Search Results (211)

Background/Objectives: Early diagnosis of stroke is crucial for effective treatment with tissue plasminogen activator (tPA) and endovascular thrombectomy. Emergency medical services (EMSs) screening and the early activation of emergency department (ED) stroke protocols reduce treatment times and improve patient outcomes. This study aims to validate ED stroke protocol activation by EMSs in a large stroke center. Methods: This retrospective cross-sectional study was conducted at Magen David Adom and Shamir Medical Center between 1 January 2019 and 31 December 2019. Data were categorized into patients suspected by EMSs of having a stroke and those not suspected by EMSs but diagnosed as having a stroke in the ED. The primary outcome was the accuracy of EMSs in activating ED stroke protocols. Results: In this study, there were 23,061 patients, of which 11,841 (51.9%) were females. The mean age was 61.4 (SD = 22.72) years old. EMSs suspected 743 (3.22%) patients were having a stroke. In 587 (79%), EMSs activated ED stroke protocols. There were 88 cases where strokes were diagnosed in the ED when EMSs did not suspect a stroke. The overall EMSs negative predictive value (NPV) was 100% while the positive predictive value (PPV) was 20%. Conclusions: While Israeli EMSs over-activate the ED stroke protocol, stroke patients are almost never missed, achieving the goal of prehospital stroke screening. To prevent resource waste, all involved teams should be notified, and the actual activation of the stroke protocol should be carried out by an ED physician upon patient arrival. Communication between all levels regarding stroke protocol should also be increased to decrease the time to treatment. Full article

Hand gestures are essential for interaction in augmented and virtual reality (AR/VR), allowing users to intuitively manipulate virtual objects and engage with human–machine interfaces (HMIs). Accurate gesture recognition is critical for effective task execution. However, users often encounter difficulties due to the lack of immediate and clear feedback from head-mounted displays (HMDs). Current tracking technologies cannot always guarantee reliable recognition, leaving users uncertain about whether their gestures have been successfully detected. To address this limitation, haptic feedback can play a key role by confirming gesture recognition and compensating for discrepancies between the visual perception of fingertip contact with virtual objects and the actual system recognition. The goal of this paper is to compare a simple vibrotactile ring with a full glove device and identify their possible improvements for a fundamental gesture like pinching and fine moving of objects using Microsoft HoloLens 2. Where the pinch action is considered an essential fine motor skill, augmented reality integrated with haptic feedback can be useful to notify the user of the recognition of the gestures and compensate for misaligned visual perception between the tracked fingertip with respect to virtual objects to determine better performance in terms of spatial precision. In our experiments, the participants’ median distance error using bare hands over all axes was 10.3 mm (interquartile range [IQR] = 13.1 mm) in a median time of 10.0 s (IQR = 4.0 s). While both haptic devices demonstrated improvement in participants precision with respect to the bare-hands case, participants achieved with the full glove median errors of 2.4 mm (IQR = 5.2) in a median time of 8.0 s (IQR = 6.0 s), and with the haptic rings they achieved even better performance with median errors of 2.0 mm (IQR = 2.0 mm) in an even better median time of only 6.0 s (IQR= 5.0 s). Our outcomes suggest that simple devices like the described haptic rings can be better than glove-like devices, offering better performance in terms of accuracy, execution time, and wearability. The haptic glove probably compromises hand and finger tracking with the Microsoft HoloLens 2. Full article

