Search Results (967)

Background/Objectives: Children in paediatric palliative care often face school attendance barriers due to complex health needs. This study describes post-training perceptions of a training program by a pediatric hospice team to prepare school care assistants to safely include children with complex conditions, focusing on procedural skills, knowledge of the child, and family partnership. Methods: Care assistants who completed a structured course at the Paediatric Palliative Care Centre, University Hospital of Padua (2023–2024), were surveyed immediately after training. The program combined classroom instruction with hands-on simulation using high-fidelity mannequins and standard devices, including suction, pulse oximetry, ventilation, enteral feeding, and tracheostomy care. It also covered modules on urgent and emergency management, as well as family communication. An anonymous online questionnaire gathered socio-demographic data, prior training, clinical tasks performed, self-efficacy levels, and open-ended feedback. Quantitative results were analyzed descriptively, while qualitative comments were subjected to thematic analysis. Results: Of 130 invited assistants, 105 participated (81%). Participants reported strong perceived confidence: 85% selected the upper end of the 5-point scale (“very” or “extremely”) for routine-management ability, and 60% selected these same response options for emergency-management ability. In the most severe events recalled, 60.5% of incidents were resolved autonomously, 7.6% involved contacting emergency services, and 3.8% involved community or hospice nurses. Seventy-five percent judged the course comprehensive; thematic analysis of 102 comments identified satisfaction, requests for regular refreshers, stronger practical components, and requests for targeted topics. Conclusions: Immediately after the session, participants tended to select the upper end of the self-assurance item for both routine and emergency tasks. Combining core emergency procedures with personalized, child-specific modules and family-partnership training may support safety, trust, and inclusion. Regular refreshers and skills checks are advised. Full article

The emergence of SARS-CoV-2 posed a great global threat and emphasized the urgent need for diagnostic tools that are rapid, reliable, sensitive and capable of real-time monitoring of SARS-CoV-2 infections. Recent investigations have identified a potential connection between SARS-CoV-2 infection and gut dysbiosis, highlighting the sophisticated interplay between the virus and the host microbiome. This review article discusses the eminence of nanobiosensors, as state-of-the-art tools, to investigate and clarify the connection between SARS-CoV-2 pathogenesis and gut microbiome imbalance. Nanobiosensors are uniquely advantageous owing to their sensitivity, selectivity, specificity, and reliable monitoring capabilities, making them well-suited for identifying both viral particles and microbial markers in biological samples. We explored a range of nanobiosensor platforms and their potential use for concurrently monitoring the gut dysbiosis induced by different pathological conditions. Additionally, we explore how advanced sensing technologies can shed light on the mechanisms driving virus-induced dysbiosis, and the implications for disease progression and patient outcomes. The integration of nanobiosensors with microfluidic devices and artificial intelligence algorithms has also been explored, highlighting the potential of developing point-of-care diagnostic tools that provide comprehensive insights into both viral infection and gut health. Utilizing nanotechnology, scientists and healthcare professionals may gain a more profound insight into the complex interaction dynamics between SARS-CoV-2 infection and the gut microenvironment. This could pave the way for enhanced diagnostic and prognostic approaches, treatment courses, and patient care for COVID-19. Full article

