Search Results (9,431)

Background/Objectives: Ostomy creation surgery is a common intervention for patients with conditions such as colorectal cancer, ulcerative colitis, Crohn’s disease, or acute events like trauma and gastrointestinal perforation. Individuals with an ileostomy face unique challenges when managing their new ostomies due to the liquid caustic nature of the effluent, increasing the likelihood of leakage and peristomal skin complications (PSCs). This sub-analysis evaluates the prevalence of leakage and PSCs in a cohort of individuals with a new ileostomy and examines the risk of leakage of different ostomy pouching systems and their impact on leakage and PSCs. Methods: This sub-analysis examined a cohort of 98 patients from a previously published retrospective chart review of stoma-creation surgeries at the University of Pittsburgh Medical Center. Data on pouching system selection, leakage, and PSCs were collected from electronic medical records and evaluated across 479 pouch changes. Two main barrier pouching systems were analyzed: elastic tapeless border (ETB) and ceramide-infused tape-border (CIB) barriers. Statistical analyses using generalized linear mixed models assessed the risk of leakage for each barrier type and controlled for significant differences in the sub-groups. Results: The prevalence of leakage in the ileostomy cohort was 19%, with the prevalence of leakage increasing over successive pouch changes. The ETB sub-group experienced a significantly lower risk of leakage (13.7%) compared to CIB (29.3%), reflecting a 53.2% lower risk of leakage with ETB (p = 0.03; OR 2.45). Conclusions: This sub-analysis of ileostomy patients confirms that ETB significantly reduces the risk of leakage in this more difficult to manage population compared to CIB, a clinically important consideration in PSC development and overall ostomy management. Evidence-based selection of ostomy barriers can improve patient outcomes, enhance quality of life, and reduce healthcare resource utilization. Full article

In the process of Chinese-style modernisation, the socially and culturally coordinated development of cities in the Yangtze River Economic Belt is important for promoting regional coordinated development, enhancing the balance of public services, and strengthening cultural soft power. This study used quantitative methods, including the construction of an indicator system, spatial correlation analysis, and Zipf’s rank-size rule, on data from 2011 to 2021 to analyse the capacity for coordinated social and cultural development and assessed the spatial distribution characteristics of the Yangtze River Economic Belt. The study found that the overall level of social and cultural coordination among the cities in the Yangtze River Economic Belt steadily improved; however, significant regional disparities still exist, particularly in areas such as social security and cultural integration. Spatially, a “high in the east, low in the west” pattern is observed, with the Yangtze River Delta city cluster leading development, the midstream cluster playing a supportive role, and the Chengdu–Chongqing city cluster showing significant internal disparities. Core cities such as Shanghai, Hangzhou, Wuhan, and Chengdu demonstrated driving effects in areas such as culture, education, and healthcare; however, some peripheral cities remain underdeveloped. This study suggests the need to enhance the development of the Yangtze River’s culture, promote the development of cultural industry clusters, foster the integration of various business models, leverage scientific and educational resources, optimise the cultural consumption market, and achieve the coordinated development of the social and cultural sectors, thereby enabling the Yangtze River Economic Belt to play a greater role in Chinese-style modernisation. Full article

Background/Objectives: Artificial intelligence (AI) is increasingly integrated into everyday life, including the complex and highly regulated healthcare sector. Given healthcare’s essential role in safeguarding human life and well-being, AI deployment requires careful oversight to ensure safety, effectiveness, and ethical compliance. This paper aims to examine the current regulatory landscapes governing AI in healthcare, particularly in the European Union (EU) and the United States (USA), and to propose practical tools to support the responsible development and implementation of AI systems. Methods: The study reviews key regulatory frameworks, ethical guidelines, and expert recommendations from international bodies, professional associations, and governmental institutions in the EU and USA. Based on this analysis, the paper develops structured questionnaires tailored for AI developers and implementers to help operationalize regulatory and ethical expectations. Results: The proposed questionnaires address critical gaps in existing frameworks by providing actionable, lifecycle-oriented tools that span AI development, deployment, and clinical use. These instruments support compliance and ethical integrity while promoting transparency and accountability. Conclusions: The structured questionnaires can serve as practical tools for health technology assessments, public procurement, accreditation processes, and training initiatives. By aligning AI system design with regulatory and ethical standards, they contribute to building trustworthy, safe, and innovative AI applications in healthcare. Full article