Background/Objectives: Tick-borne encephalitis (TBE) is a notifiable disease in Poland, with the highest incidence in the northeastern region. Although vaccination is highly effective, breakthrough infections occasionally occur. This study aimed to describe the clinical features of vaccinated and unvaccinated TBE cases, assess long-term hospitalization trends, and estimate vaccine effectiveness (VE) in a highly endemic region. Methods: We retrospectively analyzed 1518 laboratory-confirmed TBE cases hospitalized at the University Clinical Hospital in Białystok, Poland, from 1988 to 2020. Clinical and cerebrospinal fluid (CSF) parameters were compared between vaccinated and unvaccinated individuals. Vaccine effectiveness was estimated using the screening method, based on aggregated regional vaccine uptake data from 1999 to 2020. Results: Among all cases, 13 (0.9%) occurred in individuals who had received at least one dose of vaccine, including 4 who had completed the full primary vaccination schedule. Hospitalized vaccinated patients showed similar demographic and clinical characteristics compared to unvaccinated patients, though CSF findings suggested an earlier and more dynamic immune response. Seasonal analysis revealed a sustained increase in TBE hospitalizations and a possible extension of the transmission season into late summer and autumn. Estimated VE was 94.4% (95% CI 85.2–97.9%), though this should be interpreted with caution due to the small number of vaccinated cases and assumptions regarding population-level coverage. Conclusions: This study provides detailed clinical data on breakthrough TBE cases and long-term epidemiological insights from an endemic region in Poland. While vaccine effectiveness appears high, low uptake remains a public health concern. These findings underscore the need for improved vaccination coverage and ongoing surveillance to monitor evolving transmission patterns. Full article

The severity of physical disability at leprosy diagnosis reflects the timeliness of case detection and the effectiveness of disease surveillance. This study evaluates machine learning models to predict factors associated with late leprosy diagnosis—defined as grade 2 physical disability (G2D)—in Brazil from 2018 to 2022. Using an observational cross-sectional design, we analyzed data from the Notifiable Diseases Information System and trained four machine learning models: Random Forest, LightGBM, CatBoost, XGBoost, and an Ensemble model. Model performance was assessed through accuracy, area under the receiver operating characteristic curve (AUC-ROC), recall, precision, F1 score, specificity, and Matthew’s correlation coefficient (MCC). An increasing trend in G2D prevalence was observed, averaging 11.6% over the study period and rising to 13.1% in 2022. The Ensemble model and LightGBM demonstrated the highest predictive performance, particularly in the north and northeast regions (accuracy: 0.85, AUC-ROC: 0.93, recall: 0.90, F1 score: 0.83, MCC: 0.70), with similar results in other regions. Key predictors of G2D included the number of nerves affected, clinical form, education level, and case detection mode. These findings underscore the potential of machine learning to enhance early detection strategies and reduce the burden of disability in leprosy, particularly in regions with persistent health disparities. Full article

In recent years, maximum residue limit (MRL) standards regulated by governments have become increasingly stringent. MRL standards aim to protect human health and environmental sustainability by setting maximum allowable residue concentrations for chemical substances in imported products. In November 2020, the European Union published EU Regulation 2020/1085, imposing stricter MRL standards on imported agricultural products. As standard-setting leaders implement more restrictive MRLs and export-oriented countries adjust their chemical practices to align with these standards, it is essential to examine the emerging trade patterns associated with MRLs and exports. This paper investigates the impact of maximum residue limits (MRLs) on China’s agricultural exports, using disaggregated product-level data (HS eight-digit) for 237 products across 43 importing countries from 2006 to 2021. The results show that a 10% more stringent MRL at the mean in the previous year leads to a 6.6% decrease in the current-year export values of China’s agricultural products. Stricter MRLs for insecticides significantly reduce China’s agricultural exports, while MRLs for fungicides and herbicides have no significant effect. Additionally, I analyze the top 10 most frequently notified chemical substances in goods from China, as reported by the European Commission’s Rapid Alert System for Food and Feed (RASFF) over 2020–2024. More stringent MRLs for Chlorpyrifos, Diafenthiuron, and Carbendazim significantly impede China’s agricultural exports to the European Union. Conversely, China’s agricultural exports to USMCA, ASEAN, and BRI member countries are sensitive to more restrictive MRLs for Diafenthiuron, while benefiting from tougher MRLs for Tolfenpyrad, Dinotefuran, and Imidacloprid. The impacts of MRLs on the extensive and intensive margins of exports suggest that more restrictive MRLs do not significantly affect the probability of exporting, but they reduce export values conditional on the export decisions. The findings suggest that tightening MRL standards by importing countries do not necessarily impede agricultural trade; in some cases, they facilitate China’s agricultural exports to these markets. This study provides policymakers with a comprehensive analysis to formulate strategies for enhancing agricultural exports and highlights the role of food safety standards in sustainable development. Full article

