Search Results (892)

Exposure to light is an important factor in regulating sleep and sleep quality, especially for elderly people with a high risk of sleep problems. A systematic literature review was conducted to explore the current understanding of the relationship between light and sleep quality of the elderly, and to identify methodological gaps and soundness of existing studies to inform the design of future experimental studies. Specific focus is given to healthcare centres and similar settings due to their controlled environment and the high prevalence of sleep disturbances. Out of 406 publications screened from four databases—namely Google Scholar, Semantic Scholar, Lens.Org, and Scopus—380 studies remained after removing duplicates, and 19 studies published after 2002 that were relevant to the review topic were selected based on the PRISMA 2020 guidelines. The selected studies were analysed using six key aspects, which reflect typical components of experimental design such as participants’ characteristics, experiment and exposure duration, mode of light exposure, lighting and light interventions, experiment procedure, and data collection methods. The results indicated that many studies have limitations in terms of the accuracy and generalisability of findings in representing the entire elderly population due to issues with experimental design or control of the participants’ attendance. The results suggest that future studies should increase the duration of light intervention to around 21–35 days and the number of participants to around 14 and 47. The issues identified from the experimental designs of the selected studies provide valuable insights for establishing guidelines and recommendations for future studies. Full article

Background: Pharmacy schools in the United Kingdom (UK) are required by the regulator to train pharmacy students to be culturally competent. To meet this requirement, the Reading School of Pharmacy (RSoP) incorporated an inaugural, stand-alone, introductory session on intercultural competency. This study aimed to gather students’ experiences of the lecture. Methods: A qualitative study documented the experiences of students in Years 2 and 3 of the Master of Pharmacy (MPharm) at the RSoP from 15 September to 31 December 2023. Semi-structured interviews were conducted online via Microsoft Teams^®. A demographic form was prepared and sent as an online survey link on the Online Surveys^® platform. All eligible students were invited to participate in the study via student mailing lists. An interview guide was prepared. Thematic analysis was conducted to identify key themes related to students’ awareness, the perceived importance of the subject in healthcare, and students’ preferred learning methods. The transcripts were coded, and similar codes were grouped to form sub-themes and themes. The study was approved by a research ethics committee. Results: A total of 11 students attended the interviews. Three major themes emerged: (1) awareness of and reflection on cultural competence, (2) understanding cultural competence and its importance, and (3) student-preferred pedagogy. The students suggested incorporating workshops and simulation-based assessments. Conclusions: MPharm pharmacy students at the RSoP appear to be receptive to new educational interventions aimed at enhancing cultural competence. They prefer practice-based learning and assessment methods when it comes to developing this skill. Full article

Background: Digital Pathology (DP) and Artificial Intelligence (AI) have strongly developed in recent years, especially in pathology, with a high interest in dermatopathology. Accelerated by the COVID-19 pandemic, DP and AI are now integrated in pathology, research and education, bringing value to histopathological diagnoses, telepathology and personalized medicine. This narrative review presents a comprehensive literature review by defining three research directions, using scientometric analysis, of the current state of DP and AI in pathology and dermatopathology. Methods: The research was conducted through the Pubmed and Web of Science databases, within the research period of January 2019–July 2025: a two-phase methodology. Four independent pathologists selected the articles in accordance with the inclusion and exclusion criteria, and the synthesis of the articles was based on three research directions. Results: The research shows that CNN (Convolutional Neural Network), AI powered diagnostic platforms and telepathology strongly contribute to increasing the speed and accuracy of diagnostics, especially on cutaneous malignant skin tumors. There are still several challenges and limitations in terms of validation, interoperability, initial high implementation costs, ethics and transparency in AI and equity in healthcare. Conclusions: DP and AI are essential pillars of modern dermatopathology, with a high necessity of standardization, regulation and a multidisciplinary approach. Full article

