accelerometers located on the pavement. Firstly, this research analyzes the distribution of pavement vibration responses in both lateral and vertical directions based on the Finite Element Method (FEM) data provided in the literature. Then, pavement vibration data is collected by roadside sensors with a Full-scale Accelerated Loading Tester, considering varying vehicle speeds, loads, and lateral positions. The results reveal that the vertical peak acceleration increases linearly with vehicle speed within a range of 5–22 km/h, decreases following a power law as the lateral distance between the wheel center and sensor increases from 0.4 to 0.9 m, which is consistent with the trends observed in the literature’s FEM data. The vibration energy of the vertical acceleration exhibits a positive linear correlation with the total vehicle load, with a correlation coefficient of 0.885. This approach offers a practical method for vehicle load estimation, optimal sensor deployment, and enhancement of pavement performance monitoring systems.

This study aims to evaluate and compare the efficacy and safety of endotracheal intubation in the lateral versus supine position, with both approaches combined with airway surface anesthesia, in patients undergoing gastrointestinal endoscopic surgery. A total of 128 patients undergoing gastrointestinal endoscopic surgery under general anesthesia with intubation were randomized into a lateral (L, n=64) or supine (S, n=64) intubation group, both receiving airway surface anesthesia, between January and March 2025. The primary outcome measure was intubation time, while secondary outcomes included changes in intraoperative vital signs, number of intubation attempts, first-pass success rate, positioning time, healthcare worker satisfaction, and postoperative complications. No significant differences were found between the two groups in terms of age, sex, height, weight, BMI, ASA classification, and airway assessment ( > 0.05). Mean intubation times differed slightly between groups (S group: 37.4±7.6s, 95% CI 35.5-39.3; L group: 40.1±8.5s, 95% CI 38.0-42.2). The non-inferiority margin (δ) for this study was 6s, and the upper limit of the L group's confidence interval (42.2s) was below the threshold of 39.3 + 6s. Thus, lateral position intubation was not inferior to supine intubation in terms of intubation time. There were no significant differences between the groups in the number of intubation attempts or first-pass success rate ( > 0.05). However, during positioning, the S group experienced greater hemodynamic fluctuations and a longer positioning time compared to the L group, and these differences were statistically significant ( < 0.05). Neither group showed any dental injuries or hypoxemia, and there were no significant differences in adverse reactions between the groups ( > 0.05). Compared with conventional supine intubation, lateral position endotracheal intubation with airway surface anesthesia achieves similar efficacy while providing better hemodynamic stability, faster positioning, and higher provider satisfaction.

Introduction Calcaneus is the most commonly fractured tarsal bone. Open reduction and internal fixation of the displaced intra-articular fractures is considered the gold standard treatment. The lateral extensile approach is the most commonly used approach, and usually, the patients are kept in lateral decubitus position. Recent study has descried calcaneus fracture fixation utilizing the lateral extensile approach with the patient in prone position. The aim of this study was to compare the postoperative radiological outcome, reoperation rate, operative and anesthesia time, infection and the wound complications rate between the two groups. Methods The data of 49 adult patients with unilateral closed calcaneus fracture underwent open reduction and internal fixation using lateral extensile approach were collected. Postoperative Bohler’s, Gissane angles and complications rate were compared between the two groups. Results A total of 49 patients were included. Lateral position was utilized in 26 patients (53.1%), while 23 patients (46.9%) were operated in prone position. Majority of the patients were males 87.8% (43 patients), and the mean age of the patients was 31.12 ± 7.50. The most commonly mechanism of injury was fall from height in (91.8%) of the patients. The mean preoperative Bohler’s angle was 9.33 ± 13.07 and increased to 22.69 ± 9.15 postoperatively. The mean preoperative angle of Gissane was 130.45 ± 26.98 whereas it was 124.76 ± 17.20 postoperatively. The mean postoperative Bohler’s angle and angle of Gissane were significantly higher among patient who underwent fixation in lateral position (25.88 ± 6.62, 137.15 ± 11.17) when compared to the prone one (19.09 ± 10.35, 110.74 ± 10.81). There was no significant difference between the two groups regarding the reoperation rate ( p 0.947), infection ( p 0.659, operative time (p 0.688), anesthesia time ( p 0.522) and wound complications ( p 0.773). Conclusion Surgical restoration of the Bohler’s and Gissane’s angles with the patient placed in the lateral decubitus position remains superior to the prone position with no difference in the complication rate between the two groups.