Search Results (1,057)

Invasive candidiasis (IC), characterized by the most common clinical manifestation of candidemia, is a fungal infection with a high mortality rate and a significant impact on global public health. It is estimated that each year there are between 227,000 and 250,000 hospitalizations related to IC, with more than 100,000 associated deaths. In Latin America and the Caribbean (LA&C), the absence of a standardized surveillance system has led to multicenter studies documenting incidences ranging from 0.74 to 6.0 cases per 1000 hospital admissions, equivalent to 50,000–60,000 hospitalizations annually, with mortality rates of up to 60% in certain high-risk groups. Armed conflicts and structural violence in LA&C cause forced displacement, the collapse of health systems, and poor living conditions—such as overcrowding, malnutrition, and lack of sanitation—which increase vulnerability to opportunistic infections, such as IC. Insufficient specialized laboratories, diagnostic technology, and trained personnel impede pathogen identification and delay timely initiation of antifungal therapy. Furthermore, the empirical use of broad-spectrum antibiotics and the limited availability of echinocandins and lipid formulations of amphotericin B have promoted the emergence of resistant non-albicans strains, such as Candida tropicalis, Candida parapsilosis, and, in recent outbreaks, Candidozyma auris. Full article

Accurately assessing the depth of anaesthesia in animals remains a challenge, as traditional monitoring methods fail to capture subtle changes in brain activity. This review aimed to systematically map and critically evaluate the range of quantitative variables derived from electroencephalography (EEG) used to monitor sedation or anaesthesia in live animals, excluding laboratory rodents, over the past 35 years. Studies were identified through comprehensive searches in major biomedical databases (PubMed, Embase, CAB Abstract). To be included, studies had to report EEG use in relation to anaesthesia or sedation in living animals. A total of 169 studies were selected after screening and data extraction. Information was charted by animal species and reported EEG-derived variables. The most frequently reported variables were spectral edge frequencies, spectral power metrics, suppression ratio, and proprietary indices, such as the Bispectral Index. Methodological variability was high, and no consensus emerged on optimal EEG measures across species. While EEG-derived quantitative variables provide valuable insights, their interpretation remains highly context-dependent. Further research is necessary to refine these methods, explore variable combinations, and improve their clinical relevance in veterinary medicine. Full article

Optical Coherence Tomography (OCT) has evolved from a breakthrough ophthalmologic imaging tool into a cornerstone technology in interventional cardiology. After its initial applications in retinal imaging in the early 1990s, OCT was subsequently envisioned for cardiovascular use. In 1995, its ability to visualize atherosclerotic plaques was demonstrated in an in vitro study, and the following year marked the acquisition of the first in vivo OCT image of a human coronary artery. A major milestone followed in 2000, with the first intracoronary imaging in a living patient using time-domain OCT. However, the real inflection point came in 2006 with the advent of frequency-domain OCT, which dramatically improved acquisition speed and image quality, enabling safe and routine imaging in the catheterization lab. With the advent of high-resolution, second-generation frequency-domain systems, OCT has become clinically practical and widely adopted in catheterization laboratories. OCT progressively entered interventional cardiology, first proving its safety and feasibility, then demonstrating superiority over angiography alone in guiding percutaneous coronary interventions and improving outcomes. Today, it plays a central role not only in clinical practice but also in cardiovascular research, enabling precise assessment of plaque biology and response to therapy. With the advent of artificial intelligence and hybrid imaging systems, OCT is now evolving into a true precision-medicine tool—one that not only guides today’s therapies but also opens new frontiers for discovery, with vast potential still waiting to be explored. Tracing its historical evolution from ophthalmology to cardiology, this narrative review highlights the key technological milestones, clinical insights, and future perspectives that position OCT as an indispensable modality in contemporary interventional cardiology. As a guiding thread, the myth of Prometheus is used to symbolize the evolution of OCT—from its illuminating beginnings in ophthalmology to its transformative role in cardiology—as a metaphor for how light, innovation, and knowledge can reveal what was once hidden and redefine clinical practice. Full article

