Search Results (659)

We reviewed vancomycin-resistant Enterococcus (VRE) colonisation of inpatients of a spinal cord injury centre. The centre consists of one single occupancy en suite room and ten multi-occupancy rooms where two to six patients stay in a cubicle. These patients share bathroom and toilet facilities. Active screening for VRE is performed by taking rectal swabs on admission of patients to the spinal unit. The patients, who are colonised with VRE, are not isolated due to constraints in resources. During a twelve-month period (April 2024 to April 2025), 33 patients tested positive for VRE. In April 2025, 17 of 40 in-patients tested positive for VRE. During the last six 12-month periods from 2019, the number of patients testing positive for VRE has shown an upward trend from 18 during 2019–2020 to 33 during 2024–2025. No patient developed systemic infection with VRE (blood stream infection, endocarditis, meningitis, intra-abdominal sepsis, infection of a spinal implant or baclofen pump) during the study period. Twelve patients underwent implantation of a baclofen pump during 2024–2025. No patient developed VRE infection from the implant. We believe that non-isolation of patients colonised with VRE may be a pragmatic approach in a resource-poor healthcare facility. It is possible that non-isolation could have contributed to an increase in the number of patients who became colonised with VRE. Attention should be paid to infection prevention measures including hand washing and environmental cleaning to prevent the spread of VRE colonisation of inpatients and VRE infection of at-risk patients, e.g., immune-compromised individuals. Full article

Due to the burdens of critical operations, firefighters are at occupational risk of developing mental health problems such as post-traumatic stress symptoms (PTSS) or anger. In this study, we assessed the impact of a firefighting operation with two fatalities and eleven injuries among colleagues on the mental health of those involved. Aims: The study hypothesizes that firefighters who were acquainted with the wounded or deceased show more PTSS and score higher on the STAXI-2 State Anger, Anger Expression-In/Out, and Anger Control-In/Out compared to those who were not. The second hypothesis assumes that the deployed group shows more PTSS and scores higher on the STAXI-2 State Anger, Anger Expression-In/Out, and Anger Control-In/Out compared to the grouping of non-deployed colleagues. Methods: A total of N = 138 firefighters were included, of which n = 32 were deployed and n = 106 were not (n = 26 acquainted with wounded or injured; n = 107 not acquainted with wounded or injured; n = 5 not specified). Both groups completed a standardized questionnaire voluntarily and after providing written informed consent ten months after the incident. The questionnaire consisted of the Posttraumatic Stress Checklist for DSM-5 (PCL-5) and the State-Trait Anger Inventory (STAXI-2) questionnaire. Results: Firefighters who knew the injured or deceased colleagues had significantly higher PTSS [T(23.7) = −2.5; p = 0.019; d = 0.67; 95% CI = (−10.8, −1.0)], state anger [T(74.2) = 2.4; p = 0.021; d = 0.41; 95% CI = (0.2, 2.0)], and anger control scores [T(124) = −2.7; p = 0.008; d = 0.71; 95% CI = (−5.9, −0.9)]. In addition, the deployed group showed higher anger control [T(134) = 2.0; p = 0.046; d = 0.42; 95% CI = (0.0, 4.2)] and outward anger expression [T(73.5) = −2.2; p = 0.032; d = 0.40; 95% CI = (−2.3, −0.1)] scores compared to their non-deployed colleagues. Discussion: Future psychological pre- and post-deployment interventions should place more focus on the increased vulnerability of those acquainted with wounded or deceased colleagues. Full article

