Search Results (86)

Neonatal respiratory distress is a primary contributor to neonatal morbidity and mortality worldwide. Non-invasive respiratory support such as nasal continuous positive airway pressure (NCPAP) and bubble NCPAP (bNCPAP) are often used as the first line of treatment for neonatal respiratory distress, including respiratory distress syndrome; however, many hospitals in low- and middle-income countries do not have access to advanced respiratory support devices beyond NCPAP. A novel, non-invasive bubble positive pressure ventilation device has been developed as a low-cost, non-electric alternative to providing respiratory support in such scenarios. In this article, we propose evidence-based guidelines for the initiation, titration, and weaning of the new device. Full article

Air quality monitoring (AQM) is key to maintaining healthy air in cities. This is crucial in low- and middle-income countries due to increasing evidence of poor air quality but lack of monitors to consistently collect evaluate air quality data and effect policy changes, mainly because of the costs of monitoring devices. In participating in a challenge for the development of low-cost AQM devices in low-resource regions, an Arduino-based device with sensors for particulate matter size, temperature, and humidity data acquisition was developed for deployment in Port Harcourt, a city in Nigeria’s Niger Delta region, exposed to poor air quality partly due to gas and oil production activities. During the project, challenges to AQM were encountered, including inadequate awareness of air quality issues, lack of necessary AQM device components, unavailability of trained manpower and partnerships, and lack of funding. However, lack of a means of calibrating the device was a major hindrance, as no reference AQM instrument was available, rendering the data acquired largely qualitative, educational, and useless for regulatory purposes. There is an urgent need for AQM in such cities. However, a robust AQM strategy must be designed and used to address these constraints, especially whilst using low-cost devices, for significant progress in acquiring robust air quality data in such low-resource regions to be made. Full article

Cervical cancer causes 350,000 deaths annually, with 90% occurring in low- and middle-income countries (LMICs), despite being largely preventable through vaccination and screening. This review examines innovative approaches to address screening coverage gaps worldwide, analysing both established programmes in high-income countries and implementation strategies for LMICs. Self-sampling technologies demonstrate significant potential to improve the uptake of cervical screening, thereby improving cervical cancer prevention compared to traditional methods, particularly benefiting underserved populations across all healthcare settings. Among self-collection devices, vaginal brushes achieve sensitivity of 94.6% (95% CI: 92.4–96.8) for HPV detection, while novel approaches like the tampon show promising results (sensitivity 82.9–100%, specificity 91.6–96.8%) with high user acceptability. Implementation strategies vary by healthcare context, with high-income countries achieving success through integrated screening programmes and digital solutions, while LMICs demonstrate effective adaptation through community-based distribution (20–35% uptake) and innovative delivery methods. In resource-limited settings, self-sampling increases participation through enhanced patient comfort and cultural acceptability, while reducing costs by 32–48%. Progress toward WHO’s cervical cancer elimination goals require careful consideration of local healthcare infrastructure, cultural contexts and sustainable financing mechanisms. Future research priorities include optimising self-sampling technologies for sustainability and scalability, developing context-specific implementation strategies and validating artificial intelligence applications to enhance screening efficiency across diverse healthcare settings. Full article

The recent fast advances in consumer electronics, especially in cell phones and displays, have led to the development of ultra-thin, hence flexible, glasses. Once available, such flexible glasses have proven to be of great interest and usefulness in other fields, too. Flexible photonics, for instance, has quickly taken advantage of this new material. At first sight, “flexible glass” appears to be an oxymoron. Glass is, by definition, fragile and highly breakable; its structure has puzzled scientists for decades, but it is evident that in most conditions it is a rigid material, so how can it bend? This possibility, however, has aroused the interest of artists and craftsmen since ancient times; thus, in Roman times the myth of flexible glass was born. Furthermore, the myth appeared again in the Middle Age, connected to a religious miracle. Today, however, flexible glass is no more a myth but a reality due to the fact that current technology permits us to produce micron-thick glass sheets, and any ultra-thin material can be bent. Flexibility is coming from the present capability to manufacture glass sheets at a tens of microns thickness coupled with the development of strengthening methods; it is also worth highlighting that, on the micrometric and nanometric scales, silicate glass presents plastic behavior. The most significant application area of flexible glass is consumer electronics, for the displays of smartphones and tablets, and for wearables, where flexibility and durability are crucial. Automotive and medical sectors are also gaining importance. A very relevant field, both for the market and the technological progress, is solar photovoltaics; mechanical flexibility and lightweight have allowed solar cells to evolve toward devices that possess the advantages of conformability, bendability, wearability, and moldability. The mature roll-to-roll manufacturing technology also allows for high-performance devices at a low cost. Here, a brief overview of the history of flexible glass and some examples of its application in solar photovoltaics are presented. Full article

