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Search Results (432)

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15 pages, 1211 KiB  
Review
Epigenetic Regulation of Neutrophils in ARDS
by Jordan E. Williams, Zannatul Mauya, Virginia Walkup, Shaquria Adderley, Colin Evans and Kiesha Wilson
Cells 2025, 14(15), 1151; https://doi.org/10.3390/cells14151151 - 25 Jul 2025
Viewed by 333
Abstract
Acute respiratory distress syndrome (ARDS) is an inflammatory pulmonary condition that remains at alarming rates of fatality, with neutrophils playing a vital role in its pathogenesis. Beyond their classical antimicrobial functions, neutrophils contribute to pulmonary injury via the release of reactive oxygen species, [...] Read more.
Acute respiratory distress syndrome (ARDS) is an inflammatory pulmonary condition that remains at alarming rates of fatality, with neutrophils playing a vital role in its pathogenesis. Beyond their classical antimicrobial functions, neutrophils contribute to pulmonary injury via the release of reactive oxygen species, proteolytic enzymes, and neutrophil extracellular traps (NETs). To identify targets for treatment, it was found that epigenetic mechanisms, including histone modifications, hypomethylation, hypermethylation, and non-coding RNAs, regulate neutrophil phenotypic plasticity, survival, and inflammatory potential. It has been identified that neutrophils in ARDS patients exhibit abnormal methylation patterns and are associated with altered gene expression and prolonged neutrophil activation, thereby contributing to sustained inflammation. Histone citrullination, particularly via PAD4, facilitates NETosis, while histone acetylation status modulates chromatin accessibility and inflammatory gene expression. MicroRNAs have also been shown to regulate neutrophil activity, with miR-223 and miR-146a potentially being biomarkers and therapeutic targets. Neutrophil heterogeneity, as evidenced by distinct subsets such as low-density neutrophils (LDNs), varies across ARDS etiologies, including COVID-19. Single-cell RNA sequencing analyses, including the use of trajectory analysis, have revealed transcriptionally distinct neutrophil clusters with differential activation states. These studies support the use of epigenetic inhibitors, including PAD4, HDAC, and DNMT modulators, in therapeutic intervention. While the field has been enlightened with new findings, challenges in translational application remain an issue due to species differences, lack of stratification tools, and heterogeneity in ARDS presentation. This review describes how targeting neutrophil epigenetic regulators could help regulate hyperinflammation, making epigenetic modulation a promising area for precision therapeutics in ARDS. Full article
(This article belongs to the Section Cell Microenvironment)
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23 pages, 6061 KiB  
Article
Genomic Insights into Emerging Multidrug-Resistant Chryseobacterium indologenes Strains: First Report from Thailand
by Orathai Yinsai, Sastra Yuantrakul, Punnaporn Srisithan, Wenting Zhou, Sorawit Chittaprapan, Natthawat Intajak, Thanakorn Kruayoo, Phadungkiat Khamnoi, Siripong Tongjai and Kwanjit Daungsonk
Antibiotics 2025, 14(8), 746; https://doi.org/10.3390/antibiotics14080746 - 24 Jul 2025
Viewed by 390
Abstract
Background: Chryseobacterium indologenes, an environmental bacterium, is increasingly recognized as an emerging nosocomial pathogen, particularly in Asia, and is often characterized by multidrug resistance. Objectives: This study aimed to investigate the genomic features of clinical C. indologenes isolates from Maharaj [...] Read more.
