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Right ventricular (RV) strain is an important factor in evaluating RV function. This study aimed to predict mortality in patients with pulmonary hypertension (PH) and right heart failure (RHF) using an artificial intelligence (AI)-assisted multimodal echocardiography approach. A total of 586 patients with PH and RHF were enrolled. Transthoracic echocardiography (TTE) was performed either before hospital admission in the outpatient department or after admission in the inpatient unit. RV structure and function were assessed using two-dimensional measurements and speckle tracking strain analysis of septal and the free-wall segments. A multimodal deep-learning framework, integrating clinical variables, conventional echocardiographic indices, and AI-extracted RV strain features was developed to predict in-hospital and follow-up mortality. Model performance was evaluated using receiver operating characteristic (ROC) curves and the area under the curve (AUC). The death group had significantly higher NT-proBNP levels, pulmonary artery systolic pressure (PASP), and average RV longitudinal strain (RVLS) than the survival group. Logistic regression identified PASP and average RVLS as independent predictors of in-hospital mortality, while Cox regression confirmed average RVLS as an independent predictor of follow-up mortality. The testing AUC for the AI model was 0.823 (0.741–0.905). The AI-guided TTE framework provides an effective and efficient method for mortality prediction in patients with PH and RHF, supporting personalized clinical decision-making and risk stratification.
Eastern Croatia includes settlements with historically elevated arsenic (As) concentrations in drinking water. Of 488 recruited adults, nine were excluded solely because no questionnaire was available; the exclusion was independent of measured arsenic concentrations, and the harmonised analytical cohort therefore comprised 479 adults from eight settlements. Total As concentrations in drinking water, hair, serum, and urine were measured in samples collected in June 2015 by inductively coupled plasma mass spectrometry. Kidney cancer data (ICD-10 C64) for 2000–2018 were obtained from the Croatian National Cancer Registry and analysed ecologically. MDCK1 cells were exposed to As2O3 at 10–200 µg/L for 48, 72, and 96 h, and acetylcholinesterase (AChE) activity was measured in human erythrocytes. Čepin had the highest median As concentrations in drinking water (191.75 µg/L) and urine (68.14 µg/L). Across all eight settlements, drinking-water As was strongly associated with urinary As (slope = 0.537; 95% CI, 0.352–0.722; R2 = 0.894; p < 0.001). However, in a sensitivity analysis excluding Čepin and using the seven non-Čepin settlement means reported, the association weakened (r = 0.740; R2 = 0.548; slope = 1.246; 95% CI, −0.054 to 2.547; p = 0.057), indicating substantial influence of the Čepin hotspot. Associations with hair As (R2 = 0.294; p = 0.165) and serum As (R2 = 0.239; p = 0.219) were not statistically significant. In a multivariable Gamma generalized linear model, residence in Čepin was associated with higher expected urinary As than residence in Vladislavci (adjusted mean ratio, 2.90; 95% CI, 1.90–4.42; p < 0.001), while female sex was associated with a lower expected concentration (adjusted mean ratio, 0.80; 95% CI, 0.66–0.97; p = 0.024). No statistically significant effect of As2O3 on MDCK1 viability or erythrocyte AChE activity was observed. The findings support urinary total As as a biomarker of recent environmental exposure, but do not establish causal associations with kidney toxicity or kidney cancer.
Aim: The aim of this study was to identify the occupational risks, working conditions, health problems, and protective practices related to worker health among auto paint workers. Materials and Methods: This research was designed as a qualitative study using a phenomenological approach. A total of 13 auto paint workers participated in the study. Data were collected through face-to-face, semi-structured, and in-depth interviews. Results: Participants primarily reported exposure to chemical hazards as their main occupational risk. In addition, long working hours and working in cold environments, particularly during the winter months, were identified as additional occupational risks. The most commonly reported health problems were respiratory diseases and dermatological conditions. The findings also revealed that occupational training activities and protective practices were inadequate. Furthermore, participants expressed concerns about the lack of new apprentices in industrial areas, emphasizing the potential shortage of skilled auto paint workers in the future. Conclusion: The respiratory and dermatological health problems observed among auto paint workers were largely associated with chemical exposure and insufficient protective measures. These findings indicate a clear need for systematic interventions aimed at increasing risk awareness and ensuring the effective and consistent use of personal protective equipment.
Background: An ulcer is an epidermal breach with or without the involvement of deeper tissues. Etiology can range from vasculopathy, neuropathy, infections, vasculitis, trauma, skin malignancies, and dermatological conditions such as pyoderma gangrenosum, necrobiosis lipoidica, and blistering disorders. Dermoscopy is an imaging technique enabling in vivo visualization of the epidermal surface. The device, being portable and user-friendly, has already slid into our routine practice as a non-invasive diagnostic tool. Aims and Objectives: This study aimed to describe the dermoscopy of chronic leg ulcers and correlate them with underlying etiology. Materials and Methods: The study included 40 clinically diagnosed chronic (>6 weeks) leg ulcers using a dermoscope (Dermlite DL4) presenting to the dermatology outpatient department in a tertiary care center in North India. Results: The average age was 41.8 years. The male: female ratio was 29:11. The most common cause was venous/stasis ulcer (30%), followed by mixed etiology (15%) and neuropathic (12.5%). Melanoma was rare. Dotted vessels were seen in 37.5% of cases, followed by pomegranate-like and glomerular vessels (27.5% and 25%, respectively). The background was red in 52.5% of cases; other features such as altered pigment network over surrounding skin (67.5%), white cicatrix (42.5%), thick white lines (35%), and keratin plugs (22.5%) were also observed. Conclusion: Dermoscopy is a relatively new tool in the field of dermatology that amplifies microscopic characteristics. This series attempts to study dermoscopic features of chronic leg ulcers and correlate them with clinical diagnosis. Further studies are required to validate these findings and design a dermoscopy-based triage algorithm for treatment and biopsy considerations in high-risk cases.
A dual-mode sensing platform based on FeMoVo nanozyme achieves sensitive glutathione (GSH) detection through distinct colorimetric (TMB) and fluorometric (OPD) signal outputs.
