Search Results (5,111)

Background: Pelvic fractures are among the most complex and life-threatening injuries encountered in trauma and orthopedic surgery, often resulting from high-energy trauma and leading to severe complications. This review synthesizes recent advancements in pelvic trauma care, with a focus on comparing damage control orthopedics (DCO) and early total care (ETC) strategies, operative versus nonoperative management, and outcomes of minimally invasive versus traditional ORIF techniques. Results: Our comparative analysis highlights that DCO remains the preferred approach for hemodynamically unstable patients, prioritizing rapid stabilization and reducing mortality from hemorrhage. In contrast, ETC has demonstrated superior functional recovery outcomes in stable polytrauma patients, with a 30–40% reduction in pulmonary complications and shorter ICU stays when performed within 24–48 h post-injury. Additionally, percutaneous fixation reduces soft tissue trauma and infection risk but increases the likelihood of malunion, while ORIF provides superior anatomical restoration with a higher risk of postoperative infections. Hybrid approaches, integrating percutaneous techniques with limited open reduction, show promise in minimizing operative time and complications while achieving stable fixation. Conclusions: These findings reinforce the importance of tailoring surgical strategies to patient physiology and injury patterns. DCO and ETC have distinct but complementary roles, and emerging hybrid techniques offer a middle ground that balances stability with reduced morbidity. A precision medicine approach, integrating AI-driven predictive modeling and real-world clinical data, is essential for optimizing outcomes and developing evidence-based treatment protocols. Large-scale, multicenter trials are needed to validate these approaches and establish standardized guidelines for pelvic fracture management. Full article

Wound healing is a complicated biological process that is important for restoring tissue integrity and function after injury. Infection, usually due to bacterial colonization, significantly complicates this process by hindering the course of healing and enhancing the chances of systemic complications. Recent advances in wearable biosensors have transformed wound care by making real-time monitoring of biomarkers such as pH, temperature, moisture, and infection-related metabolites like trimethylamine and uric acid. This review focuses on recent advances in biosensor technologies designed for wound management. Novel sensor architectures, such as flexible and stretchable electronics, colorimetric patches, and electrochemical platforms, enable the non-invasive detection of changes associated with wounds with high specificity and sensitivity. These are increasingly combined with AI and analytics based on smartphones that can enable timely and personalized interventions. Examples are the PETAL patch sensor that applies multiple sensing mechanisms for wide-ranging views on wound status and closed-loop systems that connect biosensors to therapeutic devices to automate infection control. Additionally, self-powered biosensors that tap into body heat or energy from the biofluids themselves avoid any external batteries and are thus more effective in field use or with limited resources. Internet of Things connectivity allows further support for remote sharing and monitoring of data, thus supporting telemedicine applications. Although wearable biosensors have developed relatively rapidly and their prospects continue to expand, regular clinical application is stalled by significant challenges such as regulatory, cost, patient compliance, and technical problems related to sensor accuracy, biofouling, and power, among others, that need to be addressed by innovative solutions. The goal of this review is to synthesize current trends, challenges, and future directions in wound healing and infection monitoring, with emphasis on the potential for wearable biosensors to improve patient outcomes and reduce healthcare burdens. These innovations are leading the way toward next-generation wound care by bridging advanced materials science, biotechnology, and digital health. Full article

Epileptic and developmental encephalopathies (EDEs) are a group of severe, genetically various neurological conditions characterized by early-onset seizures and developmental impairments. Recent advances in molecular genetics and diagnostic tools have led to the development of precision therapies, aiming to address the deep causes of these disorders. Examples, such as pyridoxine for pyridoxine-dependent epilepsy and the ketogenic diet for GLUT1 deficiency syndrome illustrate the potential of presumed tailored treatments. However, challenges persist, as current therapies often fail to fully mitigate neurodevelopmental impairments. Moreover, traditional phenotype-based management strategies, while effective for seizure control, do not address the root causes of these disorders, underscoring the limitations of existing approaches. This article explores the evolving landscape of precision medicine in EDEs, emphasizing the importance of genetic insights in therapy design and the need for a multidisciplinary approach. It also highlights the barriers to widespread implementation, including diagnostic delays, accessibility, and a lack of robust clinical evidence. To fully realize the potential of precision therapies, comprehensive genetic integration, innovation in treatment, and global collaboration are essential. The future of EDE management lies in therapies that not only control symptoms but also correct genetic and molecular defects, offering a more effective, individualized approach to care. Full article

