Search Results (192)

Background and Clinical Significance: Overlap of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) in children is a rare but life-threatening metabolic emergency. The coexistence of hyperosmolality and ketoacidosis increases neurologic vulnerability and complicates fluid and insulin management. Early identification and osmolality-guided therapy are essential to prevent cerebral edema and other complications. This case describes a 5-year-old boy with new-onset type 1 diabetes mellitus (T1D) presenting with DKA/HHS overlap two weeks after influenza vaccination—an unusual temporal association without proven causality. Case Presentation: A previously healthy 5-year-old presented with progressive polyuria, polydipsia, nocturnal enuresis, fatigue, and drowsiness. Two weeks earlier, he had received the influenza vaccine. Examination revealed moderate dehydration without Kussmaul respiration or altered consciousness. Laboratory evaluation showed glucose 45.9 mmol/L (826 mg/dL; reference 3.9–7.8 mmol/L), venous pH 7.29 (reference 7.35–7.45), bicarbonate 12 mmol/L (reference 22–26 mmol/L), moderate ketonuria, and measured serum osmolality 344 mOsm/kg (reference 275–295 mOsm/kg), fulfilling diagnostic criteria for DKA/HHS overlap. After an initial 20 mL/kg 0.9% NaCl bolus, fluids were adjusted to maintenance plus approximately 10% deficit using 0.45–0.75% NaCl according to sodium/osmolality trajectory. Intravenous insulin (approximately 0.03–0.05 IU/kg/h) was initiated once blood glucose no longer decreased adequately with fluids alone and had stabilized near 22.4 mmol/L (≈400 mg/dL). Dextrose was added when glucose reached 13.9 mmol/L (250 mg/dL) to avoid rapid osmolar shifts. Hourly neurological and biochemical monitoring ensured a glucose decline of 2.8–4.2 mmol/L/h (50–75 mg/dL/h) and osmolality decrease ≤3 mOsm/kg/h. The patient recovered fully without cerebral edema or neurologic sequelae. IA-2 antibody positivity with low C-peptide and markedly elevated HbA1c confirmed new-onset T1D. Conclusions: This case highlights the diagnostic and therapeutic challenges of pediatric DKA/HHS overlap. Osmolality-based management, conservative insulin initiation, and vigilant monitoring are crucial for preventing complications. The temporal proximity to influenza vaccination remains incidental. Full article

Ureterolithiasis is a common cause of ureteral obstruction in dogs, often leading to kidney injury. Medical expulsive therapy (MET) using α-adrenergic antagonists has been proposed as a nonsurgical treatment option in selected cases and is thought to facilitate ureteral stone passage by reducing ureteral smooth muscle tone. A 9-year-old castrated male Chihuahua weighing 1.78 kg was presented with anorexia. Physical examination revealed 7% dehydration and pale mucous membranes. Serum biochemistry demonstrated severe azotemia, with markedly elevated symmetric dimethylarginine (>100 μg/dL; reference interval [RI], 0–14 μg/dL), blood urea nitrogen (157.9 mg/dL; RI, 7–25 mg/dL), and creatinine (2.2 mg/dL; RI, 0.5–1.5 mg/dL). On day 4 of hospitalization, ultrasonography revealed dilation of the renal pelvis (16.1 mm), ureteral distention (3.74 mm), and multiple ureteroliths (maximum diameter, 3.31 mm) at the ureterovesical junction. Antegrade pyelography confirmed a right ureteral obstruction. As the owner declined surgical intervention, MET including tamsulosin, was initiated with close clinical monitoring. After 3 days, improvement in azotemia and resolution of ureteral obstruction were observed. Although concurrent medical treatments were administered, this case provides clinical insight into the potential role of tamsulosin as part of medical management of obstructive ureterolithiasis in a dog with small distal ureteral stones. Full article