Background: Chryseobacterium indologenes, an environmental bacterium, is increasingly recognized as an emerging nosocomial pathogen, particularly in Asia, and is often characterized by multidrug resistance. Objectives: This study aimed to investigate the genomic features of clinical C. indologenes isolates from Maharaj Nakorn Chiang Mai Hospital, Thailand, to understand their mechanisms of multidrug resistance, virulence factors, and mobile genetic elements (MGEs). Methods: Twelve C. indologenes isolates were identified, and their antibiotic susceptibility profiles were determined. Whole genome sequencing (WGS) was performed using a hybrid approach combining Illumina short-reads and Oxford Nanopore long-reads to generate complete bacterial genomes. The hybrid assembled genomes were subsequently analyzed to detect antimicrobial resistance (AMR) genes, virulence factors, and MGEs. Results: C. indologenes isolates were primarily recovered from urine samples of hospitalized elderly male patients with underlying conditions. These isolates generally exhibited extensive drug resistance, which was subsequently explored and correlated with genomic determinants. With one exception, CMCI13 showed a lower resistance profile (Multidrug resistance, MDR). Genomic analysis revealed isolates with genome sizes of 4.83–5.00 Mb and GC content of 37.15–37.35%. Genomic characterization identified conserved resistance genes (blaIND-2, blaCIA-4, adeF, vanT, and qacG) and various virulence factors. Phylogenetic and pangenome analysis showed 11 isolates clustering closely with Chinese strain 3125, while one isolate (CMCI13) formed a distinct branch. Importantly, each isolate, except CMCI13, harbored a large genomic island (approximately 94–100 kb) carrying significant resistance genes (blaOXA-347, tetX, aadS, and ermF). The absence of this genomic island in CMCI13 correlated with its less resistant phenotype. No plasmids, integrons, or CRISPR-Cas systems were detected in any isolate. Conclusions: This study highlights the alarming emergence of multidrug-resistant C. indologenes in a hospital setting in Thailand. The genomic insights into specific resistance mechanisms, virulence factors, and potential horizontal gene transfer (HGT) events, particularly the association of a large genomic island with the XDR phenotype, underscore the critical need for continuous genomic surveillance to monitor transmission patterns and develop effective treatment strategies for this emerging pathogen. Full article
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8 pages, 1550 KiB  
Case Report
Diagnostic Challenges in Acute Leukemia: From Dental Pain to Catastrophic Intracerebral Hemorrhage
by Anatoli Pinchuk, Stefan P. Roch, Christian Mawrin, Daniel Behme, Klaus-Peter Stein, Belal Neyazi, Martin Mikusko, Ibrahim Erol Sandalcioglu and Ali Rashidi
Hematol. Rep. 2025, 17(4), 36; https://doi.org/10.3390/hematolrep17040036 - 23 Jul 2025
Viewed by 190
Abstract
Background and Clinical significance: Acute leukemias are neoplasms of the hematopoietic system that are caused by the extensive proliferation of immature precursor cells (‘blasts’), mainly in the bone marrow. They frequently manifest with vague and non-specific clinical symptoms, making early diagnosis particularly [...] Read more.
Background and Clinical significance: Acute leukemias are neoplasms of the hematopoietic system that are caused by the extensive proliferation of immature precursor cells (‘blasts’), mainly in the bone marrow. They frequently manifest with vague and non-specific clinical symptoms, making early diagnosis particularly challenging. Case Presentation: This case report describes the clinical course of a female patient who initially sought dental care due to a persistent toothache—an atypical and misleading symptom. Subsequent investigations revealed a diagnosis of acute leukemia. Although the malignancy was identified promptly and the appropriate therapeutic measures were initiated, the disease progressed with alarming rapidity. The patient ultimately developed a massive intracerebral hemorrhage—a devastating complication likely related to leukemia-associated coagulopathy. Despite emergent neurosurgical intervention, the hemorrhage proved fatal. Conclusions: This case highlights the critical need for heightened clinical suspicion in the presence of unusual symptoms and illustrates the complex interplay between hematologic malignancies and coagulopathic complications. Full article
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9 pages, 213 KiB  
Protocol
Time Intervals in the Pathway to Diagnosis of Patients with Cancer
by Joseba Rabanales-Sotos, Ángel López-González, Blanca Sánchez-Galindo, Gema Blázquez-Abellán, Juan Manuel Téllez-Lapeira and Jesús López-Torres-Hidalgo
Nurs. Rep. 2025, 15(7), 261; https://doi.org/10.3390/nursrep15070261 - 17 Jul 2025
Viewed by 265
Abstract
Background: Around one-quarter of all people in the developed world die of cancer, with primary care being the main setting in which the disease is first suspected because the majority of patients consult a general practitioner (GP) when they present with symptoms. Diagnostic [...] Read more.
Background: Around one-quarter of all people in the developed world die of cancer, with primary care being the main setting in which the disease is first suspected because the majority of patients consult a general practitioner (GP) when they present with symptoms. Diagnostic delay may thus be attributable to the patient, the GP, or the healthcare system. While some findings suggest that as much as half of the total delay consists of patient delay, more research is nonetheless needed into how GPs can facilitate access to diagnostic evaluation when patients experience symptoms. Methods: A retrospective observational study will be conducted to evaluate a cohort of patients diagnosed with cancer, with data being obtained from both primary and specialised care settings. Different time intervals will be analysed, dating from onset of first symptoms to diagnosis or initiation of treatment, and will be classified as: patient interval; primary-care interval; healthcare-system interval; diagnostic interval; treatment interval; and total interval. Study variables will include patient characteristics (socio-demographic, risk factors, morbidity, etc.), tumour characteristics (tumour stage, symptom onset, alarm symptoms, etc.), and healthcare characteristics (place of initial consultation, referral to specialised care, etc.). Discussion: The study will describe diagnostic delays in patients with cancer in primary care, considering the time elapsed between symptom onset and initial consultation, request for tests and/or patient referral, first evaluation in the hospital setting, and date of diagnostic confirmation and treatment initiation. Additionally, the study will make it possible to identify the patient-, healthcare-, and disease-related variables that intervene in the duration of such delays. Full article
16 pages, 462 KiB  
Article
Prevalence and Determinants of Suicidal Ideation Among Physicians in Saudi Arabia
by Ayedh H. Alghamdi, Mohammed A. Aljaffer, Ahmad H. Almadani, Saleh A. Alghamdi, Hasan R. Alshehri, Akeel A. Alyateem, Refan T. Hashim and Fahad D. Alosaimi
Healthcare 2025, 13(13), 1632; https://doi.org/10.3390/healthcare13131632 - 7 Jul 2025
Viewed by 458
Abstract
Background: The mental health of physicians has become a pressing global concern. High rates of depression, anxiety, and burnout are reported in the literature, with each condition linked to reduced job satisfaction, increased medical errors, and ultimately suicidal ideation (SI). Although research on [...] Read more.
