Search Results (219)

Background: Chronic stress in childhood and adolescence leads to excessive cortisol secretion, adipokines production and obesity with all the negative mental and physical effects on the health of individuals and adulthood. Objectives: The aim of the present non-randomized controlled trial was to investigate the effect of a stress management protocol with diaphragmatic breathing (DB) and physiotherapy exercise on stress, body composition, cardiorespiratory and metabolic markers of children and adolescents with morbid obesity. Methods: The study included 31 children and adolescents (5–18 years old) with morbid obesity (22 in the intervention arm and 9 controls). All participants completed anxiety questionnaires and a self-perception scale. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), blood pressure (BP) and SpO₂ were measured. Fasting glucose, uric acid, triglycerides, HbA1c, (AST/SGOT), (ALT/SGPT), HDL, LDL, insulin, ACTH, cortisol, HOMA-IR, 17-OH, S-DHEA, SHBG were assessed, and anthropometric measurements were also performed. Results: In the intervention group, 4 months after the treatment, an improvement was noted in the BMI, BMI z-score, waist-to-height ratio, FEV1, SpO₂, pulse and systolic BP. HDL increased, ALT/SGPT and insulin resistance improved. Positive changes were observed in temporary and permanent stress and self-esteem of children in the intervention group, including anxiety, self-perception, physical appearance, etc. Conclusions: A combined exercise and DB protocol has a positive effect on stress, by improving body composition, reducing insulin resistance, and ameliorating physical and mental health and quality of life of pediatric patients with morbid obesity. Full article

Nasal obstruction is a common symptom of nasal conditions, with nasal resistance being a crucial physiological indicator for assessing severity. However, traditional rhinomanometry faces challenges with interference, limited automation, and unstable measurement results. To address these issues, this research designed a nasal resistance measurement system based on multi-sensor fusion of pressure and flow. The system comprises lower computer hardware for acquiring raw pressure–flow signals in the nasal cavity and upper computer software for segmenting and filtering effective respiratory cycles and calculating various nasal resistance indicators. Meanwhile, the system’s anti-interference capability was assessed using recall, precision, and accuracy rates for respiratory cycle recognition, while stability was evaluated by analyzing the standard deviation of nasal resistance indicators. The experimental results demonstrate that the system achieves recall and precision rates of 99% and 86%, respectively, for the recognition of effective respiratory cycles. Additionally, under the three common interference scenarios of saturated or weak breaths, breaths when not worn properly, and multiple breaths, the system can achieve a maximum accuracy of 96.30% in identifying ineffective respiratory cycles. Furthermore, compared to the measurement without filtering for effective respiratory cycles, the system reduces the median within-group standard deviation across four types of nasal resistance measurements by 5 to 18 times. In conclusion, the nasal resistance measurement system developed in this research demonstrates strong anti-interference capabilities, significantly enhances the automation of the measurement process and the stability of the measurement results, and offers robust technical support for the auxiliary diagnosis of related nasal conditions. Full article

Background: There has been a reduction in successful H. pylori eradication rates recently, which is largely attributed to increasing antibiotic resistance. In areas of high dual clarithromycin and metronidazole resistance such as ours, Maastricht VI/Florence guidelines recommend bismuth quadruple therapy (BQT) as first line of therapy; however, the availability of bismuth was poor in Ireland until recently. Similarly, tetracycline, a component of BQT, is restricted locally, with doxycycline (D) being approved and reimbursed for most indications. Aims: To assess the efficacy of BQT-D therapy for H. pylori eradication in an Irish cohort. Methods: All patients testing positive for H. pylori in three Irish referral centres by urea breath test, stool antigen, or histology were treated prospectively with BQT-D (bismuth subcitrate 120 mg QDS, metronidazole 400 mg TDS, doxycycline 100 mg BD and esomeprazole 40 mg BD) for 14 days. Eradication was evaluated with a urea breath test (UBT) >4 weeks after therapy cessation or by stool antigen testing, as available. Outcomes were recorded and analysed according to demographics and H. pylori treatment history of the patients. Results: 217 patients completed post-eradication testing. Of which, 124 (57%) were female, with a mean age 52 years. 180 patients (83%) were treatment-naïve. A total of 165/180 (92%) of the treatment-naïve patients had successful eradication. There was no association between eradication and gender or age in this cohort (p = 0.3091, p = 0.962 respectively). A total of 29 patients received this therapy as second-line therapy, of which 22 (76%) had successful eradication. Eight patients received the regimen as rescue therapy, with seven (88%) having successful eradication. No serious adverse events were reported. Eleven individuals (6.5%) commented on the complicated nature of the regimen, with 11 tablets being taken at five intervals daily. Conclusions: BQT-D as first-line therapy for H. pylori infection is highly effective in a high dual-resistance population, achieving >90% eradication. BQT-D as a second-line treatment performed less well. Our data support BQT-D as a first-line treatment. Full article

