Search Results (1,135)

Stroke is a significant global health concern characterized by the abrupt disruption of cerebral blood flow, leading to neurological impairment. Accurate and timely diagnosis—enabled by imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI)—is essential for differentiating stroke types and initiating interventions like thrombolysis, thrombectomy, or surgical management. In parallel, recent advancements in wearable technology, particularly smart clothing, offer new opportunities for stroke prevention, real-time monitoring, and rehabilitation. These garments integrate various sensors, including electrocardiogram (ECG) electrodes, electroencephalography (EEG) caps, electromyography (EMG) sensors, and motion or pressure sensors, to continuously track physiological and functional parameters. For example, ECG shirts monitor cardiac rhythm to detect atrial fibrillation, smart socks assess gait asymmetry for early mobility decline, and EEG caps provide data on neurocognitive recovery during rehabilitation. These technologies support personalized care across the stroke continuum, from early risk detection and acute event monitoring to long-term recovery. Integration with AI-driven analytics further enhances diagnostic accuracy and therapy optimization. This narrative review explores the application of smart clothing in conjunction with traditional imaging to improve stroke management and patient outcomes through a more proactive, connected, and patient-centered approach. Full article

Monitoring cardiovascular health enables continuous and real-time risk assessment. This study utilized the Framingham Heart Study dataset to develop and evaluate machine-learning models for predicting mortality risk based on key cardiovascular parameters. Some machine-learning algorithms were applied to multiple machine-learning models. Among these, XGBoost achieved the highest predictive performance, each with an area under the curve (AUC) value of 0.83. Feature importance analysis revealed that coronary artery disease, glucose levels, and diastolic blood pressure (DIABP) were the most significant risk factors associated with mortality. The primary contribution of this research lies in its implications for public health and preventive medicine. By identifying key risk factors, it becomes possible to calculate individual and population-level risk scores and to design targeted early intervention strategies aimed at reducing cardiovascular-related mortality. Full article

Despite growing global momentum to reduce the number of children who never received a dose of any vaccine, i.e., zero-dose (ZD) children, persistent geographic and social inequities continue to undermine progress toward universal immunization coverage. In Madagascar, where routine vaccination coverage remains below 50% in most regions, the non-governmental organization Doctors for Madagascar and public sector partners are implementing the SOAMEVA program: a targeted community-based initiative to identify and reach ZD children in sixteen underserved districts in the country’s south. This paper outlines the equity-sensitive evaluation design developed to assess the implementation and impact of SOAMEVA. It presents a forward-looking evaluation framework that integrates both quantitative program monitoring and qualitative community insights. By focusing at the fokontany level—the smallest administrative unit in Madagascar—the evaluation captures small-scale variation in ZD prevalence and program reach, allowing for a detailed analysis of disparities often masked in aggregated data. Importantly, the evaluation includes structured feedback loops with community health workers and caregivers, surfacing local knowledge on barriers to immunization access and program adoption. It also tracks real-time adaptations to implementation strategy across diverse contexts, offering insight into how routine immunization programs can be made more responsive, sustainable, and equitable. We propose eight design principles for conducting equity-sensitive evaluation of immunization programs in similar fragile settings. Full article

Male infertility is a multifactorial condition often associated with disruptions in sperm metabolism and mitochondrial function, yet traditional semen analysis provides limited insight into these molecular mechanisms. Understanding sperm bioenergetics and metabolic dysfunctions is crucial for improving the diagnosis and treatment of conditions such as asthenozoospermia and azoospermia. This systematic review synthesizes recent literature, focusing on advanced tools and techniques—including omics technologies, advanced imaging, spectroscopy, and functional assays—that enable comprehensive molecular assessment of sperm metabolism and development. The reviewed studies highlight the effectiveness of metabolomics, proteomics, and transcriptomics in identifying metabolic biomarkers linked to male infertility. Non-invasive imaging modalities such as Raman and magnetic resonance spectroscopy offer real-time metabolic profiling, while the seminal microbiome is increasingly recognized for its role in modulating sperm metabolic health. Despite these advances, challenges remain in clinical validation and implementation of these techniques in routine infertility diagnostics. Integrating molecular metabolic assessments with conventional semen analysis promises enhanced diagnostic precision and personalized therapeutic approaches, ultimately improving reproductive outcomes. Continued research is needed to standardize biomarkers and validate clinical utility. Furthermore, these metabolic tools hold significant potential to elucidate the underlying causes of previously misunderstood and unexplained infertility cases, offering new avenues for diagnosis and treatment. Full article