The influence of natural β-cyclodextrin (β-CD) on the overall antioxidant activity of berry extracts is presented in this study. Raw raspberry (Rubus idaeus L.) and β-CD-assisted dehydrated strawberry (Fragaria × ananassa Duch.) ethanolic extracts (RB and SB, respectively) were spectrophotometrically monitored in the presence of 1 mM 2,2-diphenyl-1-picrylhydrazyl (DPPH·) solution in the absence or presence of β-CD. Cyanidin 3-O-glucoside (Cy3G) was used as standard compound, being identified by RP-HPLC in both RB and SB at 14.62 and only 0.15 mg/100 g fresh weight (fw). Pelargonidin 3-O-glucoside (Plg3G) was the most concentrated anthocyanin in SB (estimated at 2.46 mg/100 g fw). Higher antioxidant activities (expressed as the radical scavenging activity, RSA, %) were obtained for SB dehydrated in the presence of β-CD. The RSA values increased by 35% in comparison with the SB dehydrated by the classical method. On the other hand, the DPPH· reaction kinetic parameters significantly differed for RB extracts evaluated in the presence of 1 mM β-CD (in water). The DPPH· reaction rate in the 3–15 min time range was 25% higher for the RB extracts obtained from the β-CD-assisted dehydrated samples. This study demonstrates for the first time the protection capacity of β-CD against the degradation of antioxidants during the classical dehydration process of berries. This technology can be extended to other fruits and scaled up for obtaining high-quality fruit-based products. Full article

Background: Climate change is intensifying extreme heat exposure in Mediterranean agricultural systems. Migrant workers engaged in outdoor fieldwork are a highly vulnerable population with limited access to resources. Crucially, there is a notable lack of data on how heat affects these workers in this specific region. Objective: This study aimed to analyze the physiological effects of high-temperature exposure by quantifying and correlating indirect indicators of dehydration and electrolyte imbalance (sodium and potassium losses, sweat, body weight, and blood pressure). Methods: An observational study was conducted over nine consecutive days involving ten agricultural participants, yielding 90 observations. Measurements of body weight, heart rate, blood pressure, skin temperature, sweat loss, and sodium and potassium concentrations were taken before, during, and after daily field activity. Results: Results showed considerable interindividual variability in thermophysiological responses. Participants lost an average of 0.8 kg (range –9.1 to +3.6 kg) and produced 3.91 L of sweat (range 1.9–6.4 L), with sodium and potassium losses of 4932 mg and 646 mg, respectively. Sweat loss correlated with sodium (r = 0.414, p = 0.001) and potassium (r = 0.791, p < 0.001), and diastolic blood pressure was moderately associated with weight loss (r = 0.576, p = 0.016). Conclusions: Sweat loss was the main driver of electrolyte depletion, with marked interindividual variability. Monitoring sweat-related indicators and diastolic blood pressure could help detect dehydration risk in agricultural workers exposed to extreme heat. Targeted hydration strategies and occupational health education are essential to mitigate these risks. Full article

Functionalized hydrogels represent an emerging class of smart materials being explored for advancing next-generation wearable technologies, owing to their flexibility, biocompatibility, stimuli-responsiveness, and tunable properties. This review provides an overview of recent developments in hydrogel-based wearables, highlighting their potential to enhance adaptive, multifunctional, and environmentally sustainable devices and textiles. It begins by examining progress in wearable sensors, energy storage and harvesting, biosignal monitoring, and smart textiles, as well as the associated challenges, including limited battery life, inadequate skin adhesion, user discomfort, and constrained functionality. The review further explores the synthesis, fabrication techniques, properties, and types of hydrogels tailored for wearable technologies, followed by a detailed discussion of their applications in smart batteries, supercapacitors, sensors, nanogenerators, fabrics and hybrid systems. It also highlights integrating artificial intelligence (AI) and the Internet of Things (IoT) to improve designs; enhance performance through real-time monitoring, data analytics, and user interaction; and expand functionality. Also, it analyzes key limitations of current hydrogels—particularly in energy density, dehydration resistance, fatigue behaviour, and large-scale reproducibility—and outlines strategies based on hierarchical material design, sustainable and biodegradable formulations, and standardized testing and regulatory alignment. The review concludes by affirming the role of hydrogel-based technologies in shaping the future of wearable innovations across healthcare, lifestyle, and beyond and outlines promising research directions. Full article

It is relevant to develop new technologies to enable the intensive monitoring of kidney function in a minimally invasive, rapid, and economic way. With this goal, the current work compared infrared spectra in the mid- (MIR) and near-infrared (NIR) regions to predict the biomarkers of kidney function, i.e., serum creatinine, urea, and albumin. After the evaluation of diverse spectra pre-processing methods and spectral regions, it was possible to develop, in either spectral region, good to excellent regression models to predict these three biomarkers, with determination coefficients (R²) of over 0.9 and relatively low root mean squared error (RMSE). The two techniques are complementary, since the MIR spectroscopic platform presents the advantage of enabling high-throughput analysis, as it includes the sample analysis based on a micro-plate with 96 wells, only requiring a simple dehydration step before spectra acquisition, while the NIR spectroscopic platform enables the direct analysis of the serum solutions in real time. Therefore, both platforms present complementary characteristics with a high potential to enable reagent-free and frequent monitoring of kidney function and incorporation into point-of-care diagnostic systems. Full article

