Search Results (74)

Background/Objectives: Impaired consciousness has various causes. One such cause includes hypoglycemia, which may be symptomatic or asymptomatic and is associated with high mortality. Autonomic abnormalities are also common in hypoglycemic patients. Early detection is critical for improving prognosis. In this study, we evaluated changes in vital signs and pupillary responses before and after glucose administration in patients with hypoglycemia managed in a prehospital emergency setting. Methods: This retrospective observational study included 583 adult patients from the Tokyo Fire Department database. All patients were suspected by emergency medical technicians (EMTs) to have hypoglycemia-related impaired consciousness and showed improved consciousness after receiving intravenous glucose infusion at the scene. Vital signs, level of consciousness, and pupillary responses were assessed before and after glucose administration. Results: The mean patient age was 58.9 years, and approximately 90% had comorbid diabetes mellitus. Tachypnea was common at the scene, with 27% showing tachycardia, while blood pressure remained normal. Miosis and abnormal pupillary light reflexes were observed in 68% and 84% of cases, respectively. Anisocoria occurred in 7.6% of the patients. After glucose administration, both abnormal reflexes and anisocoria significantly decreased (both p < 0.0001). Although vital signs did not consistently reflect autonomic responses, changes in pupillary findings were prominent. Conclusions: Altered pupillary responses are common in hypoglycemic coma. Findings such as miosis and anisocoria can result from various causes, including central nervous system disorders and cholinergic toxicity; thus, careful differential diagnosis is essential. Normal blood pressure may help to distinguish hypoglycemic coma during prehospital care. Full article

Food-Induced Immediate Response of the Esophagus (FIRE) is a newly described syndrome observed in eosinophilic esophagitis (EoE) patients. It is defined by an immediate hypersensitivity reaction of the esophagus that occurs when specific foods and beverages interface with esophageal mucosa. The available data regarding this topic is scarce. Therefore, we aimed to review relevant publications in order to better characterize the main aspects of this syndrome and hypothesize about potential mechanisms underlying FIRE syndrome and possible future therapeutic approaches. We searched PubMed, Embase, and Web of Science databases for relevant articles published before February 1st, 2025. The results were narrowed down to four articles describing a total of 105 cases of FIRE syndrome. These patients had a distinct clinical presentation, characterized by retrosternal discomfort or pain, differentiating it from solid food dysphagia or pollen-food allergy syndrome (PFAS). Currently, diagnosis is based on clinical presentation, with no diagnostic tests or biomarkers available. Emerging evidence suggests that IgE-mediated hypersensitivity, mast cells, and neuroimmune interactions may play a central role in the pathogenesis of FIRE syndrome. The therapeutic approaches remain speculative, with trigger avoidance being the main option. This article brings to the forefront the need for continued research to address current knowledge gaps regarding FIRE syndrome, which is important for optimizing patient management. Full article

Improvement in the intelligence and reliability of traditional complex machinery in service (TCMIS) is a prerequisite to guarantee the safety and stable production of these manufacturing enterprises. Existing studies on condition monitoring of TCMIS typically suffer from an insufficient volume of data, incomplete consideration of issues, low monitoring accuracy, and lack of long-term validity. This paper proposes to utilize Digital Twin (DT) technology to construct a new generation of intelligent condition monitoring systems and take the coal mill of a coal-fired power plant as an example for practical illustration. The results of the study show that the method used in this paper is 96% for fault diagnosis, which is higher than the level in existing studies, and the practical application effect in coal-fired power plants also proves the effectiveness of this study. This study can provide program references for the development of intelligent transformation of TCMIS, and also provide technical support for the application and promotion of DT technology in this field. Full article

We demonstrated the development, implementation, and functional verification of the combustion science payload deployed on the China Space Station. The Combustion Science Experiment System (CSES) integrated seven subsystems and modular plugins to address the major challenges facing microgravity combustion research, including the lack of long-duration experimental platforms, spatial constraints, and safety risks. Through on-orbit testing, the core functions of the CSES under microgravity conditions were validated, including gas supply, ignition, combustion diagnostic, exhaust purification, and emission. The system achieved autonomous experiment execution by ground-injected commands. Data from on-orbit methane combustion experiments demonstrated that the CSES was capable of stably supplying oxygen and fuel gas at a preset flow rate, real-time combustion diagnosis, and provided high-resolution flame image. Effectively exhaust gas purification and emission control of the CSES have also been tested and verified. It provides a safe, reliable, and stable microgravity environment of long-duration research for the combustion science and the development of spacecraft fire safety technology. Full article

