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Indoor Positioning Systems (IPSs) are essential for applications requiring accurate location awareness in indoor environments. However, achieving high precision remains challenging due to signal interference and environmental variability. This study proposes a multimodal IPS that integrates Bluetooth Received Signal Strength Indicator (RSSI) measurements and video imagery using machine learning (ML) and ensemble learning techniques. The system was implemented and deployed in the Hall of Biodiversity at the Natural History and Science Museum of the University of Porto. The venue presented significant deployment issues, namely restrictions on beacon placement and lighting conditions. We trained independent ML models on RSSI and video datasets, and combined them through ensemble learning methods. The experimental results from test scenarios, which included simulated visitor trajectories, showed that ensemble models consistently outperformed the RSSI-based and video-based models. These findings demonstrate that the use of multimodal data can significantly improve IPS accuracy despite constraints such as multipath interference, low lighting, and limited beacon infrastructure. Overall, they highlight the potential of multimodal data for deployments in complex indoor environments.

European Society of Gastrointestinal Endoscopy recommends needle-knife fistulotomy (NKF) as the preferred precut technique. However, there is little information on whether NKF performed at different times is associated with different success and adverse event rates. We compared the outcomes of 3 different timings of NKF. This was an observational study conducted at 4 institutions and this was a retrospective analysis of prospectively collected data. We included 330 consecutive patients submitted to NKF attempt for biliary access. Patients were divided into three groups: NKF as an initial procedure for biliary access (group A, n = 121); early NKF defined as after 5 min, 5 attempts, or 2 pancreatic passages (group B, n = 99); and late NKF: after at least 10 min of unsuccessful standard biliary cannulation (group C, n = 110). We assessed the success rate of biliary cannulation at initial ERCP, time to perform NKF until biliary cannulation, overall biliary cannulation rate (second ERCP when initial failure), adverse event rate, and predictors of post-ERCP pancreatitis (PEP). The initial cannulation rate was 98%, 91% and 94% for groups A, B and C respectively, p  = 0.08, whereas overall biliary cannulation rate was 100%, 95% and 98%, p  = 0.115. The adverse event rate/PEP was 4.1%/2.5%, 7.1%/4% and 10.9%/8.2%, for groups A, B and C respectively, ( p  = 0.197 and p  = 0.190). Median time for creating the fistula was A = 4.0 min, B = 3.2 min, and C = 5.6 min, p  < 000.1. Each additional minute spent attempting cannulation increased the odds ratio (OR) for PEP by 1.072, and patients with 3 or more risk factors for pancreatitis had a higher chance of PEP. In conclusion, the timing of NFK does not appear to influence success rates but late NFK is associated with a higher time to create a fistula and an increased risk of pancreatitis. Primary NFK is associated with a high rate of success and a low rate of PEP and deserves additional investigation.

Mosquito-borne diseases can pose significant burdens. In many countries, they pose a risk to national economies and the well-being of humans and animals. To mitigate this, mosquito surveillance is crucial to assess the real and potential transmission of mosquito-borne diseases. Between 2020 and 2023, mosquito larvae were collected from both indoor and outdoor breeding sites in urban and rural areas of 4 municipalities of Santiago and Boavista Islands in Cabo Verde. Mosquitoes were identified morphologically and by polymerase chain reaction-based techniques that targeted the mitochondrial cytochrome C oxidase subunit I sequence. During this period, 6,825 breeding sites were assessed, and of 8,094 mosquito specimens screened, 194 specimens of Culex thalassius were identified for the first time in the country in 4 municipalities of Santiago and Boavista Islands. This new finding highlights the importance of including entomological surveillance in health systems. Although this species has only been detected on a few islands, it is important to continuously monitor it to determine its distribution, spread/dispersal, density, and potential involvement in pathogen transmission.

Cancer is often considered a disease of older adults, yet in recent decades an increasing number of people under the age of 50 have been diagnosed with cancer worldwide. According to global data, the most common early-onset cancers include breast, tracheal/bronchus/lung, stomach, and colorectal cancers, followed by thyroid, pancreas, and liver malignancies. These cancers often behave more aggressively than those diagnosed later in life and contribute substantially to premature mortality and disability. Researchers believe that this trend is driven less by hereditary syndromes and more by cumulative environmental and lifestyle exposures beginning early in life. Diets high in ultra-processed foods, reduced physical activity, antibiotic overuse, pollution, psychosocial stress, and disruptions of the gut microbiome have all been implicated as potential contributors. Unlike inherited cancer syndromes, most early-onset cancers are sporadic, arising from complex interactions between modifiable exposures and host biology. Younger patients face unique challenges: they are underrepresented in clinical trials, often lack access to age-appropriate multidisciplinary care, and experience disruptions to education, employment, and family planning. Addressing this growing public health concern requires earlier screening for high-risk groups, investment in adolescent and young adult (AYA)-specific biorepositories and research, and policies that prioritize prevention, equity, and tailored care for younger populations.

