Search Results (81)

Deep retrofits are one of the few pathways to decarbonize the existing building stock while simultaneously improving climate resilience. These retrofits improve insulation, airtightness, and mechanical equipment efficiency. NRCan’s Prefabricated Exterior Energy Retrofit (PEER) project developed prefabricated building envelope retrofit solutions to enable net-zero performance. The PEER process was demonstrated on two different pilot projects completed between 2017 and 2023. In 2024, in partnership with industry partners, NRCan developed new low-carbon retrofit panel designs and completed a pilot project to evaluate their performance and better understand resiliency and occupant comfort post-retrofit. The Low-Carbon Climate-Resilient (LCCR) Living Lab pilot retrofit was completed in 2024 in Ottawa, Canada, using low-carbon PEER panels. This paper outlines the design and construction for the pilot, including panel designs, the retrofitting process, and post-retrofit building and envelope commissioning. The retrofitting process included the design and installation of new prefabricated exterior retrofitted panels for the walls and the roof. These panels were insulated with cellulose, wood fibre, hemp, and chopped straw. During construction, blower door testing and infrared imaging were conducted to identify air leakage paths and thermal bridges in the enclosure. The retrofit envelope thermal resistance is RSI 7.0 walls, RSI 10.5 roof, and an RSI 3.5 floor with 0.80 W/m²·K U-factor high-gain windows. The measured normalized leakage area @10Pa was 0.074 cm²/m². The net carbon stored during retrofitting was over 1480 kg CO₂. Monitoring equipment was placed within the LCCR to enable the validation of hygrothermal models for heat, air, and moisture transport, and energy, comfort, and climate resilience models. Full article

This research investigates the integration of green cores as central biophilic elements in residential architecture, proposing a climate-responsive design methodology grounded in architectural optimization. The study begins with the full-scale refurbishment of a compact urban apartment, wherein interior partitions, fenestration and material systems were reconfigured to embed vegetated zones within the architectural core. Light exposure, ventilation potential and spatial coherence were maximized through data-driven design strategies and structural modifications. Integrated planting modules equipped with PAR-specific LED systems ensure sustained vegetation growth, while embedded environmental infrastructure supports automated irrigation and continuous microclimate monitoring. This plant-centered spatial model is evaluated using quantifiable performance metrics, establishing a replicable framework for optimized indoor ecosystems. Photosynthetically active radiation (PAR)-specific LED systems and embedded environmental infrastructure were incorporated to maintain vegetation viability and enable microclimate regulation. A programmable irrigation system linked to environmental sensors allows automated resource management, ensuring efficient plant sustenance. The configuration is assessed using measurable indicators such as daylight factor, solar exposure, passive thermal behavior and similar elements. Additionally, a post-occupancy expert assessment was conducted with several architects evaluating different aspects confirming the architectural and spatial improvements achieved through the refurbishment. This study not only demonstrates a viable architectural prototype but also opens future avenues for the development of metabolically active buildings, integration with decentralized energy and water systems, and the computational optimization of living infrastructure across varying climatic zones. Full article

Background/Objectives: Hepatitis B virus (HBV) remains a persistent challenge for transfusion safety. Although testing for hepatitis B surface antigen (HBsAg) and nucleic acid testing (NAT) reduces transmission risk, antibodies to hepatitis B core antigen (anti-HBc) and antibodies to hepatitis B surface antigen (anti-HBs) provide additional insight into past infection and vaccine-induced immunity. We aimed to determine their seroprevalence among blood donors in southern Croatia and assess associations with age, occupation, and time since vaccination. Methods: This cross-sectional study was conducted between February and November 2024 at two regional transfusion centers in southern Croatia. A total of 1008 voluntary blood donors, all HBsAg- and NAT-negative, were tested for anti-HBc and anti-HBs using chemiluminescent microparticle immunoassay. Demographic and vaccination data were collected through verified medical records. Results: Anti-HBc was detected in 0.5% of donors, exclusively among the unvaccinated. Protective anti-HBs levels were found in 38.1% overall and 70.6% of vaccinated donors, with significant declines by age and more than 15 years post-vaccination (p = 0.024). Healthcare workers showed higher seroprotection than non-healthcare donors (67.0% vs. 35.1%; p < 0.001), although one-third still lacked protective levels. Conclusions: HBV exposure was rare, but waning vaccine-induced immunity was evident, with protective anti-HBs levels in 70.6% of vaccinated donors, declining with age and time since vaccination. These findings highlight the need for periodic monitoring of anti-HBs and targeted booster strategies, especially in older and occupationally exposed groups. HBsAg and NAT provide a high level of transfusion safety, while the role of routine anti-HBc testing in this low-endemic context should be carefully evaluated in view of its potential benefits and drawbacks. Donor-based surveillance is a valuable tool for evaluating long-term vaccine effectiveness and guiding public health policy. Full article