Background: The mental health of physicians has become a pressing global concern. High rates of depression, anxiety, and burnout are reported in the literature, with each condition linked to reduced job satisfaction, increased medical errors, and ultimately suicidal ideation (SI). Although research on physicians’ mental health is emerging in Saudi Arabia, data on suicidality remain scarce. Objective: This study aims to determine the prevalence of SI and its determinants among physicians in Saudi Arabia. Methods: A cross-sectional study was conducted with 423 physicians across all medical specialties of all ranks, who were recruited using a convenience sampling technique. The study tool comprised three main sections. The first section included questions regarding sociodemographic factors, lifestyle, and work-related factors. The second section included items on suicidality and the Patient Health Questionnaire-9 to screen for depressive symptoms. The third section included the Brief Resilient Coping Scale (BRCS) to measure the coping mechanisms of the participants. Results: SI was disclosed by 9.7% of the respondents, with 0.5% reporting previous suicide attempts. Suicidal ideation was independently associated with low income (OR = 3.94, 95% CI 1.32–11.76, p = 0.014) and higher depression scores (OR = 1.09 per point, 95% CI 1.02–1.16, p = 0.008). Moreover, knowing a colleague with suicidal behavior (i.e., knowing a colleague who had contemplated suicide or had attempted suicide/died by suicide) was significantly associated with SI among our participants (p < 0.001 and p < 0.006, respectively). Higher scores on the BRCS, specifically with respect to growing from adversity and actively replacing losses, were linked to lower odds of SI (p < 0.001 and p < 0.045, respectively). Conclusions: Physicians in Saudi Arabia experience an alarming level of SI that is associated with low income and depression. The results of this study underscore the importance of additional research to evaluate the effectiveness of intervention programs designed to enhance mental health support for physicians, encourage adaptive coping mechanisms, foster peer support networks, and combat stigma associated with mental illnesses. Full article
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11 pages, 207 KiB  
Article
High User Satisfaction Rates with DEXCOM Continuous Glucose Monitoring Device in People with Type 1 Diabetes—A Pilot Cross-Sectional Study
by Benái Paponette, Laura Keaver, Peter Lynch, Elias Eltoum, Liam Clarke, Jordan Carty, Siobhan Bacon and Catherine McHugh
Diabetology 2025, 6(7), 64; https://doi.org/10.3390/diabetology6070064 - 2 Jul 2025
Viewed by 401
Abstract
Background/Objectives: DEXCOM™ continuous glucose monitoring devices (DCGMs) have been shown to improve glycaemic control and complication rates in people with Type 1 diabetes (T1DM). However, little qualitative data exists regarding user satisfaction, useful features and the overall lived experience of using a [...] Read more.