Background: Seafarers are highly susceptible to work-related injuries, which can result in serious consequences or permanent disabilities. Understanding the frequency and characteristics of occupational injuries is crucial for developing effective prevention strategies and identifying their underlying patterns and causes. This study aimed to determine the frequency and characteristics of telemedicine-assisted work-related injuries among seafarers on board Italian-flagged vessels. Methods: A retrospective descriptive study was conducted to analyze occupational injuries using medical data recorded in the Centro Internazionale Radio Medico (C.I.R.M.) database from 1 January 2010 to 31 December 2022. Injuries in the database were coded according to the 10th revision of the International Classification of Diseases (ICD-10) by the World Health Organization (WHO). Variables extracted from the database included injury type, seafarers’ age, rank, nationality, worksite, gender, date of injury, affected body region, clinical outcomes, and other demographic and occupational characteristics. Injury frequency and characteristics (e.g., location, type, and cause) were analyzed and stratified by seafarers’ rank and worksite groups. Results: The analysis included 793 seafarers who sustained injuries. Their average age was 39.15 ± 10.49 years (range: 21 to 70 years). Deck ratings and engine officers accounted for 27.9% and 20% of those who claimed injuries, respectively. 39.2% of injured seafarers were aged between 30 and 40 years. In terms of affected body parts, the most reported injuries were to the hand/wrist (33.3%), followed by the knee/lower legs (21%), and the head/eye (19%). Open wounds (38%) and burns/abrasions (14%) were the most common types of injury. Slips/falls (32%), burns/explosions (16.6%), and overexertion while lifting or carrying (14.8%) were the leading causes of injury during the study period. Nearly 35% of injuries affected workers on the deck and were due mainly to slips/falls, 19% in the engine room were due to being caught in machinery or equipment, and 32.5% in the catering department were due to burns/explosions. Conclusions: One-third of seafarers who suffered work-related injuries sustained hand and/or wrist injuries, with slips/falls being a significant cause. The results of this study emphasize the need for preventative measures in the marine sector, particularly to reduce risks associated with slips and falls, overexertion, and other injury-causing factors. Campaigns for the larger use of protective equipment are desirable to reduce occupational accidents at sea and provide better health protection for seafarers. Full article

Background and Objectives: Padel is becoming an increasingly popular sport, yet epidemiological data on sport-related musculoskeletal injury in Portuguese practitioners are limited. This study aimed to provide a comprehensive epidemiological analysis of Padel practitioners in Portugal to fill this gap. Materials and Methods: A nationwide self-reported questionnaire was administered to Portuguese Padel practitioners. The questionnaire covered sociodemographic, occupational, and health-related items. Results: Overall, 69.2% of respondents reported at least one lifetime Padel injury (mean 2.1 ± 1.2 injuries per injured athlete). Estimated injury incidence was 3.4 ± 4.7 injuries per 1000 h of exposure for the total sample (6.1 ± 4.9 per 1000 h among injured athletes). Tendinous (35.6%) and muscular (26.1%) injuries predominated. Most affected anatomical sites were the elbow (18.0%), ankle (16.6%), knee (12.5%), and shoulder (10.5%). Injuries most frequently occurred during training (32.9%) and were commonly attributed to fatigue/overload (24.1%). Reported severity was commonly moderate to severe (most frequent absences: 3–4 weeks and 1–3 months); physiotherapy was the principal management approach. Multivariable analyses identified several associations of practical relevance: higher body mass index was linked to greater overall injury risk (and specifically neck injuries); female sex was associated with higher odds of muscular injuries; years of Padel experience and equipment characteristics (e.g., number of overgrips) showed site-specific associations; and instructor supervision correlated with greater warm-up adherence and lower odds of elbow injury. Playing surface also influenced risk patterns. Conclusions: Portuguese Padel practitioners in this study experience a substantial burden of predominantly tendinous and muscular injuries concentrated at the elbow and lower limb. Athlete factors, exposure, surface, equipment, and supervision represent modifiable targets for multidisciplinary prevention and rehabilitation strategies. Full article

Background/Objectives: Respiratory impairment is the leading cause of morbidity and mortality in participants with spinal cord injury (SCI). Cervical SCI (cSCI) severely compromises respiratory function due to paralysis and weakness of the respiratory muscles. Recent evidence suggests that transcutaneous electrical spinal cord stimulation (tSCS) may enhance motor strength and promote functional recovery. Therefore, cervical tSCS, applied at cervical segments, holds potential as a therapeutic strategy to improve respiratory function in participants with cervical SCI. Methods: This randomized controlled trial with a partial crossover design included participants with both complete and incomplete cSCI. Neurological assessments were used, as well as tests to evaluate pulmonary function maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and spirometric measurements. These assessments were conducted at baseline and after the last session. The experimental group received tSCS at the C3–C4 and C6–C7 cervical spinal levels, delivered at a frequency of 30 Hz during occupational therapy. The control group underwent identical occupational therapy sessions without stimulation. Each session lasted 30 min and was conducted over eight days. Results: Fifteen participants with cSCI received tSCS, while 11 cSCI participants were included in the control group. Seven participants took part in both groups. Only the tSCS group showed significant improvements in MIP, MEP, and forced vital capacity (p < 0.05), while no significant changes were observed in the control group. Conclusions: tSCS applied at the cervical segments can promote respiratory function following cervical SCI. This approach may support neuroplasticity and help reduce long-term respiratory complications in participants with cervical SCI. However, to confirm these effects, long-term stimulation protocols and follow-up studies in larger SCI populations are required. Full article

