Search Results (5,117)

COPD remains a prevalent and debilitating respiratory condition, necessitating early and accurate diagnosis for optimal clinical intervention. In this study, we propose a novel deep learning-based diagnostic framework that employs the ECAPA-TDNN (Emphasized Channel Attention, Propagation and Aggregation—Time Delay Neural Network) architecture to classify respiratory sound signals from the ICBHI dataset. Originally designed for speaker verification, ECAPA-TDNN introduces channel attention and multi-scale feature aggregation, which we adapt for the first time to the domain of medical acoustic analysis. This architecture allows the model to effectively capture subtle and discriminative patterns in pathological breathing sounds, overcoming the limitations of conventional CNN-based methods. Our methodology integrates rigorous signal preprocessing, log-Mel spectrogram extraction, and data augmentation to enhance robustness and generalization. An Attentive Statistics Pooling mechanism is employed for temporal feature summarization, while Grad-CAM-based explainability is incorporated to improve the interpretability of the diagnostic predictions. The model is rigorously validated using a five-fold cross-validation scheme, achieving a mean validation accuracy of 96.8% with consistently high F1-scores and recall rates across all folds. Comparative analysis with prior methods highlights the superiority of our ECAPA-TDNN-based approach in terms of diagnostic precision, robustness, and potential clinical applicability. To the best of our knowledge, this is the first work to adapt ECAPA-TDNN for COPD detection from respiratory sounds, establishing a new benchmark in interpretable and high-performance acoustic-based respiratory disease screening. Full article

Fully mechanized coal mining is a key method of coal extraction. As mining intensity increases, dust pollution in fully mechanized mining faces has become increasingly severe, significantly hindering the coal industry‘s alignment with the “Healthy China” strategy. To address the prominent dust pollution and the inefficiency of current spray dust suppression methods, this study proposes a combined spray dust suppression system. Using the Taigemiao mining area—where the coal dust exhibits hydrophilic characteristics—as a case study, we investigate the system’s spray flow field characteristics via numerical simulation. The results indicate that activating the shearer‘s external nozzles increases the airflow velocity near the shearer to 4 m/s, with the droplet concentration at the breathing zone height peaking at 28,786 mg/m³. Furthermore, activating the inter-support spray-induced dust removal device boosts the airflow velocity to 15.8 m/s, generating negative pressure at the dust suction inlet and forming a high-concentration droplet zone near the coal wall. During the operation of the combined system, the droplet distribution is characterized by “three high-concentration areas” and “post-nozzle attenuation.” The optimal droplet proportion reaches 93.81%, maintaining an appropriate velocity within the efficient dust capture range. Overall, the dust capture efficiency of the combined system is significantly superior to that of a single spray system. Full article

Background and Objectives: Pregnancy causes various physiological and hormonal changes that disrupt sleep architecture and modify respiratory patterns, increasing the risk of sleep-related breathing disorders (SBDs) such as obstructive sleep apnea (OSA) and potentially exacerbating pre-existing conditions. These disorders have been linked to adverse maternal and fetal outcomes. However, current screening tools remain inadequate, and data, including from Portugal, remain limited. This study aimed to assess the prevalence of SBD symptoms suggestive of sleep-disordered breathing during pregnancy, characterize the population, and explore associations with demographic and anthropometric parameters. Materials and Methods: A prospective observational study was conducted from July to December 2024 at Hospital da Luz Lisboa, involving pregnant women ≥ 18 years attending routine consultations. Participants completed a structured questionnaire that assessed demographic and anthropometric data, comorbidities, ten SBD symptoms, and the Epworth Sleepiness Scale (ESS). Results: The cohort included 289 participants, with a mean age of 34.4 years and pre-pregnancy body mass index (BMI) of 23.6 kg/m². On average, women reported 3.1 SBD symptoms, with fatigue (65.4%), memory/concentration impairment (52.2%), and non-restorative sleep (50.5%) being the most common. Excessive daytime sleepiness (ESS >10) was present in 22.8% of the population. Snoring was significantly associated with older age and higher BMI (p = 0.0009 and p < 0.0001, respectively). Both the number of symptoms and ESS scores tended to increase with gestational age, particularly in the third trimester. Women with diabetes had higher odds of reporting snoring, nocturnal dyspnea, and witnessed apneas, with odds ratios of 4.65, 8.77, and 11.38, respectively. Conclusions: SBD symptoms and daytime sleepiness are highly prevalent in pregnancy and typically increase with advancing gestation. These findings emphasize the need for improved clinical strategies to enable early identification and management of SBD in pregnant women, thereby reducing maternal-fetal complications. Full article