Background/Objectives: DEXCOM™ continuous glucose monitoring devices (DCGMs) have been shown to improve glycaemic control and complication rates in people with Type 1 diabetes (T1DM). However, little qualitative data exists regarding user satisfaction, useful features and the overall lived experience of using a DCGM which will strongly impact one’s quality of life (QOL), compliance and the self-management of diabetes. This study aimed to assess DCGM users’ satisfaction rates and experiences with device features in patients with T1DM in Ireland. Methods: A questionnaire consisting of open- and closed-ended questions together with a glucose monitoring satisfaction survey (GMSS) was offered to all patients attending Sligo University Hospital (SUH) diabetes clinic who used a DCGM for at least six months. Results: Data was analysed for 73 participants. Self-reported QOL improved in 88% of participants and 52% of participants reported fewer hypoglycaemic events. The features most liked by participants were alerts given when the glycaemic target was not in range, improved quality of life, improved hypoglycaemia awareness and the need for reduced finger pricking. However, concerns were also identified about redundant alarms and sensor failures, phone incompatibility and skin reactions. DCGM was associated with good levels of glucose monitoring satisfaction with an overall satisfaction score of 3.67 ± 1.24 out of 5. Participants reported high openness (4.01 ± 0.91), increased trust (3.77 ± 1.16) and low emotional (1.70 ± 0.97) and behavioural burden (2.38 ± 1.10) with DCGM usage. Male participants who had diabetes for a mean duration of 20.06 ± 0.89 years and used DEXCOMTM for approximately 2 years demonstrated significantly higher levels of satisfaction (p < 0.05). Conclusions: The findings of this study provide a first exploration of patients’ perspectives on DCGM devices in an Irish setting. Results suggest that DCGM users are highly satisfied with the device with an increase in self-reported QOL. Adaptations to features based on patient feedback should be considered to further enhance user satisfaction and maximise QOL benefits. Full article
13 pages, 218 KiB  
Article
Beyond the Scale: The Hidden Burden of Underweight and Cachexia in Adults with Congenital Heart Defects and Heart Failure—Results from the Pathfinder CHD-Registry
by Ann-Sophie Kaemmerer-Suleiman, Sebastian Freilinger, Annika Freiberger, Oliver Dewald, Stefan Achenbach, Gert Bischoff, Anna Engel, Peter Ewert, Frank Harig, Jürgen Hörer, Stefan Holdenrieder, Harald Kaemmerer, Renate Kaulitz, Frank Klawonn, Detlef Koch, Dirk Mentzner, Nicole Nagdyman, Rhoia Neidenbach, Wolfgang Schmiedeberg, Mathieu N. Suleiman, Elsa Ury, Robert David Pittrow, Leonard Bernhard Pittrow, Benjamin Alexander Pittrow, Fabian von Scheidt, Wolfgang Wagener, Nicole Wolfrum, Michael Huntgeburth and Fritz Mellertadd Show full author list remove Hide full author list
J. Clin. Med. 2025, 14(12), 4355; https://doi.org/10.3390/jcm14124355 - 18 Jun 2025
Viewed by 564
Abstract
Background/Objectives: Heart failure (HF) poses a major challenge in managing adults with congenital heart defects (ACHD). Emerging evidence suggests that HF in ACHD increases the risk of underweight due to heightened metabolic demands, gastrointestinal complications, and psychological factors such as anxiety and depression. [...] Read more.
Background/Objectives: Heart failure (HF) poses a major challenge in managing adults with congenital heart defects (ACHD). Emerging evidence suggests that HF in ACHD increases the risk of underweight due to heightened metabolic demands, gastrointestinal complications, and psychological factors such as anxiety and depression. Despite its critical implications, few studies have examined this association. This study evaluates the relationship between HF and underweight—defined as a body mass index (BMI) < 18.5—in ACHD. Methods: The Pathfinder-CHD Registry is a prospective, observational, web-based HF registry including ACHD with manifest HF, history of HF, or significant risk for HF. It documents congenital diagnoses, HF type, comorbidities, and treatments. Patients were categorized by BMI into mild (17.00–18.49), moderate (16.00–16.99), and severe (<16.00) underweight. Results: As of September 2024, the registry enrolled 1420 adults (mean age 31.8±11.3 years; 49.2% female). Underweight was present in 59 patients (4.2%): 62.7% mild, 18.6% moderate, and 18.6% severe. Among the remaining 1361 patients, 52.8% had normal weight, 32.8% were overweight, and 14.2% were obese. Women had significantly lower metabolic body weight than men (p = 0.002). Underweight correlated with younger age (p < 0.001) and CHD type (p = 0.02). Notably, 42.9% of underweight patients had cyanotic CHD. Conclusions: Underweight is an underrecognized problem in ACHD with HF. Adults with complex CHD or connective tissue disorders are disproportionately affected. Underweight should be seen as an alarm sign requiring personalized, multidisciplinary management, including nutritional support, tailored therapy, and close monitoring to improve outcomes. Full article
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22 pages, 1052 KiB  
Review
Antimicrobial Photodynamic Therapy for Superficial, Skin, and Mucosal Fungal Infections: An Update
by Laura Beatriz Borim da Silva, Ivana Giovannetti Castilho, Fabiana Alves de Souza Silva, Mahmoud Ghannoum, Maíra Terra Garcia and Paulo Henrique Fonseca do Carmo
Microorganisms 2025, 13(6), 1406; https://doi.org/10.3390/microorganisms13061406 - 17 Jun 2025
Viewed by 679
Abstract
The global burden of fungal infections is rising at an alarming rate, with superficial, cutaneous, and mucosal mycoses among the most prevalent. Conventional treatments rely on oral and topical antifungal agents; however, these therapies are often limited by adverse effects, toxicity, frequent recurrence, [...] Read more.