The prefabrication and assembly of rebar parts can reduce construction costs and time while enhancing construction quality and safety. The primary objective of this paper is to quantify the overall stiffness of rebar parts. A three-dimensional rotational stiffness solution model of welded spots is proposed from the perspective of revealing the overall stiffness required for welded rebar parts. Considering the influence of the rebar diameter, 105 sets of T-type welded rebar specimens and two types of loading devices were designed, and a graded loading failure test was carried out. On this basis, the constitutive model of welded spots and the method for evaluating the model parameters are presented. Moreover, in order to verify the rationality of the proposed constitutive model and its parameter values, the deformation of welded rebar parts for the middle pylon of Changtai Yangtze River Bridge was tested onsite. The results show that analyzing the three-dimensional rotational stiffness of welded spots is the key to obtaining the overall stiffness of welded rebar parts, and its rotational stiffness decreases rapidly after an elastic platform. The constitutive model parameters of welded spots such as initial stiffness, elastic rotation angle, and stiffness degradation rate conform to Gaussian distribution. When the model parameters of welded spots are taken as the mean value of the distribution function, the simulated values are basically in good agreement with the measured values, with a maximum error of only 8.54%, indicating that the proposed constitutive model can better quantify the overall stiffness of the welded rebar parts. Full article

Early detection of breast cancer plays a crucial role in reducing the number of cases diagnosed at advanced stages, thereby lowering the high healthcare costs required to achieve disease-free survival and helping to prevent avoidable premature deaths. However, women living in rural and low-income areas face multiple obstacles that limit their access to conventional screening methods, such as mammography, which has been widely proven effective, particularly in high-income countries. The main barriers include a lack of healthcare infrastructure, long distances to medical facilities, high costs associated with large-scale screening programs, and shortages of specialized personnel. In this context, emerging technologies offer innovative solutions with the potential to mitigate these challenges. The development of strategies supported by artificial intelligence and the use of portable devices capable of overcoming geographical and sociocultural barriers represent valuable complementary tools for strengthening community-driven screening programs and expanding the reach of large-scale initiatives. However, to date, no comprehensive analysis has been conducted on the availability of evidence assessing the outcomes of breast cancer screening programs in vulnerable and underserved communities. This manuscript outlines the benefits of emerging portable technologies powered by artificial intelligence for detecting significant breast lesions in low-resource rural areas, where traditional screening methods are often difficult to implement. It also highlights gaps in the current knowledge, drawing on the available evidence. A search using PubMed yielded 7629 articles on breast cancer screening, of which only 59 (0.77%) addressed resource-limited settings and rural populations. Further filtering identified 29 original studies (0.38%) with specific epidemiological designs involving humans as the unit of analysis. The findings revealed significant disparities in evidence availability: nine studies originated from high-income countries, while fewer than half were from low-income or lower middle-income countries. Only two studies were conducted in Latin America, specifically in Peru and Argentina. This limited evidence poses challenges for generalizing and replicating recommendations for unexplored settings. Full article