Leprosy, a chronic disease caused by Mycobacterium leprae, continues to be a significant public health challenge in Brazil, which has a high rate of new cases and late diagnoses. This study investigates the relationship between Primary Health Care (PHC) and Family Health Strategy (FHS) coverage and leprosy detection in Minas Gerais, a state marked by heterogeneity in the distribution of the disease. This observational and ecological study analyzed data from 2010 to 2020, which were obtained from the Notifiable Diseases Information System (SINAN) and the EGESTOR-AB portal. Using statistical methods, such as Pearson’s correlation and Prais–Winsten Linear Regression, trends and associations between coverage variables and leprosy indicators were assessed. This study found that PHC and FHS coverage expansion in Minas Gerais was not directly associated with a uniform reduction in late leprosy diagnosis. The findings indicate that the expansion of PHC and the FHS has not been accompanied by a homogeneous reduction in late diagnoses. It is therefore recommended that active surveillance actions be strengthened, that teams be continuously trained, and that strategies recommended by the WHO be integrated. Full article

(1) Background: Brazilian spotted fever (BSF) is a tick-borne disease that has occurred in several Brazilian regions, caused by Rickettsia spp. bacteria and mainly transmitted by Amblyomma ticks. Despite the high BSF lethality in several Brazilian endemic areas, predictors and associated risk factors remain to be fully established. Accordingly, the retrospective study herein aimed to assess BSF cases and associated factors in an endemic area of western São Paulo state. (2) Methods: Notified cases identified by the System for Epidemiological Surveillance of São Paulo (CVE), from January 2007 to December 2021, were gathered and analyzed by Logistic Multivariate Regression (LMR) to assess potential risk factors for BSF. (3) Results: Overall, 74/1121 (6.6%; 95% CI: 5.29–8.21) individuals were considered positive for BSF. Univariate analysis showed previous contact with capybaras (OR: 1.89; 95% CI: 1.0–3.55; p < 0.001) and raising horses (OR = 1.4; 95% CI: 0.66–2.67; p = 0.45), while LMR revealed living in rural areas (OR = 2.0; 95% CI: 1.02–3.73; p = 0.037) as an associated risk factor for BSF. (4) Conclusions: The results herein show that the geographically studied area still shows high occurrence of BSF, mostly for individuals living or visiting areas overlapping free-ranging capybaras. Full article

For occupant safety in vehicular networks, emergency messages derived from vehicular incidents should be exchanged only during their validity period and in zones containing involved entities. Problems arise for mobile entities in vehicular networks that change their location over time, where data may be further communicated in out-of-context space and time. Current solutions extend from the naive assumption of notifying every entity in the network about emergencies with data flooding and clusters and by means of specific communication only in the affected zones—geo-routing—of incidents’ relative data. However, delivering useless data to uninvolved entities results in wasted resources and more overheads in the former cases and the work of obtaining knowledge and secondary site services from neighbors in the latter. In this paper, we propose that the common task of disseminating emergency messages for occupant safety among entities should only be communicated only where and when useful, namely, if spatio-temporal constraints apply regarding those incidents. Our solution is inspired by the communication of working social insects that exchange data through pheromones regardless of closeness or knowledge among colony members for food retrieval. The results show that communication based on space–time constraints makes better use of resources than other solutions. Full article

