Search Results (2,358)

Background: Patients with pancreatic cancer (PC) commonly present with reduced aerobic fitness, sarcopenia, and malnutrition, which may increase perioperative risk and compromise access to chemotherapy treatments. Although exercise-based prehabilitation can improve physical fitness, its implementation is often limited by short diagnostic-to-surgery intervals and treatment-related toxicity. Methods: We conducted a pilot prospective pretest–posttest feasibility study in Torino, Italy. Patients with PC undergoing neoadjuvant chemotherapy prior to surgery were offered a 4-week, partially supervised, home-based bimodal exercise prehabilitation program (single-arm design) combining remotely monitored high-intensity interval training (HIIT) on a cycle ergometer with functional and resistance exercises. The primary outcome was adherence to prescribed exercise frequency, intensity, and duration, objectively assessed via remote monitoring. Secondary outcomes included cardiorespiratory fitness (CPET), muscle function, body composition, fatigue, quality of life, and circulating inflammatory markers. Results: From July 2022 to February 2024, 23 patients were screened; 15 were eligible and 10 enrolled. Four participants discontinued the intervention (two due to asthenia/fatigue, one due to chemotherapy-related adverse events, and one for organizational reasons), leaving six participants who completed the program. Among completers, fatigue and quality of life did not change meaningfully. Aerobic capacity and muscle function outcomes were generally stable, with few pre–post changes exceeding the minimum clinically important difference (MCID) thresholds used. Body composition markers and the assessed circulating cytokines/chemokines remained unchanged except for IL-6 levels, which decreased significantly (p < 0.05). Conclusions: A partially supervised, home-based HIIT-based prehabilitation program is feasible for a subset of PC patients undergoing neoadjuvant therapy, but a substantial attrition rate suggests the need for more flexible symptom-adapted prescriptions and enhanced supportive strategies. Full article

NetworkGuard is a modular edge-based virtual network sensing framework designed for residential smart home security. The system interprets network telemetry—such as DNS queries, firewall events, VPN latency, and connection establishment delay—as structured sensing signals for gateway-level monitoring. Implemented on a Raspberry Pi 4 and managed via an Android interface, NetworkGuard integrates DNS filtering (Pi-hole), firewall enforcement (UFW), encrypted VPN tunneling (WireGuard), and an AI-assisted advisory layer for contextual log interpretation. During a six-week residential deployment, DNS blocking efficiency improved from 81.2% to 97.0% following blocklist refinement, while VPN connection establishment time decreased from approximately 3012 ms to 2410 ms after configuration tuning. ICMP-based measurements indicated a stable tunnel latency under moderate traffic conditions. Controlled validation scenarios—including DNS manipulation attempts, port scanning, and VPN interruption testing—confirmed consistent firewall enforcement and tunnel containment. The results demonstrate that layered security principles can be adapted into a lightweight, reproducible edge architecture suitable for small-scale residential IoT environments without a reliance on enterprise infrastructure. Full article

Cats are among the most beloved and affectionate companion animals to humans. Historically, they have been utilised to manage pests or offer comfort and companionship, a practice that continues today. Due to human malpractice, unowned free-roaming cats (as stray pets or feral cats) are now considered amongst the 100 worst invasive species, and are responsible for the decline and even the disappearance of many wild species worldwide. Free-roaming cats maintain their hunting instincts, causing problems for native species, which is recognised as a major issue in island biodiversity. Despite their impact, limited studies have been conducted to understand the spatial activity of free-roaming cats in the Mediterranean when they are away from their caregivers (owners who feed and care for their cats while allowing unrestricted outdoor roaming). To investigate this, we used GPS tracking collars to monitor 15 free-roaming cats on the island of Cyprus, during spring–autumn 2022. The monitored cats were active in a spectrum of different habitats, from forests and farmland to shrublands and the suburbs. We monitored cats for 5.6 days, on average, to investigate their home range sizes (KDE 95%; median: males = 55,678 m²; females = 11,377 m²), daily distance travelled (median: males = 1233 m; females = 538 m), and daily/nocturnal activity, and the factors that influence these patterns. The animals’ sex, shelter availability, and the type of coverage in an area show statistically significant differences in relation to their home range, while activity peaked during the afternoon hours, a finding that is also statistically confirmed. Although the sample size of the study is relatively small, the influence of environmental and anthropogenic factors on the home range of free-roaming cats in Cyprus is revealed. These findings offer quantitative evidence and can contribute to wildlife conservation and free-roaming cat management. Full article