In a construction industry characterized by rapid change and increasing complexity, traditional labor-intensive methods of structural safety inspection suffer from numerous limitations, including low productivity, extended project duration, and high costs. Accuracy and speed are particularly vital for safety diagnosis in older structures, fire-damaged buildings, and large-scale facilities, yet conventional methods heavily rely on human expertise, leading to variability and potential unreliability of results. This study quantitatively assessed the productivity improvements and economic benefits of integrating terrestrial laser scanning (TLS) and building information modeling (BIM) into the structural safety assessment process. Both the conventional visual inspection and the TLS-based approach were treated as production systems, and queueing theory was employed to analyze waiting times, service rates, and costs. The analysis of three real-world projects revealed that the TLS-based 3D scanning reverse modeling method reduces total project costs—including survey duration, labor input, as well as service and waiting costs—by about 80–89% compared to the visual inspection method. Additionally, the return on investment (ROI) at the project level varies from approximately 12% to 136%, and when applied to multiple projects at the company level, the overall ROI reaches about 162%, demonstrating the long-term economic benefits of adopting digital technology. These findings suggest that TLS-3D scanning reverse modeling in the construction industry has substantial potential in terms of productivity gains and economic impact. Full article

Gas distribution stations (GDSs), pivotal nodes in long-distance natural gas transportation networks, are susceptible to catastrophic fire and explosion accidents stemming from system failures, thereby emphasizing the urgency for robust safety measures. While previous studies have mainly focused on gas transmission pipelines, GDSs have received less attention, and existing risk assessment methodologies for GDSs may have limitations in providing accurate and reliable accident probability predictions and fault diagnoses, especially under data uncertainty. This paper introduces a novel dynamic accident probability assessment framework tailored for GDS under data uncertainty. By integrating Bayesian network (BN) modeling with fuzzy expert judgments, frequentist estimation, and Bayesian updating, the framework offers a comprehensive approach. It encompasses accident modeling, root event (RE) probability estimation, undesired event (UE) predictive analysis, probability adaptation, and accident diagnosis analysis. A case study demonstrates the framework’s reliability and effectiveness, revealing that the occurrence probability of major hazards like vapor cloud explosions and long-duration jet fires diminishes significantly with effective safety barriers. Crucially, the framework acknowledges the dynamic nature of risk by incorporating observed failure incidents or near-misses into the assessment, promptly adjusting risk indicators like UE probabilities and RE criticality. This underscores the importance for decision-makers to maintain a heightened awareness of these dynamics, enabling swift adjustments to maintenance strategies and resource allocation prioritization. By mitigating assessment uncertainty and enhancing precision in maintenance strategies, the framework represents a significant advancement in GDS safety management, ultimately striving to elevate safety and reliability standards, mitigate natural gas distribution risks, and safeguard public safety and the environment. Full article

Probiotic administration has become common practice in neonatal intensive care units (NICUs) to prevent necrotizing enterocolitis (NEC) and promote gut health in preterm infants. While probiotics are generally considered safe, rare cases of probiotic-related sepsis have been reported. We present a case of Lactobacillus rhamnosus sepsis in a preterm infant, highlighting the challenges involved in its diagnosis. The infant developed symptoms of sepsis on the 13th day of probiotic treatment. Laboratory analyses, including MALDI-TOF, BioFire BCID2 panel, and whole-genome sequencing (WGS), helped confirm the diagnosis and the presence of Lactobacillus rhamnosus. In this case, accurately identifying the Lactobacillus rhamnosus strain proved challenging, as initial analyses using the Vitek 2 system yielded incorrect identifications. This highlights the limitations of automated systems in distinguishing closely related species, reinforcing the need for advanced molecular techniques to achieve precise strain identification and confirm a probiotic-related infection. Given these diagnostic complexities, it is crucial for clinicians to maintain a high index of suspicion for probiotic-related infections in cases of unexplained sepsis, as this awareness can prompt further diagnostic investigations to ensure accurate pathogen identification. The infant responded to ampicillin therapy, showing clinical improvement within 10 days and was discharged in good health at 67 days of life. This case underscores the importance of advanced molecular diagnostic methods to confirm probiotic-related infections and highlights the need for caution in administering probiotics to vulnerable populations, such as preterm infants. Clinicians must maintain a high index of suspicion for probiotic-associated sepsis in unexplained cases of infection and tailor antibiotic therapy based on susceptibility profiles. These findings emphasize the need for rigorous monitoring, appropriate probiotic strain selection, and optimized safety protocols in NICUs to mitigate potential risks. Full article

In this study, we address the critical issue of accurately detecting series AC arc faults, which are often challenging to identify due to their small fault currents and can lead to devastating electrical fires. We propose an intelligent diagnosis method based on the extreme learning machine (ELM) model to enhance detection accuracy and real-time monitoring capabilities. Our approach involves collecting high-frequency current signals from 23 types of loads using a self-developed AC series arc fault data acquisition device. We then extract 14 features from both the time and frequency domains as candidates for arc fault diagnosis, employing a random forest to select the most significantly changed features. Finally, we design an ELM classifier for series arc fault diagnosis, achieving an identification accuracy of 99.00% ± 0.26%. Compared to existing series arc fault diagnosis methods, our ELM-based method demonstrates superior recognition performance. This study contributes to the field by providing a more accurate and efficient diagnostic tool for series AC arc faults, with broad implications for electrical safety and fire prevention. Full article

