Search Results (180)

Repeated exposure to low-level blast overpressure (BOP) during controlled detonations is an emerging occupational health concern for military breachers and Special Operations Forces personnel, given accumulating evidence that chronic exposure may produce subtle, subclinical neurotrauma. This study derived a latent neuroinjury construct integrating three complementary domains of brain health—post-concussive symptoms, working-memory performance, and circulating biomarkers—to determine whether breachers exhibit coherent patterns of neurobiological alteration. Symptom severity was assessed using the Rivermead Post-Concussion Questionnaire (RPQ), and working memory was assessed with the N-Back task and a panel of thirteen neuroproteomic biomarkers was measured reflecting astroglial activation, neuronal and axonal injury, oxidative stress, inflammatory signaling, and neurotrophic regulation. Experienced Canadian Armed Forces breachers with extensive occupational BOP exposure were compared with unexposed controls. Bayesian latent-variable modeling provided probabilistic evidence for a chronic, subclinical neurobiological signal, with the strongest contributions arising from self-reported symptoms and smaller but consistent contributions from the biomarker domain. Working-memory performance did not load substantively on the latent factor. Several RPQ items and circulating biomarkers showed robust loadings, and the latent neuroinjury factor was elevated in breachers relative to controls (97% posterior probability). The pattern is broadly consistent with subclinical neurobiological stress in the absence of measurable cognitive impairment, suggesting early or compensated physiological alterations rather than overt dysfunction. This multidomain, biomarker-informed framework provides a mechanistically grounded and scalable approach for identifying subtle neurobiological strain in military personnel routinely exposed to repetitive low-level blast. It may offer value for risk stratification, operational health surveillance, and the longitudinal monitoring of neurobiological change in high-risk occupations. Full article

Background: The use of continuous glucose monitoring (CGM) offers several benefits. Compared to point-of-care (POC) capillary glucose tests, user acceptability is greater, and time in the target glucose range is improved. If these advantages can be transferred from outpatient to in-patient settings, CGM could assist clinicians in making timely, proactive treatment decisions. Scope of the review: This scoping review focuses on clinical studies of CGM use in hospital settings among non-pregnant adults, with a particular focus on studies from 2023 to 2025. It examines the latest evidence and guidelines and sets out the clinical and analytical considerations involved in implementing in-patient CGM. Main findings: In-hospital CGM facilitates hypoglycemia detection, especially asymptomatic and nocturnal episodes. Data on the impact of CGM use on clinical outcomes are scarce, and most studies focus on the reliability of CGM technology rather than clinical outcomes. Several factors affect CGM accuracy in hospitals, such as medications, fluid management, and hemodynamic disturbances. Despite between-device and settings-related variability, CGM devices generally show reasonable accuracy, with Mean Absolute Relative Differences (MARDs) ranging from 10% to 23%. In-hospital CGM has also improved workflows and reduced personnel exposure in infectious disease settings. Key implementation challenges: The MARD thresholds for safe in-hospital CGM use without confirmatory POC testing and evidence-based protocols for CGM application in ICU and non-ICU settings are not yet established. Despite challenges related to implementation, including personnel training, integrating diabetes technology with electronic health records, and costs, the benefits of improved monitoring and in-patient safety make CGM use worthwhile to pursue. Full article

The health and operational continuity of emergency responders are fundamental pillars of sustainable and resilient disaster management systems. These personnel operate in high-risk environments, exposed to intense physical, environmental, and psychological stress. This makes it crucial to monitor their health to safeguard their well-being and performance. Traditional methods, which rely on intermittent, voice-based check-ins, are reactive and create a dangerous information gap regarding a responder’s real-time health and safety. To address this sustainability challenge, the convergence of the Internet of Things (IoT) and wearable biosensors presents a transformative opportunity to shift from reactive to proactive safety monitoring, enabling the continuous capture of high-resolution physiological and environmental data. However, realizing a field-deployable system is a complex “system-of-systems” challenge. This review contributes to the field of sustainable emergency management by analyzing the complete technological chain required to build such a solution, structured along the data workflow from acquisition to action. It examines: (1) foundational health sensing technologies for bioelectrical, biophysical, and biochemical signals; (2) powering strategies, including low-power design and self-powering systems via energy harvesting; (3) ad hoc communication networks (terrestrial, aerial, and space-based) essential for infrastructure-denied disaster zones; (4) data processing architectures, comparing edge, fog, and cloud computing for real-time analytics; and (5) visualization tools, such as augmented reality (AR) and heads-up displays (HUDs), for decision support. The review synthesizes these components by discussing their integrated application in scenarios like firefighting and urban search and rescue. It concludes that a robust system depends not on a single component but on the seamless integration of this entire technological chain, and highlights future research directions crucial for quantifying and maximizing its impact on sustainable development goals (SDGs 3, 9, and 11) related to health, sustainable cities, and resilient infrastructure. Full article

