Search Results (240)

Background: Digital health technologies have expanded access to home fetal heart rate (FHR) monitoring devices, enabling fetal surveillance outside clinical settings. However, evidence on women’s awareness, acceptance, and experiences with these devices remains limited. Objective: To assess awareness, adoption, user experience, perceived reassurance, and attitudes toward home FHR monitoring among pregnant and postpartum women. Methods: A cross-sectional online survey was conducted using a structured questionnaire distributed via Google Forms. Eligible participants were women aged ≥18 years who were currently pregnant or had been pregnant within the previous two years. The survey evaluated awareness and use of home FHR monitoring devices, usage patterns, sources of recommendation and instruction, emotional responses, perceived reassurance, mobile application integration, and overall attitudes. Descriptive statistics and exploratory subgroup analyses were performed. Results: A total of 225 women completed the survey; 166 (73.8%) reported using a home FHR monitoring device during pregnancy. Most users reported positive emotional experiences, with calmness as the most common response. Home monitoring was generally perceived as reassuring, and many participants felt calmer on days of device use. Gynecologists were the primary source of device recommendations and usage instructions. Participants highlighted the importance of professional guidance, clear instructions, and mobile application support. Primiparous women had significantly higher adoption rates than multiparous women (p < 0.001). Conclusions: Home FHR monitoring was widely accepted and commonly perceived as reassuring. These devices may support patient-centered prenatal care when accompanied by appropriate professional guidance. Further prospective studies are needed to assess their clinical utility, safety, and integration into prenatal care pathways. Full article

Background: Many patients with heart failure with reduced ejection fraction (HFrEF) remain undertreated in routine practice. Delayed treatment intensification, poor adherence, and fragmented follow-up are common barriers. Low-cost digital support may help reduce this implementation gap. Objective: This study evaluated whether a simple digital support pathway was associated with better 6-month treatment adherence and guideline-directed medical therapy (GDMT) optimization in ambulatory patients with stable HFrEF. Methods: This single-center matched cohort study compared a prospective digital-support cohort with a historical usual-care cohort. The intervention combined smartphone-based telemanagement, home blood pressure and heart-rate reporting, daily weight surveillance, and scheduled video consultations. The co-primary endpoints were treatment adherence at 6 months and GDMT optimization, assessed by change in foundational HFrEF drug classes and by a prespecified exploratory GDMT optimization score. Results: After 1:1 propensity-score matching, 200 patients were included, with 100 patients in each cohort. Treatment adherence at 6 months was higher in the digital-support cohort than in usual care (82.0% vs. 64.0%, p = 0.004). The intervention cohort also had more frequent class addition, more dose escalation, a greater increase in foundational drug classes, and a larger improvement in GDMT optimization score (all p < 0.001). Heart failure hospitalization and the composite of heart failure hospitalization or all-cause death were less frequent in the digital-support cohort, but these clinical outcomes were exploratory. Conclusions: A pragmatic low-cost digital support pathway was associated with better adherence and more complete GDMT optimization in ambulatory patients with HFrEF. The findings support further prospective multicenter evaluation. Full article

Background/Objective: Conventional cardiotocography (CTG) is an essential tool for fetal surveillance but remains inaccessible in many low-resource settings. Emerging low-cost, wireless mobile CTG systems designed for home-based use may enhance global access to fetal monitoring. Nevertheless, their concordance with conventional CTG in the interpretation of FHR patterns remains insufficiently validated. This study aimed to evaluate agreement in the readability and interpretability of FHR baseline patterns and accelerations/decelerations between mobile and conventional CTG. Methods: A prospective study was conducted in pregnant women undergoing antepartum surveillance to evaluate agreement in the interpretation of FHR tracings simultaneously obtained from mobile and conventional CTG. Each paired tracing was independently and blindly assessed by two physician reviewer groups. Results: A total of 404 women underwent simultaneous assessment with both modalities. Agreement in baseline FHR interpretation was excellent between reviewer groups and modalities (ICC > 0.95). Interpretation of accelerations and decelerations also demonstrated very good agreement (κ = 0.8–0.9), whereas agreement for FHR variability and uterine contractions was moderate. Both reviewer groups assigned slightly but significantly higher quality scores and satisfaction scores to conventional CTG compared with mobile CTG. Conclusions: Mobile CTG demonstrates excellent agreement with conventional CTG in the assessment of FHR baseline and accelerations/decelerations. However, the overall quality and user satisfaction associated with mobile CTG were slightly lower than those observed with conventional CTG. Because of its advantages, including lower cost, portability, and user-friendly design, mobile CTG may serve as a feasible alternative for antepartum surveillance in low-resource settings worldwide. Full article