One of the most recent concerns of this pandemic regards the role of schools reopening in disease transmission, as well as the impact of keeping schools closed. While school reopening seems critical for the education and mental health of children, adolescents, and adults, so far the literature has not systematically reached a consensus whether to recommend the return to schools in a way that would be safe for students and staff. To synthesize and critically evaluate the scientific evidence on the potential risk of accelerating the Coronavirus Disease 2019 (COVID-19) pandemic among children, adolescents, young adults, and adults with school reopening. This systematic review and meta-analysis protocol was elaborated following the PRISMA-P. We will include all observational study designs, which report on the potential risk of accelerating the COVID-2019 pandemic with school reopening. Electronic databases included were MEDLINE/PubMed, Cochrane Library, EMBASE, Web of Science, SCOPUS and CNKI. Additional sources will be also retrieved, including Clinical trials.gov-NIH, The British Library, Pro Quest Dissertations Database, Public Health Gray Literature Sources and Health Evidence, Google Scholar, and pre-prints [medRXiv]. No restriction to language or date will be used as search strategy. In an independently manner, two investigators will select studies, perform data extraction, as well as perform a critical appraisal of the risk of bias and overall quality of the selected observational studies, based on their designs. The heterogeneity among the studies will be assessed using the I2 statistic test. According to the results of this test, we will verify whether a meta-analysis is feasible. If feasibility is confirmed, a random-effect model analysis will be carried out. For data analysis, the calculation of the pooled effect estimates will consider a 95% CI and alpha will be set in 0.05 using the R statistical software, v.4.0.4. In addition, we will rate the certainty of evidence based on Cochrane methods and in accordance with the Grading of Recommendations Assessment, Development and Evaluation (GRADE). This systematic review and meta-analysis will provide better insights into safety in the return to school in the context of the COVID-2019 pandemic, at a time when vaccination advances unevenly in several countries around the world. Hence, consistent data and robust evidence will be provided to help decision-makers and stakeholders in the current pandemic scenario. CRD42021265283; https://clinicaltrials.gov.

Path planning techniques are of major importance for the motion of autonomous systems. In addition, the chosen path, safety, and computational burden are essential for ensuring the successful application of such strategies in the presence of obstacles. In this context, this work introduces a modified potential field method that is capable of providing obstacle avoidance, as well as eliminating local minima problems and oscillations in the influence threshold of repulsive fields. A three-dimensional (3D) vortex field is introduced for this purpose so that each robot can choose the best direction of the vortex field rotation automatically and independently according to its position with respect to each object in the workspace. A scenario that addresses swarm flight with sequential cooperation and the pursuit of moving targets in dynamic environments is proposed. Experimental results are presented and thoroughly discussed using a Crazyflie 2.0 aircraft associated with the loco positioning system for state estimation. It is effectively demonstrated that the proposed algorithm can generate feasible paths while taking into account the aforementioned problems in real-time applications.

Background Depression is one of the most common mental disorders among adolescents, negatively affecting their well-being and imposing a substantial economic burden on society. Understanding its prevalence and associated factors is crucial for effective prevention and intervention strategies. Methods This was a cross-sectional, quantitative study conducted nationwide in Cape Verde during October and November 2023. A structured sample of 782 adolescents (52.7% male), aged 15–19, was randomly selected from households and interviewed using the Mini International Neuropsychiatric Interview (MINI 5.0). Key validated instruments - including the MINI, BDI-II, DASS-21, BAI, BHS, BSS, MSPSS, SCS-SF and ASSIST - were employed for diagnostic and symptom assessment. Those diagnosed with depressive disorders completed additional self-assessment questionnaires. Data was analyzed using appropriate statistical tests to assess associations and significance levels ( p  < 0.05). Results The overall prevalence of depressive disorders was 11%, significantly higher in females ( p  < 0.05). No significant variation was observed across municipalities ( p  = 0.287), except for the major depressive episodes with melancholic features, which were more prevalent in Santa Catarina and Praia, followed by S. Vicente and S. Felipe [χ²(20, N  = 105) = 36.844; p  < 0.001]. Depressive symptoms were significantly associated with female sex, low family income, anxiety, stress, hopelessness, impaired social and romantic relationships, and elevated suicide risk ( p  < 0.05). However, no significant associations were found with current generalized anxiety disorder or alcohol abuse and other psychoactive substance use ( p  > 0.05). Self-compassion and perceived social support emerged as protective factors against depression ( p  < 0.05). Conclusions This study presents the first nationally representative data on adolescent depression in Cape Verde. The findings indicate a high prevalence (11%) of depressive disorders among adolescents aged 15–19, with considerable functional impairment and increased suicide risk. Key associated factors include being female, low household income, psychological distress (anxiety, stress, hopelessness), and difficulties in interpersonal relationships. Conversely, self-compassion and social support serve as important protective factors. Addressing gender disparities and reinforcing mental health interventions - especially for girls and adolescents from low-income families - is essential to reducing the burden of adolescent depression in Cape Verde. Clinical trial number Not applicable.

