Search Results (8,960)

Inflammatory bowel disease (IBD), a chronic inflammatory disorder with relapsing/remitting characteristics, lacks reliable non-invasive biomarkers for accurate diagnosis and longitudinal monitoring. This study explored salivary exosomal miRNAs as potential biomarkers to address this unmet clinical need. Using discovery (24 IBD patients [11 active, 13 remission] and 6 healthy controls [HCs]) and validation cohorts (102 IBD patients [53 active, 49 remission] and 18 HCs), we analyzed miRNA profiles via reverse transcription quantitative PCR (RT-qPCR). Receiver operating characteristic (ROC) curves evaluated diagnostic performance, with area under the curve (AUC) quantifying discriminatory capacity. Initial screening revealed 23 miRNAs significantly upregulated in IBD salivary exosomes. An 8-miRNA signature distinguished IBD patients from HCs in validation analyses, with five miRNAs (hsa-miR-1246, hsa-miR-142-3p, hsa-miR-16-5p, hsa-miR-301a-3p, and hsa-miR-4516) showing strong correlations with disease activity. The combination of hsa-miR-16-5p and hsa-miR-4516 achieved robust discrimination (AUC = 0.925 for IBD vs. HCs; AUC = 0.82 for active disease vs. remission). A composite model integrating all five miRNAs demonstrated superior performance (AUC = 1.00 for IBD/HC differentiation; AUC = 0.86 for disease activity assessment). These findings reveal dynamic associations between salivary exosomal miRNA signatures and IBD progression, underscoring their utility as non-invasive diagnostic tools. This approach enables serial sampling, enhances patient compliance, and provides actionable insights for personalized disease management, establishing salivary exosomal miRNAs as promising candidates for clinical translation in IBD care. Full article

This study aims to critically assesses the application and limitations of Universal Design (UD) and Inclusive Design (ID) in Bangkok’s public parks and proposes a context-sensitive framework to enhance urban inclusivity. While UD has contributed significantly to improving physical accessibility—through standardized features such as ramps, tactile paving, and clear circulation paths—it often fails to address emotional comfort, cultural representation, and participatory engagement. In contrast, ID emphasizes co-creation, contextual adaptability, and symbolic inclusion, offering a more holistic and equity-driven approach. Using a five-dimensional comparative framework—philosophy, function, spatial logic, user engagement, and evaluation—this research analyzes three major public parks: Benjakitti Forest Park, Chatuchak (Railway) Park, and Chulalongkorn Centenary Park. Each site was evaluated through narrative critique, dimension scoring, and radar diagram visualizations. The findings reveal that while all three parks exhibit strong UD characteristics, they lack alignment with ID principles, particularly in the areas of community engagement and emotional resonance. These typologies highlight a broader trend in Thai public space planning, wherein accessibility is interpreted narrowly as compliance rather than inclusion. The study concludes by proposing policy and design recommendations for embedding ID into future park development, positioning ID not only as a design approach but as a paradigm for spatial justice, belonging, and cultural sustainability. Full article

Determining the amount of biowaste generated, separated, and recycled at source in households (BHrecycled) is crucial for assessing its potential inclusion in the total mass of waste prepared for reuse and recycling on the country level. Although the EU has introduced standardized rules for BHrecycled measurement, it is still a major challenge. This study, the first to be conducted on a large scale in Poland and the EU countries, aimed to determine the actual mass of BHrecycled (kitchen waste (B_K) per capita per year (kg/(capita·year)) and garden waste (B_G) per square meter of green area (kg/(m²·year)) in 1150 households that use an active composting unit located in more than 400 municipalities in all the voivodeships in Poland. Each municipality is characterized by individual MSW generation (MSW_G) values (the amount of waste generated per capita per year). The MSW_G values of the municipality where the household was located were used to group the data of B_K and B_G. In Poland, the average masses of B_K and B_G remained within the ranges of 81.02–107.49 kg/(capita·year) and 1.02–2.87 kg/(m²·year), respectively, across the MSW_G value. However, there was no clear statistical relationship between the MSW_G value and B_K or B_G. The average masses of B_K and B_G were ca. 97 kg/(capita·year) and ca. 2 kg/(m²·year). These results enable the determination of the total amount of BHrecycled in Poland. By incorporating these findings into waste management, strategies, monitoring, and reporting practices can be improved. Moreover, it promotes compliance with the EU recycling targets. Full article