The rapid evolution of Smart Homes and Smart Buildings is driven by the transition from the Internet of Things (IoT) to the Artificial Intelligence of Things (AIoT). Within this scenario, Security Systems are particularly critical and data-intensive systems. Despite extensive research, a high-level synthesis focusing exclusively on the synergy between AIoT and Security Systems in Smart Home and Smart Building application domains is still lacking. To bridge this gap, this paper presents a systematic Tertiary Study (TS) following a well-known research protocol. 13 Secondary Studies (SSs) were synthesized and discussed from an initial pool of 139 publications (years 2024–2025). Findings reveal that monitoring is the most addressed system, followed by security and alarm, while surveillance and access control remain comparatively underexplored. Moreover, results highlight a definitive shift toward Edge and Fog computing to meet latency and privacy requirements, whereas Deep Learning and Ensemble Learning techniques predominate for anomaly detection and predictive maintenance. This study identifies open challenges and future research directions, providing a foundational roadmap for resilient, cognitive-driven security infrastructures in smart environments. Full article

As they are home to numerous significant ecosystems, natural resources, and a growing population, coastal regions are among the most vital locations on Earth. This study, pertaining to the east coast of the UAE, integrates nine distinct characteristics to provide a thorough methodology for assessing integrated coastal vulnerability. Land use and land cover (LULC), nearshore bathymetry, coastal geomorphology, coastal slope, shoreline erosion and deposition, population density, wave and tide, and nearshore benthic features are important parameters that are examined. For the first time, coastal benthic features are included to assess coastal vulnerability in this region. By combining the variably weighted rank values of the nine variables, an Integrated Coastal Vulnerability Index was created, which divides the coastline into low-, moderate-, and high-risk categories. The methodology improves the precision of regional risk assessments by combining these factors with data from real-time coastal surveillance. Approximately 26.4% of the UAE’s 178 km east coast (or 47.1 km) is at high risk, followed by 17.3% (or 30.9 km) at moderate risk and 56.3% (or 100.2 km) at low risk. The offshore areas of the east coast of the UAE are prone to shoaling and tunneling effects from incoming high waves at certain areas due to the concave-shaped bathymetry and medium-range canyons present, which exacerbate storm surges or tsunamis due to the shoaling effect. For a 3 m rise in sea level, most significantly, 5.58 km² of plantation and 14.39 km² of residential areas will be damaged in the Kalba and Fujairah regions. Additional commercial spaces totaling 1.07 km² will also have an impact, adding to the existing 2.59 km² of oil bunkers in Fujairah. More than 40,000 people who live within 3.0 m of the UAE’s east coast in six separate districts—Kalba, Fujairah City, Mirbah and Qidfa, Khorfakkan, Dadna and Bidya, and Dibba—will be impacted if a tsunami wave or storm surge of three meters strikes the east coast. Our results are intended to assist government agencies, coastal planners, and policymakers in the Northeast Emirates (Fujairah and Sharjah) in creating sustainable and successful adaptation and mitigation plans for areas most vulnerable to coastal hazards. In addition to enhancing scientific knowledge of coastal vulnerabilities, this integrative method is a useful tool for making well-informed decisions in the face of shifting socio-economic and climatic situations. Full article