Distributed recycling of high-density polyethylene (HDPE) into filament for use in material extrusion 3D printing has been proposed as part of a circular economy. There is a gap in the understanding of the potential for HDPE to release contaminants that are potentially hazardous to human health during reuse. Herein, HDPE from post-consumer packaging waste was sorted into food and non-food (NF) streams and virgin HDPE was taken as a benchmark material. All materials were extruded into filaments and recycled multiple times while monitoring emissions. In general, particle and organic chemical emissions decreased by 93 to 99% and 73 to 99%, respectively, with increased reprocessing cycle without appreciable decline in mechanical (Young’s modulus decreased by 5 to 16%), processability (melt flow index stable from 0.2 to 0.7 g/10 min for waste plastics), and thermal properties (crystallinity ranged from a 6% decrease to a 9% increase) of plastics. An exception was a sub-stream of NF plastic that had increased particle emissions (up to 3100%) with reprocessing cycle. Reductions in emissions during filament extrusion appeared to be more influenced by reprocessing cycle than by any specific process step (grinding, etc.). The progressive decline in emissions without appreciable loss of polymer integrity could be exploited to pre-condition HDPE to reduce potential hazardous emissions prior to extruding into filament. This work helps fill the knowledge gap on approaches to recycling plastics in distributed settings such as home-based businesses, which is critical for developing effective recommendations for controls to enable safe work practices such as the use of ventilation to minimize exposures. Full article

Background/Objectives: Renal denervation (RDN) has re-emerged as an adjunctive treatment option for patients with uncontrolled or resistant hypertension, with contemporary sham-controlled trials showing a modest but reproducible reduction in out-of-office blood pressure. However, in routine practice, apparent treatment resistance often reflects pseudoresistance caused by the white-coat effect, poor measurement quality, therapeutic inertia, or nonadherence. This review aimed to summarize the contemporary evidence on renal denervation in uncontrolled or resistant hypertension and to propose a pragmatic, measurement-first framework for patient selection, integration into routine care, and a structured post-procedural response assessment. Methods: This article is a narrative, implementation-focused review. A structured search of PubMed, Embase, Cochrane CENTRAL, and Web of Science was performed from database inception through January 2026. We prioritized the randomized sham-controlled RDN trials, major meta-analyses, guidelines, consensus documents, and studies addressing ABPM, HBPM, medication adherence, and telemonitoring. Results: The contemporary sham-controlled trials support RDN as an adjunctive option with a modest blood pressure-lowering effect, which is best assessed by out-of-office measurements. The placebo-adjusted reductions in ambulatory systolic blood pressure were generally in the 4–6 mmHg range. Appropriate use requires the confirmation of sustained uncontrolled hypertension, the exclusion of pseudoresistance, the optimization of treatment, and an adherence assessment. We identified three phenotypes most likely to benefit and proposed a three-axis framework for a response assessment at 3 and 6 months. Conclusions: RDN should be viewed not as a substitute for antihypertensive therapy but as a program-based adjunct for carefully selected patients. The measurement-first care pathway presented here should be interpreted as a pragmatic clinical model intended to operationalize the available trial and guideline evidence in routine care, rather than as a prospectively validated algorithm or formal consensus recommendation. Full article

Background: Nursing homes are congregate settings for elderly individuals where infectious diseases can easily spread. The elderly are at high risk of contracting and dying from influenza, and the most effective way to prevent this is to receive the influenza vaccine. Methods: This study conducted a cross-sectional survey of elderly people in nursing homes to investigate the occurrence of influenza symptoms during the 2024–2025 flu season, as well as vaccination status and reasons for receiving or not receiving the vaccine. Bivariate logistic regression was used to determine the factors influencing the vaccination rate. Results: Of the 1024 elderly people who participated in the survey, 25.39% reported experiencing flu-related symptoms in the previous flu season. While 16.21% of the elderly expressed willingness to receive vaccination, only 5.57% actually received it. Influenza vaccination was positively correlated with educational attainment (aOR 3.800, 95% CI 1.480–9.758 for middle school; aOR 5.138, 95% CI 1.738–15.191 for high school), monthly household income (aOR 0.216, 95% CI 0.072–0.644 for >8000), ability for self-care (aOR 0.269, 95% CI 0.123–0.591), and the scale of the nursing home (aOR 9.033, 95% CI 1.531–53.305 for 151–299; aOR 2.629, 95% CI 1.359–5.084 for ≥300). Willingness to receive the influenza vaccination was positively correlated with an unhealthy health status (aOR 0.398, 95% CI 0.204–0.779), symptoms of influenza (aOR 2.730, 95% CI 1.861–4.007), nursing home location (aOR 1.537, 95% CI 1.099–2.941 for outer suburbs), and the scale of the nursing home (aOR 1.991, 95% CI 1.154–3.435 for 151–299; aOR 2.158, 95% CI 1.374–3.390 for ≥300). Most elderly people who received the vaccine believed that vaccination could effectively prevent flu and that it could reduce the risk of complications, the rest were not vaccinated due to concerns about adverse reactions, mobility issues, or the distance to vaccination sites. Conclusions: Low awareness of flu vaccines and physical inability to travel to vaccination sites may be potential barriers to receiving the flu vaccine. It is worrying that the influenza vaccination rate is low among the elderly in nursing homes in Shanghai. As a result, it is crucial to prioritize targeted monitoring and intervention strategies for vulnerable populations living in collective institutions. Full article