The Multi-User Textile Analysis Laboratory (LTex), a case study from a Brazilian university, was established to address the technical demands of the local textile industry, a regional hub with a predominantly female workforce. Globally, laboratories seeking recognition for their technical competence rely on accreditation to a widely adopted international standard. This work explores how the technical requirements of this standard can be integrated with Environmental, Social, and Governance (ESG) principles, using a Brazilian recommended practice aligned with global frameworks such as the UN Sustainable Development Goals as a reference. The goal is to propose a unified framework for sustainable and inclusive management in university laboratories. The research employed an exploratory literature review, a documentary analysis comparing the two normative documents, the development of a structured checklist, and the formulation of a conceptual model for sustainable and inclusive laboratory management. The findings identified both overlaps and gaps, particularly regarding risk management, transparency, and gender equity, and supported the creation of an evaluation tool structured around six thematic axes. The proposed checklist enables simultaneous assessment of technical compliance and ESG maturity, guiding laboratories toward aligning accreditation processes with sustainability goals. The LTex case study demonstrates the model’s applicability and its potential to foster regulatory compliance, organizational improvement, and female empowerment in technical leadership. Full article

Background/Objectives: Colorectal cancer (CRC) ranks third in the Western world in cancer incidence and second as the cause of cancer-related deaths. Despite advances in perioperative care, minimizing postoperative morbidity is crucial in clinical practice. Digitalization of the healthcare process plays a key role in genuinely and effectively engaging patients. Our aim was to evaluate a digital solution for remote monitoring of patients with CRC, from surgery indication to postoperative discharge. Methods: We developed a digital solution using Value Stream Mapping (VSM) to identify patient care flow and Lean Sigma for optimization and efficiency. We incorporated the Enhanced Recovery After Surgery (ERAS)/RICA pentamodal recommendations to create a program with an individualized schedule for each patient, who received tailored educational, medical, and practical information at every stage of the process. Results: A total of 193 patients used the digital solution, with >75% adhering to ERAS recommendations. The median length of hospital stay was 5 days, with low adherence leading to 3.4 (p = 0.628) or 3.27 (p = 0.642) extra days in the hospital compared to patients with intermediate and high adherence, respectively. The mean comprehensive complication index (CCI) was 9.1/100, which was higher in patients with low adherence (15) versus intermediate (8.17; p = 0.027) and high (7.42; p = 0.011) adherence. An increase in self-perception of quality of life by 9.2% was identified at the end of the process compared to the outcome at the beginning (p = 0.09), and 80% rated their overall satisfaction with the care process as 8 or higher out of 10. Conclusions: The digital solution facilitates the monitoring of CRC care and implementation and adherence to ERAS recommendations, improving patient engagement and satisfaction. Full article

Background/Objectives: The World Health Organization’s Surgical Safety Checklist (WHO SSC) is known to reduce surgical complications and mortality, yet its implementation remains inconsistent across institutions. This study evaluated compliance with a modified SSC and assessed the impact of structured interventions to improve adherence at the University Hospital of Split, Croatia. Methods: A before-and-after study analyzed a sample of 1437 completed SSCs over four time points between April 2024 and May 2025: the baseline and after three successive interventions (an official letter from the hospital director emphasizing mandatory SSC use, individual meetings with department heads and head nurses reinforcing its importance, and a quality audit review of SSC completeness with leadership). Checklist completeness was assessed across five SSC sections: General Information, Sign In, Time Out, Sign Out, and Staff Info. Results: Overall checklist completeness increased from 78.3 ± 8.5% at baseline to 86.3 ± 2.5%, 92.0 ± 3.8%, and 94.7 ± 4.8% after the first, second, and third interventions, respectively (p < 0.001). All checklist sections improved significantly: General Info rose from 91.1 ± 6.0% to 98.6 ± 2.6% (p < 0.001); Sign In from 85.0 ± 11.4% to 97.0 ± 3.5% (p = 0.002); Time Out from 79.0 ± 14.6% to 96.4 ± 6.5% (p < 0.001); Sign Out from 70.2 ± 11.2% to 87.7 ± 11.0% (p = 0.003); and Staff Info from 70.7 ± 12.9% to 100.0 ± 0.0% (p < 0.001). Post hoc testing confirmed significant gains versus baseline for all three interventions (Dunnett’s test), with a further significant improvement between the first and third interventions (Tukey’s HSD, p = 0.011). Conclusions: Structured, low-cost interventions emphasizing administrative support, education, and communication significantly improved SSC adherence across a large tertiary hospital. This initiative represents a pioneering effort in Croatia and offers a scalable model for similar public healthcare systems aiming to enhance patient safety. Full article