Vitamin D₃ is an essential fat-soluble vitamin for the human body. Its metabolite, 25-hydroxyvitamin D₃ (25(OH)D₃), serves as the primary biomarker to assess vitamin D levels. The monitoring of 25(OH)D₃ concentration is crucial for human health assessment. While traditional detection methods offer high sensitivity and accuracy, they are operationally complex and costly. This review systematically summarizes the most recent progress in 25(OH)D₃ detection technologies. Special attention is given to the recognition modes of 25(OH)D₃ by antibodies, nucleic acids, and molecularly imprinted recognition elements. Subsequently, the design strategies of diverse types of biosensors, including fluorescent, colorimetric, and electrochemical biosensors, are analyzed. Moreover, the development of portable devices, smartphone software, and flexible wearable devices for detection applications is also examined. Biosensing detection platforms are compared from the perspectives of target recognition, signal conversion, signal output, and application scenarios. Additionally, the potential of biosensor detection platforms in clinical diagnosis, health management, and community health surveillance is further investigated. Finally, the future trends of intelligent, portable, accurate, and home-use 25(OH)D₃ detection systems are delineated. This review offers a comprehensive reference for researchers developing next-generation 25(OH)D₃ diagnostic sensors and provides insights for the early prevention and treatment of vitamin D deficiency-related diseases. Full article

Objectives: To present novel strategies in the diagnosis and management of spondylodiscitis in a patient with tetraplegia. Case Presentation: A 44-year-old man presented with increased spasms despite having a SynchroMed II Medtronic for intrathecal infusion of baclofen. The C-reactive protein level was raised. Infection was suspected, but there were no localising signs. Positron Emission Tomography (PET) was performed to identify the focus of infection. PET showed an increased Fluorodeoxyglucose uptake in the L-5 vertebral body and the associated ill-defined soft tissue anteriorly. There was significant erosion and destruction of the S-1 vertebra. Magnetic Resonance Imaging of the lumbo-sacral spine revealed destruction and collapse of the S-1 vertebral body and a 6 cm × 2 cm anterior paravertebral abscess collection. This patient was managed in his home. Intravenous administration of 1 g of Ertapenem daily was provided by community nurses for eight weeks. Blood tests were performed in the community setting, and the patient was monitored by spinal unit doctors. Results: Follow-up CT revealed abnormal soft tissue, expanding and replacing the S-1 vertebral body, with appearances in keeping with an infective process. Using CT guidance and the Madison bone biopsy kit, multiple cores were obtained from the left sacral bone. Four of the five specimens showed no growth after extended incubation. Propionibacterium acnes were isolated after 10 days of incubation from the tissue from the sacral bone biopsy only. A shared decision was made towards active surveillance. Follow-up CT of the abdomen showed a stable appearance of the lumbar and sacral spine. Conclusions: A complex case of spondylodiscitis can be diagnosed and managed while the patient stays mainly in their home, avoiding prolonged admission to the spinal unit, in alignment with the “hospital to community” aspect of the National Health Service’s 10-year Health Plan for England. A diagnostic pathway with PET-CT as the first approach proved useful when the site of infection was unclear. Active surveillance obviated the need for extended periods of antibiotic therapy, which could have led to complications such as antibiotic-induced toxicity and microbial resistance to antibiotics. Full article

Sound Event Localization and Detection (SELD) integrates Sound Event Detection (SED) and Direction-of-Arrival Estimation (DOAE) to recognize and localize sound events in various applications, including urban sound sensing, wildlife monitoring, and home surveillance. Recently, advancements in machine learning, particularly deep learning techniques, have demonstrated remarkable success in improving SELD performance. However, training deep learning models for SELD is challenged by the limited availability of high-quality spatial audio data, which is essential for accurate model generalization. This paper explores the effectiveness of data augmentation techniques in overcoming this limitation. We evaluate the impact of Frequency Shift (FS), Random Cutout (RC), and Channel Swapping (CS) on SELD performance using a comprehensive set of experiments. Our findings indicate that all tested augmentation combinations except FS alone significantly improve SELD performance, reducing the SELD error by approximately 8% compared to no augmentation. The differences among effective combinations are not statistically significant, suggesting that the decision to augment is more impactful than the specific combination chosen. This work highlights the critical role of data augmentation in enhancing SELD systems and suggests future research directions, including testing these techniques with different model architectures and exploring additional augmentation methods. Full article