Climate change is among the most significant challenges of the 21st century, with global warming, heat stress, floods, and drought occurring in various parts of the globe, including Africa. The impact of climate change on health is becoming increasingly substantial on the African continent due to weaknesses in economies, infrastructure, and healthcare systems. This review explores the relationship between climate change and emerging and re-emerging infectious diseases in Africa and highlights possible solutions. It was conducted by summarizing and synthesizing related information from relevant scientific publications. This review reveals that climate change significantly contributes to Africa’s emerging and re-emerging infectious diseases, including Ebola, Marburg, Lassa fever, dengue fever, malaria, and cholera. The impact of climate change on infectious diseases is variable across the continent, with countries in West and Central Africa experiencing more significant climate change-instigated disease burdens. Multisectoral cooperation between climate change actors, environmental health researchers, policy makers, and political leaders centered in the One Health approach is necessary to develop and implement resilient interventions for climate change-induced emerging and re-emerging infections and related health hazards. Full article

Postoperative pain management after hospital discharge remains one of the main clinical challenges. The use of digital and telemedicine tools offers new opportunities for the continuous monitoring of, and timely intervention in, patients discharged and followed at home. This scoping review, conducted according to the PRISMA-ScR checklist and the Joanna Briggs Institute methodology, analyzed 26 studies selected through a search of PubMed, Scopus, and Web of Science databases. Inclusion criteria comprised studies published between 2015 and 2025 that involved patients discharged home after surgery, that used digital or telemedicine tools for pain management, and that included active involvement of healthcare professionals and reported clinical outcomes. Studies show the use of a variety of digital tools, including mobile applications, web platforms, wearable sensors, automated messaging systems, and virtual reality technologies, alternating across settings for the assessment and management of pain at home, educational and therapeutic support, and to enhance communication between healthcare professionals and patients. Most reported outcomes focus on improved home-based pain control, a reduction in opioid consumption, and a high level of patient satisfaction. However, some challenges remain, particularly the low level of digital literacy among certain segments of the population. In conclusion, the implementation of telemedicine and digital technologies for managing postoperative pain at home proves to be a promising strategy. Nonetheless, it requires further scientific investigation and, from policymakers, significant investments in professional training and technological infrastructure to ensure an increasingly equitable and sustainable distribution of home healthcare services. Full article

Promethazine hydrochloride (PMH) is a first-generation antipsychotic drug created from phenothiazine derivatives that is widely employed to treat psychiatric disorders in human healthcare systems. However, an overdose or long-term intake of PMH can lead to severe health issues in humans. Hence, establishing a sensitive, accurate, and efficient detection approach to detect PMH in human samples is imperative. In this study, we designed orthorhombic copper molybdate microspheres decorated on reduced graphene oxide (Cu₃Mo₂O₉/RGO) composite via the effective one-pot hydrothermal method. The structural and morphological features of the designed hybrid were studied using various spectroscopic methods. Subsequently, the electrochemical activity of the composite-modified screen-printed carbon electrode (Cu₃Mo₂O₉/RGO/SPCE) was assessed by employing voltammetric methods for PMH sensing. Owing to the uniform composition and structural benefits, the combination of Cu₃Mo₂O₉ and RGO has not only improved electrochemical properties but also enhanced the electron transport between PMH and Cu₃Mo₂O₉/RGO. As a result, the Cu₃Mo₂O₉/RGO/SPCE exhibited a broad linear range of 0.4–420.8 µM with a low limit of detection (LoD) of 0.015 µM, highlighting excellent electrocatalytic performance to PMH. It also demonstrated good cyclic stability, reproducibility, and selectivity in the presence of chlorpromazine and biological and metal compounds. Furthermore, the Cu₃Mo₂O₉/RGO/SPCE sensor displayed satisfactory recoveries for real-time monitoring of PMH in human urine and serum samples. This study delivers a promising electrochemical sensor for the efficient analysis of antipsychotic drug molecules. Full article

