Search Results (12,413)

Background: Submarines represent extremely confined environments where breathing air is continuously recirculated for extended periods with minimal renewal, generating complex multipollutant atmospheres. Objectives: This critical narrative review aims to (i) summarize sources and composition of submarine indoor air, (ii) evaluate respiratory and cardiovascular risks for crews, and (iii) assess current purification technologies. Methods: A narrative review was conducted following PRISMA recommendations applicable to non-systematic reviews. The PubMed search covered all years from inception to September 2025, complemented by backward citation tracking and technical reports. Results: Eligible studies consistently report elevated levels of CO₂, VOCs, NO_X, CO, PM_2.5, and bioaerosols aboard submarines. Evidence from submariner cohorts and toxicological studies indicates risks of airway irritation, impaired mucociliary defenses, endothelial dysfunction, cardiovascular stress, and neurobehavioral alterations. Conclusions: Submarine indoor air quality is a credible determinant of crew health. Existing filtration systems mitigate some risks but do not address multipollutant mixtures adequately. Improved real-time monitoring, advanced filtration, CFD-guided airflow optimization, and longitudinal medical surveillance are necessary. Full article

Mild cognitive impairment (MCI) is a nosological entity that requires special attention from a therapeutic perspective, because annual conversion rates to dementia of 5–15% in these cases are considered typical. This narrative review aimed to identify available data supporting the efficacy and tolerability of various pharmacological therapeutic interventions by searching PubMed/MEDLINE, the Cochrane Database of Systematic Reviews, and the Web of Science (WoS) Core Collection for primary and secondary reports published over the last 25 years on the pharmacological treatment of MCI. The retrieved interventions were distributed in five large categories: (1) conventional cognitive enhancers; (2) disease-modifying therapeutic interventions; (3) strategies mitigating vascular risk and management of concomitant medications; (4) adjuvant and nootropic formulations; (5) case management of non-cognitive symptoms in MCI. The most broadly applicable pharmacological strategies in MCI include systematic deprescribing and optimisation of concomitant therapies, reducing anticholinergic and sedative load, avoiding iatrogenic hypoglycaemia and excessive blood pressure lowering, and careful, individualised treatment of vascular risk factors. Based on the randomised controlled trials, meta-analyses, and contemporary guidelines, a pragmatic pharmacological approach to MCI is suggested. Further trials with better design are urgently needed to document the efficacy and safety of pharmacological interventions in patients diagnosed with MCI. Full article

Tissue regeneration is essential for wound healing, organ function restoration, and overall patient recovery. Its success significantly impacts medical procedures in fields like internal medicine and orthopedics, enhancing patient quality of life. Recent advances in regenerative medicine, particularly the combination of advanced drug delivery systems (DDS) and bioengineering, have enabled customized methods to improve tissue regeneration outcomes. However, conventional tissue engineering techniques have drawbacks, often using static scaffolds that lack the dynamic properties of real tissues, leading to subpar healing outcomes. The use of 3D printing and other advanced scaffolding techniques allows for the creation of bio functional scaffolds that deliver bioactive molecules at precise locations and times. The optimal integration of biological systems with enhanced material properties for personalized treatment options remains unclear. There is a need for more research into the complex interactions between cellular biology, drug delivery, and material technology to improve tissue regeneration. Despite progress in developing bioactive scaffolds and localized drug delivery methods, the interactions among different scaffold materials, bioactive agents, and cellular behaviors within the regenerative ecosystem are not fully understood. While there is extensive research on 3D-printed scaffolds in tissue engineering, there is a lack of studies integrating bio printing with in vivo biological reactions in real time. Limited research on the dynamic integration of patient-specific parameters in regeneration methods highlights the need for customized approaches that consider individual physiological differences and the complex biological environment at injury sites. Additionally, challenges arise when translating laboratory results into effective therapeutic applications, underscoring the necessity for interdisciplinary collaboration and innovative design approaches that align advanced material properties with biological needs. Full article