Background: Shift-working healthcare workers (HCWs) are at elevated cardiovascular (CV) risk due to chronic circadian disruption; however, gender-stratified data on CV risk profiles and modifiable risk factor distribution by occupational exposure duration remain scarce in the Italian hospital setting. This cross-sectional study aimed to characterise the 10-year CV risk profile and the distribution of modifiable risk factors in a hospital-based sample of shift-working HCWs. Methods: A retrospective cross-sectional study was conducted using data from routine occupational health surveillance of shift-working HCWs at a large Italian hospital in Salento, Southern Italy (survey year: 2025). The 10-year CV risk was estimated using the CUORE Project algorithm, validated for the Italian population. Risk was stratified by gender, age group, and shift work duration. Multivariable logistic regression models, adjusted for age, marital status, and presence of children at home, evaluated associations between selected risk factors and CV risk category. The study was reported in accordance with STROBE guidelines. Results: Of 765 HCWs included (320 males, 445 females; mean age 49.3 ± 8.5 years), male workers showed a significantly higher mean 10-year CV risk score (4.98 ± 2.8 vs. 1.34 ± 0.9; p < 0.05). Among male workers, the odds of moderate/high CV risk increased progressively with shift work duration (aOR 6.4 for >30 years). Males also showed significantly higher prevalence of arterial hypertension, overweight, and obesity across all strata. Conclusions: Male shift-working HCWs represent a higher-risk subgroup, characterised by a greater burden of modifiable cardiovascular risk factors. Integration of validated risk assessment tools into occupational health surveillance may support targeted preventive strategies in hospital settings. Full article

Analog digital video recorders (DVRs) are still extensively used in small-to-medium business and home security systems, but there are special problems when it comes to forensic recovery of video evidence in these systems that are not covered by tools or methodology. Compared to the IP-based network video recorders, analog DVRs packetize video frames of several coaxial-connected cameras into a single interleaved binary stream on disk, necessitating channel demultiplexing before single camera footage can be reassembled. In this paper, we discuss a multi-channel analog Dahua DVR system utilizing the DHAV frame format, with a focus on the forensic recovery approach. Three significant contributions are presented in the methodology: (1) a channel demultiplexing algorithm that separates interleaved frames with up to 32 cameras on the basis of embedded channel identifiers and temporal coherence analysis; (2) a frame sequence stitching mechanism to reassemble continuous video segments on the basis of non-contiguous disk fragments using adaptive frame number tolerance (±3 frames) and temporal validation (≤1 second difference); and (3) a native C implementation with Win32 GUI providing significant performance improvements over interpreted alternatives. The system was tested on 14 analog Dahua DVR hard drives of various models, with a 92.3% recovery rate (97.1% on hard drives with no hardware damage), 91.3% temporal accuracy, 97.5% channel separation accuracy and a 1.8% false positive rate. The methodology fills an important gap in the literature of surveillance forensics, where current studies have only concentrated on IP-based digital systems, and analog DVRs form an estimated 35–40% of operational surveillance systems across emerging markets. The channel demultiplexing capability, which is not found in any current commercial or academic tool, enables automated per-camera organization of interleaved streams, converting what was previously a manual multi-day process into an automated one. Full article