Resistive gas sensors have attracted significant attention due to their simple architecture, low cost, and ease of integration, with widespread applications in environmental monitoring, industrial safety, and healthcare diagnostics. This review provides a comprehensive overview of recent advances in resistive gas sensors, focusing on their fundamental working mechanisms, sensing material design, device architecture optimization, and intelligent system integration. These sensors primarily operate based on changes in electrical resistance induced by interactions between gas molecules and sensing materials, including physical adsorption, charge transfer, and surface redox reactions. In terms of materials, metal oxide semiconductors, conductive polymers, carbon-based nanomaterials, and their composites have demonstrated enhanced sensitivity and selectivity through strategies such as doping, surface functionalization, and heterojunction engineering, while also enabling reduced operating temperatures. Device-level innovations—such as microheater integration, self-heated nanowires, and multi-sensor arrays—have further improved response speed and energy efficiency. Moreover, the incorporation of artificial intelligence (AI) and Internet of Things (IoT) technologies has significantly advanced signal processing, pattern recognition, and long-term operational stability. Machine learning (ML) algorithms have enabled intelligent design of novel sensing materials, optimized multi-gas identification, and enhanced data reliability in complex environments. These synergistic developments are driving resistive gas sensors toward low-power, highly integrated, and multifunctional platforms, particularly in emerging applications such as wearable electronics, breath diagnostics, and smart city infrastructure. This review concludes with a perspective on future research directions, emphasizing the importance of improving material stability, interference resistance, standardized fabrication, and intelligent system integration for large-scale practical deployment. Full article

This study investigated a factory fire that resulted in an unusual situation that caused the deaths of two firefighters. The official fire investigation report was analyzed, records were obtained, and on-site investigations and interviews were conducted. Using these additional data and a calorimetric analysis to determine the combustibility of goods stored in the building at the time, a functional 3D model was produced, and a fire dynamics simulator (FDS) was run. The model was augmented using the results of calorimetric experiments for three types of primary goods being stored in the warehouse area: paper lunch boxes, tissue paper, and corrugated boxes. The reaction heat data obtained for each of the three sample types was 848.24, 468.29, and 301.21 J g⁻¹, respectively. The maximum mass loss data were 98.522, 84.439, and 90.811 mass% for each of the three types, respectively. A full-scale fire scene reconstruction confirmed the fire propagation routes and changes in fire hazard factors, such as indoor temperature, visibility, and carbon monoxide concentration. The FDS results were compared to the NIST recommended values for firefighter heat exposure time. The cause of death for both firefighters was also investigated in terms of the heat resistance of the facepiece lenses of their self-contained breathing apparatus. Based on the findings of this study, recommendations can be made to forestall the recurrence of similar events. Full article