Background/Objectives: Direct oral anticoagulants (DOACs) are now the guideline-recommended alternative to vitamin K antagonists (VKAs) for long-term anticoagulation in patients with non-valvular atrial fibrillation. However, accurately assessing their impact on ischemic stroke outcomes remains challenging, primarily due to uncertainty regarding anticoagulation status at the time of hospital admission. This preliminary study addresses this gap by using point-of-care testing (POCT) to confirm DOAC activity at bedside, allowing for a more accurate comparison of 90-day functional outcomes between anticoagulated and non-anticoagulated stroke patients. Methods: We conducted a retrospective cohort study of 786 ischemic stroke patients admitted to the University of Pécs between February 2023 and February 2025. Active DOAC therapy was confirmed using the ClotPro^® viscoelastic testing platform, with ecarin Clotting Time (ECT) employed for thrombin inhibitors and Russell’s Viper Venom (RVV) assays for factor Xa inhibitors. Patients were categorized as non-anticoagulated (n = 767) or DOAC-treated with confirmed activity (n = 19). Mahalanobis distance-based matching was applied to account for confounding variables including age, sex, pre-stroke modified Rankin Scale (mRS), and National Institutes of Health Stroke Scale (NIHSS) scores at admission and 72 h post-stroke. The primary outcome was the change in mRS from baseline to 90 days. Statistical analysis included ordinary least squares (OLS) regression and principal component analysis (PCA). Results: After matching, 90-day functional outcomes were comparable between groups (mean mRS-shift: 2.00 in DOAC-treated vs. 1.78 in non-anticoagulated; p = 0.745). OLS regression showed no significant association between DOAC status and recovery (p = 0.599). In contrast, NIHSS score at 72 h (p = 0.004) and age (p = 0.015) were significant predictors of outcome. PCA supported these findings, identifying stroke severity as the primary driver of outcome. Conclusions: This preliminary analysis suggests that ischemic stroke patients with confirmed active DOAC therapy at admission may achieve 90-day functional outcomes comparable to those of non-anticoagulated patients. The integration of bedside POCT enhances the reliability of anticoagulation assessment and underscores its clinical value for real-time management in acute stroke care. Larger prospective studies are needed to validate these findings and to further refine treatment strategies. Full article

The relationship between temperature and mortality is well-documented, yet most existing studies assume this relationship remains static over time. This study investigates whether the temperature-mortality association in Chicago from 1987 to 2000 has changed in shape or location of key features, such as change points. We apply nonparametric regression techniques to estimate the temperature-mortality functions for each year using daily mortality and temperature data from the National Morbidity, Mortality, and Air Pollution Study (NMMAPS) database. A permutation-based test is used to assess whether the shapes of these functions differ across time, while a bootstrap procedure evaluates the consistency of change points. Intensive simulation studies are conducted to evaluate the permutation-based test and bootstrap procedure based on Type I error and power. The proposed tests are compared with F tests in terms of Type I error and power. For the real data set, the analysis finds significant variation in the functional shapes across years, indicating evolving mortality responses to temperature. However, the estimated change points—temperatures associated with peak mortality—remain statistically consistent. These findings suggest that while the population’s overall vulnerability pattern may shift, the temperature threshold linked to maximum mortality has remained stable. This study contributes to understanding the temporal dynamics of climate-sensitive health outcomes and highlights the importance of flexible modeling in public health and climate adaptation planning. Full article

This paper presents the design, implementation, and experimental validation of a Condition Monitoring (CM) circuit for SiC-based Power Electronics Converters (PECs). The paper leverages in situ drain–source resistance (R_ds,on) measurements, interfaced with cloud connectivity for data processing and lifetime assessment, addressing key limitations in current state-of-the-art (SOTA) methods. Traditional approaches rely on expensive data acquisition systems under controlled laboratory conditions, making them unsuitable for real-world applications due to component variability, time delay, and noise sensitivity. Furthermore, these methods lack cloud interfacing for real-time data analysis and fail to provide comprehensive reliability metrics such as Remaining Useful Life (RUL). Additionally, the proposed CM method benefits from noise mitigation during switching transitions by utilizing delay circuits to ensure stable and accurate data capture. Moreover, collected data are transmitted to the cloud for long-term health assessment and damage evaluation. In this paper, experimental validation follows a structured design involving signal acquisition, filtering, cloud transmission, and temperature and thermal degradation tracking. Experimental testing has been conducted at different temperatures and operating conditions, considering coolant temperature variations (40 °C to 80 °C), and an output power of 7 kW. Results have demonstrated a clear correlation between temperature rise and R_ds,on variations, validating the ability of the proposed method to predict device degradation. Finally, by leveraging cloud computing, this work provides a practical solution for real-world Wide Band Gap (WBG)-based PEC reliability and lifetime assessment. Full article