Severe nasal vestibular stenosis in brachycephalic cats involves species-specific anatomical structures distinct from those in dogs, often leading to a high recurrence rate even after standard surgical correction. This case report introduces an innovative surgical strategy for a refractory Exotic Shorthair cat presenting with obligate open-mouth breathing and complete nasal obstruction despite three previous surgical interventions. To remove the recurrent scar tissue and maximize the nasal vestibular lumen, a combined surgical approach was performed, incorporating a ventral vertical resection, bilateral wedge resections, and bilateral single pedicle advancement flaps. To maintain the acquired airway and prevent restenosis, a steroid-eluting bioabsorbable implant (PROPEL Contour) was placed within the resected nasal vestibule, marking its first application in veterinary medicine. Postoperatively, open-mouth breathing resolved immediately. At the long-term 20-month follow-up, normal nasal breathing was maintained without restenosis or nasal discharge, with complete resolution of all preoperative clinical signs, and no implant-related adverse effects or infections were observed. The concurrent application of radical structural resection and a PROPEL Contour implant effectively suppresses tissue regrowth and maintains stable nasal patency, offering a highly promising therapeutic protocol for refractory feline nasal vestibular stenosis. Full article

Background: Race walking, an Olympic discipline, produces an increase in energy cost and a change in the recruitment pattern of muscle fibres compared with running, yet the cardiorespiratory responses of elite race walkers to severe-intensity exercise remain poorly characterised. Objectives: (i) To determine whether exhaustive exercise performed at vΔ50 elicits VO₂max in young elite race walkers, and (ii) to compare the temporal and metabolic profiles of this effort with those of similarly trained runners. Methods: Fourteen elite junior athletes (seven race walkers and seven runners) completed an incremental test to determine velocity at the lactate threshold (vLT), vVO2max, and VO2max, followed by a constant-velocity trial at individual vΔ50 performed to voluntary exhaustion on a 400 m track. Breath-by-breath VO2, heart rate, capillary blood lactate concentration, and time to exhaustion, time limit (Tlim) were measured. Results: At vΔ50 (≈94% vVO2max), the race walkers reached VO2max, with no detectable VO2 slow component (SC) in six of seven participants. In contrast, runners exhibited a significant SC (8 ± 3% of total VO2). The energy cost (EC) was 16% higher in race walking than in running (p < 0.01). Conclusions: In elite junior race walkers, it seems that vΔ50 reliably elicits VO2max primarily due to a high baseline oxygen cost rather than a progressive VO2 SC, contrasting with the kinetic response observed in running. These discipline-specific responses suggest that interval training in race walking should be prescribed using walking-specific thresholds. This study is preliminary, given the small sample size; further studies with larger cohorts are warranted. Full article

Despite many efforts to curtail drunk driving, alcohol-related traffic fatalities and injuries continue to be a major public health problem in the United States (U.S.) and most of the world. Technologies exist that prevent an automobile from starting if the driver’s breath alcohol exceeds 20 milligrams per deciliter (mg/dL), but these devices are only fitted to vehicles of individuals who have been convicted of Driving Under the Influence (DUI). A new approach must be taken to reduce the incidence of drunk driving by integrating an alcohol sensor system in vehicles as part of the delivered hardware. The system must be fast, accurate, and contactless—meaning that a forced exhalation is not required to measure the concentration of alcohol on the breath. We report on a novel device, the Driver Alcohol Detection System for Safety (DADSS) Breath Alcohol Sensor System, which uses the mid-infrared region of the electromagnetic spectrum to concurrently monitor alcohol and expired carbon dioxide (CO₂) to accurately quantify the breath alcohol concentration in samples that have been diluted in the atmosphere before being measured. The system was validated in a research laboratory with 70 male and female volunteers in 187 individual study days. Participants were given various doses of alcohol to consume and then breath and blood samples were collected simultaneously. Pearson correlation coefficients between the DADSS Breath Alcohol Sensor system and blood samples indicate a strong correlation between the measures, with an overall Pearson correlation of 0.8875 over an alcohol concentration range of 0–220 mg/dL. These results indicate that incorporating the DADSS system into motor vehicles has the potential to reduce the incidence of drunk driving. Full article