With the rapid development of data technologies, the high privacy sensitivity of big data in healthcare imposes higher demands on its security supervision. This paper analyzes the interactive dynamics between the behaviors of regulators and regulated entities, aiming to explore the symmetry and balance between the utilization and protection of big data in healthcare in China. A two-party evolutionary game model between regulators and regulated entities is constructed and refined by incorporating herding preference utility coefficients, and simulation analyses are performed using MATLAB. Furthermore, the main models and differences in health data regulation among the United States, the European Union, the United Kingdom, and China are discussed for broader relevance. This study finds that the fine amount imposed on regulated entities during process supervision has a significant impact on their behavior, yet it cannot eliminate unstable fluctuations in the system. Reducing the prevention costs of regulated entities is the fundamental approach for the system to achieve an equilibrium state of maximum social welfare. Herding preference utility enhances system stability, and when this utility is sufficiently strong, it may even eliminate unstable fluctuations in the system. It is suggested that regulators should carefully consider the prevention costs of regulated entities when proposing prevention requirements, implement subsidy policies when necessary, explore a new model of multi-stakeholder collaborative supervision, enhance the risk awareness of relevant organizations, and strengthen publicity and guidance, thereby achieving the goal of big data security supervision in healthcare. Full article

The increasing complexity in hospital waste management requires innovative solutions that integrate sustainability and regulatory compliance. This study proposes an AI-based decision tool to support the circular management of healthcare waste. The approach combines two key elements: (i) the systematic qualitative analysis of international, European, and national regulations, scientific literature, and best practices aimed at identifying strategic actions; (ii) the prioritization of these actions through machine learning, using a Random Forest classifier. We identified 55 actions, grouped into 13 thematic areas, and used them as input variables to assess their impact on regulatory compliance. The variable importance analysis allowed us to classify actions according to their strategic relevance, guiding the structure of the tool and its user interface. Validation, conducted on four simulated case studies, demonstrated the system’s ability to improve compliance monitoring, operational efficiency, and the implementation of circular economy and Zero-Waste strategies. The proposed model represents a scalable and evidence-based solution capable of supporting the ecological transition of healthcare facilities in line with EU directives and the Sustainable Development Goals. Full article

Volumetric video streaming holds transformative potential for telemedicine, enabling immersive remote consultations, surgical training, and real-time collaborative diagnostics. However, transmitting sensitive patient data (e.g., 3D medical scans, surgeon head/gaze movements) raises critical privacy risks, including exposure of biometric identifiers and protected health information (PHI). To address the above concerns, we propose SecureTeleMed, a dual-track encryption scheme tailored for volumetric video based telemedicine. SecureTeleMed combines viewport obfuscation and region of interest (ROI)-aware frame encryption to protect both patient data and clinician interactions while complying with healthcare privacy regulations (e.g., HIPAA, GDPR). Evaluations show SecureTeleMed reduces privacy leakage by 89% compared to baseline encryption methods, with sub-50 ms latency suitable for real-time telemedicine applications. Full article

The increasing demographic aging of society is a great challenge to the healthcare sector and raises the socio-economic burden. Therefore, elucidating the mechanisms of aging and developing safe effective anti-aging products to prolong people’s healthy lifespan are paramount nowadays. Panax ginseng has been highly regarded since ancient times for its ability to enhance health and prolong life. However, its main active substances of anti-aging and their mechanisms are not fully understood. In this research, Caenorhabditis elegans was used as a model organism to explore and confirm the key active substances from Panax ginseng and the mechanisms that exert anti-aging effects. Various ginsenoside compounds were evaluated based on longevity, anti-stress, physiological function, etc. Ginsenoside Re, which has powerful anti-aging activity, was screened. In the follow-up trials, transcriptomics and RT-qPCR techniques were used to investigate the mechanism of Re in exerting its anti-aging properties. Differential genes were enriched in the Insulin/Insulin-like Growth Factor-1 Signaling (IIS) pathway, the neuropeptide signaling pathway, and lipid metabolism. A significant increase in the expression levels of daf-16, sgk-1, skn-1, hsf-1, hsp-16.2, sod-3, gst-4, fil-2, lips-11, cyp-35A4, and aex-2 genes, and a significant decrease in the expression levels of daf-2, age-1, and akt-2 genes were verified. These suggest that ginsenoside Re exerts its life-extending influence by regulating lipid metabolism and the IIS pathway. Full article

