Search Results (81)

Urine pH serves as an indicator of systemic acid–base balance and helps detect early-stage urinary and renal disorders. However, conventional monitoring methods rely on instruments or manual procedures, limiting their use among vulnerable groups such as infants and bedridden elderly individuals. In this study, a pH-responsive smart hydrogel was developed and integrated into diapers to enable real-time, equipment-free, and visually interpretable urine pH monitoring. An optimised degumming process enabled one-step preparation of a silk fibroin–sericin aqueous solution. We employed a visible light-induced photo-crosslinking strategy to fabricate a dual-network hydrogel with enhanced strength and stability. Increasing sericin content accelerated gelation (≤15 min) and improved performance, achieving a maximum stress of 54 kPa, strain of 168%, and water absorption of 566%. We incorporated natural anthocyanins and fine-tuned them to produce four distinct colour changes in response to urine pH, with significantly improved colour differentiation (ΔE). Upon contact with urine, the hydrogel displays green within the normal pH range, indicating a healthy state. At the same time, a reddish-purple or blue colour serves as a visual warning of abnormal acidity or alkalinity. This intelligent hydrogel system combines rapid gelation, excellent mechanical properties, and a sensitive visual response, offering a promising platform for body fluid monitoring. Full article

Background: Diaper dermatitis (DD) frequently occurs following pediatric gastrointestinal surgery and may lead to severe morbidity despite preventive measures. This study aims to evaluate the effectiveness of potato-derived protease enzyme inhibitor cream (PPEIC) in preventing DD after gastrointestinal surgery in children. Methods: In this double-blinded, single-center RCT, 30 patients under three years of age undergoing gastrointestinal surgery were randomized 1:1 to prevention using PPEIC or Panthenol cream (PC). The creams were applied after each diaper change for four weeks postoperatively. At two and four weeks, two observers evaluated photographs of the perianal region for the presence and severity of DD. The primary outcome was the severity of DD four weeks after surgery. Results: From November 2020 to March 2023, 30 patients were included. Two patients withdrew directly after randomization, resulting in 13 PPEIC and 15 PC patients. In total, nineteen patients (73.1%) developed DD—eight (66.7%) in the PPEIC group and 11 (78.6%) in the PC group (p = 0.665)—of whom twelve (63.2%) suffered severe DD. All DD cases developed within the first two weeks, resulting in half of the patients discontinuing the preventive cream before the four-week endpoint. Conclusions: This study highlights the significant issue of DD after gastrointestinal surgery, which affects 73.1% of diapered children despite prevention with PPEIC or PC. Although the study was unable to identify a superior preventive method, it offers valuable insights and goals for future research. Full article

Background: Preterm infants and their families face a challenging experience during their stay in the neonatal intensive care unit (NICU). Family-centered care emphasizes the importance of welcoming parents, involving them in their baby’s daily care, and supporting the development of parenting skills. NICU staff should support parents in understanding their baby’s needs and in strengthening the parent–infant bond. Although many tools outline what parents should learn, there is a limited structured framework to monitor their involvement in the infant’s care. Tracking parental participation in daily caregiving activities could support professionals in effectively guiding families, ensuring a smoother transition to discharge. Aims: The aim of this study was to evaluate the adherence to and effectiveness of a structured tool for parental involvement in the NICU. This tool serves several key purposes: to track the progression and timing of parents’ autonomy in caring for their baby, to support parents in building caregiving competencies before discharge, and to standardize the approach of NICU professionals in promoting both infant care and family engagement. Methods: A structured template form for documenting parental involvement (“together TO-CARE template”, TTCT) was integrated into the computerized chart adopted in the NICU of Modena. Nurses were asked to complete the TTCT at each shift. The template included the following assessment items: parental presence; type of contact with the baby (touch; voice; skin-to-skin); parental involvement in care activities (diaper changing; gavage feeding; bottle feeding; breast feeding); and level of autonomy in care (observer; supported by nurse; autonomous). We evaluated TTCT uploaded data for very low birth weight (VLBW) preterm infants admitted in the Modena NICU between 1 January 2023 and 31 December 2024. Staff compliance in filling out the TTCT was assessed. The timing at which parents achieved autonomy in different care tasks was also measured. Results: The TTCT was completed with an average of one entry per day, during the NICU stay. Parents reached full autonomy in diaper changing at a mean of 21.1 ± 15.3 days and in bottle feeding at a mean of 48.0 ± 22.4 days after admission. The mean length of hospitalization was 53 ± 38 days. Conclusions: The adoption of the TTCT in the NICU is feasible and should become a central component of care for preterm infants. It promotes family-centered care by addressing the needs of both the baby and the family. Encouraging early and progressive parental involvement enhances parenting skills, builds confidence, and may help reduce post-discharge complications and readmissions. Furthermore, the use of a standardized template aims to foster consistency among NICU staff, reduce disparities in care delivery, and strengthen the support provided to families of preterm infants. Full article