Background: The Danish National Survey of Diet and Physical Activity (DANSDA) is Denmark’s national dietary surveillance system, providing population-level data to support evidence-based government advisory tasks and policymaking, research, and education. Methods: DANSDA 2021–2024 is a cross-sectional survey based on a simple random sample of citizens aged 4–80 years from the Danish Civil Registration System. Home visits included structured interviews covering socio-economic status, family composition, ethnicity, lifestyle behaviors and attitudes, health and non-communicable diseases, dietary supplement use, and measurements of anthropometrics and blood pressure. Dietary intake was recorded using a digital or paper-based seven-day food record and a food frequency questionnaire. Physical activity was measured with a pedometer and a seven-day step diary. Participants aged 40–70 years were offered blood sampling for glucose and lipid analyses. Results: A total of 4223 individuals participated, with 3824 providing valid food records (97.4% were digital). The response rate was 26.3%. The overall underreporting rate was 24%. The sample was skewed by age, education, income, household type, and region; these variables and sex were used to generate weighting factors. Nearly 1000 blood samples were analyzed for glucose and lipids, with surplus material stored in a biobank. Conclusions: DANSDA 2021–2024 provides comprehensive data on diet, physical activity, anthropometry, blood pressure, and blood glucose and lipids. Despite declining response rates and underrepresentation of individuals with lower education and income, weighting procedures support its continued use for national monitoring and research. Strengthening participation and representativeness should be a priority in future survey cycles. Full article

Explosive ordnance (EO), including AXO (abandoned explosive ordnance), IEDs (improvised explosives devices), and UXO (unexploded ordnance), are widely recognised for their blast and fragmentation hazards, but they also represent a persistent and under-addressed source of occupational chemical exposure for explosive ordnance disposal (EOD) personnel. EOD core activities liberate mixed metals and energetic chemicals, resulting in exposures that are multi-route (inhalation of dusts and fumes, dermal loading amplified by sweat and glove occlusion, and ingestion via hand-to-mouth transfer during eating, drinking, or smoking) and multi-temporal (repeated low-dose background plus task-driven spikes), as well as chemically complex. Clinically, this can present as syndromic overlap across acute and chronic domains, with symptoms that are easily misattributed to heat stress, dehydration, infection, or fatigue. Acute effects of concern include neurotoxic presentations (headache, dizziness, confusion, tremor, and seizure), respiratory and mucosal irritation following dust or fume events, gastrointestinal symptoms, and patterns suggestive of acute hepatic or renal stress, particularly when high-intensity tasks occur in hot environments that compound physiologic strain. Chronic outcomes relevant to repeatedly exposed EOD personnel include renal function decline, neurocognitive effects that can degrade operational decision making and safety, persistent haematologic abnormalities, and endocrine disruption signals, with long-latency risks requiring cautious interpretation given sparse longitudinal data and confounding co-exposures. This review synthesises the current evidence base through an EOD lens and translates it into pragmatic clinical and programmatic actions: task-based exposure characterisation; tiered biomonitoring and medical surveillance aligned to operational tempo; incident-triggered assessment pathways after high-residue events; and prevention strategies that work under field constraints, including contamination control zones, hygiene enforcement, glove and respiratory protection optimisation, tool and vehicle decontamination, and measures to prevent secondary transfer and take-home exposure. The central takeaway is practical: EOD programs can reduce morbidity and improve readiness by treating explosive ordnance as a chemical mixture exposure problem, adopting mixture-aware clinical triage, and embedding surveillance and controls that match how EOD work is actually performed. Full article