Anxiety disorders are among the most common psychiatric conditions that significantly impair one’s quality of life and place a significant burden on healthcare systems. Conventional treatments have certain restraints, such as potential side effects and limited efficacy. Τhe underlying pathophysiological mechanisms of anxiety are not fully understood. A comprehensive literature search was performed in MEDLINE and Scopus databases for original English-language articles published between January 2014 and December 2024. Study selection, data extraction, and screening were independently carried out by multiple investigators using predefined criteria. Our review aimed to help better comprehend the molecular basis of anxiety, focusing on the hypothalamic–pituitary–adrenal (HPA) axis, serotonergic signaling, and gamma-aminobutyric acid (GABA) neurotransmission. In addition, we addressed the role of epigenetics and pharmacogenomics in personalized treatment. Although novel anxiety treatments are promising, they are predominantly preclinical and highly heterogeneous, which poses a challenge to achieving reliable therapeutic efficacy. Our findings could potentially contribute to the development of new therapeutic interventions. Further research is warranted, especially in human subjects, with an aim to combine genetic and epigenetic profiles to refine treatment approaches and develop innovative therapeutics. Full article

Telemedicine has emerged as a vital tool for expanding healthcare access, particularly in underserved areas, yet its effectiveness is often hindered by inefficient queuing systems, fluctuating patient demand, and limited resources. This study addresses these challenges by developing a hybrid Artificial Neural Network–Particle Swarm Optimization (ANN-PSO) model aimed at improving the performance of telemedicine queuing systems. A simulation-based dataset was generated to represent patient arrivals, service rates, and queuing behaviors. An ANN was trained to predict key performance metrics, including queue intensity, system utilization, and delays. To further enhance the model’s predictive capabilities, PSO was applied to optimize critical ANN parameters, such as neuron count, swarm size, and acceleration factors. The optimized ANN-PSO model achieved high predictive accuracy, with correlation coefficients (R²) consistently exceeding 0.90 and low mean squared errors across most outputs. The findings show that optimal parameter configurations vary depending on the specific performance metric, reinforcing the value of adaptive optimization. The results confirm the ANN-PSO model’s ability to accurately predict queuing behavior and optimize system performance, providing a practical decision-support tool for telemedicine administrators to dynamically manage patient flow, reduce waiting times, and enhance resource utilization under variable demand conditions. Full article

Falls are a major health concern for older adults, often leading to injuries and reduced independence. This study develops and evaluates a mobile application integrating two validated fall-risk assessment tools—the Stay Independent Brochure (SIB) and the 44-question Thai Home Falls Hazards Assessment Tool (Thai-HFHAT). The app utilizes a cloud-based architecture with a relational database for real-time analytics and user tracking. In Phase 1, 30 healthcare professionals assessed the app’s technical performance and user experience using a modified System Usability Scale (SUS), achieving a high usability score of 85.2. In Phase 2, 67 older adults used the app for self-assessment, with test–retest reliability evaluated over one week. The app showed strong reliability, with intraclass correlation coefficients (ICCs) of 0.80 for the SIB (Thai-version) and 0.77 for the Thai-HFHAT. Cloud-hosted analytics revealed significant correlations between fall occurrences and both SIB (r = 0.657, p < 0.001) and Thai-HFHAT scores (r = 0.709, p < 0.001), demonstrating the app’s predictive validity. The findings confirm the app’s effectiveness as a self-assessment tool for fall-risk screening among older adults, combining clinical validity with high usability. The integration of culturally adapted tools into a cloud-supported platform demonstrates the value of informatics in geriatric care. Future studies should focus on expanding the app’s reach, incorporating AI-driven risk prediction, enhancing interoperability with electronic health records (EHRs), and improving long-term user engagement to maximize its impact in community settings. Full article