Polylactic acid (PLA) is a promising biobased polymer celebrated for its biocompatibility, biodegradability, and advantageous mechanical properties. However, its inherent hydrophobicity and lack of hydrophilic functional groups restrict its application in advanced uses, such as nonwoven fabrics (NWFs) for masks, diapers, and biomedical products. This study explores the application of cold plasma treatments to modify the surface of PLA-based NWFs using oxygen and oxygen–argon gas mixtures. We varied power levels and exposure times to optimize surface activation. The samples treated with plasma under different conditions were analyzed to understand the impact of these treatments on the surface functionalization, morphology, and thermal properties of PLA_NWF. Additionally, as a proof of concept, the plasma-treated samples were dip-coated in green tea extract, which is rich in (-)-epigallocatechin gallate (EGCG), a natural antioxidant. The findings demonstrate that plasma treatment significantly enhances the adhesion and functionality of the active ingredient, thereby paving the way for innovative sustainable applications of surface-activated PLA-NWFs in the biomedical and cosmetic sectors or food preservation. Full article

Background: Shigella flexneri is a major cause of shigellosis in developing regions and is known to cause outbreaks in institutional settings. Transmission occurs via the fecal–oral route. It invades intestinal epithelial cells, causing diarrhea, systemic symptoms, and complications such as hemolytic uremic syndrome. This study aimed to characterize the clinical presentation, administered treatment, infection outcomes, and infection control measures during a local S. flexneri outbreak at a rehabilitation center. Methods: This case series at King Saud University Medical City (Oct–Dec 2024) investigated S. flexneri infections from a rehabilitation center. Stool and blood samples were cultured and analyzed using microbiological methods. Molecular studies were used to verify the genetic linkage between the isolates and to study their virulence genes. Results: Four cases of S. flexneri were included, involving patients with various comorbidities, residing in a rehabilitation center, and presenting with symptoms like fever and diarrhea. Laboratory investigations revealed leukocytosis, electrolyte imbalances, and elevated inflammatory markers. Imaging studies showed findings consistent with colitis in two cases. Patients were managed with IV fluids and targeted antibiotics, leading to symptom resolution. Molecular studies confirmed the genetic relatedness between the S. flexneri isolates, with virulence genes indicating cellular invasion and inflammation as primary drivers of disease severity. Outbreak management comprised contact isolation, environmental disinfection, and education. Conclusions: S. flexneri outbreaks in long-term care facilities pose challenges among bedbound patients. Diapers may facilitate transmission, and infections may cause severe complications. Robust infection control, identifying outbreak sources, and strengthening prevention strategies are essential to protect vulnerable populations. Full article