Stroke affects approximately 12 million individuals annually, necessitating swift diagnosis to avert fatal outcomes. Current hospital imaging protocols often delay treatment, underscoring the need for portable diagnostic solutions. We have investigated silver nanostars (AgNS) incubated with human plasma, deposited on a simple aluminum foil substrate, and utilizing Surface-Enhanced Raman Spectroscopy (SERS) combined with machine learning (ML) to provide a proof-of-concept for rapid differentiation of stroke types. These are the seminal steps for the development of low-cost pre-hospital diagnostics at point-of-care, with potential for improving patient outcomes. The proposed SERS assay aims to classify plasma from stroke patients, differentiating hemorrhagic from ischemic stroke. Silver nanostars were incubated with plasma and spiked with glial fibrillary acidic protein (GFAP), a biomarker elevated in hemorrhagic stroke. SERS spectra were analyzed using ML to distinguish between hemorrhagic and ischemic stroke, mimicked by different concentrations of GFAP. Key innovations include optimized AgNS–plasma incubates formation, controlled plasma-to-AgNS ratios, and a low-cost aluminum foil substrate, enabling results within 15 min. Differential analysis revealed stroke-specific protein profiles, while ML improved classification accuracy through ensemble modeling and feature engineering. The integrated ML model achieved rapid and precise stroke predictions within seconds, demonstrating the assay’s potential for immediate clinical decision-making. Full article

Industrial processes often rely on high-temperature heat, traditionally generated through the combustion of fossil fuels. However, a significant shift towards renewable and sustainable heat sources is underway, supported by environmental policies and actions such as the European Green Deal. These renewable energy systems are complex and characterized by a high degree of interdependencies between various parameters. Optimizing and orchestrating these processes for efficient heat delivery requires careful consideration of factors such as temperature levels, flow rates, and energy demands. Traditional methods often struggle to handle the complexity of these systems, hindering efforts to maximize efficiency and minimize energy waste. This paper addresses these challenges by proposing a modular digital twin framework tailored for high-temperature heat upgrade systems. By integrating with the physical heat upgrade system, the digital twin can create a dynamic and continuously updated representation of its behavior, while also providing additional advantages such as improved process simulation, predictive capabilities, enhanced design, and system integration. Using the SUSHEAT project as a case study, this work advances digital twin methodologies by introducing an architecture applicable in the early product lifecycle phases, addressing a gap in current research. Full article

Biosensors are innovative and cost-effective analytical devices that integrate biological recognition elements (bioreceptors) with transducers to detect specific substances (biomolecules), providing a high sensitivity and specificity for the rapid and accurate point-of-care (POC) quantitative detection of selected biomolecules. In the meat production chain, their application has gained attention due to the increasing demand for enhanced food safety, quality assurance, food fraud detection, and regulatory compliance. Biosensors can detect foodborne pathogens (Salmonella, Campylobacter, Shiga-toxin-producing E. coli/STEC, L. monocytogenes, etc.), spoilage bacteria and indicators, contaminants (pesticides, dioxins, and mycotoxins), antibiotics, antimicrobial resistance genes, hormones (growth promoters and stress hormones), and metabolites (acute-phase proteins as inflammation markers) at different modules along the meat chain, from livestock farming to packaging in the farm-to-fork (F2F) continuum. By providing real-time data from the meat chain, biosensors enable early interventions, reducing the health risks (foodborne outbreaks) associated with contaminated meat/meat products or sub-standard meat products. Recent advancements in micro- and nanotechnology, microfluidics, and wireless communication have further enhanced the sensitivity, specificity, portability, and automation of biosensors, making them suitable for on-site field applications. The integration of biosensors with blockchain and Internet of Things (IoT) systems allows for acquired data integration and management, while their integration with artificial intelligence (AI) and machine learning (ML) enables rapid data processing, analytics, and input for risk assessment by competent authorities. This promotes transparency and traceability within the meat chain, fostering consumer trust and industry accountability. Despite biosensors’ promising potential, challenges such as scalability, reliability associated with the complexity of meat matrices, and regulatory approval are still the main challenges. This review provides a broad overview of the most relevant aspects of current state-of-the-art biosensors’ development, challenges, and opportunities for prospective applications and their regular use in meat safety and quality monitoring, clarifying further perspectives. Full article