Objectives: The early identification of infection-causing microorganisms through multiplex PCR panels enables prompt and targeted antibiotic therapy. This study aimed to assess the performance of the BioFire^® Joint Infection Panel (BF-JIP) in analysing non-synovial fluid samples. Methods: We conducted a retrospective cohort study at Trieste University Hospital, Italy, on hospitalised adults with non-synovial fluid samples tested by both BF-JIP and traditional culture methods (November 2022–April 2024). Results: We evaluated 48 samples from 45 patients, including 24 abscess drainage fluids and 10 tissue samples. The BF-JIP showed high concordance (85.4%) and enhanced detection (4.3%) compared to culture methods. The BF-JIP excelled in cerebrospinal fluid (CSF) (100% accuracy and concordance) and in abscess drainage fluid (accuracy: 95.8%; concordance: 91.7%) identification and maintained high performance rates in patients under antibiotics. Conclusions: These findings suggest that BF-JIP is a valuable tool for accurate pathogen detection in various clinical samples, offering the additional advantage of being a rapid method. Full article

Background/Objectives: Pertussis remains a significant public health concern despite effective vaccines due to diagnostic challenges and symptom overlap with other respiratory infections. This study assesses the prevalence of Bordetella pertussis using advanced polymerase chain reaction (PCR) testing and examines the clinical outcomes over a one-month follow-up. Methods: We conducted a cross-sectional study at the University Hospital of Larissa, Greece, from April to June 2024, collecting 532 nasopharyngeal swabs from patients with respiratory symptoms. Diagnostic testing utilized the BioFire^® Respiratory 2.1 Plus Panel. Demographics, clinical presentations, vaccination histories, and clinical outcomes were systematically recorded and analyzed. Results: Of 532 patients, 47 (8.8%) were diagnosed with pertussis. The mean age was 61.87 ± 13.4 years; 57.4% were female. Only 12.8% had contact with known pertussis patients. Regarding vaccination history, 36.2% had received diphtheria, tetanus, and pertussis vaccines, with the last dose administered an average of 46 years prior to this study. The primary symptom was cough (100%), with additional symptoms including fever (36.2%) and paroxysmal cough (34%). Six patients (12.8%) required hospitalization due to pneumonia and severe respiratory failure. All patients received successful treatment; however, 23.4% reported persistent post-infectious cough at the one-month follow-up. Conclusions: PCR testing significantly improved the diagnosis of pertussis among adults presenting with respiratory symptoms. The findings highlight the need for updated vaccination strategies and improved diagnostic protocols to effectively manage pertussis and reduce its public health impact. Full article

Several studies have shown interstitial cystitis/bladder pain syndrome (IC/BPS), a chronic condition that poses challenges in both diagnosis and treatment, is associated with painful pelvic floor muscles (PFM) and altered neural drive to these muscles. However, its pathophysiology could also involve other alterations in the electrical activity of PFM motor units (MUs). Studying these alterations could provide novel insights into IC/BPS and help its clinical management. This study aimed to characterize PFM activity at the MU level in women with IC/BPS and pelvic floor myalgia using high-density surface electromyography (HD-sEMG). Signals were recorded from 15 patients and 15 healthy controls and decomposed into MU action potential (MUAP) spike trains. MUAP amplitude, firing rate, and magnitude-squared coherence between spike trains were compared across groups. Results showed that MUAPs had significantly lower amplitudes during contractions on the patients’ left PFM, and delta-band coherence was significantly higher at rest on their right PFM compared to controls. These findings suggest altered PFM tissue and neuromuscular control in women with IC/BPS and pelvic floor myalgia. Our results demonstrate that HD-sEMG can provide novel insights into IC/BPS-related PFM dysfunction and biomarkers that help identify subgroups of IC/BPS patients, which may aid their diagnosis and treatment. Full article

Accurate laboratory diagnosis of gastroenteritis is important to ensure that patients receive appropriate treatment and proper isolation precautions. This study evaluated the performance of the QIAGEN QIAstat-Dx gastrointestinal panel (QGP) in comparison to the bioMerieux BioFire FilmArray gastrointestinal panel (BGP) for the detection of gastrointestinal pathogens in 110 pediatric patients being evaluated for gastroenteritis at our hospital. We compared 23 different bacterial, viral, and parasite enteropathogens detected by the QGP against the BGP. The overall positive percent agreement (PPA) for all compared targets was 96.2% and the overall negative percent agreement (NPA) for all compared targets was 99.7%. Our study shows that QIAstat-Dx QGP provides comparable results to the BioFire BGP in our pediatric population. Additionally, the PCR cycle threshold (Ct) value reported by the QGP is potentially a helpful tool in estimating the load of the detected pathogen in stool samples. Full article