Background: Intentional occlusion of the internal iliac artery (IIA) during endovascular repair of aorto-iliac aneurysms may predispose patients to pelvic ischemic complications such as gluteal claudication, erectile dysfunction, and bowel ischemia. Iliac branch devices (IBDs) have been developed to preserve hypogastric perfusion. E-Liac (Artivion/Jotec) is one of the latest modular IBDs yet reports on mid-term performance are limited to small single-center cohorts with short follow-up. The CAMpania PugliA bRanch IliaC (CAMPARI) study is a multicenter investigation of E-Liac outcomes. Methods: A retrospective observational cohort study was conducted across five Italian vascular centers. All consecutive patients undergoing E-Liac implantation for aorto-iliac or isolated iliac aneurysms between January 2015 and December 2024 were identified from prospectively maintained registries. Inclusion criteria comprised elective or urgent endovascular repair of aorto-iliac aneurysms in which an adequate distal sealing zone was not available without covering the IIA and suitability for the E-Liac device according to its instructions for use (IFU). Patients with a life expectancy < 1 year or hostile anatomy incompatible with the IFU were excluded. The primary end point was freedom from branch instability (occlusion/stenosis, kinking, or detachment of the bridging stent). Secondary end points included freedom from any endoleak, freedom from device-related reintervention, freedom from gluteal claudication, aneurysm-related and all-cause mortality, acute renal failure, and sac regression > 5 mm. Results: A total of 69 consecutive patients (68 male, 1 female, median age 72.0 years) received 74 E-Liac devices, including 5 bilateral implantations. The mean infrarenal aortic diameter was 45 mm and the mean CIA diameter 34 mm; 14 patients (20.0%) had a concomitant IIA aneurysm (>20 mm). Concomitant fenestrated or branched aortic repair was performed in 23% of procedures. Two patients received a standalone IBD without implantation of a proximal aortic endograft. Technical success was achieved in 71/74 cases (96.0%); three failures occurred due to inability to catheterize the IIA. Distal landing was in the main IIA trunk in 58 cases and in the posterior branch in 13 cases. Over a median follow-up of 18 (6; 36) months, there were four branch instability events (5.4%): three occlusions and one bridging stent detachment. Seven patients (9.5%) developed endoleaks (one type Ib, two type II, two type IIIa, and two type IIIc). Five patients (6.8%) required reintervention, and five (6.8%) reported gluteal claudication. There were seven all-cause deaths (10%), none within 30 days or related to aneurysm rupture; causes included COVID-19 pneumonia, acute coronary syndrome, melanoma, gastric cancer, and stroke. No acute renal or respiratory failure occurred. Kaplan–Meier analysis showed 92% (95% CI 77–100) freedom from branch instability in the main-trunk group and 89% (60–100) in the posterior-branch group (log-rank p = 0.69). Freedom from any endoleak at 48 months was 87% (95% CI 75–95), and freedom from reintervention was 93% (95% CI 83–98). Conclusions: In this multicenter cohort, the E-Liac branched endograft demonstrated high technical success and favorable early–mid-term outcomes. Preservation of hypogastric perfusion using E-Liac was associated with low rates of branch instability, endoleak, and reintervention, with no 30-day mortality or aneurysm-related deaths. These findings support the safety and efficacy of E-Liac for aorto-iliac aneurysm management, although larger prospective studies with longer follow-up are needed. Full article

Urban public spaces increasingly need to address inclusivity, adaptability, and resilience in the face of health, environmental, and social challenges. Urban policies also promote improving the relationship between schools and their surroundings to mitigate and adapt to climate and social risks. This article presents EDUS Point, an experimental prototype developed within the European project FURNISH and tested in Barcelona during the COVID-19 crisis. Conceived as an Urban Living Lab (ULL), the initiative explored how modular, digitally fabricated, and temporary structures could transform school environments into open, inclusive, and human-scale public spaces. Through an inter-scalar and interdisciplinary approach, the project implemented an urban strategy, a participatory community-building process, and a digital collective platform, alongside the design, fabrication, and testing of a pilot classroom device adaptable and replicable in other schools. A mixed-methods methodology combined tactical urbanism and co-design with fabrication feasibility assessments, social observations, and spatial impact analysis. Results demonstrate that EDUS Point fostered new socio-spatial dynamics among students, teachers, and residents, improved accessibility and usability of nearby public spaces, and validated the effectiveness of low-cost, rapidly deployable interventions in addressing urban needs. The findings propose actionable frameworks, tools, and design criteria for the socio-environmental integration of schools as catalysts for inclusive and resilient urban transformation. Full article

Modern agricultural operations generate high-volume and diverse data (historical and stream) from various sources, including IoT devices, robots, and drones. This paper presents a novel smart farming architecture specifically designed to efficiently manage and process this complex data landscape.The proposed architecture comprises five distinct, interconnected layers: The Source Layer, the Ingestion Layer, the Batch Layer, the Speed Layer, and the Governance Layer. The Source Layer serves as the unified entry point, accommodating structured, spatial, and image data from sensors, Drones, and ROS-equipped robots. The Ingestion Layer uses a hybrid fog/cloud architecture with Kafka for real-time streams and for batch processing of historical data. Data is then segregated for processing: The cloud-deployed Batch Layer employs a Hadoop cluster, Spark, Hive, and Drill for large-scale historical analysis, while the Speed Layer utilizes Geoflink and PostGIS for low-latency, real-time geovisualization. Finally, the Governance Layer guarantees data quality, lineage, and organization across all components using Open Metadata. This layered, hybrid approach provides a scalable and resilient framework capable of transforming raw agricultural data into timely, actionable insights, addressing the critical need for advanced data management in smart farming. Full article