Per- and polyfluoroalkyl substances (PFAS) have been found worldwide in water, soil, plants, and animals, including humans. A primary route of exposure for humans and animals to PFAS is through the diet and drinking water. Perfluorooctane sulfonate (PFOS), a long-chain PFAS with a relatively long half-life, has been associated with adverse health effects in humans and laboratory animals. There are few toxicokinetic studies on PFOS in domestic livestock raised for human food consumption, which are critical for assessing human food safety. This work aimed to develop a simple daily accumulation model (DAM) for predicting PFOS residues in edible beef cattle muscle. A one-compartment toxicokinetic model in a spreadsheet format was developed using simple calculations to account for daily PFAS into and out of the animal. The DAM was used to simulate two case studies to predict resultant PFOS residues in edible beef cattle tissues. The results demonstrated that the model can reasonably predict PFOS concentrations in beef cattle muscle in a real-world scenario. The DAM was then used to simulate dietary PFOS exposure in beef cattle throughout a typical lifespan in order to derive a generic bioaccumulation factor. The DAM is expected to work well for other PFAS in beef cattle, PFAS in other livestock species raised for meat, and other chemical contaminants with relatively long half-lives. Full article

In December 2023, infections of western equine encephalitis virus (WEEV) within Argentina were reported to the World Health Organization (WHO). By April 2024, more than 250 human infections, 12 of which were fatal, and 2500 equine infections were identified in South America. Laboratory diagnosis and surveillance in affected countries were hindered by a lack of facilities equipped with BSL-3 laboratories, as confirmatory serodiagnosis for WEEV requires live virus in the plaque reduction neutralization test (PRNT). To expand serodiagnosis for WEEV in the Americas, we developed a virus chimera composed of vesicular stomatitis virus (VSV) engineered to display the E2-E1 glycoproteins of WEEV (VSV/WEEV) in place of the VSV glycoprotein (G). PRNT₉₀ and IC₉₀ values of parental WEEV and VSV/WEEV were analogous using sera collected from mice, horses, and chickens. VSV/WEEV rapidly formed plaques with clear borders and reduced the assay readout time by approximately 8 h compared to the parental virus. Overall, we demonstrate that chimeric VSV/WEEV is a suitable surrogate for WEEV in a diagnostic PRNT. Use of chimeric VSV/WEEV in place of authentic WEEV will dramatically expand testing capacity by enabling PRNTs to be performed at BSL-2 containment, while simultaneously decreasing the health risk to testing personnel. Full article

Objective: To characterize the profiles of resistance mutations to HIV reverse transcriptase inhibitors in Gabon. Design: Cross-sectional study conducted over 37 months, from October 2019 to October 2022, at the IST/HIV/AIDS Reference Laboratory, a reference center for the biological monitoring of people living with the human immunodeficiency virus (PWHIV) in Gabon. Methods: Plasma from 666 PWHIV receiving antiretroviral treatment was collected, followed by RNA extraction, amplification, and reverse transcriptase gene sequencing. Statistical analyses were performed using Stata^® 14.0 software (USA). Results: Six hundred and sixty-six (666) PWHIV plasma collected from 252 male and 414 female patients were analyzed and 1654 mutations were detected in 388 patients, including 849 (51.3%) associated with nucleoside reverse transcriptase inhibitors (NRTIs) and 805 (48.7%) with non-nucleoside reverse transcriptase inhibitors (NNRTIs). Three of the most prescribed treatment regimens were associated to the appearance of both NRTIs and NNRTIs resistance mutations: TDF + 3TC + EFV (24.02%; 160/666); TDF + FTC + EFV) (17.2%; 114/666) and AZT + 3TC + EFV (14.6%; 97/666). Additionally, stage 3 of CD4 T-lymphocyte deficiency, the higher viral load, and treatment duration are risk factors influencing the appearance of virus mutations. Also, treatment containing TDF-3TC + DTG is more protective against mutations. Conclusions: Drug resistance mutations are common in Gabon and compromise the efficacy of ART. Further study must search for other causes of therapeutic failure in Gabon in PWHIV. Full article