This study aims to report the number of animal cases identified in the central-south region of Paraná. It also seeks to correlate these findings with human diagnoses, thereby underscoring the importance of the One Health approach in implementing prophylactic measures and protocols for evaluating both positive and suspected cases. In August 2023, a cat diagnosed with sporotrichosis was presented at the UNICENTRO Veterinary School Clinic. Accompanying the cat was its guardian, who exhibited characteristic lesions of the disease. An epidemiological study was then initiated and spanned from August 2023 to March 2024. Cytological tests were performed on the suspected cases. From the epidemiological survey, 21 animals were tested. A total of 15 cats were confirmed to have sporotrichosis; all were unneutered males of the moggy breed with access to outdoor environments. Some pet owners also displayed symptoms and lesions consistent with sporotrichosis. Considering the recent surge in sporotrichosis cases in Brazil, along with its zoonotic potential and significance for public health—and considering its status as a notifiable disease—epidemiological studies such as this one are vital. They help in understanding the spread of the disease and are crucial for the development and implementation of prophylactic measures to protect human and animal health. Full article

Background: Brazil has witnessed the co-circulation of dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV), with outbreaks exacerbated by environmental factors, social determinants, and poor sanitation. The recent re-emergence of Oropouche virus (OROV) has added complexity to vector control strategies, emphasizing the need for integrated approaches to curb arboviruses spread. We aimed to analyze temporal trends and spatial distributions with national scope of these emerging arboviruses. Methods: An ecological study using data from the Brazilian Notifiable Diseases Information System the period from 2023 to 2024 was undertaken. Temporal trends were evaluated using Joinpoint regression, while spatial analysis was conducted using Moran’s I, and local indicators of spatial association. Results: Dengue fever cases increased by 322%, while Oropouche fever (OF) increased by 300%. The states of Amazonas and Espírito Santo reported increases in OF cases. Moran’s I test revealed spatial clustering of DENV and CHIKV. Two municipalities in the state of Mato Grosso do Sul showed cocirculation of DENV, CHIKV, and ZIKV. Conclusions: This study identified a surge in arbovirus cases between 2023 and 2024, with peak incidences from January to March and October to December, linked to favorable climatic conditions. Clustering patterns and co-circulation of arboviruses highlight the need for tailored control and prevention strategies and targeted interventions to mitigate their impact. Full article

The need for safe and healthy air quality has become critical as urbanization and industrialization increase, leading to health risks and environmental concerns. Gas leaks, particularly of gases like carbon monoxide, methane, and liquefied petroleum gas (LPG), pose significant dangers due to their flammability and toxicity. LPG, widely used in residential and industrial settings, is especially hazardous because it is colorless, odorless, and highly flammable, making undetected leaks an explosion risk. To mitigate these dangers, modern gas detection systems employ sensors, microcontrollers, and real-time monitoring to quickly identify dangerous gas levels. This study introduces an IoT-based system designed for comprehensive environmental monitoring, with a focus on detecting LPG and butane leaks. Using sensors like the MQ6 for gas detection, MQ135 for air quality, and DHT11 for temperature and humidity, the system, managed by an Arduino Mega, collects data and sends these to the ThingSpeak platform for analysis and visualization. In cases of elevated gas levels, it triggers an alarm and notifies the user through IFTTT. Additionally, the system includes a microphone and a CNN model for analyzing audio data, enabling a thorough environmental assessment by identifying specific sounds related to ongoing activities, reaching an accuracy of 96%. Full article

Background: Telematization is essential for improving port efficiency by reducing dwell times and simplifying document management. Currently, only a few ports use informatic document management tools like the Port Community System (PCS), and customs documents are produced and shared in paper format. This results in long port dwell times. Methods: A platform was developed to allow sharing of documents among port actors. The platform shares export documents of each given shipment between export and import port actors; moreover, it serves as a document management platform for ports lacking PCS. In addition, the platform helps in reorganizing the shipment in case of disruptions. Results: The platform has global validity as it allows users to share documents among all port actors worldwide. The platform is formed by the following menus: “Path”, which provides the intermodal freight path; “Shipment”, which allows one to create or change shipment data; “Send notify” to send notifies in case of disruptions; “PMIS and PCS”, which redirects to these platforms of ports involved in the project; and “Documents”, which allows one to upload and share customs documents at the global level. Conclusions: The app contributes to speeding up port operations by reducing dwell times, assists in managing shipment disruptions, and enhances intermodality in freight transportation. Full article