Background and Objectives: Chronic knee pain (cKP) affects approximately 25% of adults worldwide, with prevalence increasing over recent decades. While conventional treatments have clinical limitations, several types of electrical stimulation have been suggested to improve patients’ quality of life. The electrical stimulation literature contains inadequate patient-reported outcome measures (PROMs) data. Encouraging preliminary H-Wave^® device PROMs results for chronic neck, shoulder, and low back pain have previously been published. This PROMs study’s goal is to similarly assess the efficacy of H-Wave^® device stimulation (HWDS) in patients with differing knee disorders. Materials and Methods: This is an independent, retrospective, observational cohort study analyzing H-Wave^® PROMs data, prospectively and sequentially collected over 4 years. In total, 34,192 pain management patient final surveys were screened for participants who were at least 18 years old, used H-Wave^® for any knee-related disorder, reporting chronic pain from 90 to 730 days, with device treatment duration from 22 to 365 days. PROMs included effects on function, pain, sleep quality, need for medications, ability to work, and patient satisfaction; additional data includes gender, age (when injured), chronicity of pain, prior treatments, and frequency and length of device use. Results: PROMs surveys from 34,192 HWDS patients included 1143 with “all knee”, 985 “knee injury”, and 124 “knee degeneration” diagnoses. Reported improvements in function/ADL (96.51%) and work performance (84.63%) were significant (p < 0.0001), with ≥20% pain relief in 86.76% (p < 0.0001), improving 2.96 points (average 0–10 NRS). Medication use decreased (69.85%, p = 0.0008), while sleep improved (55.33%) in knee injury patients. Patient satisfaction measures exceeded 96% (p < 0.0001). Subgroup analysis suggests that longer device use and shorter pain chronicity resulted in increased (p < 0.0001) HWDS benefits. Conclusions: HWDS PROMs data analysis demonstrated similarly encouraging outcomes for cKP patients, as previously reported for several other body regions. Knee injury and degeneration subgroups had near-equivalent benefits, as observed for all knee conditions. Despite many reported methodological limitations, which limit causal inference and preclude broader recommendations, HWDS appears to potentially offer several benefits for refractory cKP patients, requiring further studies. Full article

Background: Digitalisation is transforming medical education, but its integration into ultrasound training remains limited. This study evaluates the needs of students and physicians regarding digitally supported ultrasound education. Materials and Methods: A multi-year cross-sectional study (2017–2022) employed two standardised questionnaires. The first assessed the perceived relevance of ultrasound in medical education, the desirability of compulsory teaching, and the integration of digital media and case-based learning. The second explored user-centred requirements for e-learning formats, including functionality, multimedia design, usability, interactivity, and financing, as well as current use of digital devices and reference materials. Data were collected using dichotomous and 7-point Likert scales (1 = high need/strong agreement, 7 = low need/weak agreement). Results: A total of 3479 responses were analysed (2821 students; 658 physicians). Both groups showed strong support for integrating ultrasound into curricula (1.3 ± 0.7) and mandatory education (1.4 ± 0.9), with students expressing significantly greater support (p < 0.001). There was broad agreement on the integration and development of digital media (1.7 ± 1.0), as well as the use of case studies (1.4 ± 0.8), with no significant differences between groups (p > 0.05). Case-based learning as a stand-alone format was less favoured (3.4 ± 1.9). In the user-centred needs analysis, both groups rated features like search functions (1.4 ± 0.8), usability (1.5 ± 0.9), and learning objective checks (2.7 ± 1.6) as important. High-quality media (1.5 ± 0.9) and pathology explanations (1.6 ± 1.1) were also highly valued. Students primarily relied on digital platforms, while physicians used a more varied mix of digital platforms, guidelines, and textbooks. Conclusions: The study highlights the need for more extensive, digitally supported ultrasound training, with a focus on functionality and usability. Standardisation through structured certification processes should be considered for future implementation. Full article

The integration of operational technology (OT) and information technology (IT) within the Industrial Internet of Things (IIoT) has posed prominent security challenges for resource-constrained devices. Existing authentication architectures often suffer from critical vulnerabilities: one is their reliance on centralized trusted third parties, which creates single points of failure; the other is their use of static credentials like biometrics, which pose severe privacy risks if compromised. To address these limitations, this paper proposes DLR-Auth, which combines chaotic synchronization of semiconductor superlattice physically unclonable functions (SSL-PUFs) with Shamir’s secret sharing (SSS) to enable decentralized registration and revocable templates. Notably, DLR-Auth is a two-party authentication framework that removes the need for a separate online registration authority that operates directly between a user device ($U{D}_i$) and a server (S). In our setting, the server S still acts as the central relying party and hardware authority embedding the matched SSL-PUF module. The protocol also includes an efficient multi-access mechanism optimized for high-frequency interactions. Formal security analysis with the Real-or-Random (ROR) model proves the semantic security of the session key, while performance evaluations demonstrate that DLR-Auth has significant advantages in computational and communication efficiency. DLR-Auth thus offers a robust, scalable, lightweight solution for next-generation secure IIoT systems. Full article