To meet the European Green Deal targets, the construction sector must improve building thermal performance via advanced insulation systems. Eco-friendly sandwich panels offer a promising solution. Therefore, this work aims to develop and validate a new eco-friendly composite sandwich panel (basalt fibres and recycled extruded polystyrene) with enhanced multifunctionality for lightweight and energy-efficient building façades. Two panels were produced via vacuum infusion—a reference panel and a multifunctional panel incorporating phase change materials (PCMs) and silica aerogels (AGs). Their performance was evaluated through lab-based thermal and acoustic tests, numerical simulations, and on-site monitoring in a living laboratory. The test results from all methods were consistent. The PCM-AG panel showed 16% lower periodic thermal transmittance (0.16 W/(m²K) vs. 0.19 W/(m²K)) and a 92% longer time shift (4.26 h vs. 2.22 h), indicating improved thermal inertia. It also achieved a single-number sound insulation rating of 38 dB. These findings confirm the panel’s potential to reduce operational energy demand and support long-term climate goals. Full article

Network Music Performance (NMP) refers to network-based remote collaboration when applied to music performances, such as musical education, music production and live music concerts. In NMP, the most important parameter for the Quality of Experience (QoE) of the participants is low end-to-end audio delay. Increasing delays prevent musicians’ synchronization and lead to a suboptimal musical experience. Visual contact between the participants is also crucial for their experience but highly demanding in terms of bandwidth. Since audio compression induces additional coding and decoding delays on the signal path, most NMP systems rely on audio quality reduction when bandwidth is limited to avoid violating the stringent delay limitations of NMP. To assess the delay and quality tolerance limits for NMP and see if they can be satisfied by emerging 5G networks, we asked eleven pairs of musicians to perform musical pieces of their choice in a carefully controlled laboratory environment, which allowed us to set different end-to-end delays or audio sampling rates. To assess the QoE of these NMP sessions, each musician responded to a set of questions after each performance. The analysis of the musicians’ responses revealed that actual musicians in delay-controlled NMP scenarios can synchronize at delays of up to 40 ms, compared to the 25–30 ms reported in rhythmic hand-clapping experiments. Our analysis also shows that audio quality can be considerably reduced by sub-sampling, so as to save bandwidth without significant QoE loss. Finally, we find that musicians rely more on audio and less on video to synchronize during an NMP session. These results indicate that NMP can become feasible in advanced 5G networks. Full article

Background/Objectives: Laboratory tests conducted in community settings are occasionally repeated within hours of presentation to pediatric emergency departments (PEDs). Reducing unnecessary repetitions can ease child discomfort and alleviate the healthcare burden without compromising the diagnostic process or quality of care. The aim of this study was to develop a decision tree (DT) model to guide physicians in minimizing unnecessary repeat blood tests in PEDs. The minimal decision tree (MDT) algorithm was selected for its interpretability and capacity to generate optimally pruned classification trees. Methods: Children aged 3 months to 18 years with community-based complete blood count (CBC), electrolyte (ELE), and C-reactive protein (CRP) measurements obtained between 2016 and 2023 were included. Repeat tests performed in the pediatric emergency department within 12 h were evaluated by comparing paired measurements, with tests considered justified when values transitioned from normal to abnormal ranges or changed by ≥20%. Additionally, sensitivity analyses were conducted for absolute change thresholds of 10% and 30% and for repeat intervals of 6, 18, and 24 h. Results: Among 7813 children visits in this study, 6044, 1941, and 2771 underwent repeated CBC, ELE, and CRP tests, respectively. The mean ages of patients undergoing CRP, ELE, and CBC testing were 6.33 ± 5.38, 7.91 ± 5.71, and 5.08 ± 5.28 years, respectively. The majority were of middle socio-economic class, with 66.61–71.24% living in urban areas. Pain was the predominant presented complaint (83.69–85.99%), and in most cases (83.69–85.99%), the examination was conducted by a pediatrician. The DT model was developed and evaluated on training and validation cohorts, and it demonstrated high accuracy in predicting the need for repeat CBC and ELE tests but not CRP. Performance of the DT model significantly exceeded that of the logistic regression model. Conclusions: The data-driven guide derived from the DT model provides clinicians with a practical, interpretable tool to minimize unnecessary repeat laboratory testing, thereby enhancing patient care and optimizing healthcare resource utilization. Full article