Keratoconus is a progressive corneal disorder that can lead to irreversible visual impairment if not detected early. Despite its high prevalence, early diagnosis is often delayed, especially in low-to-middle-income countries due to limited awareness and restricted access to advanced diagnostic tools such as corneal topography, tomography, optical coherence tomography, and corneal biomechanical assessments. These technologies are essential for identifying early-stage keratoconus, yet their high cost limits accessibility in resource-limited settings. While cost and portability are important for accessibility, the sensitivity and specificity of diagnostic tools must be considered as primary metrics to ensure accurate and effective detection of early keratoconus. This review examines both traditional and advanced diagnostic techniques, including the use of machine learning and artificial intelligence, to enhance early diagnosis. Artificial intelligence-based approaches show significant potential for transforming keratoconus diagnosis by improving the accuracy and sensitivity of early diagnosis, especially when combined with imaging devices. Notable innovations include tools such as SmartKC, a smartphone-based machine-learning application, mobile corneal topography through the null-screen test, and the Smartphone-based Keratograph, providing affordable and portable solutions. Additionally, contrast sensitivity testing demonstrates potential for keratoconus detection, although a precise platform for routine clinical use has yet to be established. The review emphasizes the need for increased awareness among clinicians, particularly in underserved regions, and advocates for the development of accessible, low-cost diagnostic tools. Further research is needed to validate the effectiveness of these emerging technologies in detecting early keratoconus. Full article

The article presents an innovative approach for secure authentication in internet banking transactions, utilizing an Out-of-Band visual two-factor authorization protocol. With the increasing rise of cyber attacks and fraud, new security models are needed that ensure the integrity, authenticity, and confidentiality of financial transactions. The identified gap lies in the inability of traditional authentication methods, such as TANs and tokens, to provide security in untrusted terminals. The proposed solution is the Dynamic Authorization Protocol (DAP), which uses mobile devices to validate transactions through visual codes, such as QR codes. Each transaction is assigned a unique associated code, and the challenge must be responded to within 120 s. The customer initiates the transaction on a computer and independently validates it on their mobile device using an out-of-band channel to prevent attacks such as phishing and man-in-the-middle. The methodology involves implementing a prototype in Java ME for Android devices and a Java application server, creating a practical, low-computational-cost system, accessible for use across different operating systems and devices. The protocol was tested in real-world scenarios, focusing on ensuring transaction integrity and authenticity. The results show a successful implementation at Banco do Brasil, with 3.6 million active users, demonstrating the efficiency of the model over 12 years of use without significant vulnerabilities. The DAP protocol provides a robust and effective solution for securing banking transactions and can be extended to other authentication environments, such as payment terminals and point of sale devices. Full article

Background: Sleep is one of the most essential processes for sustaining cognitive, emotional, and physical health across all age groups. Insomnia or inadequate sleep significantly impacts health and poses economic burdens due to increased healthcare costs and reduced productivity. Objectives and Methods: This study aimed to investigate sleep quality in the Romanian active population using an online survey incorporating the Pittsburgh Sleep Quality Index (PSQI). Conducted over four months in 2023, the survey gathered 2243 complete responses from urban and rural residents over the age of 18. Results: The results highlight gender and urban–rural disparities in sleep quality, revealing that females and urban residents experienced poorer sleep compared to their counterparts. Additionally, sleep quality was found to significantly worsen with age, with elders (56+ years) reporting the highest PSQI scores, indicating greater sleep difficulties compared to middle-aged adults and youngsters. A high prevalence of sleep disturbances, daytime dysfunctions, and sleep medication use was reported. Common pre-sleep activities included using electronic devices and watching TV, while fewer participants engaged in reading books or consuming alcohol and caffeine. Additionally, participants’ bedding preferences were documented. Conclusions: Our study highlights the influence of various factors on sleep quality and emphasizes the need for targeted public health interventions to improve sleep health in Romania. Full article