A comprehensive understanding of the factors influencing the epidemiological dynamics of COVID-19 across the pandemic waves—particularly in terms of disease severity and mortality—is critical for optimizing healthcare services and prioritizing high-risk populations. Here we aim to analyze the factors associated with short-term and prolonged hospitalization for COVID-19 during the first three pandemic waves. We conducted a retrospective observational study using data from individuals reported in the e-SUS-VS system who were hospitalized for COVID-19 in a state in a southeast state of Brazil. Hospitalization duration was classified as short or prolonged based on a 7-day cutoff, corresponding to the median length of hospital stay during the second pandemic wave. Bivariate analyses were performed using the chi-square test for heterogeneity. Logistic regression models were used to estimate odds ratios (ORs) and their respective 95% confidence intervals (CIs), with statistical significance set at 5%. When analyzing hospitalization duration across the three waves, we found that 51.1% (95%CI: 49.3–53) of hospitalizations in the first wave were prolonged. In contrast, short-duration hospitalizations predominated in the second (54.7%; 95% CI: 52.4–57.0) and third (51.7%; 95% CI: 50.2–53.2) waves. Factors associated with prolonged hospitalization varied by wave. During the first wave, older adults (≥60 years) (OR=1.67; 95%CI: 1.35–2.06), individuals with ≥10 symptoms (OR=2.03; 95%CI: 1.04–3.94), obese individuals (OR=2.0; 95%CI: 1.53–2.74), and those with ≥2 comorbidities (OR=2.22; 95%CI: 1.71–2.89) were more likely to experience prolonged hospitalization. In the second wave, he likelihood of extended hospital stays was higher among individuals aged ≥60 years (OR=2.04; 95%CI: 1.58–2.62) and those with ≥2 comorbidities (OR=1.77; 95%CI: 1.29–2.41). In the third wave, prolonged hospitalization was more frequent among older adults (OR=1.89; 95%CI: 1.65–2.17,), individuals with 5–9 symptoms (OR=1.52; 95%CI: 1.20–1.92), obese individuals (OR=2.2; 95%CI: 1.78–2.73), and those with comorbidities (OR=1.45; 95%CI: 1.22–1.72 and OR=2.0; 95%CI: 1.69–2.45). In conclusion, we identified variations in hospitalization patterns across the pandemic waves, although the differences were relatively subtle. These variations likely reflect gradual shifts in the risk factors associated with prolonged hospital stays. Our findings highlight t the importance of implementing targeted public health interventions, particularly those designed to reduce disease severity and improve clinical outcomes among vulnerable populations at greater risk of extended hospitalization.

This article analyzes spatial autocorrelations and the formation of clusters of exports, based on research and development (R&D) intensity in Portugal. The central idea is that exports show relative interdependence and spillover effects among nearby regions and a direct relationship with R&D expenditures. It adopts the new taxonomy of the OECD, separating exports by manufacturing and non-manufacturing activities by technological intensity. Methodologically, it applied exploratory spatial data analysis (ESDA), using global Moran’s index and LISA. The results showed the presence of positive spatial autocorrelation of exports and the formation of a cluster of the high–high type for the Área Metropolitana do Porto and Região de Aveiro . There is also a positive spatial autocorrelation for exports associated with R&D expenditures as well as the formation of a regional cluster with high–high pattern for the Região de Aveiro . This outcome can be explained, in part, by nationally and internationally recognized universities and research centers surrounding the region, favoring knowledge spillovers across the regions.