During catheter interventional procedures, the catheter inevitably encounters the vessel wall. When the push–pull force at the catheter–vessel wall interface exceeds a certain threshold, it may cause vascular damage. The mechanical feedback at the catheter–blood interface are still areas that urgently need to be addressed. This study provides essential experimental data and mechanical feedback to inform and validate such simulations. Therefore, this article first analyzed the movement form and mechanical state of the catheter and blood vessel during vascular interventional surgery. Based on this, this paper analyzes the movement forms and mechanical states of the catheter and blood vessels during intervention, focusing on the contact force between the catheter and blood vessels. The results of the three-point bending test indicate that the bending deformation force of the tube increases as the radius decreases, and the overall deformation progresses from elastic deformation to the yield limit. The normal force of the tube on the lumen and the average push–pull force at the end of the tube are all positively correlated with the moving speed and bending degree of the tube. Statistical analysis revealed that the degree of lumen curvature had a significantly greater influence on the push–pull force than catheter motion speed. The above research provides guidance for friction at the medical device–vessel interface and coating design. Full article

Rapid advancements in surveying technology have necessitated the development of more accurate and efficient tools. Leica Geosystems AG (Heerbrugg, Switzerland), a leading provider of measurement and surveying solutions, has initiated a study to enhance the capabilities of its GNSS INS-based surveying systems. This research focuses on integrating the Leica GS18 I GNSS receiver and the AP20 AutoPole with a Time of Flight (ToF) camera through sensor fusion. The primary objective is to leverage the unique strengths of each device to improve accuracy, efficiency, and usability in challenging surveying environments. Results indicate that the fused AP20 configuration achieves decimetre-level accuracy (2.7–4.4 cm on signalized points; 5.2–20.0 cm on natural features). In contrast, the GS18 I fused configuration shows significantly higher errors (17.5–26.6 cm on signalized points; 16.1–69.4 cm on natural features), suggesting suboptimal spatio-temporal fusion. These findings confirm that the fused AP20 configuration demonstrates superior accuracy in challenging GNSS conditions compared to the GS18 I setup with deviations within acceptable limits for most practical applications, while highlighting the need for further refinement of the GS18 I configuration. Full article

This study evaluates the morphological performance of the CardioBAN wearable electrocardiogram (ECG) device by comparing its beat-level waveform accuracy against a clinically certified reference system (GE Vivid E9). A cycle-by-cycle Dynamic Time Warping (DTW) analysis was employed to assess beat-level waveform similarity between both devices in 17 healthy participants under controlled conditions. Each cardiac cycle from CardioBAN was aligned to its reference counterpart, enabling a fine-grained comparison of waveform shape. The resulting DTW distances (mean 0.493 ± 0.166) demonstrated overall high morphological agreement, with lower values occurring in recordings with stable beat morphology and higher values primarily reflecting normal variability related to minor motion artifacts or electrode–skin impedance fluctuations. A complementary Bland–Altman analysis of point-wise amplitude differences after DTW alignment showed minimal bias (0.079) and narrow limits of agreement (−0.897–1.055), confirming strong amplitude concordance between systems. These findings indicate that the CardioBAN wearable reliably reproduces key ECG morphological features under controlled, short-term recording conditions. Further studies encompassing ambulatory environments and clinical populations are needed to evaluate its suitability for real-world and pathological scenarios. Full article

Alzheimer’s Disease (AD) is one of the most commonly seen neurodegenerative disorders, where early detection of its biomarkers is crucial for effective management. Conventional diagnostic methods are often expensive, time-consuming, and highly complex, which highlights an urgent need for point-of-care biosensing technology. In this work, we developed assays on three-dimensional (3D) graphene foam electrodes by functionalising them with a 1-Pyrenebutyric acid N-hydroxysuccinimide ester (Pyr-NHS) to enable effective antibody immobilisation for the detection of amyloid beta peptides (Aβ42 and Aβ40), key biomarkers for AD. Pyr-NHS linkers were used for stable functionalisation, followed by binding with Aβ42 and Aβ40 antibodies, and then bovine serum albumin (BSA) was employed as a blocking agent to minimise non-specific bindings on the electrode surface. Differential Pulse Voltammetry (DPV) measurements showed satisfactory stability over 12 days (RDS upper limit was <10%) and highly sensitive and specific detection of Aβ42 and Aβ40, with insignificant interference of tau217 protein. The biosensor exhibited a low limit of detection (LOD) with 252 aM for Aβ42 and 395 aM for Aβ40, covering 0.125 fM–1 nM and 0.125 fM–100 pM linear ranges, respectively. Further validation was conducted on spiked-diluted human plasma. This excellent analytical performance was attributed to the stable Pyr-NHS functionalisation, the 3D graphene foam enabling superior conductivity and a larger surface area on the working electrode, and the optimisation of antibody concentration for immobilisation. These promising results suggest that 3D graphene foam-based biosensors have considerable potential for early detection of AD biomarkers and developing cost-effective, portable, and reliable point-of-care devices. Full article