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, particularly in low- and middle-income countries, where it poses a significant burden. In Latin America, the estimated prevalence of COPD is notably high, but the management and treatment of the disease have progressed slowly. This review examines the current status of inhalation therapy for COPD in Latin America, focusing on pharmacological therapies, inhalation devices, and the potential of advanced drug delivery systems. Pharmacological management predominantly relies on inhaled bronchodilators and corticosteroids, though access to these therapies varies considerably across the region. Inhalation devices, such as metered-dose inhalers (MDIs) and dry powder inhalers (DPIs), play a critical role in effective treatment delivery. However, their usage is often compromised by incorrect technique, low adherence, and limited availability, especially for DPIs. Emerging technologies, including nanoformulations, represent a promising frontier for the treatment of COPD by improving drug delivery and reducing side effects. However, significant barriers, such as high development costs and inadequate infrastructure, hinder their widespread adoption in the region. This review highlights the need for a multifaceted approach to enhance COPD management in Latin America, including optimizing access to existing inhalation therapies, strengthening healthcare infrastructure, improving provider training, and engaging patients in treatment decisions. Overcoming these challenges is crucial to improving COPD outcomes across the region. Full article

The communication of Industrial Internet of Things (IIoT) devices faces important security and privacy challenges. With the rapid increase in the number of devices, it is difficult for traditional security mechanisms to balance performance and security. Although schemes based on encryption and authentication exist, there are still difficulties in achieving lightweight security. In this paper, an authentication and key exchange scheme combining hardware security features and modern encryption technology is proposed for the MQTT-SN protocol, which is not considered security. The scheme uses Physical Unclonable Functions (PUFs) to generate unpredictable responses, and combines random numbers, time stamps, and shared keys to achieve two-way authentication and secure communication between devices and broker, effectively preventing network threats such as replay and man-in-the-middle attacks. Through verification, the proposed scheme has proved effective in terms of security and robustness, has computational and communication cost advantages compared with recent schemes, and provides higher availability. Full article

Backgrounds: Sleep disturbances are prevalent among elderly individuals. While polysomnography (PSG) serves as the gold standard for sleep monitoring, its extensive setup and data analysis procedures impose significant costs and time constraints, thereby restricting the long-term application within the general public. Our laboratory introduced an innovative biomarker, utilizing artificial intelligence algorithms applied to PSG data to estimate brain age (BA), a metric validated in cohorts with cognitive impairments. Nevertheless, the potential of exercise, which has been a recognized means of enhancing sleep quality in middle-aged and older adults to reduce BA, remains undetermined. Methods: We conducted an exploratory study to evaluate whether 12 weeks of moderate-intensity exercise can improve cognitive function, sleep quality, and the brain age index (BAI), a biomarker computed from overnight sleep electroencephalogram (EEG), in physically inactive middle-aged and older adults. Home wearable devices were used to monitor heart rate and overnight sleep EEG over this period. The NIH Toolbox Cognition Battery, in-lab overnight polysomnography, cardiopulmonary exercise testing, and a multiplex cytokines assay were employed to compare pre- and post-exercise brain health, exercise capacity, and plasma proteins. Results: In total, 26 participants completed the initial assessment and exercise program, and 24 completed all procedures. Data are presented as mean [lower 95% CI of mean, upper 95% CI of mean]. Participants significantly increased maximal oxygen consumption (Pre: 21.11 [18.98, 23.23], Post 22.39 [20.09, 24.68], mL/kg/min; effect size: −0.33) and decreased resting heart rate (Pre: 66.66 [63.62, 67.38], Post: 65.13 [64.25, 66.93], bpm; effect size: −0.02) and sleeping heart rate (Pre: 64.55 [61.87, 667.23], Post: 62.93 [60.78, 65.09], bpm; effect size: −0.15). Total cognitive performance (Pre: 111.1 [107.6, 114.6], Post: 115.2 [111.9, 118.5]; effect size: 0.49) was significantly improved. No significant differences were seen in BAI or measures of sleep macro- and micro-architecture. Plasma IL-4 (Pre: 0.24 [0.18, 0.3], Post: 0.33 [0.24, 0.42], pg/mL; effect size: 0.49) was elevated, while IL-8 (Pre: 5.5 [4.45, 6.55], Post: 4.3 [3.66, 5], pg/mL; effect size: −0.57) was reduced. Conclusions: Cognitive function was improved by a 12-week moderate-intensity exercise program in physically inactive middle-aged and older adults, as were aerobic fitness (VO₂max) and plasma cytokine profiles. However, we found no measurable effects on sleep architecture or BAI. It remains to be seen whether a study with a larger sample size and more intensive or more prolonged exercise exposure can demonstrate a beneficial effect on sleep quality and brain age. Full article