Diabetes, a major global healthcare challenge, is characterized by chronic hyperglycemia and significantly exacerbates the severity of systemic complications. Iron, an essential element ubiquitously present in biological systems, is involved in many biological processes facilitating cell proliferation and growth. However, excessive iron accumulation promotes oxidative damage through the Fenton reaction, thereby increasing the incidence of diabetes and worsening diabetic complications. Notably, ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, has emerged as a key mechanism underlying diabetes and diabetic complications. In this review, we provide an update on the current understanding of iron metabolism dysregulation in diabetes risk, and disclose the mechanistic links between iron overload and diabetes evidenced in hereditary hemochromatosis and thalassemia. We particularly highlight iron-mediated oxidative stress as a central nexus impairing glucose metabolism and insulin sensitivity. Furthermore, we discuss the significance of dysmetabolic iron and ferroptosis activation in the progression of diabetes and diabetic complications, as well as the possible application of natural products for iron metabolism regulation and ferroptosis-inhibition-targeted therapeutic strategies to treat diabetes and diabetic complications. Full article

Background/Objectives: Fat-soluble 25-hydroxyvitamin D (25-OHD) may be endogenously synthesized or obtained from dietary sources. Notably, it is crucial in calcium homeostasis, gene regulation, and immune system modulation, being even more relevant during prenatal stages, as the embryo utilizes vitamin D obtained from maternal plasma. Moreover, 25-OHD has been recently demonstrated to affect hematological parameters. We aimed to determine the correlation between maternal plasma 25-OHD levels, other blood parameters, and fetal anthropometric outcomes. Methods: Pregnant women attending an obstetrics and gynecology clinic during their gestation period were recruited, and data during follow-ups until the birth of their child were collected (IRB Approval Code: 07-XD-096). Data from 103 pregnant women were analyzed. Results: Compared to participants with normal levels, pregnant women with inadequate plasma 25-OHD levels exhibited a higher red blood cell count (4.3 ± 0.51 vs. 4.1 ± 0.42; p = 0.012) and lower mean corpuscular volume (86.4 ± 8.47 vs. 90.4 ± 6.74; p = 0.003), mean corpuscular hemoglobin (28.1 ± 3.34 vs. 29.6 ± 2.70; p = 0.008), plasma folate (12.6 ± 5.91 vs. 15.6 ± 5.86; p = 0.006), and vitamin B12 (289 ± 174 vs. 352 ± 147; p = 0.001) levels. Fish consumption frequency was positively associated with plasma 25-OHD levels. Conclusions: 25-OHD deficiency was correlated with alterations in hematological markers, plasma folate, and vitamin B12 levels. Given the high prevalence of 25-OHD deficiency in women of fertile age, government policies and healthcare professionals should emphasize vitamin D consumption adequacy in fertile women and expectant mothers. Full article

Zinc is an essential trace element involved in critical physiological functions such as gene expression, immune regulation, and cellular proliferation. This review explores the link between zinc homeostasis and cancer, with a specific focus on LIV-1 zinc transporters and their potential relevance to cancer research and treatment priorities in Saudi Arabia, as informed by global data. Zinc homeostasis is maintained by two major transporter families: ZIP (SLC39A) and ZnT (SLC30A). The dysregulation of specific ZIP transporters, particularly ZIP4, ZIP7, ZIP6, and ZIP10, has been implicated in cancer progression. Bioinformatic analyses revealed the significant overexpression of ZIP4, ZIP7, and ZIP6 in breast cancer and ZIP4 in colorectal cancer, which are the most common cancers among Saudi women and men, respectively. Notably, ZIP4 and ZIP7 upregulation correlated with poorer clinical outcomes, whereas ZIP6 was positively associated with survival in breast cancer. These findings underscore the potential of zinc transporters as prognostic biomarkers and therapeutic targets. Despite the substantial global evidence, research on zinc transporters in the Saudi population remains limited. Considering the Kingdom’s rising cancer burden and unique genetic, environmental, and dietary factors, understanding zinc metabolism in this context is important. Targeted research may support precision medicine strategies and improve outcomes in line with Saudi Arabia’s healthcare transformation goals. Full article