Background/Objectives: Healthcare workers in chronic care hospitals are vulnerable to psychosocial risks such as burnout and moral injury due to prolonged patient exposure and limited institutional support. This study assessed the prevalence of burnout and moral injury among staff at the Chronic Diseases Hospital of Sebiș, Romania, and examined their associations with perceived stress and managerial support. Methods: A cross-sectional study was conducted between October 2022 and October 2024, including 62 healthcare workers (physicians, nurses, and auxiliary staff). Participants completed a sociodemographic survey, the Maslach Burnout Inventory (MBI), the Moral Injury Symptom Scale-Health Professional (MISS-HP), and additional items on perceived stress and institutional support. Statistical analysis included descriptive statistics, group comparisons, correlation matrices, and logistic regression. Results: High emotional exhaustion (MBI-EE ≥ 27) was reported by 45.2% of participants, with the highest rates among nurses (50%) and auxiliary staff (45.5%). Mean moral injury scores were moderate (mean = 5.3), with elevated levels observed in nurses and auxiliary staff. Pearson correlation analysis revealed no strong linear associations between burnout dimensions and moral injury. Logistic regression did not identify emotional exhaustion, perceived stress, or support as significant predictors of high moral injury. Conclusions: Burnout and moral injury are prevalent but appear to be partially dissociated in this Romanian chronic care setting. Moral injury may arise from contextual ethical pressures beyond general occupational strain. Interventions should focus on ethical climate, institutional responsiveness, and peer-based moral support to enhance staff resilience. Full article

Road traffic accidents are the eighth leading cause of human deaths. In order to study two-vehicle accidents, this paper extracted data from 493 two-vehicle accidents from the CIDAS database from 2011 to 2022, used machine learning methods to analyze the accident data, and obtained the significance of two-vehicle accident parameters. Finally, five typical scenarios of two-vehicle accidents were obtained based on this. The results of the significance analysis show that vehicle parameters have a greater impact on occupant injury in the host vehicle; clustering results show that lighting, the number of lanes, the other vehicle’s type, and the speed of the host vehicle have a large impact on occupant injury (for example, the injury rate for the high-speed, nighttime Scenario II was 52.9%, compared to just 10.9% for the lower-speed Scenario IV). Factor analysis results show that precipitation has a large impact on occupant injury, as the frequency of injuries in rainy conditions was 13.4% higher, and the frequency of serious injuries was 7.9% higher, than in accidents without rain. This paper innovatively uses factor analysis to reduce the dimensionality of categorical variables, which provides research ideas for related research. At the same time, the clustering results obtained in this paper also provide references for the establishment of corresponding test scenarios for autonomous driving and the establishment of standards. Full article

Many trauma-focused psychotherapies for posttraumatic stress disorder (PTSD) focus on the most distressing trauma. However, military personnel are often exposed to multiple traumatic experiences. This study aimed to evaluate and categorize the top three traumatic experiences identified by United States (U.S.) military service members seeking treatment for PTSD and compare frequency of trauma types by demographic/military characteristics. Active duty service members and veterans (N = 110) with PTSD identified and ranked their top three most distressing experiences. Behavioral health professionals classified experiences according to one categorical and four dichotomous classification schemes. The categorical scheme included life threat to self, life threat to others, aftermath of violence, traumatic loss, moral injury by self, and moral injury by others. The Life Threat to Self classification represented the largest portion of categorical experiences (43%). Most experiences were dichotomously classified as military-related (86%), combat-related (70%), non-sexual (91%), and trainability (versus futility; 71%). Women were more likely to report sexual traumatic experiences and less likely to report military- and combat-related experiences. Military occupational specialty, number of deployments, time in military, active duty status, and marital status were also associated with different classification rates. There was noteworthy variability in types of experience across top three traumas, especially among certain subpopulations. Full article