Background/Objectives: During the COVID-19 pandemic, several antivirals were approved or repurposed, but their safety profiles have not been fully compared. Pharmacovigilance data help clarify how these drugs perform in real-world use. Methods: This study performed a comparative pharmacovigilance analysis of eight antivirals used or tested during the COVID-19 pandemic, based on individual case safety reports (ICSRs) retrieved from the EudraVigilance database, reported up to 9 February 2025 and extracted from the official platform on 12 February 2025. Adverse reactions were assessed by system organ class (SOC), demographic patterns, and seriousness, and disproportionality analysis (reporting odds ratio (ROR)) was conducted to identify potential safety signals. Results: A total of 64,776 ICSRs were analyzed. Among approved antivirals, nirmatrelvir/ritonavir (NTV/r) accounted for 13.4% (n = 8693) of reports, while remdesivir (RDV) represented 6.3% (n = 4105). Repurposed antivirals such as ribavirin and lopinavir/ritonavir dominated the dataset, together making up over 80% (n = 51,978) of all reports. RDV was associated with a high proportion of serious adverse events (84%, n = 3448), and showed consistent ROR signals in hepatobiliary, renal, cardiac, and general disorders, with values exceeding 2 in several comparisons. NTV/r displayed a milder overall profile, but with positive RORs for psychiatric disorders, gastrointestinal disorders, and product-related issues. The most affected SOCs across all drugs included general disorders (31.6%, n = 20,493), gastrointestinal (19.5%, n = 12,625), nervous system (17.8%, n = 11,511), and investigations (20.4%, n = 13,219). Demographic analysis showed that most events occurred in adults aged 18–64, with RDV more often reported in elderly patients and NTV/r more frequently associated with reports from female patients and non-healthcare reporters. Conclusions: This study highlights distinct pharmacovigilance profiles of COVID-19 antivirals and supports the role of real-world data in guiding safer therapeutic choices. Full article

Assistive technology (AT) is increasingly utilized across various sectors, including digital healthcare and sports education. E-learning plays a vital role in enabling students with special needs, particularly those in remote areas, to access education. However, as the adoption of AI-based AT systems expands, the associated cybersecurity challenges also grow. This study aims to examine the impact of AI-driven assistive technologies on cybersecurity in digital healthcare applications, with a focus on the potential vulnerabilities these technologies present. Methods: The proposed model focuses on enhancing AI-based AT through the implementation of emerging technologies used for security, risk management strategies, and a robust assessment framework. With these improvements, the AI-based Internet of Things (IoT) plays major roles within the AT. This model addresses the identification and mitigation of cybersecurity risks in AI-based systems, specifically in the context of digital healthcare applications. Results: The findings indicate that the application of the AI-based risk and resilience assessment framework significantly improves the security of AT systems, specifically those supporting e-learning for blind users. The model demonstrated measurable improvements in the robustness of cybersecurity in digital health, particularly in reducing cyber risks for AT users involved in e-learning environments. Conclusions: The proposed model provides a comprehensive approach to securing AI-based AT in digital healthcare applications. By improving the resilience of assistive systems, it minimizes cybersecurity risks for users, specifically blind individuals, and enhances the effectiveness of e-learning in sports education. Full article