Out-of-pocket expenditure (OOPE) comprises 62% of national health expenditure in India. This heavy reliance on direct payments has engendered economic vulnerability and catastrophic financial pressures (typically defined as out-of-pocket spending exceeding a certain threshold of household income, leading to financial hardship) on households in a country where public health spending remains below targeted levels. The onset of the COVID-19 pandemic intensified these financial hardships further, as both total healthcare spending and OOPE experienced significant escalations due to the increased need for emergency care, vaccination efforts, and expanded health infrastructure. A retrospective, single-center study was conducted using data from COVID-19 patients admitted between June 2020 and June 2022. Patient data were collected from the Medical Records, IT, and Finance departments. A validated proforma was used for data extraction. Descriptive statistics were calculated, and the Shapiro–Wilk test was applied to assess normality of billing and OOPE data. Patients were stratified into three groups based on their insurance status, allowing for comparative analysis of OOPE percentages and absolute expenditures. The 2715 COVID-19 patients were categorized into three groups according to their health financing: those covered under AB-PMJAY (42.76%), private health insurance (22.16%), and the uninsured (35%). While the median billing amounts were comparable across these groups (ranging between INR 85,000 and INR 90,000), a substantial disparity was observed in terms of financial burden. All patients covered under AB-PMJAY incurred no OOPE, whereas privately insured patients had a median OOPE that constituted approximately 21% of their total billing amounts, with significant variability among different insurers. The uninsured group represented 35% of the cases and experienced the highest median OOPE, indicating substantial financial risk. The COVID-19 pandemic has revealed critical gaps in India’s health financing framework. This study emphasizes the strong financial protection provided by AB-PMJAY, while also exposing the limitations of private health insurance in shielding patients from substantial healthcare costs. As the country progresses toward universal health coverage, there is a pressing need to expand public health insurance schemes that are inclusive, equitable, and effectively implemented. Additionally, strengthening regulation and accountability in the private insurance sector is essential. The study findings reinforce that AB-PMJAY has been highly successful in reducing OOPE and enhancing financial risk protection. Although private insurance reduced OOPE, patients still faced considerable expenses. The stark difference in OOPE of 100% for uninsured patients, 21.16% for privately insured, and 0% for AB-PMJAY beneficiaries underscores the importance of further expanding AB-PMJAY to reach more vulnerable populations. Full article

Digital transformation in healthcare has introduced data privacy challenges, as hospitals struggle to protect patient information while adopting digital technologies such as AI, IoT, and cloud more rapidly than ever before. The adoption of powerful third-party Machine Learning as a Service (MLaaS) solutions for disease prediction has become a common practice. However, these solutions offer significant privacy risks when sensitive healthcare data are shared externally to a third-party server. This raises compliance concerns under regulations like HIPAA, GDPR, and Australia’s Privacy Act. To address these challenges, this paper explores a decentralized, privacy-preserving approach to train the models among multiple healthcare stakeholders, integrating Federated Learning (FL) with Homomorphic Encryption (HE), ensuring model parameters remain protected throughout the learning process. This paper proposes a novel Homomorphic Encryption-based Adaptive Tuning for Federated Learning (HEAT-FL) framework to select encryption parameters based on model layer sensitivity. The proposed framework leverages the CKKS scheme to encrypt model parameters on the client side before sharing. This enables secure aggregation at the central server without requiring decryption, providing an additional layer of security through model-layer-wise parameter management. The proposed adaptive encryption approach significantly improves runtime efficiency while maintaining a balanced level of security. Compared to the existing frameworks (non-adaptive) using 256-bit security settings, the proposed framework offers a 56.5% reduction in encryption time for 10 clients and 54.6% for four clients per epoch. Full article