This paper is part of an ongoing research study on developing a methodology for the low-cost creation of the Digital Twin of an urban neighborhood for sustainable, transparent, and participatory urban management to enable low-and middle-income economies to meet the UN Sustainable Development Agenda 2030 successfully and timely, in particular SDGs 1, 7, 9, 10, 11, and 12. The methodology includes: (1) the creation of a geospatial data infrastructure by merging Building Information Models (BIMs) and 3D cadastral data that may support a number of applications (i.e., visualization of 3D volumetric legal entities), and (2) the use of Artificial Intelligence (AI) platforms, Machine Learning (ML), and sensors that are interconnected with devices located in the various property units to test and predict future scenarios and support energy efficiency applications. Two modular platforms are created: (1) to interact with the AI sensors for building tracking and management purposes (i.e., alarms, security cameras, control panels, etc.) and (2) to analyze the energy consumption data such as future predictions, anomaly detection, and scenario making. A case study is made for an urban neighborhood in Athens. It includes a dynamic weather simulation and visualization of different seasons and times of day in combination with internal energy consumption. Full article

In this paper, an eight-port antenna array is presented for 5G handheld terminals to support multiple-input multiple-output (MIMO) operations. The reported design involves three layers: the top contains eight circular microstrip feed elements; the middle is a low-cost FR-4 substrate, and the bottom layer is a ground plane with four etched octagonal slots. Each resonating element is fed by 50-ohm sub-miniature connectors. To mitigate the detrimental effects of mutual coupling of ports and enhance overall isolation between the adjacent microstrip-fed circular patch elements, a neutralization line is strategically implemented between the feed lines of the antenna array. The design configuration involves two elements at each vertex of the printed circuit board (PCB). The overall dimensions of the PCB are 150 × 75 mm². Each slot and its corresponding radiating elements exhibit linear dual polarization and diverse radiation patterns. The proposed antenna design achieves the required operating bandwidth of more than 1000 MHz spanning from 3 to 4.2 GHz, effectively covering all the upper C-band frequency range of 3.3 GHz to 4.2 GHz allocated for 5G n77 and n78 frequency range 1 (FR1). Required port isolation and lower envelop correlation coefficient (ECC) are achieved for the band of interest. The proposed design gives a peak gain of up to 4 dB for the said band. In addition to these results, degradation in the performance of the antenna array is also investigated during different operating modes of the handheld device. Measured results from the fabricated unit cell and whole array also have a good match with simulated results. On the whole, the proposed antenna possesses the potential to be used in 5G and the open radio access network (ORAN) compliant handheld devices. Full article

Diabetic foot complications constitute a large and rapidly growing global health problem, causing one million lower-extremity amputations annually. These amputations are typically preceded by preventable diabetic foot ulcers (DFUs). However, 80% of the world’s diabetics now reside in low- and middle-income countries, where many healthcare settings lack the resources required to implement recommended DFU risk assessment and prevention strategies. There is an unmet need for a more resource-efficient DFU risk assessment method. In this study, a low-cost, purely mechanical plantar pressure evaluation device was designed toward this end. The device consists of a grid of plastic bistable compliant mechanisms, which present a visual series of binary outputs in response to applied pressure. By having diabetic patients step on the device, non-specialist healthcare providers can easily assess patients’ plantar pressures, which are predictive of future DFUs. A prototype was fabricated and pilot-tested with 41 healthy subjects. It demonstrated a sensitivity of 25.6%, although sensitivity reached 60% for heavier subjects. Sensitivity could likely be significantly improved by lowering the device’s profile and increasing the sensing area. Strained health systems may then be able to use this device to allocate scarce healthcare resources more efficiently to prevent costly DFUs and amputations. Full article