Breathing-controlled electrical stimulation (BreEStim) is an innovative neuromodulation intervention that synchronizes deep voluntary breathing with peripheral electrical stimulation. Prior studies have shown its analgesic effects in healthy adults and spinal cord injury patients with neuropathic pain. The present study used EEG to examine BreEStim’s neural effects on sensory, affective, and cognitive components of pain. Fourteen healthy participants (7 M, 7 F) completed 30 min of BreEStim and conventional electrical stimulation (EStim) interventions in a randomized, crossover within-subject design. Electrical pain thresholds (EPT) and EEG were recorded pre- and post-intervention. Event-related potentials (ERPs) at pre-EPT-level stimuli before and immediately after each intervention were analyzed for early sensory (P30) and affective (P250) processing, while resting-state EEG assessed spectral power across delta, theta, alpha, and beta bands for cognitive processing. Both BreEStim and EStim increased EPT, indicating short-term habituation. There was no change in early ERP responses (P30) after each intervention, suggesting preserved sensory perception. BreEStim selectively reduced P250, reflective of the affective component of pain. BreEStim significantly increased delta and theta band power and reduced alpha band power on resting-state EEG analyses, whereas no significant changes after EStim were observed. Collectively, BreEStim preserves sensory encoding while selectively modulating affective and cognitive dimensions of pain, supporting its potential as a targeted, non-pharmacological neuromodulation strategy. Full article

Work-related stress is a significant concern among employees in multinational corporations, where workloads and performance expectations are high. This study examines pre–post changes associated with a Virtual Reality (VR)-based mindfulness intervention designed to support stress management after a workday. A sample of 134 corporate employees from multinational companies reporting moderate to high stress participated in the study. Physiological indicators, including heart rate and skin conductance, were recorded before and after the VR session, alongside self-reported measures of perceived stress and relaxation. The intervention consisted of immersive VR environments integrating guided breathing, calming narration, and natural landscapes. Results indicated significant reductions in physiological stress markers following the intervention compared to baseline levels, accompanied by improvements in self-reported relaxation, reduced tension, and enhanced mental clarity. These findings suggest that VR-based mindfulness is associated with short-term reductions in both physiological and perceived stress. VR-based mindfulness may represent a complementary and non-invasive approach to stress management in individuals exposed to high occupational demands. Future research using controlled designs and longitudinal approaches is needed to evaluate the sustained effects of repeated VR sessions and their integration into corporate wellness programs. Full article

Background: Gymnasts are reported as a population at high risk of low back pain. The prevention and treatment of low back pain often rely on improving the effectiveness of deep stabilizer muscles through exercises that aim to reach spinal alignment and axial lengthening. However, the scientific evidence regarding the effect of the specific instructions used during exercises on the spinopelvic complex is still lacking. To address this gap of knowledge, the aim of this pilot study was to examine the effect of specific postural and breathing instructions (spine straightening, forced expiration and perineal contraction) on the sagittal alignment of the spine before and after fifteen weeks of a specific muscle strengthening program. Methods: Low-dose biplanar radiographic images were taken in neutral position and in the five specific postures before and after the program and associated skeletal 3D reconstructions were performed allowing calculation of sacral slope, pelvic tilt, lumbar lordosis and thoracic kyphosis. Results: Sixteen gymnasts completed the entire protocol and were included in the analysis. At the end of the program, most of the postures tested led to a decrease in sacral slope, an increase in pelvic tilt, a reduction in lumbar lordosis, and a decrease in thoracic kyphosis, but with varying efficiency; the condition combining spine straightening, perineal contraction and forced expiration appeared to be the most effective in influencing all parameters simultaneously. Conclusions: The results strongly encourage combining an instruction of spine straightening with instructions of both expiration and perineal contraction, which is information of interest for coaches, physiotherapists and medical professionals. Full article

Measles remains a major global public health challenge as declining vaccination coverage fuels outbreaks worldwide. Although pneumonia is the most recognized respiratory complication, spontaneous air leak syndrome—including pneumomediastinum, subcutaneous emphysema, and pneumoperitoneum—is rarely documented. We report the case of a 9-year-old previously healthy girl with no documented measles–rubella vaccination who presented with fever, maculopapular exanthem, Koplik spots, and persistent cough. Measles was confirmed by both immunoglobulin M enzyme-linked immunosorbent assay and real-time reverse transcription polymerase chain reaction. She developed sudden cervicothoracic swelling and chest pain. Chest radiography revealed pneumomediastinum and subcutaneous emphysema; computed tomography confirmed extensive air leak including pneumoperitoneum. Flexible bronchoscopy and upper gastrointestinal endoscopy excluded structural airway and esophageal injury. Laboratory evaluation revealed elevated hepatic transaminases, gamma-glutamyl transferase, lactate dehydrogenase, and D-dimer. Conservative management with high-flow supplemental oxygen and clinical surveillance led to progressive resolution. The patient was discharged on hospital day three, asymptomatic and breathing room air. This case highlights the spectrum of air leak complications in measles and supports conservative management in hemodynamically stable pediatric patients when structural injury has been excluded. Full article