Objectives: Following the COVID-19 pandemic, global epidemiological trends demonstrate a return to pre-pandemic levels of respiratory syncytial virus (RSV) and influenza (Flu) A/B viruses. For the appropriate clinical management of viral infections, reliable and timely diagnosis is crucial. The clinical presentation of these respiratory viral infections shows significant overlaps; thus, the syndromic diagnosis of these infections becomes challenging. The goal of this study was to compare the performance of three multiplex real-time PCR-based platforms for the detection of SARS-CoV-2, Flu A, Flu B, and RSV. Materials and Methods: A retrospective study was performed on 200 de-identified nasopharyngeal and oropharyngeal specimens. All samples were tested simultaneously on three PCR-based platforms for the detection of SARS-CoV-2, Flu A, Flu B, and RSV: HealthTrackRx’s real-time PCR Open Array^® respiratory panel, TrueMark™ SARS-CoV-2, Flu A, Flu B, RSV Select Panel, and BioFire^® RP2.1 Panel. The positive and negative predictive value of each test was evaluated at a 95% confidence interval. Results: Among the 200 tested samples, the TrueMark™ and OpenArray^® laboratory-developed tests (LDTs) showed a 100% concordance for the detection of SARS-CoV-2, Flu A, Flu B, and RSV. Overall agreement of 100% was observed for nasopharyngeal samples between the laboratory-developed tests and FDA-approved BioFire^® RP2.1 Panel. Diagnostic results for these four respiratory viruses, in clinical samples, between the LDTs and the FDA-approved comparator demonstrated full concordance. Conclusions: Respiratory viral infections represent one of the major global healthcare burdens. Consequently, the accurate detection and surveillance of these viruses are critical, particularly when these viruses are known to co-circulate. The excellent performance and full concordance of the LDTs, with the BioFire^® Respiratory RP2.1 panel, in detecting SARS-CoV-2, Flu A, Flu B, and RSV shows that these tests can be confidently implemented for the clinical testing of respiratory viral infections. Full article

Background/Objectives: This study aims to evaluate the impact of the PCR multiplex panel (BioFire JI^®) on the diagnosis and management of pediatric osteoarticular infections. Methods: This retrospective study analyzed data from pediatric patients diagnosed with osteoarticular infections between January 2023 and April 2024. The effectiveness of the PCR multiplex panel in identifying pathogens was compared with traditional culture methods. Results: In total, 50 patients were identified (66.6% male, 74% under 3 years of age). They were diagnosed as follows: septic arthritis in 46%, osteomyelitis in 26%, and septic osteoarthritis in 22%. An identifiable agent was isolated by conventional culture in 22 cases (44%). Kingella kingae was the predominant pathogen identified, accounting for 50% of cases (11/22), followed by Staphylococcus aureus (9/22). The BioFire JI^® Panel PCR demonstrated a sensitivity of 93%, with a specificity of 63% when evaluated against synovial fluid culture as the reference standard. The panel identified seven additional pathogens not detected by conventional culture methods: 2/9 MSSA (22%), 1/1 S. pyogenes (100%), and 4/11 K. kingae (37%), increasing the yield by 14%. The rapid identification of pathogens facilitated timely and targeted therapeutic interventions. Conclusions: The PCR multiplex panel (BioFire JI^®) improved the diagnosis of pediatric osteoarticular infections. Full article

Despite ongoing efforts to enhance diagnostic and treatment processes, the success rate for eradicating infections, particularly prosthetic joint infections (PJIs), currently stands at around 50%. For acute infections occurring shortly after arthroplasty, guidelines recommend a treatment known as DAIR (debridement, antibiotics, and implant retention). This approach is suggested for infections within 30 days post-arthroplasty or with less than 3 weeks of symptoms, provided that there is a stable implant and adequate soft-tissue mass. Several authors have suggested extending the use of DAIR beyond the initial 3-week period in specific cases. This extension practice seems increasingly feasible due to the rapid diagnostic capabilities offered by BioFire^®. This technology allows for quick pathogen identification, aiding in the exclusion of cases that do not fit the criteria for the DAIR/DAPRI (debridement, antibiotic pearls and retention of the implant) protocol based on pathogen identification. The aim of this review is to re-examine the current literature on acute infections and present our proposed “prosthesis-saving” protocol, which integrates the BioFire^® molecular diagnostic system. Continued research and assessment of the efficacy and safety of these protocols, especially regarding extended treatment timelines, are crucial for advancing the management of acute infections and enhancing outcomes for PJI patients. Full article