Governance challenges, success factors, and stakeholder dynamics are central to the implementation of Positive Energy District (PED) Labs, which aim to develop energy-positive and sustainable urban areas. In this paper, a qualitative analysis combining expert surveys, participatory workshops with practitioners from the COST Action PED-EU-NET network, and comparative case studies across Europe identifies key barriers, drivers, and stakeholder roles throughout the implementation process. Findings reveal that fragmented regulations, social inertia, and limited financial mechanisms are the main barriers to PED Lab development, while climate change mitigation goals, strong local networks, and supportive policy frameworks are critical drivers. The analysis maps stakeholder engagement across six development phases, showing how leadership shifts between governments, industry, planners, and local communities. PED Labs require intangible assets such as inclusive governance frameworks, education, and trust-building in the early phases, while tangible infrastructures become more relevant in later stages. The conclusions emphasize that robust, inclusive governance is not merely supportive but a key driver of PED Lab success. Adaptive planning, participatory decision-making, and digital coordination tools are essential for overcoming systemic barriers. Scaling PED Labs effectively requires regulatory harmonization and the integration of social and technological innovation to accelerate the transition toward energy-positive, climate-resilient cities. Full article

Botanical gardens serve as vital centers for ex situ conservation, maintaining diverse plant species under controlled conditions. Terrestrial orchids, despite their wide diversity and distribution, often occur in small and declining populations, making their conservation increasingly urgent. This study aimed to examine the potential for establishing the first specialized orchidarium in Serbia, focusing on the native orchid species of the Fruška Gora region. A SWOT analysis, combined with site assessment data, was employed to identify key strengths, weaknesses, opportunities, and threats, informing the development of a functional zoning plan. The results indicate that such an orchidarium would offer a threefold benefit: strengthening ex situ conservation, advancing scientific research and environmental education, and promoting sustainable tourism. The proposed design consists of eight distinct zones, three of which reflect natural habitats of selected orchid species. The planned integration of a seed gene bank in the central zone, along with living plant collections and a nearby in vitro culture laboratory, establishes a comprehensive framework for the sustainable management of orchid genetic resources in the region, forming a foundation for future research and preservation. Full article

Agroecological transitions in collective urban gardens in Toulouse region were studied through the prism of global health (2011–2022). The specific meaning of “global health” in the context of urban gardens concerns the health of gardeners (well-being and physical health), plants, soil, and animals, as well as the interactions between humans and non-humans, which are crucial for gardeners. A sociotechnical research project was developed on four different collective gardening sites, consisting of the following: 1. surveys issued to 100 garden stakeholders to highlight issues and practices, participation in meetings with the social centers in charge of events, and focus groups; 2. participative agronomic and environmental measurements and field observations, including soil quality analyses; and 3. analysis of the available documentary corpus. In order to produce the results, these three research methods (surveys, agronomy, document analysis) were combined through a transdisciplinary approach, in that both the field experimentation outcomes and retrieved scientific publications and technical documents informed the discussions with gardeners. Consideration of the four different sites enabled the exploration of various contextual factors—such as soil or air quality—affecting the production of vegetables. A rise in the concerns of gardeners about the impacts of their activities on global health was observed, including aspects such as creating and enjoying landscapes, taking care of the soil and biodiversity, developing social connections through the transmission of practices, and regular outside physical activity and healthier eating. The increased consideration for global health issues by all stakeholders promotes the implementation of agroecological practices in gardens to improve biodiversity and adherence to circular economy principles. Four concepts emerged from the interviews: health, production of vegetables, living soil, and social interactions. Notably, nuances between the studied sites were observed, according to their history, environment, and organization. These collective gardens can thus be considered as accessible laboratories for social and agroecological experimentation, being areas that can strongly contribute to urban ecosystem services. Full article