Diabetic kidney disease (DKD) displays a high prevalence of cardiovascular and cerebrovascular disease. Both the kidney and the brain share common pathogenic mechanisms, such as inflammation, endothelial dysfunction, oxidative stress, and mitochondrial dysfunction. The aim of this study was to establish a potential association of cerebral vessel remodeling and its related functional impairment with biomarkers of inflammation, oxidative stress, and mitochondrial dysfunction in the early stages of DKD in type 2 diabetes mellitus (DM) patients. A cohort of 184 patients and 39 healthy controls was assessed concerning serum and urinary stromal cell-derived factor-1 (SDF-1), P-selectin, advanced oxidation protein products (AOPPs), urinary synaptopodin, podocalyxin, kidney injury molecule-1 (KIM-1), and N-acetyl-β-(D)-glucosaminidase (NAG). The quantification of the mitochondrial DNA copy number (mtDNA-CN) and nuclear DNA (nDNA) in urine and peripheral blood was conducted using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Using TaqMan tests, the beta-2 microglobulin nuclear gene (B2M) and the cytochrome b (CYTB) gene, which encodes subunit 2 of NADH dehydrogenase (ND2), were evaluated. The MtDNA-CN is the ratio of mitochondrial DNA to nuclear DNA copies, ascertained through the examination of the CYTB/B2M and ND2/B2M ratios. The intima-media thickness (IMT) measurements of the common carotid arteries (CCAs), along with the pulsatility index (PI) and resistivity index (RI) of the internal carotid arteries (ICAs) and middle cerebral arteries (MCAs), were obtained through cerebral Doppler ultrasonography (US). Additionally, the breath-holding index (BHI) was also measured by cerebral Doppler US. PI-ICAs, PI-MCAs, CCAs-IMT, RI-MCAs, and RI-ICAs demonstrated direct relationships with SDF-1, P-selectin, AOPPs, urine mtDNA, podocalyxin, synaptopodin, NAG, and KIM-1 while showing indirect correlations with serum mtDNA and the eGFR. In contrast, the BHI had negative correlations with SDF-1, P-selectin, AOPPs, urine mtDNA, synaptopodin, podocalyxin, KIM-1, and NAG while showing direct associations with serum mtDNA and the eGFR. In conclusion, a causative association exists among SDF-1, P-selectin, and AOPPs, as well as mitochondrial dysfunction, in early diabetic kidney disease (DKD) and significant cerebrovascular alterations in patients with type 2 diabetes mellitus and normoalbuminuric DKD, with no neurological symptoms. Full article

Background/Objectives: Sleep-disordered breathing (SDB), historically referred to as “sleep apnea syndrome”, particularly obstructive sleep apnea (OSA), is an independent risk factor for hypertension (HTN), stroke, heart failure, arrhythmias, and other cardiovascular disorders. Despite the well-established link between OSA and HTN and its high occurrence in cardiovascular disorders, the focus on the complex OSA–HTN axis is often overlooked or inadequately managed, which might explain the lack of notable improvements in cardiovascular outcomes for this patient population. Understanding the complex relationship between OSA and HTN is crucial due to its significant implications for clinical practice and public health. Methods: Using an expanded list of relevant MeSH terms, including “sleep-disordered breathing” and “sleep apnea syndrome”, and following the PRISMA model, peer-reviewed articles were systematically selected. Studies published from January 2000 through December 2024 were identified and screened based on predefined inclusion and exclusion criteria. Results: This review emphasizes both OSA’s independent and interaction effects on cardiovascular health and outcomes across different populations. It identifies key factors mediating the association between OSA and HTN. Conclusions: Multimodal management, including continuous positive airway pressure and lifestyle modification, is essential for treating hypertension related to OSA. Effective management of the OSA–HTN relationship is vital to improving cardiovascular outcomes. Full article

Gold nanoparticles–cuprous oxide/reduced graphene oxide/polypyrrole (AuNPs-Cu₂O/rGO/PPy) hybrid nanocomposites were synthesized for surface acoustic wave (SAW) sensors, achieving high sensitivity (2 Hz/ppb), selectivity, and fast response (~2 min) at room temperature. The films, deposited via spin-coating, were characterized by SEM, EDS, and XRD, revealing a rough, wrinkled morphology beneficial for gas adsorption. The sensor showed significant frequency shifts to NH₃, enhanced by AuNPs, Cu₂O, rGO, and PPy. It had a 6.4-fold stronger response to NH₃ compared to CO₂, H₂, and CO, confirming excellent selectivity. The linear detection range was 12–1000 ppb, with a limit of detection (LOD) of 8 ppb. Humidity affected performance, causing negative frequency shifts, and sensitivity declined after 30 days due to resistivity changes. Despite this, the sensor demonstrated excellent NH₃ selectivity and stability across multiple cycles. In simulated breath tests, it distinguished between healthy and patient-like samples, highlighting its potential as a reliable, non-invasive diagnostic tool. Full article