This Scoping Review (ScR) synthesizes advances in architectural eye-tracking (ET) research published between 2010 and 2024. Drawing on 75 peer-reviewed studies that met clear inclusion criteria, it monitors the field’s rapid expansion, from only 20 experiments before 2018, to more than 45 new investigations in the three years thereafter, situating these developments within the longer historical evolution of ET hardware and analytical paradigms. The review maps 13 recurrent areas of application, focusing on design evaluation, wayfinding and spatial navigation, end-user experience, and architectural education. Across these domains, ET reliably reveals where occupants focus, for how long, and in what sequence, providing objective evidence that complements designer intuition and conventional post-occupancy surveys. Experts and novices might display distinct gaze signatures; for example, architects spend longer fixating on contextual and structural cues, whereas lay users dwell on decorative details, highlighting possible pedagogical opportunities. Despite these benefits, persistent challenges include data loss in dynamic or outdoor settings, calibration drift, single-user hardware constraints, and the need to triangulate gaze metrics with cognitive or affective measures. Future research directions emphasize integrating ET with virtual or augmented reality (VR) (AR) to validate design interactively, improving mobile tracking accuracy, and establishing shared datasets to enable replication and meta-analysis. Overall, the study demonstrates that ET is maturing into an indispensable, evidence-based lens for creating more intuitive, legible, and human-centered architecture. Full article

The growing interest in smart buildings and the integration of IoT-based technologies is driving the development of new tools for monitoring and optimizing indoor environmental quality (IEQ). However, many existing solutions remain expensive, invasive and inflexible. This paper presents the design and validation of a compact, low-cost, and real-time sensor system, conceived for seamless integration into indoor environments. The system measures key parameters—including air temperature, relative humidity, illuminance, air quality, and sound pressure level—and is embeddable in standard office equipment with minimal impact. Leveraging 3D printing and open-source hardware/software, the proposed solution offers high affordability (approx. EUR 33), scalability, and potential for workspace retrofits. To assess the system’s performance and relevance, dynamic simulations were conducted to evaluate metrics such as the Mean Radiant Temperature (MRT) and illuminance in an open office layout. In addition, field tests with a functional prototype enabled model validation through on-site measured data. The results highlighted significant local discrepancies—up to 6.9 °C in MRT and 28 klx in illuminance—compared to average conditions, with direct implications for thermal and visual comfort. These findings demonstrate the system’s capacity to support high-resolution environmental monitoring within IoT-enabled buildings, offering a practical path toward the data-driven optimization of occupant comfort and energy efficiency. Full article