The growing need for remote patient monitoring, accelerated by the global pandemic and an aging population, necessitates the development of advanced non-contact technologies for measuring vital signs. In this study, an integrated, non-contact system for accurately measuring heart rate (HR) and body temperature (BT) is developed and validated. The proposed system combines a 60 GHz radar sensor and infrared (IR) sensor for HR and BT measurements, respectively, enhanced with advanced signal processing and an AI-based computer vision algorithm. A Window Filter and a Peak Uniformity algorithm were applied to the raw radar signal to mitigate noise and motion artifacts. For Temp measurement, an IR sensor with a narrow five-degree field of view (FOV) was integrated with a YOLO Pose-based tracking system using a camera and servo motors to automatically orient the sensor towards the user’s face. The system was validated with 30 healthy adult participants, benchmarked against a MAX30102 PPG sensor and Braun ThermoScan 7 for BT and BT measurements, respectively. The advanced signal processing reduced the HR Mean Absolute Error from 13.73 BPM to 5.28 BPM (p = 0.002), while the AI-guided IR sensor reduced the BT MAE from 4.10 °C to 1.64 °C (p < 0.001). These findings demonstrate that integrating 60 GHz radar with AI-driven tracking provides a promising approach for home-based trend monitoring. Full article

Background: Frailty is highly prevalent among older adults with cardiovascular disease (CVD) and strongly predicts disability and mortality after cardiac events. Although cardiac rehabilitation (CR) improves prognosis, frail older patients often face barriers to participating in in-person programs. eHealth-based, home-delivered CR programs incorporating tele-rehabilitation and remote monitoring may improve accessibility, yet evidence regarding their effectiveness on frailty status remains limited. Methods: We designed a multicenter, randomized, parallel-group trial enrolling people ≥65 years recently hospitalized for acute heart failure (AHF) and/or acute coronary syndrome (ACS). Participants were randomized 1:1 to an eHealth home-based tele-rehabilitation program or the usual care. The primary endpoint is frailty prevalence at follow-up, defined by an Essential Frailty Toolset (EFT) score ≥3, with co-primary outcomes being between-group differences in the mean levels of EFT and Short Physical Performance Battery (SPPB) scores after 3–6 months. Secondary endpoints include mortality and hospitalization, among others. Results: The full protocol and study procedures are reported. Between May 2024 and December 2025, 589 patients were screened at the two Italian centers involved; 442 met eligibility criteria and 209 were enrolled and randomized. Baseline characteristics were largely comparable between groups. The mean age was 77 ± 9 years, 70% were male, and 55% had ACS. Lower-than-expected enrollment was mainly attributable to refusal related to difficulties in using digital devices. Conclusions: This randomized trial will evaluate whether a multidomain, eHealth-based CR intervention can reduce the prevalence or degree of frailty in older people after AHF or ACS. We report the study protocol and baseline characteristics of the enrolled cohort, highlighting the challenge of digital illiteracy in contemporary older populations. Full article

Background/Objectives: With growing waves of migration, children speaking a home language different from the language of school literacy have become increasingly common in Western education systems. In this context, understanding and monitoring bilinguals’ reading development is crucial to inform both educational and clinical practices and ensure equitable services. The present study contributes to the literature by investigating learning patterns in single-word reading across primary school grades. Monolingual and bilingual children learning to read in an alphabetic orthography were examined. Methods: The sample consisted of 565 typically developing monolingual and bilingual primary school children from grades 1–5 (bilinguals = 162). Participants completed a computerised Lexical Decision task (LDT) recording accuracy and response times, and standardised tests of reading and cognition. A parental questionnaire was used to gather socio-demographic and linguistic information. Results: Response bias-corrected accuracy rates in the LDT revealed an increase in sensitivity across school years after correcting for potential confounds (SES, vocabulary, nonverbal intelligence). No significant effect of bilingualism was observed. Response times for correct responses also decreased consistently across grades after controlling for the same confounds. Although no significant main effect of bilingualism emerged, an interaction with grade revealed a greater decrease in response times for second-grade bilinguals compared to monolingual peers. Conclusions: Monolingual and bilingual children showed comparable sensitivity rates and reading times, suggesting similar decoding skill acquisition. However, an earlier decrease in response times for bilinguals points to a facilitatory effect in the early stages of reading development, consistent with a bilingual advantage during skill learning. Full article