Background/Objectives: The COVID-19 pandemic significantly disrupted healthcare systems worldwide, leading to increased healthcare-associated infection rates, particularly in the intensive care unit (ICU) setting. Little is known about the evolution of this phenomenon in subsequent years. Methods: This retrospective analysis of prospectively collected data (January 2020–December 2024) examined central line-associated bloodstream infections (CLABSI) in the Wroclaw Medical University hospital’s ICU during and after the COVID-19 pandemic. Results: Ninety CLABSI cases were observed in 3149 ICU patients across 39,837 patient-days and 36,038 central-vascular-catheter-days (CVC-D). The mean CLABSI frequency was 2.97 per 100 admissions, with an incidence density of 2.49 per 1000 CVC-D. CLABSI occurred more frequently in males than in females (3.51% vs. 1.69%, p = 0.003) and in patients with concomitant SARS-CoV-2 infection than in individuals without such coinfection (6.06% vs. 1.88%, p = 0.00037). Microbiological analysis revealed Staphylococcus epidermidis as the most frequent etiological factor of CLABSI (33.3%). Alert pathogens constituted 34.26% of all CLABSI etiological factors, with higher prevalence during the pandemic than afterward (51.16% vs. 23.08%, p = 0.005437). Patients with CLABSI had significantly longer ICU stays (53.57 vs. 11.62 days, p = 0.001). After adjusting for immortal time bias using matched cohort analysis, CLABSI was not associated with increased mortality (p = 0.735). The overall compliance level of adherence to CLABSI prevention measures was 86.9%, with no statistically significant difference between the pandemic and post-pandemic periods, p = 0.417. The study did not systematically collect data on catheter types, insertion sites, or clinical circumstances (emergency vs. elective), which are known risk factors that may have influenced the observed CLABSI incidence rates. Conclusions: Despite increased patient volume post-pandemic, CLABSI metrics remained stable, possibly due to the successful adaptation of infection prevention protocols. However, interpretation of incidence data should consider unmeasured confounding factors. These findings address knowledge gaps regarding how the pandemic affected CLABSI epidemiology and antimicrobial resistance patterns, with implications for infection control practices during future healthcare crises. Full article

Background: Patients undergoing head and neck surgery with free flap reconstruction are at a high risk for postoperative respiratory complications, including hypoxemia. Conventional oxygen therapy (COT) and non-invasive ventilation (NIV) may be poorly tolerated or contraindicated due to anatomical limitations. High-Flow Nasal Cannula (HFNC) therapy represents a promising alternative, offering better humidification, comfort, and oxygenation. Methods: This retrospective single-center study included 50 adult patients admitted to the ICU after head and neck oncologic surgery with flap reconstruction from January 2022 to November 2024. All patients received HFNC immediately after extubation. Hypoxemia was defined as a PaO₂/FiO₂ (P/F) ratio of < 300 mm Hg. The primary outcome was the incidence of postoperative hypoxemia. Secondary outcomes included reintubation rates and patient compliance. Data were collected at 1, 6, 12, and 24 h following HFNC initiation. Results: Out of 59 patients screened, 9 were excluded per predefined criteria. Among the 50 included, only 2 patients (4%) developed hypoxemia, with P/F ratios remaining above 250. No patients required reintubation. The respiratory rate–oxygenation index (ROX index) improved steadily during the first 24 h. HFNC was well tolerated; only three patients required minor adjustments due to discomfort. Conclusions: HFNC use in the immediate postoperative period after head and neck surgery was associated with a low incidence of hypoxemia and no reintubations. These findings suggest that HFNC is a safe and effective strategy for postoperative respiratory support in this high-risk population. Further prospective studies are warranted to confirm the benefit of HFNC in reducing hypoxemia and preventing reintubation in high-risk surgical populations. Full article

Thermal stress poses escalating threats to aquatic ecosystems, yet current biomonitoring tools lack real-time integration of multidimensional physiological responses. To address this gap, we developed the Physiological and Ecological Comprehensive Analyzer (PECA), an integrated platform combining non-contact impedance sensors for behavior analysis, dissolved gas probes for metabolic monitoring, and wearable devices for cardiac signal acquisition in freely swimming fish. Using koi carp (Cyprinus carpio var. koi) under controlled thermal regimes (22 °C, 26 °C, 32 °C) with ethical compliance, the PECA calculated a novel Physiological Stress Index (PSI) integrating behavioral strength, the respiratory quotient, and electrocardiographic parameters. The results demonstrated significant PSI reductions under acute thermal stress, correlating with suppressed metabolism and altered cardiac function. This system provides a real-time solution for detecting thermal anomalies in aquatic environments, enabling proactive water resource management in climate-vulnerable ecosystems. Full article