The global burden of fungal infections is rising at an alarming rate, with superficial, cutaneous, and mucosal mycoses among the most prevalent. Conventional treatments rely on oral and topical antifungal agents; however, these therapies are often limited by adverse effects, toxicity, frequent recurrence, and poor patient adherence due to prolonged treatment regimens. Moreover, the emergence of antifungal resistance and multidrug-resistant species such as Candidozyma auris and Trichophyton indotineae highlights the urgent need for alternative therapeutic strategies, such as antimicrobial photodynamic therapy (aPDT). aPDT is based on photophysical and photochemical processes involving a photosensitizer (PS), a light source, and molecular oxygen. When combined, these elements generate reactive oxygen species that selectively destroy microbial cells. In this review, we explore various PSs and their effectiveness in aPDT against infections caused by dermatophytes, Candida spp., and other pathogenic fungi. Promisingly, aPDT has demonstrated antifungal activity against both susceptible and resistant strains. In addition, aPDT has been successfully used in cases of mycoses unresponsive to conventional therapies, showing favorable clinical outcomes and overall safety. Current evidence supports aPDT as a valuable strategy for the management of cutaneous, mucosal, and superficial fungal infections and as a potential strategy to combat antifungal resistance. Full article
(This article belongs to the Section Antimicrobial Agents and Resistance)
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11 pages, 239 KiB  
Brief Report
Resistance Patterns of Neisseria gonorrhoeae in PLHIV: A Cross-Sectional Study from the Republic of Cyprus, 2015–2023
by Michaela Takos, George Siakallis, Annalisa Quattrocchi, Maria Alexandrou, Panagiota Papadamou, Loukia Panagiotou and Danny Alon-Ellenbogen
Antibiotics 2025, 14(6), 589; https://doi.org/10.3390/antibiotics14060589 - 7 Jun 2025
Viewed by 568
Abstract
Background: The rise in antimicrobial-resistant (AMR) strains of Neisseria gonorrhoeae is internationally recognised as a critical public health concern, with limited treatment options available. The urgency of this issue prompted the European Centre for Disease Prevention and Control to establish ‘EURO-GASP’ to monitor [...] Read more.
Background: The rise in antimicrobial-resistant (AMR) strains of Neisseria gonorrhoeae is internationally recognised as a critical public health concern, with limited treatment options available. The urgency of this issue prompted the European Centre for Disease Prevention and Control to establish ‘EURO-GASP’ to monitor trends in resistance and address developments. Comprehensive data on AMR strains in people living with HIV (PLHIV) is limited, especially in Cyprus. Objectives: To analyse trends in rates of resistant N. gonorrhoeae infections and identify any correlations between patient factors that may contribute to such in PLHIV in The Republic of Cyprus. Methods: We conducted a retrospective chart review study on N. gonorrhoea resistance among PLHIV from the Gregorios HIV reference clinic in Larnaca, Cyprus, between 2015 and 2023. Antimicrobial susceptibility was assessed via disc diffusion or gradient strip method on GC II agar against a non-homogenous panel of antibiotic preparations, based on standard laboratory practice variation. Demographic and clinical data, including antibiograms, treatments and test of cure, were recorded. Statistical analysis was performed using Stata v16, with significance set at p < 0.05. The study received approval from the Cyprus National Bioethics Committee. Results: A total of 45 isolates from 39 patients were analysed, with 62% of these demonstrating resistance to at least one antibiotic. Resistance rates were not shown to change over time. We identified a statistically significant linear association between a person having a history of an STI and the number of antibiotics which the isolate is resistant to (β = 1.2; p: 0.004). Notably, a single isolate demonstrated resistance to ceftriaxone, the first-line treatment currently recommended in both Europe and the United States. This finding is particularly alarming given the critical role of ceftriaxone in the management of gonorrhoea. Conclusions: Whilst there has been no increase in resistance rates over time, the detection of ceftriaxone-resistant N. gonorrhoeae is a significant public health concern. Given that having a history of an STI makes a person more likely to develop a resistant infection, PLHIV or those who engage in risky sexual behaviours are particularly vulnerable. There is a pressing need to enhance surveillance and implement routine susceptibility testing in Cyprus, given the country’s role as a major international hub for travel and migration. Molecular analysis can further improve our understanding. Additionally, the global public health community must urgently prioritise the development of novel therapeutic agents for the treatment of gonorrhoea. Full article
7 pages, 471 KiB  
Brief Report
Comparative Diagnostic Efficacy of HeartLogic and TriageHF Algorithms in Remote Monitoring of Heart Failure: A Cohort Study
by David Ledesma Oloriz, Daniel García Iglesias, Rodrigo Ariel di Massa Pezzutti, Fernando López Iglesias and José Manuel Rubín López
J. Cardiovasc. Dev. Dis. 2025, 12(6), 209; https://doi.org/10.3390/jcdd12060209 - 31 May 2025
Viewed by 744
Abstract
Introduction: Implantable defibrillator devices (ICDs) can be used for remote monitoring of different variables, including some related to Heart Failure (HF). Two different algorithms (TriageHF and HeartLogic) arise by combining some of these variables to generate an estimation of HF decompensation risk in [...] Read more.