Idiopathic pulmonary fibrosis (IPF) and autoimmune usual interstitial pneumonia (aUIP) share overlapping clinico-radiological features, complicating differential diagnosis. Electronic nose (eNose) technology characterizes exhaled breath profiles (“breathprints”) and may offer a non-invasive diagnostic approach in fibrotic interstitial lung diseases. To evaluate whether eNose breathprint analysis can discriminate between IPF and aUIP. In this cross-sectional study of 60 patients (34 IPF, 26 aUIP), breathprints were analyzed using principal component analysis (PCA, retaining eigenvalues > 1). Group differences were assessed via independent t-tests. Linear discriminant analysis (LDA) with leave-one-out cross-validation evaluated the discriminatory performance of PC combinations. PCA identified four principal components, with PC1 explaining 96% of the total variance. PC1 scores were significantly higher in aUIP compared to IPF (mean difference −0.53; 95% CI −1.04 to −0.02; p = 0.04); PC2-PC4 showed no significant differences (p > 0.3). LDA utilizing PC1 and PC3 achieved a cross-validated classification accuracy of 73.3% (95% CI 60.7–84.4, p < 0.05). eNose-derived breathprints showed preliminary discriminatory potential between IPF and autoimmune UIP, supporting further validation of this non-invasive adjunctive approach. Breathomics represents a promising non-invasive adjunctive tool for phenotyping fibrotic interstitial lung diseases, though larger validation studies integrating clinical and biological data are warranted. Full article

The kidney and the brain share similarities in terms of structure and haemodynamic regime. The aim of the study was to assess a potential correlation of vascular endothelial growth factor (VEGF), soluble vascular endothelial growth factor receptor-1 (sFlt-1), and placental growth factor (PlGF) with biomarkers of podocyte damage, proximal tubular (PT) dysfunction, and endothelial dysfunction, as well as with cerebral vessels haemodynamic indices in neurologic asymptomatic type 2 DM patients. A cohort of 212 patients diagnosed with type 2 DM and 49 age- and gender-matched healthy controls were enrolled in the study. Parameters studied were urinary albumin/creatinine ratio (UACR), biomarkers of podocyte damage (synaptopodin, podocalyxin), PT dysfunction (kidney injury molecule-1-KIM-1, N-acetyl-β-(D)-glucosaminidase-NAG), endothelial dysfunction (P-selectin), VEGF, sFlt-1, and PlGF. The cerebrovascular hemodynamic indices evaluated were intima–media thickness (IMT) in the common carotid arteries (CCAs), the pulsatility index (PI), and the resistivity index (RI) in the internal carotid arteries (ICAs) and middle cerebral arteries (MCAs). Cerebrovascular reactivity (CVR) was assessed by the breath-holding index (BHI). In multivariable regression analysis, serum VEGF correlated directly with UACR, synaptopodin, NAG, serum P-selectin; serum sFlt-1 correlated directly with UACR, synaptopodin, podocalyxin, NAG, KIM-1; serum PlGF correlated negatively with eGFR and directly with UACR, synaptopodin, KIM-1. IMT-CCA correlated indirectly with eGFR and directly with UACR, serum P-selectin, and serum sFlt-1. The PI-ICAs correlated negatively with eGFR and positively with UACR, synaptopodin, serum P-selectin, and serum sFlt-1. The PI-MCAs correlated indirectly with eGFR and directly with synaptopodin, serum P-selectin, and serum sFlt-1. The RI-ICAs had a negative correlation with eGFR and a positive one with UACR, synaptopodin, NAG, KIM-1, urinary sFlt-1, and serum PlGF. The RI-MCAs displayed an indirect correlation with eGFR and a direct correlation with NAG, KIM-1, and serum sFlt-1. The BHT correlated directly with eGFR and negatively with serum P-selectin and serum PlGF. The study shows a significant association of VEGF, sFlt-1, and PlGF with biomarkers of podocyte injury, PT dysfunction, and endothelial dysfunction in early stages of DKD. These pro-angiogenic and anti-angiogenic factors correlated with cerebrovascular haemodynamic indices in neurologic asymptomatic type 2 DM, even in the normoalbuminuric stage of diabetic kidney disease. Full article