Background: Little is known about mental health among tuberculosis (TB) patients in Thailand. This study aimed to identify factors associated with mental health problems in TB patients in urban Thailand. Methods: This cross-sectional study collected data from 210 TB patients receiving treatment at two tertiary care hospitals in the Bangkok Metropolitan Region of Thailand using consecutive sampling. The General Health Questionnaire (GHQ-12) and the Patient Health Questionnaire (PHQ-9) were used to assess mental health problems and probable depression, respectively. Results: Among TB patients, 34.3% had mental health problems (95% CI: 27.8–40.8), and 23.8% had depression (95% CI: 18.0–29.6). The final model from logistic regression with forward selection identified factors significantly associated with mental health problems, including high family support (OR = 0.45; 95% CI: 0.24–0.83) and perceived stigma: low (OR = 2.77; 95% CI: 1.16–6.60), moderate (OR = 3.56; 95% CI: 1.66–7.65), and high (OR = 3.56; 95% CI: 1.31–9.67) versus no stigma. Depression was associated with income ≥10,000 baht (OR = 0.43; 95% CI: 0.21–0.87), alcohol consumption (OR = 2.90; 95% CI: 1.27–6.64), and high social support from healthcare providers (OR = 0.44; 95% CI: 0.22–0.87). Conclusion: This study highlights the need to integrate mental health services into the TB care program to address the TB challenge in Thailand. Policies such as routine mental health screening and psychological counseling alongside treatment, as well as expanded social support and stigma reduction interventions, should be implemented to reduce the risk of mental health issues, particularly depression, and improve treatment outcomes among Thai TB patients. Full article

Manual intravenous (IV) monitoring delays, put patients at risk, as the reaction time of nursing staff can be critical to the patient’s health. The widespread use of LoRa networks today is a reality. The deployment of devices and applications based on LoRa networks in healthcare environments, such as hospital facilities, is of great interest and can offer both time savings for medical and nursing staff and improvements in medical care. In this work an integrated low-cost, real-time monitoring system for fluid infusion based on a LoRa network is presented. The measured (monitoring) data are the weight of the fluid infusion flask and the number of fluid drops. The design of the system and the affordability of the materials (low-cost devices) give the possibility for immediate application in healthcare environments. As the system consists of low-cost sensors, and given that it is intended for health purposes, extensive research has been carried out on the evaluation and reliability of the measurements. The proposed system is intended for medical care; in this sense it should have the lowest possible measurement error. The evaluation of the system has revealed a polynomial equation as a corrective factor for weight and shows an improvement of the error from 2% of the raw measurements to 0.6% of the corrected measurements, while regarding the calculation of the weight from the measurement of the droplets, it shows an error of 1.6%. The proposed system contributes directly to both the valuable time of the medical staff and the improvement of patient care. The evolution of technology should be applied to the health sector and low-cost and internet of things (IoT) devices can be applied to healthcare after thorough evaluation and calibration procedures. Full article

Background/Objectives: Poisoning represents a significant global public health challenge, particularly with its complex manifestations in adult populations. Understanding regional epidemiology through digital health systems is crucial for developing evidence-based prevention and management strategies. This nationwide study analyzes hospital-based toxicology teleconsultation data from the Toxicology Consultation Service-Saudi Medical Appointments and Referrals Center (TCS-SMARC) platform to characterize the epidemiological patterns, clinical features, and outcomes of adult poisoning cases across Saudi regions. Methods: We conducted a retrospective cross-sectional analysis of 6427 adult poisoning cases where hospitals sought teleconsultation from the Saudi Toxicology Consultation Service (TCS) from January to December 2023. Descriptive statistics were used to analyze poisoning rates by demographic characteristics, agents responsible for the poisoning, clinical presentations, and management decisions. Population-adjusted rates were calculated using the national census data. Associations between variables were analyzed using cross-tabulations and chi-square tests. Results: Young adults aged 18–35 years constituted most cases (58.67%), with the highest population-adjusted rates observed among those aged 18–24 (5.15 per 10,000). Medicine-related poisonings were the most common across all regions (50.04%), followed by bites and stings (15.31%). Regional analysis indicated relatively uniform poisoning rates across Business Units (BUs) (2.02–2.74 per 10,000). Most cases (87.44%) were asymptomatic, with 91.71% exhibiting normal Glasgow Coma Scale scores, although substance abuse cases had higher rate of severe manifestations (24.34%). Significant seasonal variations were observed (p < 0.001), with peak incidents occurring in the summer (29.25%). Management decisions primarily involved hospital observation (40.27%) and admission (30.34%), with agent-specific variations in care requirements (p < 0.001). Conclusions: This comprehensive analysis demonstrates the effectiveness of Saudi Arabia’s digital health infrastructure in capturing and managing nationwide poisoning data. The integrated digital platform enables real-time surveillance, standardized triage, enhanced access to specialized toxicology services, and coordinated management across diverse geographical contexts. Our findings inform evidence-based recommendations for targeted prevention strategies, particularly for young adults and medicine-related poisonings, while establishing a scalable model for digital health-enabled poisoning management. Full article