Fishermen operating in pelagic fisheries often experience significant barriers to medical care due to geographic isolation, harsh environmental conditions, and the absence of onboard healthcare personnel. Telemedicine offers an effective approach to overcome these limitations by enabling remote diagnosis, monitoring, and treatment through satellite-based communication systems. This review summarizes the progress and applications of telemedicine in maritime and other austere environments, focusing on technological advancements, clinical implementations, and emerging trends in artificial intelligence-driven healthcare. Evidence from pilot and retrospective studies highlights the growing use of wearable devices, telementored ultrasound, digital photography, and cloud-based monitoring systems for managing acute and chronic medical conditions at sea. The integration of machine learning and deep learning algorithms has further improved fatigue, stress, and motion detection, enhancing early risk assessment among seafarers. Despite challenges such as limited connectivity, data privacy concerns, and training requirements, the adoption of telemedicine significantly improves health outcomes, reduces emergency evacuations, and promotes occupational safety. Future directions emphasize the development of 5G-enabled Internet of Medical Things networks and predictive AI tools to establish comprehensive maritime telehealth ecosystems for fishermen in pelagic operations. Full article

Wild birds are relevant reservoirs and sentinels for zoonotic pathogens such as Chlamydia psittaci and West Nile virus (WNV), both of which can affect animal and public health. Wildlife rehabilitation centers (WRCs) offer unique opportunities for passive surveillance of emerging and re-emerging infectious diseases, particularly in urban and peri-urban settings. From 2013 to 2022, a total of 1024 bird samples were collected upon admission to WRCs in the Community of Madrid, Spain. Oropharyngeal and cloacal swabs, as well as tissue samples, were tested using real-time PCR targeting the ompA gene of C. psittaci and the 3’NC region of WNV. One sample tested positive for C. psittaci by real-time PCR in 2021, yielding a positivity rate of 0.22% (95% CI: 0.01–1.19). No positive cases were detected during the remaining years of the study. All samples tested negative for WNV over the nine-year period. The low detection rate suggests limited circulation of these pathogens among wild birds in central Spain, though it may partly reflect the variability inherent to passive surveillance and sample-type heterogeneity. However, continued surveillance is warranted, especially in high-risk avian species and personnel occupationally exposed in avian rehabilitation facilities using expanded sample sizes and complementary diagnostic tools. Extending monitoring beyond the typical vector season and increasing testing of sensitive tissues, particularly for WNV, may further enhance detection sensitivity and strengthen early-warning capacity. These efforts are essential to improve early detection and risk assessment within a One Health framework. Full article

Bacterial contaminants in ambulances could have a major impact on morbidities, mortalities, and healthcare resources, especially if these bacteria are antimicrobial-resistant. As far as we know, this is the first study in Al-Qassim region to evaluate the prevalence of bacterial contaminants in swab samples obtained from ambulances from Alqwarah General Hospital, Al-Qassim region, Saudi Arabia as an indicator for evaluation of the implemented infection control measures, and screen the antibiotics profiles of the isolates against the most regularly used antimicrobials. In total, 204 samples were collected from the ambulances following patient transport. To evaluate the effect of vehicle decontamination, 204 swabs were collected from the same sites of the ambulances immediately after cleaning and disinfection. The isolates were identified using standard bacteriological and biochemical methods, as recommended by the Clinical Laboratory Standard Institute (CLSI). The antibiotic susceptibility patterns were assessed using the Kirby–Bauer disc diffusion method. The prevalence of bacterial contamination in the samples collected following patient transport was 46.08%. In total, 83.33%, 75.00%, and 66.66% of the samples collected from DC shock apparatuses, ceilings, and emergency personnel seats, respectively, were contaminated. Furthermore, ceilings, DC shock apparatuses, emergency personnel seats, cervical collars, and monitors were found to harbor 10.8%, 9.8%, 7.8%, 6.8%, and 6.8% of the 102 bacterial isolates, respectively. Gram-positive organisms represented 96.1% of all bacterial isolates. Bacillus spp. was the most common isolate, accounting for 60.8% of all bacterial isolates. Although Pseudomonas aeruginosa and Proteus spp. isolates were sensitive to all the tested antimicrobials, many Gram-positive bacterial isolates were resistant to some antibiotics in variable frequencies. After 48 h of aerobic incubation (with or without 5–10% CO₂) on nutrient, blood, chocolate, and MacConkey agar plates at 37 °C, no bacterial growth was detected in the samples collected immediately following cleaning and disinfection. This is the second Saudi study to evaluate the prevalence of bacterial contaminants in Saudi Arabian ambulances, and it could help health policy makers in improving the implemented infection prevention and control measures in Saudi Arabian ambulances. The samples taken after patient transport revealed bacterial contaminants with varying rates of antimicrobial resistance. Policies ensuring the optimal cleaning and disinfection of ambulances can minimize the potential of bacterial infection for high-risk patients, their relatives, and healthcare providers. Full article