Furuncular myiasis is rarely reported in Southeast/Eastern Europe and may be underrecognized or misdiagnosed in non-endemic settings. We described two imported furuncular myiasis cases diagnosed in Romania following travel to Peru and confirmed the etiologic agent by larval morphology and mitochondrial cytochrome c oxidase subunit I (COI) sequencing. We also conducted a narrative review of published case reports/series from Southeast/Eastern Europe (1900–2025) and summarized case characteristics. A previously healthy 31-year-old woman and 32-year-old man presented with painful furuncle-like lesions on the upper back near the shoulder and the posterolateral upper arm, respectively, associated with pruritus and a sensation of movement. Each lesion had a central punctum with intermittent air bubbles. Occlusion of the breathing pore with petroleum jelly facilitated mechanical extraction of one barrel-shaped larva per lesion. Microscopy showed features consistent with second-instar Dermatobia hominis larvae, and COI sequencing demonstrated 97.14–99.33% identity with reference D. hominis sequences. Literature review identified 25 travel-associated cases, with D. hominis involved mostly after travel to Central/South America. These cases highlight the value of travel history and key diagnostic clues for D. hominis myiasis in travelers that may enable timely diagnosis and minimally invasive management. Greater awareness and reporting are needed to better define epidemiology. Full article

The Chinese giant salamander (Andrias davidianus) is a nationally protected species in China, and its respiratory behavior serves as a key indicator of its physiological state, health status, and biological rhythm. However, research on intelligent monitoring of its respiratory behavior remains limited due to several challenges, including the species’ nocturnal habits, resulting in low image contrast and poor quality in dark environments; extremely subtle breathing movements; and high-cost manual annotation, leading to a scarcity of high-quality annotated visual data. These factors severely constrain the application of deep learning techniques in this field. To support research on respiratory behavior monitoring in the Chinese giant salamander, this study constructs and releases the CGS-BR dataset, which is the first vision-based dataset dedicated specifically to respiratory behavior detection in this species. The dataset was collected under controlled simulated breeding conditions and consists of 1732 images extracted from 215 high-definition video clips. Following a standardized procedure, each complete respiratory cycle is manually annotated into four stages: head-up, diving, exhalation, and inhalation. To validate the effectiveness of this dataset, this study selects YOLOv8n as the baseline model, which balances detection accuracy, speed, and parameter count, enabling efficient giant salamander respiratory detection under limited resources. By comparing it with several representative models, we provide a reliable evaluation of the dataset’s applicability. CGS-BR aims to provide fundamental data support for research on respiratory monitoring in the Chinese giant salamander, laying the foundation for subsequent applications in conservation management, captive breeding, health monitoring, and early disease warning. Full article

Background/Objectives: Radiation therapy for left-sided breast cancer exposes the heart and lungs to incidental radiation, increasing long-term risk of cardiopulmonary morbidity. This study evaluated the dosimetric impact of DIBH compared with free breathing (FB) and explored patient- and treatment-related predictors of benefit. Methods: We retrospectively analyzed 90 patients with left-sided breast cancer or chest wall irradiation planned under both FB and DIBH. Dosimetric parameters included mean heart dose (MHD), mean lung dose (MLD), heart V5, and lung V20. Univariable analyses assessed associations between dose reductions (Δ%) and clinical factors (age, BMI, fractionation, boost, nodal fields, and smoking). Multivariable regression identified independent predictors. Results: DIBH significantly reduced mean doses to the heart (FB 4.25 ± 1.47 Gy vs. DIBH 2.64 ± 1.28 Gy; Δ −1.60 Gy, p < 0.001, and Cohen’s d = 2.46) and lung (FB 14.00 ± 3.45 Gy vs. DIBH 11.64 ± 3.32 Gy; Δ −2.36 Gy, p < 0.001, and Cohen’s d = 2.73). Similarly, heart V5 (median Δ −10.5%, p < 0.001) and lung V20 (median Δ −5.5%, p < 0.001) were significantly improved. Higher BMI was independently associated with smaller relative reductions in MHD (−1.4% per unit, p < 0.001) and MLD (−0.31% per unit, p = 0.019). Hypofractionation was linked to greater MHD and MLD reductions (+8.9%, p = 0.007), (3.7%, p = 0.035), respectively. Supraclavicular field irradiation increased lung exposure, while internal mammary chain fields elevated both lung and heart doses. Age showed no significant influence. Conclusions: DIBH provides robust and consistent reductions in cardiac and pulmonary radiation doses during left-sided breast irradiation. The degree of sparing is modulated by BMI, fractionation, and nodal field inclusion. Full article