Introduction: Implantable defibrillator devices (ICDs) can be used for remote monitoring of different variables, including some related to Heart Failure (HF). Two different algorithms (TriageHF and HeartLogic) arise by combining some of these variables to generate an estimation of HF decompensation risk in the following days. Until now, no other trial has evaluated both algorithms in a head-to-head comparison. The primary objective is to compare diagnostic accuracy of both algorithms in a similar cohort of patients. Material and Methods: Descriptive monocentric cohort study of a series of 64 patients who have been implanted with a Medtronic or Boston Scientific ICD with the TriageHF or Heart Logic algorithm available during the period between January 2020 and June 2022, with a total of 27 patients in the HeartLogic group and 37 patients in the TriageHF group. Results: During the period of the study there were a total of 1142 alarms analyzed. There were no differences in the basal characteristics of both groups. We reported a risk alarm–patient ratio of 1.31 ± 1.89 in the HeartLogic group and of 3.32 ± 3.08 in the TriageHF group (p < 0.01). In the TriageHF group, we reported a lower specificity with (0.76), with higher sensitivity (0.97) and PPV (0.18), and similar NPV (1). Survival analysis shows no statistical differences between both algorithms in the 30 days following the alert. Conclusions: TriageHF algorithm had higher sensibility and PPV, leading to a higher number of alerts/patients, while HeartLogic algorithm had a better specificity. These differences should be considered to optimize patient follow-ups in home monitoring. Full article
(This article belongs to the Special Issue Artificial Intelligence in Cardiac Electrophysiology)
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16 pages, 3971 KiB  
Article
Simple Design of Mechanical Ventilator for Mass Production May Offer Excellent Performance, Precise Monitoring, and Advanced Safety
by Simon Walzel, Ladislav Bis, Vaclav Ort and Karel Roubik
Appl. Sci. 2025, 15(10), 5631; https://doi.org/10.3390/app15105631 - 18 May 2025
Viewed by 649
Abstract
The COVID-19 pandemic raised global concerns about the shortage of ventilators and revealed the challenges of rapidly scaling up production to meet emergency needs. In response, numerous teams worldwide attempted to develop emergency and simple mechanical ventilators. Among these, the CoroVent ventilator was [...] Read more.
The COVID-19 pandemic raised global concerns about the shortage of ventilators and revealed the challenges of rapidly scaling up production to meet emergency needs. In response, numerous teams worldwide attempted to develop emergency and simple mechanical ventilators. Among these, the CoroVent ventilator was developed to meet the urgent need for ventilatory support in the Czech Republic. The aim of this study was to describe the innovative and simple design of the CoroVent emergency ventilator, evaluate its compliance with international safety and performance standards, verify its reliability under simulated clinical conditions, and demonstrate its suitability for use in crisis scenarios. CoroVent was designed with a focus on the clinical needs of patients with COVID-19 respiratory failure and to ensure safe ventilation while maintaining a simplified design. It features volume-controlled, pressure-limited mandatory ventilation and supports key adjustable parameters such as tidal volume, respiratory rate, inspiratory-to-expiratory time ratio, inspired oxygen fraction, and positive end-expiratory pressure (PEEP). The ventilator incorporates robust safety mechanisms, including alarms and a safety relief valve, to protect against excessive airway pressures. Results confirmed the ability to maintain consistent tidal volumes, stable PEEP, and precise pressure limitation over extended periods of use. The results showed that CoroVent met the essential international standards for accuracy, including those set by the UK Medicines and Healthcare products Regulatory Agency, U.S. Food and Drug Administration, and ISO 80601-2-12. Although production of these ventilators was stopped in 2021 as the Czech Republic managed the crisis and shortage of ventilators, the results validate their reliability as emergency ventilators and indicate their potential to support critical care needs in crisis situations. Full article
(This article belongs to the Section Biomedical Engineering)
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30 pages, 2618 KiB  
Article
Gender Moderates the Associations Between Responsiveness to Alarming Oral Sensations, Depressive Symptoms, and Dietary Habits in Adolescents
by Leonardo Menghi, Lara Fontana, Silvia Camarda, Isabella Endrizzi, Maria Pina Concas, Paolo Gasparini and Flavia Gasperi
Nutrients 2025, 17(10), 1653; https://doi.org/10.3390/nu17101653 - 12 May 2025
Viewed by 628
Abstract
Background/Objectives: As a peripheral effect of depression-related traits, sensory responses may predispose individuals to depressive symptoms by prompting suboptimal dietary patterns with long-term effects on mood. Mood disturbances in adolescence are strong predictors of adult mental illness, making it crucial to identify [...] Read more.