The Internet of Medical Things (IoMT) is revolutionizing healthcare by enabling continuous monitoring and real-time data collection through interconnected medical devices such as wearable sensors and smart health monitors. These devices generate sensitive physiological data, including cardiac signals, glucose levels, and vital signs, that are integrated into electronic health records (EHRs). Machine Learning (ML) and Deep Learning (DL) techniques have shown significant potential for predictive diagnostics and decision support based on such data. However, traditional centralized ML approaches raise significant privacy concerns due to the transmission and aggregation of sensitive health information. Additionally, compliance with data protection regulations, such as the Health Insurance Portability and Accountability Act (HIPAA) and General Data Protection Regulation (GDPR), restricts centralized data sharing and analytics. To address these challenges, this study introduces FED-EHR, a privacy-preserving Federated Learning (FL) framework that enables collaborative model training on distributed EHR datasets without transferring raw data from its source. The framework is implemented using Logistic Regression (LR) and Multi-Layer Perceptron (MLP) models and was evaluated using two publicly available clinical datasets: the UCI Breast Cancer Wisconsin (Diagnostic) dataset and the Pima Indians Diabetes dataset. The experimental results demonstrate that FED-EHR achieves a classification performance comparable to centralized learning, with ROC-AUC scores of 0.83 for the Diabetes dataset and 0.98 for the Breast Cancer dataset using MLP while preserving data privacy by ensuring data locality. These findings highlight the practical feasibility and effectiveness of applying the proposed FL approach in real-world IoMT scenarios, offering a secure, scalable, and regulation-compliant solution for intelligent healthcare analytics. Full article

The health technology assessment (HTA) is a multidisciplinary process utilized to determine the clinical, economic, social, and ethical value of new health technologies before they are incorporated into healthcare systems. In the case of rare diseases, such as Cystic Fibrosis (CF), challenges arise due to limited evidence and high treatment costs. Indeed, although CF transmembrane conductance regulator (CFTR) modulators are breakthrough therapies for CF, their incorporation into public health systems has been complex with considerable challenges, especially in low- and middle-income countries. This article presents a descriptive and exploratory case study of the regulatory and policy journey for CFTR modulators to be approved in Brazil. Based on a narrative review and document analysis, we highlight the importance of building lay society knowledge to shape policy decisions and promote equitable access to innovative therapies. In parallel, we critically reflect on the HTA process and highlight efforts in the training, education, and coordination required to enable meaningful public engagement and landmark achievements. Full article

Background and Rationale: Visceral disorders, both functional and organic, significantly impact health-related quality of life and pose a challenge for healthcare systems. Osteopathy offers manual, systemic, and patient-centered approaches for their management, yet these remain controversial due to limited scientific support and methodological inconsistencies. In the evolving landscape of healthcare regulation in Europe, and particularly in Italy, exploring clinical reasoning and operational models in visceral osteopathy is essential. This study aimed to explore the beliefs, clinical reasoning, and management strategies of experienced Italian osteopaths in the treatment of visceral disorders using a Constructivist Grounded Theory approach. Methods: This qualitative study applied a Constructivist Grounded Theory approach to explore the beliefs and clinical practices of 10 experienced Italian osteopaths. Semi-structured interviews were transcribed, coded, and thematically analyzed, integrating literature comparisons to support theory generation. Results: Four core themes emerged: (1) education and professional development, (2) definition and identification of visceral disorders, (3) clinical management strategies, and (4) multidisciplinary collaboration. The findings reveal marked heterogeneity in diagnostic frameworks and treatment rationales, often driven by tradition and subjective interpretation rather than empirical evidence. Palpatory assessments were frequently prioritized over patient-reported outcomes. Conclusion: The study highlights substantial fragmentation in Italian visceral osteopathic practice, echoing challenges across Europe. Promoting a shift towards critical thinking, evidence-based models, shared terminology, and interprofessional integration is essential for contextualising osteopathic contributions to the care of individuals presenting with visceral-related problems. These findings provide insights into the fragmented clinical practices of Italian osteopaths and may contribute to shaping a more critical and evidence-informed approach within Italian osteopathic practice and professional development, which is now more relevant than ever, given the recent integration of osteopathy into the Italian higher education system. Full article