Drowsiness constitutes a significant risk factor in diverse occupational settings, including healthcare, industry, construction, and transportation, contributing to accidents, injuries, and fatalities. Electroencephalography (EEG) signals, offering direct measurements of brain activity, have emerged as a promising modality for drowsiness detection. However, the inherent non-stationary nature of EEG signals, coupled with substantial inter-subject variability, presents considerable challenges for reliable drowsiness detection. To address these challenges, this paper proposes a hybrid approach combining convolutional neural networks (CNNs), which excel at feature extraction, and support vector machines (SVMs) for drowsiness detection. The framework consists of two modules: a CNN for feature extraction from EEG scalograms generated by the Continuous Wavelet Transform (CWT), and an SVM for classification. The proposed approach is compared with 1D CNNs (using raw EEG signals) and transfer learning models such as VGG16 and ResNet50 to identify the most effective method for minimizing inter-subject variability and improving detection accuracy. Experimental evaluations, conducted on the publicly available DROZY EEG dataset, show that the CNN-SVM model, utilizing 2D scalograms, achieves an accuracy of 98.33%, outperforming both 1D CNNs and transfer learning models. These findings highlight the effectiveness of the hybrid CNN-SVM approach for robust and accurate drowsiness detection using EEG, offering significant potential for enhancing safety in high-risk work environments. Full article

Background: Radiation exposure in the cardiac catheterization laboratory remains a critical occupational hazard for interventional cardiologists and staff, contributing to orthopedic injuries, cataracts, and malignancy. In parallel, procedural complexity continues to increase, demanding both precision and safety. Robotic-assisted percutaneous coronary intervention (R-PCI), alongside advanced shielding systems and imaging integration, has emerged as a transformative strategy to minimize radiation and enhance operator ergonomics. Objective: This state-of-the-art review synthesizes the current clinical evidence and technological advances that support a radiation-reduction paradigm in percutaneous coronary intervention (PCI), with a particular focus on the role of R-PCI platforms, procedural modifications, and emerging shielding technologies. Methods: We reviewed published clinical trials, registries, and experimental studies evaluating robotic PCI platforms, contrast and radiation dose metrics, ergonomic implications, procedural efficiency, and radiation shielding systems. Emphasis was given to the integration of CT-based imaging (coronary computed tomography angiography—CCTA, fractional flow reserve computed tomography—FFR-CT) and low-dose acquisition protocols. Results: R-PCI demonstrated technical success rates of 81–100% and clinical success rates up to 100% in both standard and complex lesions, with significant reductions in operator radiation exposure (up to 95%) and procedural ergonomic burden. Advanced shielding technologies offer radiation dose reductions ranging from 86% to nearly 100%, while integration of (CCTA), (FFR-CT), and Artificial Intelligence (AI) -assisted procedural mapping facilitates further fluoroscopy minimization. Robotic workflows, however, remain limited by lack of device compatibility, absence of haptic feedback, and incomplete integration of physiology and imaging tools. Conclusions: R-PCI, in combination with shielding technologies and imaging integration, marks a shift towards safer, radiation-minimizing interventional strategies. This transition reflects not only a technical evolution but a philosophical redefinition of safety, precision, and sustainability in modern interventional cardiology. Full article

The iron and steel industries globally have a high prevalence of occupational injuries, which need to be reduced. Obtaining safety climate information from workers assists in understanding the safety status at the workplace. This study aimed to assess the safety climate in the iron and steel industries and its association with occupational injuries. A cross-sectional study was conducted in four iron and steel industrial sites in Tanzania. Three hundred and twenty-one workers from the production lines and 50 managers/supervisors participated. The data were collected by interviews using the Kiswahili version of the Nordic Safety Climate Questionnaire (NOSACQ-50) and the modified International Labor Organization (ILO) manual on methods for occupational injuries. The managers/supervisors scored higher than the workers in five of the NOSACQ-50 dimensions. Most workers with low scores on safety climate had experienced occupational injuries. Analyses of the workers who had been injured at work showed that the dimensions ‘management safety priority and ability’, and ‘management safety justice’ were significant predictors of occupational injuries in the iron and steel industries, when adjusting for working years and working hours per day. This indicates that safety climate is a predictor of occupational injuries, and it is important to improve the safety priorities and commitments among the employees. Full article