Mental illnesses can have a significant impact on individuals experiencing acute coronary syndromes (ACS). Mental illnesses are associated with an increased cardiovascular risk profile and early onset of cardiovascular disease. A critical aspect of this interplay is the effect of psychiatric conditions on left ventricular ejection fraction (LVEF), a key parameter in evaluating cardiac function and predicting long-term outcomes in ACS patients. The present single-center, retrospective study investigated the associations between psychiatric conditions and cardiac function, with a focus on LVEF in ACS patients. The inclusion criteria were Italian nationality and 30 years or older. One hundred and sixty-four patients without (M_age = 68.8 ± 10.6, 62 females) and 161 patients with a psychiatric diagnosis (M_age = 68.4 ± 13.7, 63 females) were enrolled. The data collected included sociodemographic variables, psychiatric diagnoses, LVEF, ACS type (STEMI/NSTEMI), smoking status, previous interventions, and pharmacological treatments. Statistical analyses included chi-square, t-tests, ANOVAs, and ANCOVA to assess differences across groups. Findings revealed lower LVEF in patients with a psychiatric diagnosis compared to patients without a psychiatric diagnosis (p = 0.004, d = 0.36). Patients without a psychiatric diagnosis were associated with NSTEMI (p = 0.047, φ = 0.11), hypertension (p = 0.003, φ = −0.16), and dyslipidemia (p = 0.022, φ = −0.13). In contrast, patients with a psychiatric diagnosis were associated with STEMI (p = 0.047, φ = 0.11), neurological dysfunction (p = 0.014, φ = 0.14), and chronic obstructive pulmonary disease (p = 0.010, φ = 0.14). Among psychiatric diagnoses, anxiety disorders were associated with lower LVEF compared to substance abuse disorders (p = 0.012, d = −0.81). The findings underscore the complex relationship between mental illness and cardiac function, emphasising the need to integrate psychiatric evaluations into cardiology care to optimise the management of both mental and cardiovascular health. This study has several limitations, including its design, which prevents causal conclusions, and the use of convenience sampling, which limits the generalizability of the findings. Full article

This study introduces a concise questionnaire designed to evaluate the quality of urban public spaces as a simplified method for collecting community needs and perspectives, enabling these insights to be effectively combined with metrics and viewpoints from policymakers and decision-makers. The case study was carried out in one of the smallest municipalities of Attica, in the town of Kaisariani, Athens, with an emphasis on the central square and the park of the area. Findings show that the majority of respondents prioritize improving the vegetation and lighting of Kaisariani Square, as well as demands for more benches and cultural/art elements. The most important negative experience was the feeling of neglect and lack of cleanliness. Concerns about lighting and lack of care/cleanliness were also key at the park. Addressing current gaps in the public space assessment literature, the study lays the groundwork for future research and supports the creation of easy-to-use quality assessment tools. In contrast to more analytical approaches, the proposed questionnaire tool provides a streamlined and efficient method for capturing users’ perceptions of public spaces. Its design ensures that evaluations are not time-consuming or resource-intensive, allowing citizen feedback to be seamlessly integrated into various public space management processes rather than being limited to exhaustive and costly research efforts. As urban environments continue to expand, the adoption of such techniques will be essential for fostering sustainable and resilient communities that prioritize the well-being of their citizens. Full article

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition frequently associated with cardiovascular comorbidities, including ischemic heart disease (IHD), heart failure (HF), and atrial fibrillation (AF). These conditions significantly impact patient outcomes, yet their prevalence and risk factors remain underexplored in primary care settings. This study investigates the role of age, sex, and smoking status in the prevalence of IHD, HF, and AF among patients with COPD managed in general practice settings. Methods: A retrospective analysis was conducted using de-identified electronic health records from eleven general practitioner (GP) practices in Northern Ireland. Patients with COPD were identified through the Quality and Outcomes Framework (QOF) register, and the presence of IHD, HF, and AF was recorded. Statistical analyses included chi-square tests and independent t-tests to examine associations between cardiovascular comorbidities and patient demographics, with significance set at p < 0.05. Results: Among the total registered population of 77,797, there were 1575 patients with COPD, of whom 335 had IHD, 211 had AF, and 116 had HF. Patients with COPD had a significantly higher prevalence of IHD, AF, and HF compared to those without COPD. Age was a strong determinant, with older age groups, particularly those over 75 years, showing a markedly higher prevalence of all three conditions. Sex analysis revealed that male patients with COPD were significantly more likely to have IHD, AF, and HF than females. However, the association between smoking status and the presence of HF, IHD, or AF was not significantly different between current/ex-smokers and non-smokers. Conclusions: The findings highlight the high burden of cardiovascular comorbidities among patients with COPD in primary care and emphasise the need for routine cardiovascular screening. Given the strong influence of age and sex, targeted risk assessment and management strategies should be prioritised for older and male patients with COPD. The lack of association between smoking and cardiovascular comorbidities suggests that additional risk factors should be considered in cardiovascular risk assessment. A more integrated approach to managing COPD and cardiovascular conditions within general practice settings is essential to improve patient outcomes. Future research should focus on evaluating interventions that enhance early detection and multidisciplinary management of cardiovascular comorbidities in patients with COPD. Full article