Background: The dirty utility room (DUR) plays a vital role in maintaining and optimizing the safety of patients and healthcare staff. A substantial gap exists in the literature concerning the current topic in terms of empirical studies and reviews. Therefore, this study aims to shed light on the subject and provide reliable evaluations. Methods: A qualitative case study design (observational) was used. We included the DURs of hospitals in multiple regions of the Kingdom of Saudi Arabia/in wards and units of each hospital. To achieve data saturation, visits across wards and ICUs were conducted until no new information was retrieved. NVivo Software version 14 was used for management and analysis of the data. We used our notes to initiate codes and then created themes involving the six steps of thematic analysis for the observational study. Results: Among several main hospitals in the central, western, eastern, southern, and northern geographical locations in Saudi Arabia that included DURs, a total of 24 DURs were explored to capture all relevant aspects related to the observations. Considering the range of items presented in DURs, the majority of hospitals exhibited a substantial lack of equipment. There were disagreements regarding the definition of DURs and the name of DURs. The observers agreed with the practice of urine disposal, which is performed by hand. The observers from all regions mutually agreed that stool disposal methods for patients involved diapers and the cleaning of patients manually with bed sheets. Several risks of infection control were observed related to DUR design and protocols. Conclusions: This national observational study of DURs in Saudi Arabian hospitals revealed major inadequacies in the design, equipment, and processes that are critical for infection control and healthcare quality, emphasizing the critical necessity for standardized methods and appropriate equipment. Full article

Non-biodegradable superabsorbent polymers (SAPs) in personal care products (PCPs) pose significant environmental and health concerns despite their high absorption capacity. The aim of this study was to develop cellulose-based hydrogels as a sustainable alternative to those conventional SAPs, taking advantage of cellulose properties such as biocompatibility, biodegradability, and hydrophilicity. A synthesized allyl cellulose (AC) derivative was copolymerized with unusual monomers used in the production of SAPs, and the influence of monomer ratios, crosslinking density, and the ratio of cellulose to monomers on the absorption capacity was investigated and optimized. The most promising hydrogels were fully characterized for the proposed application and compared with a commercial SAP extracted from a baby diaper. The cellulose-based hydrogels showed promising absorption capacities in synthetic urine (~15 g/g), and a high centrifuge retention capacity (12.5 g/g), which was only slightly lower than the commercial SAP. These new hydrogels exhibited excellent biocompatibility and outperformed the established commercial diaper SAP. This study represents a more sustainable alternative to conventional SAPs, potentially reducing health risks while increasing the bio-based content of PCPs. Further optimization of these hydrogels could transform the hygiene product industry, by providing a balance between performance and environmental sustainability. Full article

Background: Urinary incontinence (UI) is common among hospitalized patients and often leads to complications like incontinence-associated dermatitis (IAD). This risk is heightened among patients with cognitive impairment, as delayed diaper changes can worsen skin conditions. Smart diaper sensors provide a promising solution to these challenges. Methods: A 76-year-old woman with cognitive impairment and gait disturbance presented with itchy erythema and rashes consistent with IAD. Conventional treatments offered partial relief but did not resolve the symptoms. The MONIT smart diaper sensor was used in combination with antifungal ointment. The sensor, attached externally to the diaper, monitored moisture levels in real time and sent alerts to a smartphone via Bluetooth when a diaper change was needed. Results: The MONIT system significantly improved skin condition, as evidenced by reduced scores on the incontinence-associated dermatitis and its severity (IADS) instrument and the perineal assessment tool (PAT). Conclusions: The combined use of the MONIT smart diaper sensor and antifungal treatment effectively managed IAD, reducing its severity and preventing complications. Smart diaper sensors represent valuable tools for improving care for sedentary patients with cognitive impairment, offering innovative support for timely interventions. Full article