Background/Objectives: As a peripheral effect of depression-related traits, sensory responses may predispose individuals to depressive symptoms by prompting suboptimal dietary patterns with long-term effects on mood. Mood disturbances in adolescence are strong predictors of adult mental illness, making it crucial to identify factors that may shift transient mood fluctuations into more severe mental health issues during this vulnerable period. Given the substantial gender differences in susceptibility to comorbidities of depression, we examined whether the link between sensory perception and depressive symptoms in nonclinical adolescents varied by gender and was related to dietary habits. Methods: In this cross-sectional study, 232 healthy adolescents (41.8% girls, aged 13–17) reported their diet over the past year using the EPIC Food Frequency Questionnaire and rated their liking and perceived intensity of oral sensations from four grapefruit juices and dark chocolate puddings with varying sucrose levels. Additionally, participants completed assessments of anxiety, neuroticism, pickiness, body dissatisfaction, and the Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Results: We found that girls exhibited higher levels of depression, anxiety, neuroticism, and pickiness compared to boys (Wilcoxon Rank Sum Test), and that greater responsiveness to bitterness (e.g., β = 0.264, p = 0.037) and astringency (β = 0.269, p = 0.029) predicted higher depressive symptoms exclusively in girls. PHQ-9 scores were positively associated with alcohol use in both girls (ρ = 0.176, p = 0.003) and boys (ρ = 0.148, p = 0.004) and inversely related to the intake of beneficial nutrients (e.g., fiber, polyunsaturated fats), particularly in girls. Intriguingly, moderation analyses suggested that associations between nutrient intake and acuity for alarming oral sensations were largely moderated by depression-related traits in girls, but not in boys. Conclusions: Our findings suggest that gender moderates the links between depressive symptoms, sensory perception, and dietary habits in healthy adolescents, possibly reflecting gender-specific coping strategies for comorbidities of depression. Full article
(This article belongs to the Special Issue Body Image and Nutritional Status Among Adolescents and Adults)
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20 pages, 3332 KiB  
Article
Enhancing the Usability of Patient Monitoring Devices in Intensive Care Units: Usability Engineering Processes for Early Warning System (EWS) Evaluation and Design
by Hyeonkyeong Choi, Yourim Kim and Wonseuk Jang
J. Clin. Med. 2025, 14(9), 3218; https://doi.org/10.3390/jcm14093218 - 6 May 2025
Viewed by 752
Abstract
Background/Objectives: This study aimed to enhance the usability of patient monitoring systems by integrating the Early Warning Score (EWS) function and improving user interface elements. The EWS function is expected to enable the early detection of acute deterioration and prompt medical intervention, [...] Read more.
Background/Objectives: This study aimed to enhance the usability of patient monitoring systems by integrating the Early Warning Score (EWS) function and improving user interface elements. The EWS function is expected to enable the early detection of acute deterioration and prompt medical intervention, while the optimized design supports rapid decision-making by nursing staff. Methods: Two formative usability evaluations were conducted to identify user requirements and improve the device design. A simulated usability test involved five ICU medical staff members, followed by a user preference survey with 72 ICU staff members in a real clinical setting. After incorporating feedback, a summative usability test with 23 ICU nurses was performed to evaluate the revised device. Results: Issues related to unfamiliar parameter terminology and alarm message positioning were identified, and the need for the EWS function was emphasized. The summative evaluation showed an increase in task success rate from 86% to 90% and a significant improvement in user satisfaction from 74.85 (SD: 0.88) to 89.55 (SD: 0.75) (p < 0.05). Conclusions: The integration of the EWS function and interface improvements significantly enhanced the usability of patient monitoring system. These advancements are expected to enable rapid detection of patient deterioration and support timely clinical decision-making by ICU staff. Full article
(This article belongs to the Section Intensive Care)
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11 pages, 2812 KiB  
Review
Extended-Spectrum Beta-Lactamases (ESBLs) Gene Mutations in Kuwait: How Much Do We Know? Not Much!
by Ali A. Dashti and Mehrez M. Jadaon
Bacteria 2025, 4(2), 22; https://doi.org/10.3390/bacteria4020022 - 30 Apr 2025
Viewed by 607
Abstract
Antibiotic resistance is a major problem worldwide, especially with the overuse and misuse of antibiotics. This makes it more challenging to treat patients infected with antibiotic-resistant bacteria, with more costs on the health system. This review article describes extended-spectrum β-lactam antibiotics as the [...] Read more.