Background: Molar–Incisor Hypomineralization (MIH) represents a developmental enamel defect of systemic origin, typically affecting the first permanent molars and often the incisors. Within the limitations of this study, several associations were observed between perinatal factors and MIH-related outcomes. However, most of these connections were not retained in adjusted analyses. Febrile illness during the first year of life showed a significant association with hypersensitivity. Methods: A structured 30-item questionnaire was distributed to mothers of 50 children diagnosed with MIH between February and March 2024. Data was analyzed using chi-square tests, with p < 0.05 considered significant, and univariate and multivariate logistic regressions at 95% confidence interval. Clinical diagnosis followed the Weerheijm (EAPD) criteria. Results: Maternal medication during pregnancy (antibiotics, antiepileptics, asthma drugs) was significantly associated with preterm birth (p = 0.01). Low birth weight correlated with tooth eruption disorders (p = 0.009) and perinatal complications such as hypoxia and respiratory distress (p = 0.0001). Fluoride application demonstrated a protective effect against discolorations (p = 0.005), caries (p = 0.002), and hypersensitivity (p = 0.01). In the multivariate model, febrile illness during the first year of life may be associated with hypersensitivity in MIH-affected teeth (aOR = 5.71, 95% CI: 1.01–32.27, p = 0.049). Conclusions: Maternal medication and perinatal complications, particularly low birth weight, were associated with MIH occurrence. Preventive strategies emphasizing maternal health, early screening, and remineralization-based therapies can mitigate long-term oral health impacts. Full article

Introduction: Artificial intelligence (AI) has developed into an increasingly important tool in dermatology. While new technologies integrated within laser devices are emerging, there is a lack of data on the applicability of publicly available AI models. Methods: The prospective study used an online questionnaire where participants evaluated diagnosis and treatment for 25 dermatological cases shown as pictures. The same questions were given to AI models: ChatGPT-4o, Claude Sonnet 4, Gemini 2.5 Flash, and Grok-3. Results: Dermatologists outperformed AI in diagnostic accuracy (suspected primary diagnosis-SD 75.6%) in pooled dermatologists vs. pooled AI (SD 57.0%), with laser specialists achieving the highest accuracy (SD 82.0%) and residents the lowest (SD 66.0%). There was a high heterogeneity across AI models. Gemini approached dermatologist performance (SD 72.0%), while Claude showed a low accuracy (SD 40.0%). While AI models reached near 100% accuracy in some classic/common diagnoses (e.g., acne, rosacea, spider angioma, infantile hemangioma), their accuracy dropped to near 0% on rare or context-dependent cases (e.g., blue rubber bleb nevus syndrome, angiosarcoma, hirsutism, cutaneous siderosis). Inter-rater agreement was high among laser experts in terms of diagnostic accuracy and treatment choice. Agreement between residents and AI models was highest for diagnostic accuracy and treatment choice, while it was lowest between experts and AI models. Conclusions: Before AI-based tools can be integrated into daily practice, particularly regarding diagnosis and appropriate laser treatment recommendations, specific supervised medical training of the AI model is necessary, as open-source platforms currently lack the ability to contextualize presented data. Full article

Each year, many neonates are born with genetic diagnoses that carry a range of prognoses. As the types and availability of genetic testing have expanded, neonatal intensive care units (NICUs) have served as “launching points” for their clinical application. Broad genetic testing has both improved diagnostic precision and expanded uncertainty. Genetic information may be explicitly uncertain, as in the case of a variant of unknown significance (VUS). But it is also frequently uncertain whether/how the information relates to a patient’s phenotype or what it may mean for a child’s future. Even without ambiguity in the diagnosis or prognosis, the significance within a clinical and familial context may be less certain. Applying the information to clinical care is complex and may engender confusion among clinicians and families as readily as it offers guidance. Since genetic testing results can impact management and, at times, end-of-life decisions, misunderstanding and misapplication of genetic results pose a significant risk. We describe a hypothetical case of an infant with congenital hypotonia and respiratory failure. The family, after discussions with the care team about medically appropriate care paths, is navigating goals of care and considering tracheostomy placement for chronic mechanical ventilation. They consent to rapid genome sequencing in hopes of better understanding the etiology and severity of the neuromuscular condition. We explore three possible scenarios following different genomic results. With each, we discuss how the results may impact decision-making about the best plan of care. We propose a framework for navigating discussions about genetic testing results with families of critically ill children. We illustrate the importance of a multidisciplinary approach with collaboration between neonatology, genetics, and palliative care. By employing the strengths of each subspecialty, providers can manage the inherent uncertainty in genetic testing results, help determine the meaning of the results to the family in the context of their child’s medical care, and enhance the care and support of critically ill neonates and their families. Full article