Phthalates are widely used plasticizers that can leach from consumer products and pose potential health risks, particularly to infants whose developing systems are vulnerable to environmental toxicants. While various exposure pathways have been identified, the contribution of dermal absorption from disposable diapers remains inadequately characterized. This study recruited 66 infants from Guangzhou, a representative city in southern China. Paired disposable diaper and urine samples were collected from each participant. Six phthalates in the diapers and nine metabolites in the urine were quantitatively analyzed. The predominant phthalate detected in the diapers was bis-2-ethylhexyl phthalate (DEHP, with a median concentration of 1670 ng/g, range: 678–5200 ng/g), followed by di-n-butyl phthalate (DnBP, 948 ng/g, range: 189–5980 ng/g), di-iso-butyl phthalate (DiBP, 333 ng/g, range: 16.1–4910 ng/g), and diethyl phthalate (DEP, 252 ng/g, range: 116–3350 ng/g). In urine, metabolites of DEHP (mEHP, mEHHP, and mEOHP) were the most abundant (87.1 ng/mL), followed by mnBP (metabolites of DnBP, 44.6 ng/mL), mEP (metabolites of DEP, 33.7 ng/mL), and miBP (metabolites of DiBP, 13.9 ng/mL). A positive correlation was observed between DnBP levels in diapers and mnBP levels in urine (r = 0.259, p = 0.035). Additionally, several urinary metabolites (miBP, mnBP, and mEP) were positively associated with a biomarker of DNA oxidative damage, 8-hydroxydeoxyguanosine (r = 0.265–0.316, p < 0.01). The estimated daily uptake of DEP, DiBP, DnBP, and DEHP through dermal absorption from diapers accounted for 44.9%, 19.5%, 15.1%, and 7.76% of total exposure to these phthalates, respectively. These findings suggest that dermal absorption from diapers is a significant exposure pathway for infants. Given that both the amount of exposure and the contribution of dermal uptake are higher in younger infants, further attention is warranted to understand the potential effects of transdermal phthalate exposure on infant growth and development. Full article

Superabsorbent hydrogels used in products like diapers, hygiene items, and medical patches depend on their swelling ratio. However, improving the swelling performance across hydrogel assemblies remains challenging. This study identifies a decline in the water absorption capacity in hydrogel assemblies with high swelling ratios, as confirmed through MRI analysis, and introduces a solution using a branched crosslinker to address this issue. The branched crosslinker was synthesized by grafting acrylate groups onto poly(aspartic acid)s. This branched poly(aspartic acid) crosslinker was incorporated into hydrogels with the same number of acrylate groups as PEGDA575, a conventional linear crosslinker, and their absorption performance and behavior were compared. The results showed that hydrogels with the branched crosslinker exhibited a swelling ratio twice as high as the PEGDA575 group, with a slower initial absorption rate, demonstrating a more gradual swelling behavior. Additionally, while the initial absorption rate was approximately 30% slower than the PEGDA575 group, the absorption rate showed a gradual decrease of less than 15% within the first 30 min, indicating sustained absorption behavior. Overall, the new strategy presented in this study of introducing a branched crosslinker into hydrogels is expected to be a useful application for existing industries by enhancing swelling ratios and promoting continuous absorption. Full article

Introduction: Neurogenic bladder disorders after spinal cord injury (SCI) are often problematic with urinary incontinence (UI) and recurrent urinary tract infections (UTIs) contributing to patient morbidity. Our study objective was to provide a current snapshot of the frequency of UI and UTIs in the SCI population while also quantifying their association with hospitalization. Methods: The National Spinal Cord Injury Database (2016–2021) was accessed for persons within five years of injury. The self-reported frequency of UI in the last month (none, daily, weekly, monthly), the number of UTIs requiring antibiotic treatment, and the number of hospitalizations (including reason) in the prior year were evaluated. Results: Our cohort comprised 5106 individuals within 5 years of SCI. Approximately 40% reported UI in the past month and over 50% had a UTI requiring antibiotics in the past year. Incontinence was significantly more frequent in those performing clean intermittent catheterization (CIC) (52% overall, 17% daily) compared to indwelling catheters (29% overall) or volitional void (22% overall) (p < 0.001 for each). Conversely, UTIs were most common in those using indwelling catheters (79% with at least one UTI) or CIC (70%) compared to diapers/condom catheters (46%) or volitional void (19%) (p < 0.001 for each). Increasing UI and UTI occurrences were both associated with an increased frequency of hospitalization in the prior year. Conclusions: UI and UTIs are common problems after SCI. While differing frequencies of UI and UTI are present based on bladder management, the overall frequency suggests that a continued emphasis on prevention is needed to potentially increase quality of life and decrease hospitalization. Full article