Background: Toxoplasma gondii is a globally widespread parasite responsible for toxoplasmosis, a zoonotic disease with significant impact on both human and animal health. The current lack of safe and effective treatments underscores the need for new drugs. Earlier, thiosemicarbazones (TSCs) and their metal complexes have shown promising activities against T. gondii. This study evaluated a gold (III) complex C3 and its TSC ligand C4 for safety in host immune cells and zebrafish embryos, followed by efficacy assessment in a murine model for chronic toxoplasmosis. Methods: The effects on viability and proliferation of murine splenocytes were determined using Alamar Blue assay and BrdU ELISA, and potential effects of the drugs on zebrafish (Danio rerio) embryos were detected through daily light microscopical inspection within the first 96 h of embryo development. The parasite burden in treated versus non-treated mice was measured by quantitative real-time PCR in the brain, eyes and the heart. Results: Neither compound showed immunosuppressive effects on the host immune cells but displayed dose-dependent toxicity on early zebrafish embryo development, suggesting that these compounds should not be applied in pregnant animals. In the murine model of chronic toxoplasmosis, C4 treatment significantly reduced the parasite load in the heart but not in the brain or eyes, while C3 did not have any impact on the parasite load. Conclusions: These results highlight the potential of C4 for further exploration but also the limitations of current approaches in effectively reducing parasite burden in vivo. Full article

Background: Pain is a complex phenomenon characterized by unpleasant experiences with profound heterogeneity influenced by biological, psychological, and social factors. According to the National Health Interview Survey, 50.2 million U.S. adults (20.5%) experience pain on most days, with the annual cost of prescription medication for pain reaching approximately USD 17.8 billion. Theranostic pain nanomedicine therefore emerges as an attractive analgesic strategy with the potential for increased efficacy, reduced side-effects, and treatment personalization. Theranostic nanomedicine combines drug delivery and diagnostic features, allowing for real-time monitoring of analgesic efficacy in vivo using molecular imaging. However, clinical translation of these nanomedicines are challenging due to complex manufacturing methodologies, lack of standardized quality control, and potentially high costs. Quality by Design (QbD) can navigate these challenges and lead to the development of an optimal pain nanomedicine. Our lab previously reported a macrophage-targeted perfluorocarbon nanoemulsion (PFC NE) that demonstrated analgesic efficacy across multiple rodent pain models in both sexes. Here, we report PFC-free, biphasic nanoemulsions formulated with a biocompatible and non-immunogenic plant-based coconut oil loaded with a COX-2 inhibitor and a clinical-grade, indocyanine green (ICG) near-infrared fluorescent (NIRF) dye for parenteral theranostic analgesic nanomedicine. Methods: Critical process parameters and material attributes were identified through the FMECA (Failure, Modes, Effects, and Criticality Analysis) method and optimized using a 3 × 2 full-factorial design of experiments. We investigated the impact of the oil-to-surfactant ratio (w/w) with three different surfactant systems on the colloidal properties of NE. Small-scale (100 mL) batches were manufactured using sonication and microfluidization, and the final formulation was scaled up to 500 mL with microfluidization. The colloidal stability of NE was assessed using dynamic light scattering (DLS) and drug quantification was conducted through reverse-phase HPLC. An in vitro drug release study was conducted using the dialysis bag method, accompanied by HPLC quantification. The formulation was further evaluated for cell viability, cellular uptake, and COX-2 inhibition in the RAW 264.7 macrophage cell line. Results: Nanoemulsion droplet size increased with a higher oil-to-surfactant ratio (w/w) but was no significant impact by the type of surfactant system used. Thermal cycling and serum stability studies confirmed NE colloidal stability upon exposure to high and low temperatures and biological fluids. We also demonstrated the necessity of a solubilizer for long-term fluorescence stability of ICG. The nanoemulsion showed no cellular toxicity and effectively inhibited PGE2 in activated macrophages. Conclusions: To our knowledge, this is the first instance of a celecoxib-loaded theranostic platform developed using a plant-derived hydrocarbon oil, applying the QbD approach that demonstrated COX-2 inhibition. Full article