Rural teachers often face systemic barriers that limit their ability to engage in technology-integrated pedagogy despite growing global emphasis on digital education. This study examined the digital training needs, tool proficiency, and institutional support requirements of Grade 8–12 teachers in the rural Libangeni Circuit, Mpumalanga, South Africa. Guided by Desimone’s Teacher Professional Development framework and Clarke and Hollingsworth’s Interconnected Model of Teacher Professional Growth, a quantitative descriptive survey was conducted with 85 teachers using an online questionnaire. Data captured digital tool usage, perceived proficiency, training demands, and support preferences, and were analysed using descriptive statistics and thematic coding. Teachers reported confidence in basic tools such as Microsoft Word and PowerPoint, but low proficiency in collaborative and data-oriented platforms like Teams, Excel, and online assessment tools. Demand for training aligned closely with areas of low confidence, reflecting a growth-oriented mindset. Age, gender, and experience influenced access patterns, with female and older teachers often reliant on mobile devices. Institutional barriers included inadequate infrastructure and limited data support. The findings highlight the need for differentiated, embedded, and context-sensitive digital training strategies that translate national policy goals into practical classroom-level integration. Full article

Small overall dimensions, intricate geometries, and discontinuous local surface normals characterize complex small workpieces. These features impose stringent requirements on the alignment accuracy of the workpieces when using a profilometer for three-dimensional surface measurement. This paper presents a pre-measurement method based on a reverse projection algorithm. By capturing shadow contours from multiple viewing angles, the three-dimensional pointcloud of the workpiece can be reconstructed. The reconstructed pointcloud is then used to analyze the workpiece pose and guide the path planning of a point-scanning profilometer. Experimental results show that, for a standard sphere with a radius of 12,703 mm, the measured results of the proposed measurement device achieve a fitted radius deviation of 1.8 μm when measuring 70% of the area of the spherical surface. This accuracy meets the precision requirement for guiding the path planning of the profilometer. Furthermore, the measured results from the device are employed to correct the scanning path of a five-axis profilometer for complex workpieces, such as cross-cylinder workpieces, without the need for manual pose adjustment or high-precision fixtures. Full article

Accurate and continuous tracking of athletes is essential to meet the infotainment demands and health and safety requirements of major marathon events. However, the current ability to track individual athletes or groups at mass sporting events is severely limited by the weight, size and cost of the equipment required. In marathons, Radio Frequency Identification (RFID) technology is typically used for timing but can only provide accurate tracking at widely spaced intervals, relying on heuristic and interpolation algorithms to estimate runners’ positions between measurement points. Alternative IOT solutions, such as Low Power Wide Area Network (LWPAN), have limitations in terms of range and require dedicated infrastructure and regulation. Therefore, we analyzed the potential use of smartwatches as accurate and continuous tracking devices for athletes, assessing battery consumption during tracking and standby drain, achievable GPS tracking accuracy and the update rate of data transfer from the device in urban environments. The 4G LTE battery drain is different from non-urban areas. Analysis of standby usage is necessary as devices need to conserve power for tracking. We programmed an application that allowed us to control the modalities of acquisition and transmission intervals, integrating advanced logging and statistics at runtime, and evaluated the achievable results in major marathon events. Our empirical evaluation at the Frankfurt, Athens and Vienna marathons with three different types of smartwatch tracking platforms showed the validity of this approach, while respecting some necessary limitations of the tracking settings. Median battery drain was 5.3%/h in standby before race start (σ 1.5) and 16.5%/h in tracking mode (σ 3.29), with an actual update rate varying between 19 and 57 s on Wear OS devices. The average GPS offset to the track was 4.5 m (σ 8.7). Future work will focus on integrating these consumer devices with existing time and tracking infrastructure. Full article