This paper presents a compact, dual-band, dual-polarization button antenna for Wireless Body Area Networks (WBANs) that operates in the 2.45 GHz and 5.8 GHz Industrial, Scientific, and Medical (ISM) bands. The antenna is engineered in the lower band from 2.33 to 2.8 GHz (18.3% fractional bandwidth) as a linearly polarized, top-loaded monopole, which provides an omnidirectional radiation pattern for on-body communication. In contrast, it functions as a cross-dipole in the higher band, achieving a fractional bandwidth of 66.4% (4.8–9.57 GHz) and a 3 dB axial ratio (AR) bandwidth of 57.4%, producing a broadside radiation with circular polarization for off-body communications. Prototype measurements in both free-space and on-body settings confirm the antenna’s robust performance, successfully validating its dual-band operation, dual-polarization characteristics. Furthermore, Specific Absorption Rate (SAR) simulations conducted on a human model demonstrate that the values are significantly below the established safety limits, confirming the antenna’s suitability for practical wearable applications. Full article

Fishermen operating in pelagic fisheries often experience significant barriers to medical care due to geographic isolation, harsh environmental conditions, and the absence of onboard healthcare personnel. Telemedicine offers an effective approach to overcome these limitations by enabling remote diagnosis, monitoring, and treatment through satellite-based communication systems. This review summarizes the progress and applications of telemedicine in maritime and other austere environments, focusing on technological advancements, clinical implementations, and emerging trends in artificial intelligence-driven healthcare. Evidence from pilot and retrospective studies highlights the growing use of wearable devices, telementored ultrasound, digital photography, and cloud-based monitoring systems for managing acute and chronic medical conditions at sea. The integration of machine learning and deep learning algorithms has further improved fatigue, stress, and motion detection, enhancing early risk assessment among seafarers. Despite challenges such as limited connectivity, data privacy concerns, and training requirements, the adoption of telemedicine significantly improves health outcomes, reduces emergency evacuations, and promotes occupational safety. Future directions emphasize the development of 5G-enabled Internet of Medical Things networks and predictive AI tools to establish comprehensive maritime telehealth ecosystems for fishermen in pelagic operations. Full article

Color-to-grayscale conversion is a fundamental preprocessing task with widespread applications in digital printing, electronic ink displays, medical imaging, and artistic photo stylization. A primary challenge in this domain is to simultaneously preserve global luminance distribution and local contrast. To address this, we propose an adaptive conversion method centered on a novel objective function that integrates information entropy with Edge Content (EC), a metric for local gradient information. The key advantage of our approach is its ability to generate grayscale results that maintain both rich overall contrast and fine-grained local details. Compared with previous adaptive linear methods, our approach demonstrates superior qualitative and quantitative performance. Furthermore, by eliminating the need for computationally expensive edge detection, the proposed algorithm provides an effective solution to the color-to-grayscale conversion. Full article

Tuberculous meningitis (TBM) is the most lethal form of tuberculosis (TB), with reported short-term mortality of 20–69% for patients on treatment and five-year deaths exceeding 58%. The World Health Organization has reported a new record of approximately 8.3 million new cases of TB diagnosed worldwide, with TBM accounting for 1–5% of these cases in 2024. Heterogeneous clinical manifestations, as well as difficulties in identifying TBM at onset, will delay timely therapy. Drug-resistant TB (DRTB) represents a real threat to public health and is evolving rapidly. Although new drugs have emerged to overcome DRTB, their role in TBM is limited. Our first objective was to update knowledge about the pathogenic mechanisms, clinical manifestations, diagnosis, therapy, and prevention of TBM. Another goal was to highlight advances in nanomedicine and medical imaging in terms of timely diagnosis of TBM and rapid initiation of targeted treatment, including overcoming DRTBM. The last aim was to bring to the attention of infectious disease specialists, neurologists, pediatricians, healthcare professionals, and information technology (IT) specialists the results of clinical trials on TBM published in the last two years. Technological innovation has integrated next-generation sequencing, and IT and artificial intelligence (AI) will develop new applications for precision medicine in TBM and vaccine optimization. Full article