Cervical cancer remains a major health burden among women in sub-Saharan Africa, where screening is often limited. Persistent high-risk human papillomavirus (HR-HPV) infection is the principal cause, highlighting the need for accurate molecular diagnostics. This cross-sectional study evaluated the analytical performance of one mRNA assay, APTIMA^® HPV assay (APTIMA mRNA), and two DNA-based assays, the Abbott RealTime High Risk HPV assay (Abbott DNA) and Seegene Allplex™ II HPV28 assay (Seegene DNA), in 527 cervical samples from a South African tertiary hospital, focusing on 14 shared HR-HPV genotypes. Seegene DNA yielded the highest detection rate (53.7%), followed by Abbott DNA (48.2%) and APTIMA mRNA (45.2%). APTIMA mRNA showed a strong agreement with Abbott DNA (87.9%, κ = 0.80), 89.9% sensitivity, 91.2% NPV, and the highest accuracy (AUC = 0.8804 vs. 0.8681). The agreement between APTIMA mRNA and Seegene DNA was moderate (83.4%, κ = 0.70), reflecting target differences. Many DNA-positive/mRNA-negative cases likely represent transient infections, though some may be latent with reactivation potential, warranting a follow-up. In resource-constrained settings, prioritizing transcriptionally active infections through mRNA testing may enhance screening efficiency and reduce burden. Scalable, cost-effective assays with strong clinical utility are essential for broadening access and improving cervical cancer prevention. Further studies should assess the integration of mRNA testing into longitudinal screening algorithms. Full article

Visual inspection of civil infrastructure for structural health assessment, as performed by structural engineers, is expensive and time-consuming. Therefore, automating this process is highly attractive, which has received significant attention in recent years. With the increasing capabilities of computers, deep neural networks have become a standard tool and can be used for structural health inspections. A key challenge, however, is the availability of reliable datasets. In this work, the U-net and DeepLab v3+ convolutional neural networks are trained on a synthetic Tokaido dataset. This dataset comprises images representative of data acquired by unmanned aerial vehicle (UAV) imagery and corresponding ground truth data. The data includes semantic segmentation masks for both categorizing structural elements (slabs, beams, and columns) and assessing structural damage (concrete spalling or exposed rebars). Data augmentation, including both image quality degradation (e.g., brightness modification, added noise) and image transformations (e.g., image flipping), is applied to the synthetic dataset. The selected neural network architectures achieve excellent performance, reaching values of 97% for accuracy and 87% for Mean Intersection over Union (mIoU) on the validation data. It also demonstrates promising results in the semantic segmentation of real-world structures captured in photographs, despite being trained solely on synthetic data. Additionally, based on the obtained results of semantic segmentation, it can be concluded that DeepLabV3+ outperforms U-net in structural component identification. However, this is not the case in the damage identification task. Full article

This article presents a comprehensive modeling and simulation framework for a capacitive MEMS accelerometer integrated with a sigma-delta analog-to-digital converter (ADC), with a focus on applications in wearable health and motion monitoring devices. The accelerometer used in the system is connected to a smartphone equipped with dedicated software and will be used to assess the risk of falling, which is crucial for patients with balance disorders. The authors designed the accelerometer with special attention paid to the specification required in a system, where the acceleration is ±2 g and the frequency is 100 Hz. They investigated the sensor’s behavior in the DC, AC, and time domains, capturing both the mechanical response of the proof mass and the resulting changes in output capacitance due to external acceleration. A key component of the simulation is the implementation of a second-order sigma-delta modulator designed to digitize the small capacitance variations generated by the sensor. The Simulink model includes the complete signal path from analog input to quantization, filtering, decimation, and digital-to-analog reconstruction. By combining MEMS+ modeling with MATLAB-based system-level simulations, the workflow offers a fast and flexible alternative to traditional finite element methods and facilitates early-stage design optimization for MEMS sensor systems intended for real-world deployment. Full article