Passive transfer of immunoglobulin G (IgG) through colostrum is essential for early immune protection in dairy calves. This systematic review synthesizes the most relevant evidence on colostrum quality, feeding practices, storage methods, and post-feeding assessment. High-quality colostrum (≥50 g/L IgG and low bacterial contamination) can be reliably assessed using Brix refractometry (≥22%) or radial immunodiffusion. Early administration is critical: feeding within 1–2 h after birth maximizes IgG absorption. Providing 8.5–10% of body weight (≈3–4 L) at first feeding, followed by a second feeding within 8–12 h, significantly reduces failure of passive transfer. Pasteurization at 60 °C for 60 min and controlled freezing maintain immunological integrity while reducing microbial load. Monitoring passive immunity using serum total protein (5.0–5.5 g/dL) or serum Brix (8.1–8.5%) offers practical field diagnostics aligned with the IgG ≥ 10 g/L threshold. Integrated colostrum management protocols—combining quality evaluation, timely feeding, hygienic handling, and trained personnel—are essential to improve passive immunity, health, and overall performance of dairy calves. Full article

The general spread of water safety awareness and enforcement often masks the escalating risks of emerging contaminants (ECs) that evade standard detection and monitoring techniques. Traditional monitoring infrastructures depend heavily on localized laboratory-based testing, which is expensive, time-consuming, and reliant on specialized infrastructure and skilled personnel. While specific types of ECs and detection technologies have been examined in numerous studies, a significant gap remains in compiling and commenting on this information in a concise framework that incorporates global impact and monitoring strategies. We aimed to compile and highlight the impact ECs have on global water safety and how advanced sensor technologies, when integrated with digital tools such as the Internet of Things (IoT), artificial intelligence (AI), machine learning (ML), geographic information systems (GIS), and cloud-based analytics, can enhance real-time EC detection and monitoring. Recent case studies were reviewed for the assessment of EC types, global contamination, and current state-of-the-art for EC detection and their limitations. An emphasis has been placed on areas that remain unaddressed in the current literature: a cross-disciplinary integration of integrated sensor platforms, multidisciplinary research collaborations, strategic public–private partnerships, and regulatory bodies engagement will be essential in safeguarding public health, protecting aquatic ecosystems, and ensuring the quality and resilience of our water resources worldwide. Full article

The gastrointestinal (GI) tract is a complex organ system affected by multiple disorders with diverse etiologies ranging from infections to immune dysfunction disorders and cancers. Various GI disorders, such as Helicobacter pylori infection, inflammatory bowel disease (IBD), celiac disease, irritable bowel syndrome (IBS), and colon cancer, are common and cause significant morbidity, mortality, and healthcare costs. These disorders present with overlapping signs and symptoms, warranting the need for accurate laboratory diagnostic tests for appropriate treatment implementation and treatment monitoring. The gold standard confirmatory diagnostic test for most GI disorders is endoscopy and biopsy for histological analysis. Biomarkers in blood and stool are also routinely used either as first-line screening tests or for treatment monitoring in many GI disorders. This review summarizes common GI disorders along with related currently used clinical laboratory tests in screening, diagnosis, and monitoring of these diseases, outlining the methodology, utilization, advantages, and limitations of these tests. We also highlight the effectiveness of each test as well as the professional recommendations and clinical guidelines for their use where available. Finally, we shed some light on potential future tests and biomarkers that aid in diagnosing GI disorders and how these biomarkers can be used in conjunction to complement the current tests. Some of the potential future biomarkers discussed include the differential expression of gut microbiota and their respective metabolites, as well as cytokines, as potential tests that can be used to diagnose diseases, distinguish between disease subtypes, predict disease severity and occurrence, and optimize treatment decisions. Comprehending the effectiveness of various methodologies for laboratory diagnosis of GI disorders is crucial for health care personnel, including clinical laboratory professionals and clinicians, regarding testing options, test utilization, and interpretations of results. Insights into future tests in GI diseases in the context of microbiomes, metabolites, and immune mediators based on advanced technology are also important in their appropriate clinical utilization. Full article