Background/Objectives: Colonoscopy, a common outpatient procedure requiring bowel preparation, can lead to dehydration and electrolyte disturbances. Sedation, while improving patient comfort, may exacerbate these effects and contribute to orthostatic hypotension (OH) and postural orthostatic tachycardia syndrome (POTS). This study aimed to determine the prevalence of OH and POTS following sedated colonoscopy and to identify associated risk factors. Methods: This prospective observational study included 76 adult patients (ASA I–III) who underwent colonoscopy with fentanyl–propofol sedation between August and November 2024. Blood pressure, heart rate, and orthostatic intolerance (OI) symptoms were assessed before and after mobilization. OH was defined as a systolic blood pressure decrease ≥20 mmHg or diastolic decrease ≥10 mmHg upon standing. POTS was defined as a heart rate increase ≥30 bpm or an absolute heart rate ≥ 120 bpm. Statistical analyses were performed using SPSS 29.0. Results: Post-procedural OH and/or POTS occurred in 18 patients (23.7%), and 14 patients (18.4%) reported OI symptoms such as dizziness, nausea, or blurred vision. Symptomatic patients were significantly younger than asymptomatic patients (42.7 ± 15.4 vs. 54 ± 13.9 years, p = 0.009), and symptoms were more frequent among females (p = 0.046). Preoperative diastolic blood pressure was significantly higher in patients who developed OH (p = 0.022), while other hemodynamic and demographic variables showed no significant associations. Conclusions: Orthostatic hypotension and postural tachycardia are relatively common after sedated colonoscopy. Younger age and female sex were identified as independent risk factors for OI symptoms, suggesting a possible role of autonomic variability. Routine post-procedure monitoring and assisted mobilization before discharge may improve patient safety and recovery outcomes. Full article

Assessing pollen viability and anomalies is essential to optimize resources and improve hazelnut productivity. However, knowledge of pollen viability dynamics across cultivars and environments remains limited. This study applied impedance flow cytometry to (i) monitor pollen hydration and define optimal rehydration time, (ii) quantify pollen viability over three flowering seasons, and (iii) evaluate genetic, environmental, and agronomic influences on viable and anomalous pollen formation. Viable pollen showed an adaptive response, restoring high viability (~85%) after four hours of hydration following dehydration stress. Viability displayed cultivar-specific patterns, stable across years but variable among sites. In Viterbo (central Italy, Mediterranean climate), flowering occurred 2–4 weeks earlier than in northern orchards (Piedmont, continental climate). Wild-type accessions exhibited higher viability and minimal anomalous pollen (<3%), whereas cultivated genotypes maintained abundant anomalous pollen (30–50%) across sites and seasons. Multifactorial analysis revealed that both genotype and environment affected viable pollen, while anomalous pollen depended mainly on genotype. Overall, pollen viability results from the interaction between genetic predisposition and local conditions, whereas anomalous pollen reflects stable, genotype-linked traits. These findings highlight the dominant role of cultivar-specific genetics in hazelnut pollen quality, providing a framework for breeding and orchard management strategies. Full article

The progressive aging of the population requires reliable, non-invasive, and real-time tools to monitor hydration, prevent dehydration-related complications, and promote active aging in elderly patients. Wearable sensors based on interdigitated electrodes (IDEs) and on Electrochemical Impedance Spectroscopy (EIS) represent a promising tool thanks to their miniaturization, sensitivity to dielectric variations with humidity, and compatibility with flexible substrates. This study reports the design, fabrication, and metrological characterization of inkjet-printed IDEs for skin hydration monitoring, as a building block of a multisensor wearable device. IDEs were fabricated on polyimide substrates using silver nanoparticle-based ink. Their characterization involved the following: (i) morphological evaluation by scanning electron microscopy; (ii) EIS measurements in KCl solutions, leading to developing a regression model to correlate impedance with salt concentration; (iii) in vitro EIS validation on agar gel samples, which demonstrated a robust linear relationship between the impedance phase shift at 199.5 $\mathrm{Hz}$ and water loss, with consistent sensitivity values across sensors. The results confirm the feasibility of IDEs for hydration monitoring, identifying optimal frequency ranges and validating regression models. These findings represent a critical step toward the development of multisensor wearable devices for elderly monitoring, enabling decentralized and continuous health monitoring to improve healthcare sustainability and telemedicine. Full article

Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants that tend to accumulate in solid matrices such as sewage sludge, raising concerns regarding their fate and potential ecological risks. This study aimed to develop and validate a robust analytical method for the accurate determination of PFAS in dehydrated sludge. A liquid chromatography–tandem mass spectrometry (LC–MS/MS) method was optimized for 28 PFAS, including perfluoroalkyl carboxylic acids (PFCAs) and sulfonic acids (PFSAs). Solid–liquid extraction with basic methanol was followed by cleanup using a cartridge packed with ferrite and sodium sulfate to remove moisture and particulate interferences. Chromatographic separation was performed with an Avantor^® ACE^® PFAS Delay column coupled to an Agilent triple quadrupole MS operating in negative electrospray ionization mode. The method achieved excellent sensitivity (MDL < 0.02 µg/g dry weight for most compounds), satisfactory precision (RSD < 15%), and recoveries between 80–118%. Optimization of mobile phase additives, gradient conditions, and MS parameters enhanced chromatographic resolution and signal-to-noise ratio. The validated method demonstrates high reliability for PFAS determination in complex solid matrices and can be applied as a valuable tool for environmental monitoring and risk assessment of sludge management practices. Full article

Freshwater scarcity and saline groundwater are major constraints for maintaining green roofs in coastal areas. This study evaluated the response of Jacobaea maritima subsp. sicula, (Sicilian silver ragwort) a drought-tolerant coastal ornamental plant, to tap water and seawater irrigation under Mediterranean summer conditions. Plants were grown in 10 cm-deep green-roof modules and subjected to six irrigation regimes: tap water, seawater, or alternating tap water and seawater, each applied at 4- or 8-day intervals, with irrigation volumes equal to 60% of cumulative reference evapotranspiration (ET_o). Growth, relative water content (RWC), chlorophyll index (SPAD), and leachate electrical conductivity were monitored to assess plant performance and salinity responses. Seawater irrigation caused rapid substrate salinization, leaf dehydration, and plant death within one month, while alternating seawater with tap water also failed to sustain survival. In contrast, tap water–irrigated plants maintained high RWC, chlorophyll content, and stable visual quality throughout the experimental period, even with deficit irrigation at 60% ET_o every eight days. These findings demonstrate that J. maritima subsp. sicula is well suited for freshwater-irrigated extensive green roofs in semi-arid regions, providing reliable performance under infrequent irrigation and limited water supply. However, seawater or high-salinity irrigation should be avoided. Future research should explore mixed freshwater–seawater irrigation regimes with a higher freshwater proportion, aiming to reduce total freshwater consumption while sustaining plant survival and esthetic performance. Full article

Objectives: This study evaluated changes in serum sodium (S Na) 24 h after the administration of isotonic versus hypotonic intravenous fluids (IVFs) and the incidences of dysnatremia and hyperchloremic metabolic acidosis. Methods: This double-blind, randomized controlled trial involved children aged 3 months to 5 years who were admitted to a general ward between November 2020 and September 2022 and required IVF. We randomly assigned patients (1:1) to receive either an isotonic solution (D₅0.9%NaCl) or hypotonic solution (D₅0.45%NaCl). Serum electrolyte and venous blood gas levels were obtained at the time of IVF administration and 24 and 48 h after IVF administration. During this study, all participants were monitored for vital signs, body weight, fluid intake and output, and clinical symptoms of dysnatremia. Results: Totals of 69 and 68 patients received isotonic and hypotonic solutions, respectively. The mean age was 1.95 ± 1.25 years in the isotonic group and 1.91 ± 1.32 years in the hypotonic group. The initial degrees of dehydration and biochemical indicators were not different. The change in serum sodium level at 24 h was 2.97 (2.32–3.62) mmol/L in the isotonic group and 2.19 (1.54–2.84) mmol/L in the hypotonic group. In both groups, no significant hyponatremia nor hypernatremia occurred. The incidence of hyperchloremic metabolic acidosis was not different between the groups. Neither group showed any complications. Conclusions: Isotonic fluids may be a preferred option for IVFs in pediatric patients under 5 years of age with medical conditions on a general ward, especially within 24 h, due to their potential to better maintain serum sodium levels without increasing the risk of fluid overload or electrolyte complication. Full article