Background: Despite significant advancements in diabetes care, many individuals with type 2 diabetes (T2D) do not receive optimal care and treatment. Digital interventions promoting behavioral changes have shown promising long-term results in supporting healthier lifestyles but are not implemented in most healthcare offerings, maybe due to lack of general practice support and collaboration. This study evaluates the efficacy of the Digital, Individualized, and Collaborative Treatment of T2D in General Practice Based on Decision Aid (DICTA), a randomized controlled trial integrating a patient-centered smartphone application for lifestyle support in conjunction with a clinical decision support (CDS) tool to assist general practitioners (GPs) in optimizing antidiabetic treatment. Methods: The present randomized controlled trial aims to recruit 400 individuals with T2D from approximately 70 GP clinics (GPCs) in Denmark. The GPCs will be cluster-randomized in a 2:3 ratio to intervention or control groups. The intervention group will receive one year of individualized eHealth lifestyle coaching via a smartphone application, guided by patient-reported outcomes (PROs). Alongside this, the GPCs will have access to the CDS tool to optimize pharmacological decision-making through electronic health records. The control group will receive usual care for one year, followed by the same intervention in the second year. Results: The primary outcome is the one-year change in estimated ten-year cardiovascular risk, assessed by SCORE2-Diabetes calculated from age, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol, age at diabetes diagnosis, HbA1c, and eGFR. Conclusions: If effective, DICTA could offer a scalable, digital-first approach for improving T2D management in primary care by combining patient-centered lifestyle coaching with real-time pharmacological clinical decision support. Full article

Rapid and comprehensive assessment of building damage caused by earthquakes is essential for effective emergency response and rescue efforts in the immediate aftermath. Advanced technologies, including real-time simulations, remote sensing, and multi-sensor systems, can effectively enhance situational awareness and structural damage evaluations. However, most existing methods rely on isolated time snapshots, and few studies have systematically explored the continuous, time-scaled integration and update of building damage estimates from multiple data sources. This study proposes a stepwise framework that continuously updates time-scaled, single-damage estimation outputs using the best available multi-sensor data for estimating earthquake-induced building damage. We demonstrated the framework using the 2024 Noto Peninsula Earthquake as a case study and incorporated official damage reports from the Ishikawa Prefectural Government, real-time earthquake building damage estimation (REBDE) data, and satellite-based damage estimation data (ALOS-2-building damage estimation (BDE)). By integrating the REBDE and ALOS-2-BDE datasets, we created a composite damage estimation product (integrated-BDE). These datasets were statistically validated against official damage records. Our framework showed significant improvements in accuracy, as demonstrated by the mean absolute percentage error, when the datasets were integrated and updated over time: 177.2% for REBDE, 58.1% for ALOS-2-BDE, and 25.0% for integrated-BDE. Finally, for stepwise damage estimation, we proposed a methodological framework that incorporates social media content to further confirm the accuracy of damage assessments. Potential supplementary datasets, including data from Internet of Things-enabled home appliances, real-time traffic data, very-high-resolution optical imagery, and structural health monitoring systems, can also be integrated to improve accuracy. The proposed framework is expected to improve the timeliness and accuracy of building damage assessments, foster shared understanding of disaster impacts across stakeholders, and support more effective emergency response planning, resource allocation, and decision-making in the early stages of disaster management in the future, particularly when comprehensive official damage reports are unavailable. Full article

Milk lactose concentration has been proposed as a noninvasive indicator of metabolic health in dairy cows, particularly during early lactation when metabolic demands are elevated. This study aimed to investigate the relationship between milk lactose levels and physiological, biochemical, and behavioral parameters in early-lactation Holstein cows. Twenty-eight clinically healthy cows were divided into two groups: Group 1 (milk lactose < 4.70%, n = 14) and Group 2 (milk lactose ≥ 4.70%, n = 14). Both groups were monitored over a 21-day period using the Brolis HerdLine in-line milk analyzer (Brolis Sensor Technology, Vilnius, Lithuania) and SmaXtec intraruminal boluses (SmaXtec Animal Care Technology^®, Graz, Austria). Parameters including milk yield, milk composition (lactose, fat, protein, and fat-to-protein ratio), blood biomarkers, and behavior were recorded. Cows with higher milk lactose concentrations (≥4.70%) produced significantly more milk (+12.76%) and showed increased water intake (+15.44%), as well as elevated levels of urea (+21.63%), alanine aminotransferase (ALT) (+22.96%), glucose (+4.75%), magnesium (+8.25%), and iron (+13.41%) compared to cows with lower lactose concentrations (<4.70%). A moderate positive correlation was found between milk lactose and urea levels (r = 0.429, p < 0.01), and low but significant correlations were observed with other indicators. These findings support the use of milk lactose concentration as a practical biomarker for assessing metabolic and physiological status in dairy cows, and highlight the value of integrating real-time monitoring technologies in precision livestock management. Full article