The integration of Mechanical Ventilation with Heat Recovery (MVHR) systems into heritage buildings poses a series of challenges, largely attributable to architectural constraints and conservation requirements. The present study offers an operational campaign of an MVHR system installed during the energy retrofit of a protected residential heritage dwelling in Vitoria-Gasteiz, Spain. Although environmental monitoring was carried out throughout the year, representative spring, autumn and winter days of continuous operation were analysed, as the occupants frequently avoided using the system due to noise perception. This limitation highlights the importance of considering acoustic comfort and user acceptance as critical factors in the long-term viability of MVHR in heritage contexts. The system was assessed under real-life conditions using continuous environmental monitoring, with a focus on indoor air quality (IAQ), thermal efficiency, airflow balance, and pressure losses. Despite the acceptable mean apparent thermal effectiveness (0.74) and total useful efficiency (0.96), the system’s performance was found to be constrained by significant flow imbalance (up to 106%) and elevated pressure drops, which were attributed to the legacy of the duct geometry. The results obtained demonstrate IAQ improved overall, with mean CO₂ concentrations below ~650 ppm across the analysed dataset; however, daily means occasionally exceeded 900–1000 ppm during high-occupancy periods and in the absence of spatially distributed demand control. These exceedances are consistent with the measured outdoor baseline (~400–450 ppm) and reflect the need for post-commissioning balancing and room-level sensing to sustain Category II performance in heritage dwellings. This study provides empirical evidence on the limitations and opportunities of MVHR deployment in historic retrofits, thus informing future guidelines for sustainable interventions in heritage contexts. Full article

Background: Healthcare workers face multiple, interlinked occupational health risks—burnout, post-COVID-19 sequelae (Long COVID), and extended medical leave. These outcomes often share predictors, contribute to each other, and, together, impact workforce capacity. Yet, existing tools typically address them in isolation. Objective: The objective of this study to develop and deploy an integrated, explainable artificial intelligence (AI) framework that predicts these three outcomes using the same structured occupational health dataset, enabling unified workforce risk monitoring. Methods: We analyzed data from 1244 Romanian healthcare professionals with 14 demographic, occupational, lifestyle, and comorbidity features. For each outcome, we trained a separate predictive model within a common framework: (1) a lightweight transformer neural network with hyperparameter optimization, (2) a transformer with multi-head attention, and (3) a stacked ensemble combining transformer, XGBoost, and logistic regression. The data were SMOTE-balanced and evaluated on held-out test sets using Accuracy, ROC-AUC, and F1-score, with 10,000-iteration bootstrap testing for statistical significance. Results: The stacked ensemble achieved the highest performance: ROC AUC = 0.70 (burnout), 0.93 (Long COVID), and 0.93 (extended leave). The F1 scores were >0.89 for Long COVID and extended leave, whereas the performance gains for burnout were comparatively modest, reflecting the multidimensional and heterogeneous nature of burnout as a binary construct. The gains over logistic regression were statistically significant (p < 0.0001 for Long COVID and extended leave; p = 0.0355 for burnout). The SHAP analysis identified overlapping top predictors—tenure, age, job role, cancer history, pulmonary disease, and obesity—supporting the value of a unified framework. Conclusions: We trained separate models for each occupational health risk but deployed them in a single, real-time web application. This integrated approach improves efficiency, enables multi-outcome workforce surveillance, and supports proactive interventions in healthcare settings. Full article

Background/Objective: Puberphonia is a voice disorder characterized by the persistence of a high-pitched voice in sexually mature males. In phoniatrics and speech-language pathology, it is also known as post-mutational voice instability, mutational falsetto, persistent fistulous voice, or functional falsetto. The absence of an age-appropriate vocal pitch may adversely affect psychological well-being and hinder personal, social, and occupational functioning. The aim of this study was to evaluate of the impact of phoniatric and logopedic rehabilitation on voice quality in patients with puberphonia. Methods: The study included 18 male patients, aged 16 to 34 years, rehabilitated for voice mutation disorders. Phoniatric and logopedic rehabilitation included voice therapy tailored to each subject. A logopedist led exercises aimed at lowering and stabilizing the pitch of the voice and improving its quality. A phoniatrician supervised the therapy, monitoring the condition of the vocal apparatus and providing additional diagnostic and therapeutic recommendations as needed. The duration and intensity of the therapy were adjusted for each patient. Before and after voice rehabilitation, the subjects completed the following questionnaires: the Voice Handicap Index (VHI), the Vocal Tract Discomfort (VTD) scale, and the Voice-Related Quality of Life (V-RQOL). They also underwent an acoustic voice analysis. Results: Statistical analysis of the VHI, VTD, and V-RQOL scores, as well as the voice’s acoustic parameters, showed statistically significant differences before and after rehabilitation (p < 0.005). Conclusions: Phoniatric and logopedic rehabilitation is an effective method of reducing and maintaining a stable, euphonic male voice in patients with functional puberphonia. Effective voice therapy positively impacts selected aspects of psychosocial functioning reported by patients, improves voice-related quality of life, and reduces physical discomfort in the vocal tract. Full article