Background: The evaluation of antiviral or vaccination strategies for the prevention of dengue infections in a traveler population would require extensive and complex studies. This prospective study aimed to identify a cohort of dengue naïve participants living in Medellín, a dengue endemic area, as a proxy for travelers and to determine the incidence of primary dengue virus (DENV) infection (symptomatic and asymptomatic) in this cohort. In Colombia, epidemic dengue waves occur every 3–4 years, with infected Aedes mosquitoes present in ~80% of the territory, including Medellín. Methods: Participants > 16 years of age, living in Medellín, were screened for anti-DENV immunoglobulin G (IgG). DENV seronegative participants were enrolled in this study. A serological anti-DENV survey was performed, with semiannual sample collections for up to 2 years. Acute DENV infections were evaluated by monitoring fever and testing for DENV nonstructural protein 1 and/or RNA. Results: Of the 4885 screened participants, 3008 participants (62%) were DENV seronegative and enrolled. Among them, 2263 (75%) completed this study, and 2644 (88%) had at least one serosurvey visit after baseline. Of those, 52 (2%) had laboratory-confirmed DENV seroconversion, and 19 (<1%) had febrile illness, but none had laboratory-confirmed DENV infection. Conclusions: This study identified a cohort of predominantly students, seronegative at study start, living in Medellín and serving as a proxy for a prospective DENV infection traveler population. Laboratory-confirmed primary DENV infection was found in 2% of participants, with <1% reporting febrile illnesses, meeting the WHO criteria for probable clinical dengue cases. Full article

High-quality growth of the construction industry and an improved human settlements environment are essential to sustainable urbanization. Existing studies have paid limited systematic attention to the spatial and temporal dynamics of the coordinated development between the construction industry and human settlements, as well as the underlying factors driving regional disparities. This gap restricts the formulation of precise, differentiated sustainable policies tailored to regions at different development stages and with varying resource endowments. Southern China, characterized by pronounced spatial heterogeneity and unique development trends, offers a natural laboratory for examining the spatio-temporal interaction between these two dimensions. Using panel data for 15 southern provinces (2013–2022), we applied the entropy method, coupling coordination model, Dagum Gini coefficient, spatial trend surface analysis, gravity model, and grey forecasting to evaluate current conditions and predict future trends. The main findings are as follows. (1) The coupling coordination degree rose steadily, forming a stepped spatial pattern from the southwest through the center to the southeast. (2) The coupling coordination degree appears obvious polarization effect, presenting a spatial linkage pattern with Jiangsu-Shanghai-Zhejiang, Hubei-Hunan-Jiangxi, and Sichuan-Chongqing as the core of the three major clusters. (3) The overall Dagum Gini coefficient declined, but intra-regional disparities persisted: values were highest in the southeast, moderate in the center, and lowest in the southwest; inter-regional differences dominated the total inequality. (4) Forecasts for 2023–2027 suggest further improvement in the coupling coordination degree, yet spatial divergence will widen, creating a configuration of “eastern leadership, central catch-up acceleration, and differentiated southwestern development.” This study provides an evidence base for policies that foster high-quality construction sector growth and enhance the living environment. The findings of this study indicate that policymaking should prioritize promoting synergistic regional development, enhancing the radiating and driving role of core regions, and establishing a multi-level coordinated governance mechanism to bridge regional disparities and foster more balanced and sustainable development. Full article

This paper investigates integrating a sensory data model for managing an existing 50-year-old building. A primary challenge in retrofitting older structures is the optimal deployment of high-quality sensors, systematic data acquisition, and subsequent data management. To address this, the study implemented a network of over 50 sensors connected via 270 m of wired infrastructure, deliberately avoiding wireless transmission to ensure data reliability. This configuration generates 5568 data points daily, which are archived on a dedicated server. The data is planned for integration into the Campus Geographical Information System (GIS), enabling private and public access. A methodology was employed, involving the strategic placement of sensors based on building use patterns, continuous data monitoring, and iterative sensor performance evaluation. The findings from the study indicate that integrating sensory data through this structured approach significantly enhances building management capabilities. Specifically, the results demonstrate improved energy efficiency and environmental performance, which is particularly relevant for public and educational facilities. The research highlights that a data-driven, monitoring-based management system can optimize operational functions and inform future retrofitting strategies for aging buildings. Full article