Multiple sclerosis (MS) is a chronic and incurable neurological disease of the central nervous system. Three main forms of the disease have been distinguished: relapsing–remitting form (RRMS), secondary progressive form (SPMS), and primary progressive form (PPMS). Currently, in patients with MS, in addition to pharmacotherapy, neurorehabilitation is indicated to improve the motor function of the body and action in the most physiological movement patterns possible. In this therapy, work on lost or incorrect functions is used to provide the patient with self-sufficiency in everyday life. Kinesiotherapy is used as part of neurorehabilitation. This therapy for MS includes coordination exercises aimed at facilitating movement, strengthening exercises and resistance training, balance exercises, improving stability during everyday activities stretching and relaxation exercises, improving tissue elasticity, reducing tension, and breathing exercises. In this article, we present various possibilities for using kinesiotherapy in patients with MS at various stages of disease development. Moreover, we would like to draw attention to the benefits of physical activity leading to a significant improvement in the quality of life in MS patients. We believe that a regular exercise program should be part of the neurorehabilitation program in these patients in the future. Full article

Background/Objectives: Active gamification, which incorporates game elements with physical interaction, is presented as an innovative strategy to address anxiety problems and sleep quality in children. This study aimed to evaluate the impact of an active gamification program on the aforementioned variables in children in primary education. Methods: This study utilized a randomized, controlled trial with 120 children between 8 and 11 years of age, divided into an experimental group, which participated in a 12-week gamified program, and a control group, which continued with traditional physical education classes. Results: The main findings indicate that the intervention had a significant impact on reducing anxiety, with improvements in most of the subscales evaluated except for the obsessive-compulsive disorder subscale. Significant improvements were also found in sleep quality, with reductions in bedtime resistance, nighttime awakenings, parasomnias, and sleep-disordered breathing, although no significant changes were noted in sleep-onset delay, sleep duration, sleep anxiety, and daytime sleepiness. Conclusions: The gamification intervention in physical exercise showed positive effects in reducing anxiety and improving sleep quality in primary school children, highlighting its potential as an intervention strategy in primary education classrooms. Full article

Forcecardiography (FCG) uses force sensors to record the mechanical vibrations induced on the chest wall by cardiac and respiratory activities. FCG is usually performed via piezoelectric lead-zirconate titanate (PZT) sensors, which simultaneously record the very slow respiratory movements of the chest, the slow infrasonic vibrations due to emptying and filling of heart chambers, the faster infrasonic vibrations due to movements of heart valves, which are usually recorded via Seismocardiography (SCG), and the audible vibrations corresponding to heart sounds, commonly recorded via Phonocardiography (PCG). However, PZT sensors are not flexible and do not adapt very well to the deformations of soft tissues on the chest. This study presents a flexible FCG sensor based on a piezoelectric polyvinylidene fluoride (PVDF) transducer. The PVDF FCG sensor was compared with a well-assessed PZT FCG sensor, as well as with an electro-resistive respiratory band (ERB), an accelerometric SCG sensor, and an electronic stethoscope for PCG. Simultaneous recordings were acquired with these sensors and an electrocardiography (ECG) monitor from a cohort of 35 healthy subjects (16 males and 19 females). The PVDF sensor signals were compared in terms of morphology with those acquired simultaneously via the PZT sensor, the SCG sensor and the electronic stethoscope. Moreover, the estimation accuracies of PVDF and PZT sensors for inter-beat intervals (IBIs) and inter-breath intervals (IBrIs) were assessed against reference ECG and ERB measurements. The results of statistical analyses confirmed that the PVDF sensor provides FCG signals with very high similarity to those acquired via PZT sensors (median cross-correlation index of 0.96 across all subjects) as well as with SCG and PCG signals (median cross-correlation indices of 0.85 and 0.80, respectively). Moreover, the PVDF sensor provides very accurate estimates of IBIs, with R² > 0.99 and Bland–Altman limits of agreement (LoA) of [−5.30; 5.00] ms, and of IBrIs, with R² > 0.96 and LoA of [−0.510; 0.513] s. The flexibility of the PVDF sensor makes it more comfortable and ideal for wearable applications. Unlike PZT, PVDF is lead-free, which increases safety and biocompatibility for prolonged skin contact. Full article