As the average temperature in summer rises and heat waves occur more frequently, the urban heat island (UHI) phenomenon is becoming a social problem. Asphalt road pavement stores heat during the day, raising the surface temperature, and releases the stored heat at night, thereby aggravating the UHI phenomenon. Government authorities often spray water to lower the temperature of road pavement for the safety and convenience of citizens. However, the effect is immediate and does not last long. Therefore, in order to reduce the urban heat island phenomenon by spraying water, the recovery time of the surface temperature must be delayed. In this study, Super Absorbent Polymer (SAP), a highly absorbent polymer that absorbs 100 to 500 times its weight in water, was applied to asphalt road pavement. SAP is commonly used in diapers, feminine hygiene products, soil moisturizers, and concrete, and its scope is gradually expanding. The purpose of this study is to reduce the urban heat island phenomenon by mixing the SAP into asphalt and to increase the latent heat flux by evaporating the water absorbed by the SAP, thereby delaying the recovery time of the surface temperature of the road pavement. In this study, the performance of asphalt mixtures mixed with the SAP and the thermal characteristics according to the mixing amount were analyzed. In this study, the physical properties and temperature reduction performance of the asphalt mixture according to the SAP type and content were studied. The results of indoor and outdoor experiments on asphalt mixtures using the SAP showed that they satisfied the mechanical performance criteria as asphalt pavement materials and that the temperature recovery delay effect was improved. Full article

Background: Lesch–Nyhan syndrome (LNS) is a rare X-linked recessive metabolic disorder caused by mutations in the HPRT1 gene, resulting in hypoxanthine–guanine phosphoribosyltransferase (HPRT) deficiency. Early diagnosis is critical for optimizing management and improving outcomes. This study presents a case series of three Taiwanese patients diagnosed at a single medical center. Methods: Exome sequencing and biochemical testing were used to confirm the diagnoses. Early clinical manifestations, including hyperuricemia, hypotonia, and developmental delay, were documented during the initial stages of the disease. Results: All three patients had hyperuricemia, hypotonia, spasticity, and motor developmental delay. Pathogenic variants in the HPRT1 gene were identified in two patients, while the third was confirmed by biochemical testing. Two patients had orange-colored crystalline deposits in their diapers, indicative of hyperuricosuria. Self-injurious behavior had not yet developed in two patients due to their young age. Conclusions: Early clinical features such as hyperuricemia, hypotonia, and motor delay may suggest LNS in infancy. Molecular genetic testing, particularly whole exome sequencing, can facilitate an early diagnosis before specific manifestations occur, enabling timely interventions and improving patient outcomes. Full article

In developing countries, there is currently no established waste management plan that includes resource recovery from used disposable diapers (DDs) apart from incineration and landfilling. In low-income areas with limited storage space, the complex composition and odour of used DDs make it impossible to manage properly if not supported by effective waste management systems. In the absence of effective waste management, DDs are dumped in open spaces, burned or buried. These actions pose threats to the safety and health of humans, animals and the environment. Separation and collection of DDs are critical preliminary steps to landfilling, recycling or beneficiation. In this article, we describe a case study of two pilot collection projects in Langa township in Cape Town, South Africa, to determine whether and how a source-separated collection system can work in low-income, resource-constrained areas. The lessons learned highlighted the following: The eagerness of parents to participate for the benefit of their own and their children’s health; the complementarity of the two pilot collection models to serve the needs of the community; the important role non-government organisations play in the implementation of waste management projects; the significance of the possible job creation opportunities and the unintended benefits of enhancing social cohesion. The financial sustainability of these projects needs further exploration. Full article

Drug and substance abuse is a contemporary problem among the youth and has reached crises levels in the nation of Zimbabwe. The problem has been compounded by acute socio-economic challenges that have characterised the nation for the past decade. Despite efforts to curb the problem, new forms of drug and substance abuse are emerging. This study, which is based on a documentary survey, explored the emerging trends in drug and substance abuse among youths in Zimbabwe, as well as evaluating the current measures to deal with the problem. While marijuana is viewed as the most abused drug, this study reveals some emerging trends such as the abuse of prescription drugs, use of home-made intoxicating substances, infusion of intoxicated people’s blood, ingestion of drug laced foods and drinking sodium polyacrylate from boiled diapers. Acute socio-economic challenges, ease of access and porous borders are considered the major contributory factors for drug and substance abuse. Notwithstanding the efforts by the government and law enforcement agents to deal with the scourge, this study reveals that the current measures have not been as effective as expected. Full article