Background: The long-term impact of SARS-CoV-2 infection on pulmonary function remains insufficiently characterised, particularly among individuals who have experienced mild or asymptomatic disease. This study aimed to assess spirometric changes over a three-year period and evaluate potential associations with demographic and clinical variables. Methods: We retrospectively analysed spirometry data from 103 healthcare workers (HCWs) who underwent pulmonary function tests at three time points: before the pandemic (Time 0), one year post-pandemic (Time 1), and two years post-pandemic (Time 2). Linear regression models were employed to evaluate the impact of various factors, including age, BMI, gender, smoking status, history of SARS-CoV-2 infection, vaccination status prior to infection, and the number of infections, on changes in FVC and FEV₁. Results: A statistically significant decrease in both FVC and FEV₁ were observed at Time 1 and Time 2 compared to baseline (p < 0.05). Smoking habits were significantly associated with a greater decline in both FVC and FEV₁. Multiple infections were associated with larger reductions in FVC at Time 1. No significant associations were found with age, gender, BMI, or vaccination status. Even in the absence of severe symptoms of the disease, healthcare workers exhibited a measurable decline in pulmonary function over time. Smoking and reinfection emerged as relevant factors associated with reduced lung capacity. Conclusions: These findings emphasise the need for ongoing respiratory monitoring in occupational settings and the importance of targeted preventive measures. Full article

Earth–air heat exchangers (EAHXs) use the soil’s thermal capacity to dampen the amplitude of outdoor air temperature oscillations. This effect can be used in hot and dry climates for room cooling with no or very little need for resources other than those used during the EAHX construction, an obvious advantage compared to the significant operational costs of refrigeration machines. Contrary to the streamlined process applied in conventional HVAC design (using refrigeration machines), EAHX design lacks straightforward and well-established rules; moreover, EAHXs struggle to achieve office room design cooling demands determined with conventional indoor thermal environment standards, hindering designers’ confidence and the wider adoption of EAHXs for standalone room cooling. This paper presents a graph-based method to assist in the design of a large-diameter EAHX. One year of post-occupancy monitoring data are used to evaluate this method and to investigate the performance of a large-diameter EAHX with up to 16,000 m³/h design airflow rate. Considering an adaptive standard for thermal comfort, peak EAHX cooling capacity of 28 kW (330 kWh/day, with just 50 kWh/day of fan electricity consumption) and office room load extraction of up to 22 kW (49 W/m²) provided evidence in support of standalone use of EAHX for room cooling. A fair fit between actual EAHX thermal performance and results obtained with the graph-based design method support the use of this method for large-diameter EAHX design. Full article

Background: High-voltage electrical injuries (HVEIs) represent a complex and life-threatening entity, frequently involving multi-organ damage. While traditionally linked to occupational hazards, train surfing—riding on moving trains—and train climbing—scaling stationary carriages—have emerged as increasingly common causes among adolescents. Popularized via social media, these behaviors expose individuals to the invisible danger of electric arcs from 15,000-volt railway lines, often resulting in extensive burns, cardiac complications, and severe trauma. This study presents a 30-year retrospective analysis comparing cardiac biomarkers and clinical outcomes in train-surfing injuries versus work-related HVEIs. Methods: All patients with confirmed high-voltage injury (≥1000 volts) admitted to a Level 1 burn center between 1994 and 2024 were retrospectively analyzed. Exclusion criteria comprised low-voltage trauma, suicide, incomplete records, and external treatment. Clinical and laboratory parameters—including total body surface area (TBSA), Abbreviated Burn Severity Index (ABSI), electrocardiogram (ECG) findings, intensive care unit (ICU) and hospital stay, mortality, and cardiac biomarkers (creatine kinase [CK], CK-MB, lactate dehydrogenase [LDH], aspartate transaminase [AST], troponin, and myoglobin)—were compared between the two cohorts. Results: Of 81 patients, 24 sustained train-surfing injuries and 57 were injured in occupational settings. Train surfers were significantly younger (mean 16.7 vs. 35.2 years, p = 0.008), presented with greater TBSA (49.9% vs. 17.9%, p = 0.008), higher ABSI scores (7.3 vs. 5.1, p = 0.008), longer ICU stays (53 vs. 17 days, p = 0.008), and higher mortality (20.8% vs. 3.5%). ECG abnormalities were observed in 51% of all cases, without significant group differences. However, all cardiac biomarkers were significantly elevated in train-surfing injuries at both 72 h and 10 days post-injury (p < 0.05), suggesting more pronounced cardiac and muscular damage. Conclusions: Train-surfing-related high-voltage injuries are associated with markedly more severe systemic and cardiac complications than occupational HVEIs. The significant biomarker elevation and critical care demands highlight the urgent need for targeted prevention, public awareness, and early cardiac monitoring in this high-risk adolescent population. Full article