Fibrotic diseases of the skin and lung, such as systemic sclerosis, hypertrophic scars, keloids, and pulmonary fibrosis, share core molecular mechanisms despite their distinct anatomical settings. Central to their pathogenesis are persistent fibroblast activation, immune dysregulation, ECM remodeling, and failure of resolution pathways, all modulated by an ever-changing environment and epigenetic regulation. Increasing evidence reveals that chronic injury from air pollution, ultraviolet radiation, climate stressors, and occupational hazards accelerates fibroinflammatory remodeling across these barrier organs. Moreover, shared signaling networks, including TGF-β, IL-4/IL-13, Wnt/β-catenin, and epigenetic regulators like miR-21 and miR-29, suggest convergent fibrotic programs may be subject to cross-organ therapeutic targeting. This review integrates recent insights into the exposome’s role in driving fibrosis, highlights novel RNA- and epigenetic-based interventions, and evaluates the repurposing of antifibrotic agents approved for pulmonary disease within dermatologic contexts. We emphasize the emerging concept of fibrosis-aware precision medicine and propose a unifying framework to guide integrated therapeutic strategies. In the face of global climate change and rising environmental insults, a cross-organ perspective on fibrosis offers a timely and translationally relevant approach to addressing this growing burden on human health. Full article

Physical hazards are the most common source of health effects among waste recyclers, frequently leading to worker injuries. South Africa’s formal buy-back centres (BBCs) have emerged as key nodes in the recycling chain, yet the burden of non-fatal workplace injuries among BBC recyclers is not characterised. We conducted a cross-sectional study at ten BBCs in Johannesburg, enrolling 160 waste recyclers (median age 32 years; 55.6% female). A structured, interviewer-led questionnaire captured workers’ characteristics and self-reported injuries in the past six months. Robust Poisson regression was fitted to determine associations with frequent workplace injury. Overall, 69.4% of participants reported at least one injury. Cuts and lacerations (67.6%) and sprains or muscle strains (39.6%) predominated. Each additional year of age raised the risk of frequent workplace injury by 1% (adjusted relative risk [aRR] 1.01; 95% CI 1.00–1.02), each extra hour worked per day by 22% (aRR 1.22; 95% CI 1.04–1.42), and presence of hearing or vision problems by 45% (aRR 1.45; 95% CI 1.14–1.83). Targeted interventions—such as work hour regulation, sensory-friendly accommodations, and comprehensive, fit-focused PPE programs—are needed to reduce injury risk in this vulnerable workforce. Full article

With the rapid advancement of industrial intelligence, ensuring occupational safety has become an increasingly critical concern. Among the essential personal protective equipment (PPE), safety helmets play a vital role in preventing head injuries. There is a growing demand for real-time detection of helmet chinstrap wearing status during industrial operations. However, existing detection methods often encounter limitations such as user discomfort or potential privacy invasion. To overcome these challenges, this study proposes a non-intrusive approach for detecting the wearing state of helmet chinstraps, inspired by the mechanosensory hair arrays found on spider legs. The proposed method utilizes multiple MEMS inertial sensors to emulate the sensory functionality of spider leg hairs, thereby enabling efficient acquisition and analysis of helmet wearing states. Unlike conventional vibration-based detection techniques, posture signals reflect spatial structural characteristics; however, their integration from multiple sensors introduces increased signal complexity and background noise. To address this issue, an improved adaptive convolutional neural network (ICNN) integrated with a long short-term memory (LSTM) network is employed to classify the tightness levels of the helmet chinstrap using both single-sensor and multi-sensor data. Experimental validation was conducted based on data collected from 20 participants performing wall-climbing robot operation tasks. The results demonstrate that the proposed method achieves a high recognition accuracy of 96%. This research offers a practical, privacy-preserving, and highly effective solution for helmet-wearing status monitoring in industrial environments. Full article

Musculoskeletal disorders (MSDs) remain a critical occupational health issue for nursing personnel worldwide, resulting from physically demanding tasks such as patient handling and prolonged working hours. These injuries not only compromise nursing staff’s health but also impair their performance, productivity, and overall well-being. This review analyzes the current state of assistive technologies aimed at preventing MSDs in nursing staff, highlighting their effectiveness, implementation challenges, and potential benefits. A systematic selection of the scientific literature from major databases including Web of Science, Scopus, ScienceDirect, PubMed, Taylor & Francis, and ProQuest was conducted, complemented by open-access patent records. The screening process, involving two independent reviewers, achieved moderate agreement (Cohen’s Kappa = 0.418). The findings reveal that the most affected anatomical areas include the back, shoulders, and knees. Technological interventions are classified into three main categories: physical assistance devices, digital monitoring tools, and training programs. These integrated approaches offer promising avenues to enhance occupational safety, reduce injury rates, and improve nurses’ quality of life and professional performance. Full article