Antibiotic resistance is a major problem worldwide, especially with the overuse and misuse of antibiotics. This makes it more challenging to treat patients infected with antibiotic-resistant bacteria, with more costs on the health system. This review article describes extended-spectrum β-lactam antibiotics as the most used antibacterial agents, and how bacteria developed beta-lactamases (ESBLs) to resist these antibiotics. The review focuses more on the problem of ESBLs in Kuwait to uncover which ESBLs are present and what ESBL gene mutations have been found in this country. The literature review, surprisingly, revealed a limited number of studies in Kuwait on ESBL gene mutations, published over the last 25 years. The results showed that Kuwait has an alarming number of bacterial strains with ESBL gene mutations. These studies reported different mutations in different bacterial strains isolated from different types of specimens, which were collected from different hospitals in Kuwait. The data from these studies were scattered and not linked or analysed together to highlight the big picture of the problem of ESBLs in Kuwait. This review article highlights that the amount of research on ESBLs in Kuwait is not up to the expectations of a country like Kuwait, which has high-standard research facilities. Bearing in mind that the geographic area of Kuwait is relatively small, the authors of this paper think that there might be more β-lactam bacteria spreading in Kuwait, which need to be explored, and that more research and more collaboration are needed among researchers in Kuwait to address this risky situation. Full article
(This article belongs to the Special Issue Bacterial Molecular Biology: Stress Responses and Adaptation)
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16 pages, 1873 KiB  
Article
Rising Incidence and Mortality of Early-Onset Colorectal Cancer in Young Cohorts Associated with Delayed Diagnosis
by Yazan Abboud, Anand Shah, Madison Fraser, Eric M. Montminy, Chun-Wei Pan, Kaveh Hajifathalian, Paul J. Gaglio and Ahmed Al-Khazraji
Cancers 2025, 17(9), 1500; https://doi.org/10.3390/cancers17091500 - 29 Apr 2025
Cited by 1 | Viewed by 1144
Abstract
Background and Aims: Prior data showed an increasing incidence of early-onset colorectal cancer (EO-CRC) in the US. However, there are limited comprehensive data on recent EO-CRC incidence and mortality per different age cohorts and tumor characteristics. We aimed to evaluate EO-CRC incidence [...] Read more.
Background and Aims: Prior data showed an increasing incidence of early-onset colorectal cancer (EO-CRC) in the US. However, there are limited comprehensive data on recent EO-CRC incidence and mortality per different age cohorts and tumor characteristics. We aimed to evaluate EO-CRC incidence and mortality in different populations. Methods: Age-adjusted EO-CRC incidence rates were calculated from the USCS database between 2001 and 2021. Age-adjusted EO-CRC mortality rates were calculated from the NCHS database between 2000 and 2022 and the SEER database between 2004 and 2021. The age groups were 20–44 years and 45–54 years. Tumors were categorized by anatomical location (right, transverse, left, and proximal) and stage at diagnosis (early and late). The annual and average annual percentage changes (AAPC) were estimated using joinpoint regression. Age-specific pairwise comparison was conducted. Results: A total of 474,601 patients were diagnosed with EO-CRC between 2001 and 2021. The EO-CRC incidence increased in patients aged 20–44 years faster than in those aged 45–54 years (AAPC = 1.51 vs. 0.73; AAPC difference = 0.78, p = 0.001). This was most notable in proximal colon tumors (AAPC difference = 0.88, p < 0.001). While the incidence of early-stage tumors decreased in recent years across all anatomical locations, late-stage tumors increased, mostly in the proximal colon (AAPC = 2.44). A total of 147,026 patients died from EO-CRC between 2000 and 2022. Mortality increased in patients aged 20–44 years faster than in patients aged 45–54 years, who had a stable trend (AAPC difference = 0.85, p < 0.001). The increase in mortality was noted in both early- and late-stage tumors. Conclusions: Our study provides epidemiologic evidence showing an alarming increase in EO-CRC incidence and mortality among patients aged 20–44 years compared to those aged 45–54 years, which is associated with delayed diagnosis, and mostly in proximal colon tumors. Expanding screening efforts to younger populations and addressing healthcare disparities are essential for improving early detection and outcomes for younger patients. Full article
(This article belongs to the Special Issue Emerging Trends in Global Cancer Epidemiology: 2nd Edition)
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