Occupational exposure to airborne polymethacrylate (PMMA) particles during dental laboratory procedures poses an underexplored health risk. This study presents the first integrated Computational Fluid Dynamics (CFD) and real-time particle monitoring investigation of 0.5 µm PMMA particle dispersion during mechanical polishing in an actual clinic. We quantitatively assessed particle behavior in 30 s exposure scenarios by examining the effects of dental professional work orientations and comparing two mitigation strategies, rear-inlet portable air cleaners (PACs) and a Box Dust Collector (BC), with an emphasis on the safety of both personnel and patients. The findings establish that operatory airflow is a primary safety determinant: aligning the workflow with the main airflow (0°). Furthermore, the combined use of PACs and BC demonstrated synergistic superiority, achieving the optimal reduction in peak concentrations and airborne residence time. PACs alone reduced working zone concentrations by up to 80%, while BC provided a crucial 40–60 s delay in initial plume dispersion. We conclude that effective exposure control requires a proactive, two-stage engineering defense: source confinement augmented by continuous ambient filtration. This research provides a robust, evidence-based foundation for defining airflow-aware ergonomic and combined engineering standards in the evolving digital era of dentistry. Full article

Background/Objectives: Monitoring community health and tracking SARS-CoV-2 evolution were critical priorities throughout the COVID-19 pandemic. However, widespread shortages of personal protective equipment, the necessity for social distancing, and the redeployment of healthcare personnel to clinical duties presented significant barriers to traditional sample collection. Methods: In this study, we evaluated the feasibility of using self-collected saliva specimens for the qualitative detection of SARS-CoV-2 infection. Following confirmation of reliable viral detection in saliva, we established a large-scale surveillance program in Arizona, USA, to enable clinical diagnosis and genomic sequencing from self-collected samples. Between April 2020 and December 2023, we tested approximately 1.4 million saliva samples using RT-PCR, identifying 94,330 SARS-CoV-2 infections. Whole genome sequencing was performed on 69,595 samples, yielding 54,040 high-quality consensus genomes. Results: This surveillance approach enabled real-time monitoring of general infection trends that matched regional case counts. We monitored multiple wave-like introductions of viral lineages over the course of the pandemic. We identified three periods of S gene target failure on a commercial assay and assessed its ability to make fast, genotyping assignment during the pandemic (PPV = 0.98, 95% CI = 0.97–0.99; NPV = 0.94, 95% CI = 0.94–0.96). The co-location of clinical testing and sequencing capabilities within the same facility resulted in low turnaround time from the sample collection to the generation of sequencing data (median = 12 days, IQR: 9.0–19.75). Conclusions: Our findings support the use of self-collected saliva as a scalable, cost-effective, and practical strategy for infectious disease surveillance in future pandemics. Full article

Indoor air pollution, including fine particulate matter (PM_2.5), poses a severe threat to human health. Due to the diverse sources of indoor PM_2.5 and its high spatial heterogeneity in distribution, traditional single-point fixed monitoring fails to accurately reflect the actual human exposure level. In recent years, the development of high spatiotemporal resolution monitoring technologies has provided a new perspective for revealing the dynamic distribution patterns of indoor PM_2.5. This study discusses two cutting-edge monitoring strategies: (1) mobile monitoring technology based on Indoor Positioning Systems (IPS) and portable sensors, which maps 2D exposure trajectories and concentration fields by having personnel carry sensors while moving; and (2) 3D dynamic monitoring technology based on in situ Lateral Scattering LiDAR (I-LiDAR), which non-intrusively reconstructs the 3D dynamic distribution of PM_2.5 concentrations using laser arrays. This study elaborates on the principles, calibration methods, application cases, advantages, and disadvantages of the two technologies, compares their applicable scenarios, and outlines future research directions in multi-technology integration, intelligent calibration, and public health applications. It aims to provide a theoretical basis and technical reference for the accurate assessment of indoor air quality and the prevention and control of health risks. Full article