Background/Objectives: Atrial fibrillation is the most common sustained arrhythmia and frequently occurs in the perioperative setting. However, its clinical relevance in neurosurgical patients remains poorly defined despite increased vulnerability related to brain injury, inflammation, and perioperative stress. This study aimed to determine whether newly detected postoperative atrial fibrillation (POAF) identifies a higher-risk profile and is associated with postoperative complications, resource utilization, and short-term mortality compared with patients remaining in sinus rhythm (SR). Methods: We conducted a single-center retrospective cohort study (October 2020–April 2025). Among 2619 neurosurgical procedures, only patients with both pre- and in-hospital post-procedure ECGs and no pre-existing arrhythmia were included. POAF was defined as atrial fibrillation detected on any post-procedure ECG. Outcomes were compared using Welch’s t-test, χ²/Fisher’s exact tests, and odds ratios (OR) with 95% confidence intervals (CI). This study was not designed to estimate the incidence of POAF but rather to compare outcomes within a selected ECG-screened subgroup. Results: A total of 171 patients met the inclusion criteria: 79 (46.2%) developed POAF and 92 (53.8%) remained in SR. Patients with POAF were older and had a higher burden of cardiometabolic comorbidities and were more likely to undergo craniotomy/trepanation and emergency procedures. Compared with SR, POAF was associated with higher rates of postoperative complications, longer ICU and hospital stay, lower likelihood of discharge home, and higher short-term mortality. These findings reflect a selected ECG-screened cohort and should not be interpreted as the incidence of POAF in the overall neurosurgical population. Conclusions: Newly detected POAF is associated with a higher-risk postoperative profile in neurosurgical patients. It clusters with greater comorbidity burden, more invasive and urgent procedures, increased complications, prolonged hospitalization, reduced likelihood of discharge home, and higher short-term mortality. These findings support further evaluation of rhythm surveillance and perioperative management strategies in higher-risk neurosurgical populations. Full article

Antibiotic resistance genes (ARGs) are prevalent in livestock environments due to antimicrobial use, yet their airborne dispersal into human-occupied indoor spaces remains poorly characterized. We investigated whether airborne ARGs disperse from livestock stables into farmers’ homes and surrounding outdoor environments. Electrostatic dust collectors were deployed in paired pig and cow stables and their associated homes in Jutland, Denmark, to collect settled airborne dust. Pooled samples were analyzed using shotgun metagenomic sequencing. ARG dispersal patterns were assessed using FEAST source tracking and ecological similarity metrics, including shared ARG ratios and Jaccard indices. Pig production systems exhibited higher antibiotic use and stronger resistome continuity with farmers’ homes than cow systems, reflected by greater FEAST contributions (P = 0.029) and Jaccard similarity (P = 0.029). Beta-diversity analysis supported higher compositional similarity between pig stables and homes (PERMANOVA R² = 0.23, p = 0.052), whereas cow environments showed greater divergence (R² = 0.41, P = 0.035). Across environments, tetracycline, macrolide–lincosamide–streptogramin B, and aminoglycoside resistance genes dominated, consistent with livestock-specific antibiotic use patterns. Supplementary indoor–outdoor comparisons across cow, pig, and chicken stables (from an independent 2024 sampling campaign not directly comparable to the 2008 EDC-based survey) revealed contrasting dispersal dynamics, with higher bacterial species spillover from cow stables but stronger ARG overlap from pig stables. Collectively, these findings are consistent with airborne ARG connectivity across occupational and environmental interfaces and support consideration of air as a potential pathway in One Health AMR surveillance. Full article

Foodborne botulism, caused by ingestion of pre-formed botulinum neurotoxin, is the most common form of botulism. While large outbreaks linked to commercial foods are rare, smaller outbreaks associated with home-processed products are more frequent, reflecting local dietary habits and traditional preservation practices. The aim of this paper is to provide a public health overview of reported foodborne botulism outbreaks in Romania over an 18-year period to raise awareness among clinicians and public health officials. Between 2007 and 2024, a total of 337 foodborne botulism cases were reported in Romania, of which 43% (147) were related to 55 outbreaks (median number of cases per outbreak: 2; IQR: 2–3). Most outbreaks were reported in Bihor County (11 outbreaks with 29 cases) and its neighboring county, Satu Mare (seven outbreaks, accounting for a total number of 20 cases). Outbreak-related cases were observed in younger persons with a median age of 31 years (compared to 45 years for sporadic cases) and were statistically significantly associated with consumption of pork products (p < 0.001). Fifteen deaths occurred (case fatality ratio: 4%), including three outbreak-related cases (case fatality ratio: 2%). These findings highlight the ongoing public health challenge of foodborne botulism in Romania and the need for robust surveillance, targeted educational initiatives in high-incidence counties to deliver information about safe food preparation and preservation practices, and the continuous availability of botulinum antitoxin supplies. Full article