Firefighting is a physically, mentally, and emotionally demanding occupation. These demands are exacerbated by an increase in workload, resulting in an increase in stress and a decrease in recovery. While researchers have examined the influence of workload on stress perceptions, little is known about firefighter perceptions of recovery generally, and no research investigating perceptions of holistic recovery (i.e., physical, mental, and emotional) exists. The purpose of this study was to determine the association between acute workload (i.e., call volume) and firefighter perceptions of stress and recovery from pre-shift to post-shift. Sixteen active-duty firefighters completed the Short Recovery and Stress Scale pre- and post-shift and reported call volume after every shift (N = 156 total shifts). Repeated measures correlations were used to examine the common intraindividual associations between pre- to post-shift perceptions of recovery and stress and call volume. Results indicated that as call volume increased, firefighters perceived themselves to be significantly less recovered overall [r_rm (139) = −0.22, p < 0.001], physically [r_rm (139) = −0.31, p < 0.001], mentally [r_rm (139) = −0.26, p < 0.001], and emotionally [r_rm (139) = −0.27, p < 0.005] and significantly more stressed overall [r_rm (139) = 0.28, p < 0.001], mentally [r_rm (139) = 0.25, p < 0.005], and emotionally [r_rm (139) = 0.21, p = 0.012] post-shift compared to pre-shift. These findings suggest that to optimize firefighter health and well-being, practitioners should monitor call volume and implement appropriate physical, mental, and/or emotional recovery interventions. Full article

Indoor environmental quality (IEQ) of higher education (HE) buildings significantly impacts the built environment sector. This research aimed to optimize learning environments and enhance student comfort, especially post-COVID-19. The study adopts the principles of Post-occupancy Evaluation (POE) to collect and analyze various quantitative and qualitative data through environmental data monitoring, a user perceptions survey, and semi-structured interviews with professionals. Although the environmental conditions generally met existing standards, the findings indicated opportunities for further improvements to better support university communities’ comfort and health. A significant challenge identified by this research is the inability of the facility management to physically manage and operate the vast and complex spaces within HE buildings with contemporary IEQ standards. In response to these findings, this research developed a BIM-based prototype for the real-time monitoring and automated control of IEQ. The prototype integrates a BIM model with Arduino-linked sensors, motors, and traffic lights, with the latter visually indicating IEQ status, while motors automatically adjust environmental conditions based on sensor inputs. The outcomes of this study not only contribute to the ongoing discourse on sustainable building management, especially post-pandemic, but also demonstrate an advancement in the application of BIM technologies to improve IEQ and by extension, occupant wellbeing in HE buildings. Full article