Objectives: Transforming poorly soluble crystalline drugs into their amorphous form is a well-established strategy in pharmaceutical science to enhance their solubility and improve their clinical efficacy. However, developing amorphous forms of organic drugs for pharmaceutical applications presents significant technical hurdles due to the lack of suitable analytical tools for the amorphization process. Carbamazepine is a crystalline BCS class II drug commonly used for epilepsy and trigeminal neuralgia, whose clinical efficacy is compromised by its low solubility and slow dissolution. Therefore, this study focuses on investigating the amorphization of carbamazepine to enhance its solubility by using a micro-droplet precipitation system. Methods: These micro-droplets serve as individual reactors, enabling homogeneous nucleation for precipitation of carbamazepine. During crystallization, carbamazepine undergoes an intermediate liquid–liquid phase transition characteristic of two-step nucleation. By varying the solvent’s composition (methanol/water), we characterized the kinetics and stability of the intermediate liquid phase under various conditions. Results: Our results indicate that carbamazepine can undergo either a one-step liquid-to-amorphous-solid phase transition or a two-step liquid-to-crystalline-solid phase transition. Notably, both transitions pass through a liquid-to-dense-liquid phase separation process starting from the supersaturated solution, where the generated intermediate phases exhibit different sizes and numbers that are influenced by the solvent and its concentration. Conclusions: Our findings not only elucidate the mechanism underlying the carbamazepine phase transition but also propose a novel method for studying the amorphous process, which could be broadly applicable to other poorly soluble pharmaceutical compounds and may be helpful to amorphous formulations production, potentially offering significant improvements in drug efficacy and patient compliance. Full article

Microneedle (MN)–tissue interactions play a critical role in the efficiency and reliability of transdermal drug delivery and biosensing, yet their mechanistic understanding remains limited. This study systematically investigates the effects of biological (tissue type and temperature) and mechanical (needle design, material, and insertion velocity) parameters on the performance of microneedle insertion and extraction. Experiments were performed on porcine skin, chicken breast, and agarose gel to represent varying tissue properties. Additionally, the effect of tissue temperature on replicating physiological conditions, such as hypo- and hyperthermia, was evaluated using porcine skin as the sample. A novel conical MN design integrated with surface suction-cup structures was developed to improve tissue adhesion. Mechanical responses were analyzed through force–displacement measurements, evaluating insertion force, extraction force, and relaxation time. Results show that elevated tissue temperature reduces insertion and extraction forces while shortening relaxation times, indicating increased tissue compliance. The suction-cup MNs significantly enhanced needle–tissue adhesion, with the most pronounced effect observed in chicken breast tissue, achieving more than a four-fold increase in extraction force compared to conventional conical needles. These findings provide valuable insights into optimizing the design of MNs for advanced biomedical applications. Full article

The energy transformation of transport infrastructure represents a significant challenge, being implemented along the TEN-T network under the introduced AFIR regulation (Regulation for the Deployment of Alternative Fuels Infrastructure). The goal of this transformation is the development of alternative fuels infrastructure deployed along the Trans-European Transport Network (TEN-T), dedicated to light-duty electric vehicles (eLDVs) and heavy-duty electric vehicles (eHDVs). The measures undertaken must be preceded by an analytical process assessing the assumptions outlined in the AFIR regulation, defining targeted actions for achieving the regulation’s objectives, and evaluating the baseline status as well as projected conditions for the years 2025, 2027, 2030, and 2035. This assessment is essential during the planning and management stages of the energy transformation process of transport infrastructure being undertaken by individual EU Member States. Meeting the targets set by AFIR for transport infrastructure necessitates the development of appropriate research tools. The approach proposed in this article offers an innovative framework for addressing the challenges of energy transformation. The initial step involves designing a model for the energy transformation of transport infrastructure, followed by the definition of indicators to assess the implementation of AFIR objectives. This paper presents a model for the energy transformation of road transport infrastructure, defines the individual elements of the model, specifies indicators for evaluating the transformation process, and conducts a research study incorporating these components. This article aims to elucidate the core aspects of the energy transformation of transport infrastructure, identify actions aligned with achieving the objectives of the AFIR regulation, and perform an evaluation of its implementation. Additionally, the research addresses the question of how the energy transformation of road transport infrastructure is unfolding in Poland. The study is based on the structure of electric vehicles (EVs) and transport infrastructure along the TEN-T network in the territory of Poland. The current level of AFIR compliance for eLDVs for the years 2025, 2027, 2030, and 2035 is approximately 175%, 96%, 37%, and 13%, respectively. In contrast, for eHDVs, the compliance level is around 20%, 0%, and 0% for the TEN-T core network, and approximately 10%, 3%, and 0% for the TEN-T comprehensive network. Full article