Tunnel lining voids, a common latent defect induced by the coupling effects of complex geological, environmental, and load factors, pose severe threats to operational and personnel safety. Traditional detection methods relying on Ground-Penetrating Radar (GPR) combined with manual interpretation suffer from high subjectivity, low efficiency, frequent missed or false detections, and an inability to achieve real-time monitoring. Thus, this paper proposes an intelligent identification methodology for tunnel lining voids based on an improved version of YOLOv8. Key enhancements include integrating the RepVGGBlock module, dynamic upsampling, and a spatial context-aware module to address challenges from diverse void geometries—resulting from interactions between the environment, geology, and load—and complex GPR signals caused by heterogeneous underground media and the varying electromagnetic properties of materials, which obscure void–background boundaries, as well as interference signals from detection processes. Additionally, the C2f-Faster module reduces the computational complexity (GFLOPs), parameter count, and model size, facilitating edge deployment at detection sites to achieve real-time GPR signal interpretation for tunnel linings. Experimental results on a heavy-haul railway tunnel’s lining defect dataset show 11.57% lower GFLOPs, 14.55% fewer parameters, and 13.85% smaller weight files, with average accuracies of 94.1% and 94.4% in defect recognition and segmentation, respectively, meeting requirements for the real-time online detection of tunnel linings. Notably, the proposed model is specifically tailored for void identification and cannot handle other prevalent tunnel lining defects, which restricts its application in comprehensive tunnel health monitoring scenarios where multiple defects often coexist to threaten structural safety. Full article

SARS-CoV-2, the agent responsible for coronavirus disease in 2019 (COVID-19), has caused extensive global health and socioeconomic impact due to its transmissibility and pathology. As a result, it was classified as a Risk Group 3 human pathogen, and handling samples containing live virus requires enhanced biological containment facilities (i.e., CL3) to reduce the potential of laboratory infection to personnel and the spread of the virus into the community. While the use of an authentic live virus remains the gold standard for biological assays, alternative methods have been developed to effectively evaluate neutralization activity in the absence of a replicating viral agent. Here, we describe a cell-based spike–ACE2 binding assay as a surrogate for neutralization of SARS-CoV-2 spike to identify potential neutralizing antibodies. A main advantage of this approach is the exclusion of infectious viral particles, increasing biosafety for laboratory personnel. The interaction of recombinant SARS-CoV-2 trimeric spike protein with ACE2 is monitored and quantified by flow cytometry. Notably, our previous studies have demonstrated the utility of this assay for other viruses, beyond SARS-CoV-2. The methodology presented here has exhibited a strong correlation to other widely accepted methods, such as pseudotyped lentiviral and live virus neutralization assays, in identifying neutralizing antibodies. Full article

This study evaluated a novel methodology for assessing food safety vulnerabilities in shopping malls by integrating Hazard Analysis and Critical Control Points (HACCP), Threat Assessment and Critical Points (TACCP), and Failure Mode and Effects Analysis (FMEA). Inspections were conducted in nine shopping centers across Poland, the Czech Republic, Slovakia, and Spain to identify the risk of intentional/unintentional contamination with chemical, biological, radiological, and nuclear agents. The assessment considered key operational areas, including food delivery, transportation, staff security, back-office access, product handling, and inspection protocols. Risk levels were quantified using FMEA parameters. The findings revealed an overall high to average risk score with the most critical vulnerabilities linked to back-office access, unauthorized personnel entry, and susceptibility to fraudulent inspections. Observations also highlighted infrastructural shortcomings, insufficient monitoring, and procedural gaps that could facilitate contamination. The proposed methodology offers a structured, quantitative framework for identifying and prioritizing food safety hazards in public environments. Implementing targeted countermeasures—such as enhanced surveillance, strict access control, staff training, and dedicated food handling protocols—can substantially reduce risks, thereby strengthening public health protection and operational resilience. This approach may serve as a promising framework for integrating food defense and safety assessments for food defense in high-density commercial facilities. Full article