Mucormycosis is a rare, severe fungal infection mainly affecting immunocompromised individuals. Because of limited data on its epidemiology in Oman, we present this national, multicentric, retrospective review that includes all cases of proven mucormycosis between 2006 and 2022 in Oman. There were 51 cases of mucormycosis reported in Oman. The annual incidence of mucormycosis was 0.38–0.69 cases per million population before COVID-19. During the pandemic, the incidence rose significantly to 1.76 in 2020, 5.31 in 2021, then decreased to 0.87 per million population in 2022. Diabetes was observed in 82.4% (n = 42) of the cases, COVID-19 in 47.1% (n = 24), and other chronic diseases in 72.6%. The use of steroids was reported in 33.3% (n = 17) and many patients (64.7%, n = 33) had multiple risk factors. The overall mortality rate was 41.2% (n = 21) and most deaths occurred within a month of diagnosis. Mortality rate among patients diagnosed with COVID-19 was 58.3% (14/24). Survival analysis showed a statistically significant association between COVID-19 status and patient survival (p = 0.024). Annual incidence of mucormycosis in Oman rose during the pandemic. This study highlights the epidemiological features of mucormycosis and emphasizes the importance of its inclusion in the national notifiable communicable diseases priority list as well as the importance of enhancing diagnostic capacities to detect and improve patient outcomes. Full article

Foodborne pathogens of Bacillus cereus (B. cereus), non-STEC Escherichia coli (non-STEC E. coli) and Staphylococcus aureus (S. aureus) are currently non-notifiable in Australia unless attributed to a food poisoning outbreak. Due to the lack of data around individual cases and isolations in foods, any changes in prevalence may go undetected. The aim of this study was to determine any changes in the prevalence of B. cereus, non-STEC E. coli and S. aureus in ready-to-eat (RTE) foods sampled from Western Australian restaurants, cafés, catering facilities and takeaway food premises from July 2009 to June 2022. A total of 21,822 microbiological test results from 7329 food samples analysed over this 13-year period were reviewed and analysed. Linear trend graphs derived from the annual prevalence and binary logistic regression models were used to analyse the sample results, which indicated an increase in prevalence for B. cereus. In contrast, a decrease in prevalence for both S. aureus and non-STEC E. coli was determined. Additionally, there were changes in prevalence for the three bacteria in specific months, seasons, specific RTE foods and food premises types. Further research is needed to gain a better understanding of the potential drivers behind these changes in prevalence, including the potential impacts of climate change, COVID-19, legislation and guidelines targeting specific RTE foods, and the difficulty of differentiating B. cereus from B. thuringeniesis using standard testing methods. Full article

Most fire spread is caused by the absence of suppression means at the beginning of the fire. This results in the missed golden time. There are various factors that cause initial fires, such as electrical outlets, general distribution circuits, and oil–vapor–gas cluster spaces. In most cases, these places are out of reach of human hands or they lose the initial suppression time when a fire occurs, causing the spread of fire. This study implements an intelligent fire suppression device that connects sensor IoT based on microcapsules to secure initial fire suppression and golden time in the event of a fire in blind spots that cannot be seen by humans or at a time when it is difficult to recognize a fire. The microcapsule is a micro-collection unit that collects Novec 1230 gas generated in the semiconductor production process. The microcapsule is molded into a form with a fire suppression function and, when a fire occurs, the molded body explodes and absorbs ambient oxygen to suppress the fire. The complex-sensor IoT executes smoke and heat detection generated when a fire is suppressed within 10 s, which ensures the reliability of the detector by notifying of the fire and detecting the ignition point through communication linkages such as Ieee 485 and WiFi or LoRa. Full article