Neck of femur (NOF) fractures are a critical orthopaedic emergency with a high morbidity and mortality prevalence, particularly in people living with Human Immunodeficiency Virus (PLWHIV). A combination of HIV infection, combined antiretroviral therapy (cART), and compromised bone health further increases the risk of fragility fractures. Additionally, HIV-related immune dysfunction, cART-induced osteoporosis, and perioperative infection risks further pose challenges in ongoing surgical management. Despite the rising global prevalence of PLWHIV, no specific guidelines exist for the perioperative and post-operative care of PLWHIV undergoing NOF fracture surgery. This narrative review synthesises the current literature on the surgical management of NOF fractures in PLWHIV, focusing on pre-operative considerations, intraoperative strategies, post-operative complications, and long-term outcomes. It also explores infection control, fracture healing dynamics, and ART’s impact on surgical outcomes while identifying key research gaps. A systematic database search (PubMed, Embase, Cochrane Library) identified relevant studies published up to February 2025. Inclusion criteria encompassed studies on incidence, risk factors, ART impact, and NOF fracture outcomes in PLWHIV. Data were analysed to summarise findings and highlight knowledge gaps. Pre-operative care: Optimisation involves assessing immune status (namely, CD4 counts and HIV-1 viral loads), bone health, and cART to minimise surgical risk. Immunodeficiency increases surgical site and periprosthetic infection risks, necessitating potential enhanced antibiotic prophylaxis and close monitoring of potential start/switch/stopping of such therapies. Surgical management of neck of femur (NOF) fractures in PLWHIV should be individualised based on fracture type (intracapsular or extracapsular), age, immune status, bone quality, and functional status. Extracapsular fractures are generally managed with internal fixation using dynamic hip screws or intramedullary nails. For intracapsular fractures, internal fixation may be appropriate for younger patients with good bone quality, though there is an increased risk of non-union in this group. Hemiarthroplasty is typically favoured in older or frailer individuals, offering reduced surgical stress and lower operative time. Total hip arthroplasty (THA) is considered for active patients or those with pre-existing hip joint disease but carries a higher infection risk in immunocompromised individuals. Multidisciplinary evaluation is critical in guiding the most suitable surgical approach for PLWHIV. Importantly, post-operative care carries the risk of higher infection rates, requiring prolonged antibiotic use and wound surveillance. Antiretroviral therapy (ART) contributes to bone demineralisation and chronic inflammation, increasing delayed union healing and non-union risk. HIV-related frailty, neurocognitive impairment, and socioeconomic barriers hinder rehabilitation, affecting recovery. The management of NOF fractures in PLWHIV requires a multidisciplinary, patient-centred approach ideally comprising a team of Orthopaedic surgeon, HIV Physician, Orthogeriatric care, Physiotherapy, Occupational Health, Dietitian, Pharmacist, Psychologist, and related Social Care. Optimising cART, tailoring surgical strategies, and enforcing strict infection control can improve outcomes. Further high-quality studies and randomised controlled trials (RCTs) are essential to develop evidence-based guidelines. Full article

Wildfires are increasing in extent and severity under anthropogenic climate change, with potential adverse impacts on native pollinators like wild bees. In 2019/2020, wildfires burned swathes of the Australian bushland. Whilst herbaceous angiosperms may flower in the post-fire environment, providing sustenance to native bees, pre-made holes created by wood-boring beetles that obligate cavity-nesting “renter” bees may take a longer time to recover. This may prevent native bees from colonising new areas or reduce the populations that have survived. To date, trap-nests, also known as bee hotels, have never been used as a tool to assist in providing nesting resources in post-fire environments. The project “Bee hotels to boost bees after bushfires” supported the recovery of native bee populations by installing artificial nesting substrates (bee hotels) in areas of high biodiversity value that were impacted by the 2019/2020 bushfires. This was achieved through monitoring of 1000 bee hotels (500 bamboo and 500 wooden) and visual surveys at five burnt sites and three control sites (nearby burnt sites without bee hotels) by a native bee ecologist from September–March 2021/2022. The bee hotel uptake was low initially, but by March, all hotels were occupied. Over 800 nests were created by bees in the bee hotels installed for this project and significantly more bees were observed in sites with bee hotels compared to control sites. Across sites, there was a significant negative association between honeybee density and nest occupancy, suggesting honeybees may be exerting competitive pressure on native bees in post-fire habitats. In conclusion, bee hotels, if designed correctly, can aid in boosting cavity-nesting bee populations following fires. Full article