The integration of health and social care is increasingly recognized as essential to address population ageing, the rise in chronic diseases, and persistent health inequities. Across Europe, diverse models have been developed to improve service coordination, resource efficiency, and person-centered care. This paper aims to explore international experiences in integrating health and social care, identify common strategies and challenges, and provide insights to inform policy development in countries where integration remains incipient, with a focus on Portugal. A qualitative comparative approach was employed. A systematic literature review was conducted across PUBMED, MEDLINE, and Google Scholar, including peer-reviewed articles, policy reports, and government documents. Thematic analysis was used to identify integration models, enablers, and barriers across different countries. Different models reveal that joint governance, pooled funding, strong community involvement, and digital innovation are key enablers of integration. However, common challenges persist, including fragmented governance, inconsistent implementation, and financial sustainability. In Portugal, structural separation between the health and social sectors continues to limit strategic alignment. Successful integration depends on political commitment, shared vision, and active stakeholder collaboration. European models offer adaptable lessons for Portugal and similar systems, especially regarding intersectoral coordination and preventive care. Integrating health and social care is vital for building resilient, equitable systems. Portugal must adopt a cohesive national strategy; strengthen local implementation; and embrace person-centered, sustainable solutions to ensure long-term impact. Integrating the health and social sectors is indispensable in navigating the ever-evolving healthcare landscape and promoting holistic well-being. Full article

Fibrin sealants have been implemented in the management of burn wounds. They can be used either in combination with skin grafts for full-thickness burns or alone for treating superficial and deep dermal burns. The aim of this review was to provide critical insights regarding the efficacy of fibrin sealants in enhancing wound healing, improving graft adherence, and reducing complications. Therefore, evidence from experimental models and clinical trials was synthesized, underscoring the transformative role of fibrin sealants in modern burn care. This comprehensive review includes recent evidence on the potential benefits of fibrin sealants in the management of superficial and deep dermal or full-thickness burn injuries. Clinical and experimental evidence underscores some benefits in utilizing fibrin sealants in the management of superficial and deep dermal burn injuries, or in combination with skin grafts in full-thickness burns. Furthermore, fibrin sealants diminish postoperative pain and facilitate quick recovery for daily activities; however, controversy regarding their cost still remains. This review concludes that fibrin sealants could serve as a safe and effective therapeutic option for burn wound management. The safety and efficacy of their utilization, along with their wide availability and easiness to use, could make them an alternative treatment choice when a specialized plastic surgery service is not available, or in the emergency setting across different healthcare systems. Full article

Surgical errors involving paired organs can have severe consequences, particularly in procedures where laterality is a critical factor. Wrong-site surgeries indicate failures in risk management and patient safety protocols, requiring continuous improvements in preventive strategies. In ophthalmology, where precision is essential, the adoption of structured approaches has significantly reduced the incidence of such errors. The Universal Protocol, introduced in 2004 by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), has defined standardized procedures to prevent these events and has subsequently been adapted to ophthalmic surgery by specialized scientific societies such as the American Academy of Ophthalmology (AAO). Additionally, multidisciplinary interventions, including AI-assisted verification systems, human factors analysis, and enhanced surgical checklists, continue to strengthen error prevention. This review examines the implementation and development of these strategies in ophthalmic surgery, evaluating their effectiveness and identifying persistent challenges in surgical safety Full article

Catheter-associated urinary tract infections (CAUTIs), caused by microbial colonization of catheter surfaces, are among the most common healthcare-associated infections and significantly strain healthcare systems worldwide. This review aimed to provide a comprehensive analysis of the current scientific literature and the patent landscape from 2014 to 2024 on strategies for preventing CAUTIs. A systematic search was conducted using the PRISMA method, which involved searching the Scopus database for scientific evidence and analyzing patent search results on The Lens.org platform. Co-authorship and co-occurrence analysis unveiled key contributors and emerging themes within the scientific community. Simultaneously, an in-depth inspection of patents filed elucidated top origins, applicants, and classifications. Additionally, network analysis based on keywords from papers and patents revealed the scientific scenario and the innovation trends, enriching the understanding of technological advancements. It highlights emerging technologies, key actors, and potential gaps, providing valuable insights for researchers, clinicians, and industry stakeholders, thereby contributing to overcoming barriers to treating CAUTIs. Full article