Developing reliable noninvasive diagnostic and monitoring systems for diabetes remains a significant challenge, especially in the e-healthcare domain, due to computational inefficiencies and limited predictive accuracy in current approaches. The current study integrates machine learning with a molecularly imprinted polymer biosensor for detecting D-glucose in the exhaled breath condensate or aerosol. Advanced models, such as Convolutional Neural Networks and Recurrent Neural Networks, were used to analyze resistance signals, while classical algorithms served as benchmarks. To address challenges like data imbalance, limited samples, and inter-sensor variability, synthetic data generation methods like Synthetic Minority Oversampling Technique and Generative Adversarial Networks were employed. This framework aims to classify clinically relevant glucose levels accurately, enabling non-invasive diabetes monitoring. Full article

Breath-hold diving (BHD) is defined as enduring apnea for more than 4 min. It is characterized by resistance of reactive oxygen species, reduced sensitivity to hypoxia, and low mitochondrial oxygen consumption. The energetic demands of different BHD disciplines (static, dynamic, and spearfishing) are various. Hence, the nutrition of these athletes may play an important role on their performance. The main aim of this study is to examine and propose recommendations for this specific population. Also, the aim is to divide nutrition according to main BHD disciplines (static, dynamic, and spearfishing). Mediterranean and alkaline diet could represent an appropriate BHD diet. Nutritional requirements differ between freediving (static and dynamic) and spearfishing, mainly because of the workload. Also, spearfishing includes multiple consecutive dives and hence has different recommendations. However, the proper nutrition for freedivers is based on a variety of natural foods that support acid–base balance, provide a stable source of energy, and facilitate quality recovery. By adopting healthy eating habits based on the Mediterranean and alkaline diet, along with regular hydration and adapting your diet to the specific needs of diving, divers can improve performance and ensure long-term health. Full article

Objectives and Methods: We developed a 10-item VAP care bundle to address the high incidence of VAP in Vietnamese intensive care units (ICUs), comprising (i) hand hygiene, (ii) head elevation (gatch up 30–45°), (iii) oral care, (iv) oversedation avoidance, (v) breathing circuit management, (vi) cuff pressure control, (vii) subglottic suctioning of secretions, (viii) daily assessment for weaning and a spontaneous breath trial (SBT), (ix) early ambulation and rehabilitation, and (x) prophylaxis of peptic ulcers and deep-vein thrombosis (DVT). The VAP incidence (27.0 per 1000 mechanical ventilation days) slightly and not significantly decreased in the six months after the implementation of the care bundle. Methods and Results: However, the VAP incidence (11.3 per 1000 mechanical ventilation days) significantly decreased when we updated the two-item protocol with interactive communication and education (p < 0.001). Conclusions: Although the effectiveness of the interventions via protocol updates with interactive education needs further study, this intervention can make a VAP care bundle work in a resource-constrained and multidrug-resistant environment. Full article

Water molecules from the environment or human breath are one of the main factors affecting the accuracy, efficiency, and long-term stability of electronic gas sensors. In this contribution, yttrium (Y)-doped La₂Ti₂O₇ (LTO) nanosheets were synthesized by a hydrothermal reaction, demonstrating improved proton conductivity compared to their non-doped counterparts. The response of Y-doped LTO with the optimal doping concentration to 100 ppm NO₂ at 43% relative humidity (RH) was −21%, which is four times higher than that of bare La₂Ti₂O₇. As the humidity level increased to 75%, the response of Y-doped LTO further increased to −64%. Unlike the gas doping effect observed in previous studies of semiconducting metal oxides, the sensing mechanism of Y-doped LTO nanosheets is based on the enhanced dissociation of H₂O in the presence of target NO₂ molecules, leading to the generation of more protons for ion conduction. This also resulted in a greater resistance drop and thus a larger sensing response at elevated humidity levels. Our work demonstrates that proton-conductive oxide materials are promising gas-sensing materials under humid conditions. Full article