Intelligent driving cabins operated by artificial intelligence technology are evolving into the third living space. They aim to integrate perception, analysis, decision making, and intervention. By using multimodal biosignal acquisition technologies (flexible sensors and non-contact sensing), it is possible to monitor the physiological indicators of heart rate and blood pressure in real time. Leveraging the benefits of domain controllers in the vehicle and edge computing helps the AI platform reduce data latency and enhance real-time processing capabilities, as well as integrate the cabin’s internal and external data through machine learning. Its aim is to build tailored health baselines and high-precision risk prediction models (e.g., CNN, LSTM). This system can initiate multi-level interventions such as adjustments to the environment, health recommendations, and ADAS-assisted emergency parking with telemedicine help. Current issues consist of sensor precision, AI model interpretation, security of data privacy, and whom to attribute legal liability to. Future development will mainly focus on cognitive digital twin construction, L4/L5 autonomous driving integration, new biomedical sensor applications, and smart city medical ecosystems. Full article

Self-powered sensors, leveraging their integrated energy harvesting–signal sensing capability, effectively overcome the bottlenecks of traditional sensors, including reliance on external power resources, high maintenance costs, and challenges in large-scale distributed deployment. As a result, they have become a major research focus in fields such as flexible electronics, smart healthcare, and human–machine interaction. This paper reviews the core technical paths of six major types of self-powered sensors developed in recent years, with particular emphasis on the working principles and innovative material applications associated with frictional charge transfer and electrostatic induction, pyroelectric polarization dynamics, hydrovoltaic interfacial streaming potentials, piezoelectric constitutive behavior, battery integration mechanism, and photovoltaic effect. By comparing representative achievements in fields closely related to self-powered sensors, it summarizes breakthroughs in key performance indicators such as sensitivity, detection range, response speed, cyclic stability, self-powering methods, and energy conversion efficiency. The applications discussed herein mainly cover several critical domains, including wearable medical and health monitoring systems, intelligent robotics and human–machine interaction, biomedical and implantable devices, as well as safety and ecological supervision. Finally, the current challenges facing self-powered sensors are outlined and future development directions are proposed, providing a reference for the technological iteration and industrial application of self-powered sensors. Full article

Bacteriophages, often referred to as “bacteria eaters,” have gained renewed interest as a powerful alternative to traditional antibiotics, particularly in addressing antibiotic-resistant bacterial infections. The present review summarizes data collected in Bulgaria during the 1960s, 1970s, and 1980s, drawing connections between past findings and present-day understanding of cytotoxicity and the clinical validation of bacteriophage applications. Its sections describe phage structure, mechanisms of action, and historical findings both globally and within the Bulgarian context, while also highlighting emerging trends and applications. The cited studies delve into the past through contemporary research contributions related to “Bulgarian phages”, a topic that remains underexplored in existing literature. The role of phages in medical microbiology is discussed alongside the challenges of therapeutic implementation, with particular focus on insights gained from the Bulgarian experience. In conclusion, by fostering international collaborations, investing in infrastructure, and establishing supportive policies, bacteriophage therapy can emerge as a critical tool for managing bacterial infections and reducing the global burden of antibiotic resistance in the future. Full article

Polymerase chain reaction (PCR) is vital in biological and medical research, but microfluidic PCR chips often suffer from limited reagent processing capacity and slow thermal response under high flow rates. To address this, we designed three serpentine microfluidic chips with double-sided heaters: a standard serpentine chip (case 1), one with unchamfered channel expansion areas (case 2), and one with chamfered expansions (case 3). Using numerical simulations, we analyzed temperature, velocity, and pressure distributions at flow rates of 75, 125, and 175 μL/min. At 175 μL/min, case 2 showed a 41% higher pressure drop than case 1, but also demonstrated significantly improved thermal performance: the constant-temperature zones were extended by 30 mm, 10 mm, and 30 mm at 95 °C, 72 °C, and 55 °C, respectively; the temperature gradient in expansion zones increased by 1.6 times; and the maximum temperature difference decreased by 80%. Case 2 achieved the best trade-off between thermal performance and flow resistance, making it suitable for high-flow-rate PCR applications. Full article

Medical care is increasingly evolving towards patient-centered medicine, which is at the heart of the value-based healthcare (VBHC) model. The VBHC model simultaneously prioritizes better health outcomes while optimizing costs. Its application therefore requires the use of quantitative indicators to assess the performance of healthcare systems. At the same time, in glaucoma, minimally invasive procedures are expanding therapeutic options, gaining popularity and establishing themselves as an attractive alternative to traditional, riskier glaucoma surgeries. These safer procedures are increasingly enabling early intervention in the care pathway of glaucoma patients. However, their cost-effectiveness remains to be determined. This work aims to analyze the impact of the current approach to glaucoma management through the VBHC model and to discuss performance indicators that allow for effective evaluation. Full article