Biofouling presents a major challenge for maritime industries, leading to the widespread use of copper-based biocidal coatings that, while effective, release harmful substances into marine environments. Biocide-free alternatives, such as silicone-based, hydrogel, and natural product-derived coatings, offer more sustainable solutions. This systematic review and meta-analysis assesses the functional, economic, and environmental performance of both coating types using PRISMA guidelines and literature from Scopus and ISI Web of Knowledge (2003–2025). Data from experimental, field, and modeling studies were synthesized, covering fouling intensity, coating durability, toxicity, cost-effectiveness, and regulatory compliance. Biocidal coatings generally performed better short-term, but biocide-free options showed comparable efficacy in some cases and clear environmental benefits. Although initial costs for biocide-free coatings are higher, they may yield savings over time. The meta-analysis found no significant differences in fouling or hydrodynamic performance, though quantitative evidence is limited. Research gaps remain, particularly in long-term studies, highlighting the need for standardized testing and lifecycle assessments to guide sustainable antifouling practices. The outcome of the review also showed that some evidence was excluded due to being in non-indexed sources. This highlights the importance of combining systematic and traditional review methods to ensure a more comprehensive assessment. Full article

This study investigates the thermal performance of induction motors powered by multilevel H-bridge inverters using a novel pulse-width phase shift triangle modulation (PSTM-PWM) technique. Conventional PWM methods introduce significant harmonic distortion, increasing copper and iron losses and causing overheating and reduced motor lifespan. Through experimental testing and comparison with standard PWM techniques (LS-PWM and PS-PWM), the proposed PSTM-PWM reduces harmonic distortion by up to 64% compared to the worst one and internal motor losses by up to 5.5%. A first-order thermal model is used to predict motor temperature, validated with direct thermocouple measurements and infrared thermography. The results also indicate that the PSTM-PWM technique improves thermal performance, particularly at a triangular waveform peak value of 3.5 V, reducing temperature by around 6% and offering a practical and simple solution for industrial motor drive applications. The modulation order was set to M = 7 to reduce both the losses in the power inverter and to prevent the generation of very high voltage pulses (high dV/dt), which can deteriorate the insulation of the induction motor windings over time. Full article

Background: Nonadherence to antihypertensive therapy affects nearly half of treated patients worldwide, and persistence often falls below 60% within the first year, contributing substantially to uncontrolled blood pressure and cardiovascular morbidity. Adherence and persistence to antihypertensive therapy among primary care patients in Mureș County, Romania, were assessed using validated measures, and modifiable risk factors for targeted interventions were identified. Methods: A cross-sectional study of 399 hypertensive adults (≥18 years) receiving treatment for ≥1 year across primary care clinics in Mureș County, Romania, was performed. Adherence was evaluated using the Romanian-validated Hill–Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) and confirmed by mean arterial pressure (MAP) < 100 mmHg. Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal HBCTS cutoff, and multivariate logistic regression was used to identify independent predictors of adherence. Persistence was assessed via healthcare-engagement metrics over a 360-day observation period. Results: Effective blood pressure control (MAP < 100 mmHg) was achieved by 45.9% of participants. The HBCTS demonstrated good reliability (McDonald’s ω = 0.82). ROC analysis established 51 points as an optimal threshold (sensitivity = 88.0%, specificity = 38.9%). Male gender (OR = 0.47, 95% CI: 0.29–0.75, p = 0.002) and younger age (OR = 1.04 per year, 95% CI: 1.01–1.06, p = 0.001) independently predicted poor adherence. Treatment coverage days showed the strongest correlation with blood pressure control (r = −0.50, p < 0.001). Among participants, 67.7% demonstrated persistence, achieving significantly better blood pressure control than non-persistent patients. Conclusions: The validated HBCTS (≥51 points) provides an efficient screening tool for Romanian primary care settings. Treatment coverage days emerged as the strongest modifiable predictor of blood pressure control (r = −0.50), highlighting medication availability as a key intervention target. Targeted approaches for male and younger patients, combined with systematic medication continuity monitoring, represent evidence-based strategies for reducing cardiovascular morbidity in this population. Full article