Effective Parkinson’s disease (PD) management is hindered by the intermittent nature of clinical snapshots and the discomfort of rigid monitoring hardware. This review critically evaluates the synergy between flexible bioelectronics and artificial intelligence (AI) for continuous remote monitoring. Our analysis reveals that while material innovations have achieved milligram-level sensitivity, a significant ‘translational gap’ persists due to limited validation in real-world environments and small cohort sizes. We conclude that multimodal fusion architectures are essential for accurately mapping digital biomarkers to clinical gold standards such as MDS-UPDRS. By leveraging edge AI for privacy and closed-loop feedback for intervention, this integration facilitates the transition from reactive clinical visits to proactive, personalized digital home-care ecosystems. Full article

The fetal electrocardiogram (FECG) is critical for assessing fetal cardiac electrophysiology and detecting fetal distress and arrhythmias. Single-channel abdominal electrocardiogram (AECG) enables home-based monitoring but faces challenges posed by weak fetal signals, maternal interference, and the lack of spatial information. Ensemble Empirical Mode Decomposition (EEMD) is suitable for nonstationary AECG signals but relies on accurate selection of intrinsic mode functions (IMFs). In this study, a deep learning-guided method was proposed: a one-dimensional convolutional neural network (1D CNN) scored and selected EEMD-derived IMFs, followed by maternal QRS template subtraction and secondary EEMD purification to achieve automatic FECG extraction. Leave-one-subject-out (LOSO) cross-validation was performed on 15 simulated cases and 5 ADFECGDB records, yielding a mean AUC of 0.9282 ± 0.0189 for the IMF classifier. On the independent DaISy and NIFEA arrhythmia datasets, the proposed CNN-2×EEMD method achieved correlation coefficients of 0.94–0.96, F1-scores of 0.8372–0.9565 for fetal R-peak detection, and SNR improvements of 13.39–15.88 dB. This method outperformed conventional automatic selection methods and matched the performance of manual selection. Ablation studies validated the optimal network design and IMF selection strategy, while complexity analysis (0.08 GFLOPs, 2.24 ms latency) confirmed its suitability for real-time wearable deployment. Full article

Background: Unwanted loneliness and social isolation in older adults are public health problems with negative effects on physical and mental health. The usual assessment tools, based on self-report questionnaires, have limitations in capturing these phenomena continuously and objectively. Objective: We aimed to critically analyze recent scientific evidence on the use of passive sensor technologies combined with artificial intelligence for the detection of unwanted loneliness and social isolation in older adults. Methods: Studies were reviewed in databases (PubMed, Scopus, Web of Science, and IEEE Xplore) that used wearable devices, environmental sensors in the home, smartphones, and multimodal fusion approaches. This systematic review was conducted following the PRISMA 2020 guidelines. Results: Behavioral variables derived from passive monitoring, such as mobility, time away from home, sleep patterns, and digital interactions, are consistently associated with measures of loneliness and social isolation. Likewise, artificial intelligence models based on the combination of multiple data sources show better predictive performance than unimodal approaches. Conclusions: Sensor-based technologies can complement traditional assessment methods, although their practical application requires overcoming challenges related to methodological validation, user acceptance, and ethical considerations. Full article

Background/Objectives: In Japan, hospital births predominate, with home births comprising only 0.1% of deliveries. This study assessed how documented practices for planned home births attended by independent midwives align with national guidelines and WHO intrapartum care recommendations, and assess maternal and neonatal differences before and after the COVID-19 pandemic. Methods: Records of 430 low-risk pregnant women who received continuous care at a private midwifery home over 25 years were reviewed. After excluding 8 maternal and 22 neonatal transfers, 400 records were analyzed. Descriptive statistics were compared with WHO recommendations and between the pre-pandemic (1999–2019) and post-pandemic (2020–2024) periods. Results: All women experienced spontaneous singleton cephalic labors with intermittent fetal heart rate auscultation. The mean gestational age was 277.3 days and the median labor duration was 303.5 min. Labor onset was spontaneous in 83.5% of cases. Nearly half of the women had no perineal lacerations. Postpartum blood loss ≥500 mL occurred in 14.1% of cases. Family presence was nearly universal. Neonates had a mean birth weight of 3129.0 g and high Apgar scores. Skin-to-skin contact occurred in 52.9%; exclusive breastfeeding reached 93.8% at 1 month. Post-pandemic births showed higher maternal age and higher neonatal birth weight, although these differences should be interpreted cautiously due to the small post-pandemic sample. Conclusions: Independent midwives provided evidence-based, physiologically oriented care, partially aligning with selected WHO intrapartum recommendations during planned home births. Midwife-led home births may support positive childbirth experiences and favorable maternal/neonatal outcomes for low-risk women. Post-pandemic shifts underscore the need for continued monitoring and flexible, community-based perinatal support, while recognizing the limitations of retrospective, single-site data. Full article