Background/Objectives: The multifactorial nature of immune-mediated inflammatory diseases (IMIDs) requires integrating pathophysiological understanding with subjective patient experiences. Patient-reported outcome measures (PROMs) are a useful tool for incorporating this in routine clinical practice. However, current PROMs do not fully encompass the complete subjective health experiences (SHE) of patients and are thus insufficient for guiding truly personalised care. The SHE model provides insights into SHE through the determinants of disease acceptance and perceived control. While validated across various demographics, its predictive power in IMIDs cohorts remains unexplored. This study aims to assess whether acceptance and perceived control in the SHE model predict health experiences in patients with IMID and how these immunological conditions compare. Methods: Questionnaires regarding health perception, acceptance, control, and subjective health experiences were distributed to 450 Dutch citizens. Descriptive statistics, reliability checks, and partial least squares structural equation modelling were used to examine relationships between variables. Results: Health perception strongly predicts SHE through acceptance and control. Across all conditions, the pathway moves from health perception to control, then to acceptance, and finally to SHE. However, the roles of acceptance and control differ by condition. In burdensome diseases like inflammatory bowel disease and rheumatoid arthritis, acceptance plays a greater role, while control has a stronger influence in conditions like psoriasis. Conclusions: This study supports the predictive validity of the SHE model for IMIDs, showing that disease acceptance and control affect health experiences differently across conditions. These insights improve the understanding of psychological factors in health experiences and call for tailored interventions for patients with IMID. Full article

Self-cleaning cementitious materials, particularly with TiO₂-based photocatalytic coatings, offer significant benefits by reducing surface deterioration and maintenance requirements, even in harsh urban environments. Despite the growing interest in self-cleaning cementitious materials, an international standard test method to calculate their efficiency has not yet been established for this specific type of substrate. The objective of this study was to evaluate and compare three different techniques for assessing the photocatalytic efficiency (PE) of cementitious materials coated with TiO₂: (i) spectrophotometric colorimetry (SPC); (ii) digital image processing-based colorimetry (DIP); and (iii) UV-Vis spectrophotometry (UV-Vis). Rhodamine B (RhB) was used as a model pollutant, and the photocatalytic efficiency was monitored under UV-Vis light. The results showed that each method has distinct advantages and specific challenges. SPC proved to be a practical and efficient approach, similarly to DIP, which was also accessible, providing reliable and accurate measurements. UV-Vis stood out for its precision but required careful application on cement-based substrates due to their unique porosity and adsorption characteristics. These results underscore the complementary potential of these techniques and highlight the importance of developing standardized protocols that integrate their strengths to facilitate the wider adoption of self-cleaning materials. Full article

Background: Care-experienced young people face an elevated risk of experiencing disadvantages across manifold domains, including health, housing, education, and employment. There is a dearth of accessible interventions targeted at this population to help them navigate the ‘cliff-edge’ transition to adulthood and improve their life chances. The 8-week I-CAN programme was designed to address the provision gaps and support care-experienced young people’s learning, personal development, and progression. Methods: A mixed methods design was used as part of a pilot evaluation study. The participants were n = 11 care-experienced young adults (three males; eight females); aged 19–30 years, M = 22 (3.17). The data collection methods comprised programme statistics, well-validated, self-reported questionnaires, and a focus group with I-CAN programme recipients. Results: The integrated quantitative and qualitative findings showed tentative support for the effectiveness of the I-CAN programme, with the majority of care-experienced young adults transitioning to a confirmed progression route (training, education, or employment) after completing the programme. The findings cautiously suggest that alongside proposed learning outcomes, the recipients benefited in terms of their personal development (mental wellbeing and positive self-image and empowerment). Some candidate core ‘ingredients’ or factors that had facilitated positive programme outcomes were also identified. Conclusions: Future research should focus on integrating theoretical, outcome, and process issues, and refining the I-CAN theory of change. Full article