Osmotic dehydration (OD) is an effective pre-treatment for fruit preservation, but conventional processes often lack precision due to manual control of critical variables. This work reports the design and validation of an automated OD system integrating a programmable logic controller (PLC), human–machine interface (HMI), and IoT-enabled sensors for real-time monitoring of syrup concentration and process temperature. Mango (Mangifera indica) cubes were treated under a 2³ factorial design with sucrose concentrations of 45 and 50 °Brix, immersion times of 120 and 180 min, and temperatures of 30 and 40 °C. Validation demonstrated that the IoT hydrometer achieved strong agreement with reference devices (R² = 0.985, RMSE = 0.36 °Brix), while the PLC-integrated tank sensor also demonstrate improved performance over existing calibrated thermometer (R² = 0.992, MAE = 0.20 °C). ANOVA indicated that concentration, temperature, and time significantly affected water loss and weight reduction (p < 0.01), with temperature being the dominant factor. Water loss ranged from 18.62% to 39.15% and weight reduction from 9.48% to 34.47%, while maximum solid gain reached 9.31% at 50 °Brix and 40 °C for 180 min, with stabilization consistent with case hardening. Drying kinetics were best described by the Page model (R² > 0.97). The findings highlight the effectiveness of the system for precise monitoring and optimization of OD processes. Full article

Mannitol dehydration is routinely used to prevent and treat cerebral damage after total aortic arch replacement (TAAR), but existing neuroimaging technologies cannot achieve bedside real-time quantitative assessment of its impact on cerebral perfusion in different patients. This study applied dynamic cerebral perfusion electrical impedance tomography (DCP-EIT), a non-invasive neuroimaging technique, for bedside cerebral perfusion monitoring in TAAR patients during dehydration. Seventeen patients with normal neurological function and nineteen with neurological dysfunction (ND) were enrolled. The variation patterns and differences in perfusion impedance, images, and the relative ratios (RY) of mean perfusion velocity (MV), height of systolic wave (Hs), inflow volume velocity (IV), and angle between the ascending branch and baseline (A_ab) were analyzed. Results showed DCP-EIT could visualize cerebral perfusion changes, with detected poorly perfused regions showing good consistency with ischemic areas identified by computed tomography (CT). RY of normal patients fluctuated around 0.97–1.04, with no significant difference from baseline. RY of ND patients peaked at 14–20 min after dehydration and remained higher than baseline even at 100 min (p < 0.001). DCP-EIT holds potential to optimize individualized cerebral protection strategies for other cerebral damage scenarios and neurocritical care. Full article

Water loss during storage is a major cause of postharvest quality deterioration in cucumber, yet existing methods to monitor hydration are often destructive or require expensive instrumentation. We developed a low-cost, non-destructive approach for estimating fruit relative water content (RWC) using visible-light color imaging combined with an ensemble machine-learning model (Random Forest). A total of 1200 fruits were greenhouse-grown, harvested at market maturity, and equally divided between optimal and ambient storage temperature (10 and 25 °C, respectively). Digital images were acquired at harvest and at 7 d intervals during storage, and color parameters from four standard color systems (RGB, CMYK, CIELAB, HSV) were extracted separately for the neck, mid, and blossom regions as well as for the whole fruit. During storage, fruit RWC decreased from 100% (fully hydrated condition) to 15.3%, providing a broad dynamic range for assessing color–hydration relationships. Among the 16 color features evaluated, the mean cyan component (μC) of the CMYK space showed the strongest relationship with measured RWC (R² up to 0.70 for whole-fruit averages), reflecting the cyan region’s heightened sensitivity to dehydration-induced changes in pigments, cuticle properties and surface scattering. The Random Forest regression model trained on these features achieved a higher predictive accuracy (R² = 0.89). Predictive accuracy was also consistently higher when μC was calculated over the entire fruit surface rather than for individual anatomical regions, indicating that whole-fruit color information provides a more robust hydration signal than region-specific measurements. Our findings demonstrate that simple visible-range imaging coupled with ensemble learning can provide a cost-effective, non-invasive tool for monitoring postharvest hydration of cucumber fruit, with direct applications in quality control, shelf-life prediction and waste reduction across the fresh-produce supply chain. Full article