Search Results (6,827)

Background/Objectives: Pain, anxiety, and distress are common yet frequently insufficiently managed issues for patients undergoing radiology and radiotherapy procedures. Immersive technologies, including virtual reality (VR), augmented reality (AR), and mixed reality (MR), are emerging as innovative non-pharmacological approaches to alleviate such burdens through engaging interventions. This review, combining scoping and narrative methodologies, seeks to examine the current application, efficacy, and integration of these technologies to enhance patient care and wellbeing within diagnostic and oncological environments. Methods: Employing a mixed scoping and narrative review approach, this study conducted a systematic search of PubMed, EMBASE, Scopus, and Web of Science databases (no date restrictions—search included studies up to May 2025) to identify relevant studies utilizing VR, AR, MR, or XR for mitigating pain, anxiety, or distress in patients undergoing radiology or radiotherapy. Two independent reviewers selected eligible papers, with data extracted systematically. The narrative analysis supplemented the scoping review by providing contextual insights into clinical relevance and technological challenges. Results: The screening process identified 76 articles, of which 27 were assessed for eligibility and 14 met the inclusion criteria. Most studies focused on oncology and primarily employed VR as the immersive technology. VR has shown promising effects in reducing anxiety and pain—particularly during radiotherapy sessions and invasive procedures—and in supporting patient education through engaging, immersive experiences, making it a valuable approach meriting further investigation. Patient acceptance was notably high, especially among those with elevated distress levels. However, findings in radiology were less consistent, likely due to shorter procedure durations limiting the effectiveness of VR. The variability in outcomes highlights the importance of tailoring immersive interventions to specific procedures and patient needs. The narrative component identified key barriers, such as regulatory hurdles, standardization issues, and implementation challenges, that need addressing for broader clinical adoption. Conclusions: Immersive digital therapeutics are evolving from preliminary research tools toward more structured incorporation into clinical practice. Their future success relies on harmonizing technological advancements with patient-focused design and robust clinical evidence. Achieving this will require collaborative efforts among researchers, industry stakeholders, and healthcare providers. The integration of scoping and narrative review methods in this study offers a comprehensive perspective on the current landscape and informs strategic directions for advancing immersive technologies in radiology and radiotherapy. Full article

The objective of the present study was to compare the diagnostic performance of radiography to computed tomography (CT) for the diagnosis of distal tarsal osteoarthritis. All images were interpreted and scored by 2 evaluators until a consensus was reached; they were blinded to the history, final imaging diagnosis, and results of the corresponding radiographic or CT study. On radiographs and CT images of 54 tarsi, 6 criteria (osteophyte/enthesophyte height, small/large subchondral bone radiolucencies, subchondral bone thickness, joint space narrowing) were scored in the proximal intertarsal (PIJ), distal intertarsal (DIJ), and tarsometatarsal joint (TMTJ). Compared to CT, mean radiographic scores were significantly lower for 1. small and large subchondral bone radiolucencies in all joints (p < 0.001–0.03); 2. subchondral bone thickness in the PIJ and DIJ (p = 0.03 and 0.005); and 3. enthesophyte and joint space narrowing score in the DIJ (p = 0.04 and 0.002). Low-to-high positive predictive values (PPV) were calculated for the individual criteria in all joints (0–100%). For the sum of scores of all criteria in the PIJ, DIJ, or TMTJ, respectively, PPVs were high (94–98%). In conclusion, radiography is a useful screening tool provided multiple criteria are assessed. However, CT offers significant advantages for the diagnosis of distal tarsal OA. Full article

Down syndrome (DS) is one of the prevalent chromosomal disorders, representing distinctive craniofacial features and a range of developmental and medical challenges. Due to the lack of clinical expertise and high infrastructure costs, access to genetic testing is restricted to resource-constrained clinical settings. There is a demand for developing a non-invasive and equitable DS screening tool, facilitating DS diagnosis for a wide range of populations. In this study, we develop and validate a robust, interpretable deep learning model for the early detection of DS using facial images of infants. A hybrid feature extraction architecture combining RegNet X–MobileNet V3 and vision transformer (ViT)-Linformer is developed for effective feature representation. We use an adaptive attention-based feature fusion to enhance the proposed model’s focus on diagnostically relevant facial regions. Bayesian optimization with hyperband (BOHB) fine-tuned extremely randomized trees (ExtraTrees) is employed to classify the features. To ensure the model’s generalizability, stratified five-fold cross-validation is performed. Compared to the recent DS classification approaches, the proposed model demonstrates outstanding performance, achieving an accuracy of 99.10%, precision of 98.80%, recall of 98.87%, F1-score of 98.83%, and specificity of 98.81%, on the unseen data. The findings underscore the strengths of the proposed model as a reliable screening tool to identify DS in the early stages using the facial images. This study paves the foundation to build equitable, scalable, and trustworthy digital solution for effective pediatric care across the globe. Full article

Background/Objectives: Malnutrition is a common but underrecognized complication in colorectal cancer (CRC), contributing to poor treatment outcomes and reduced quality of life. Regional data from the Gulf remains limited. This study assessed the prevalence of malnutrition and nutrition impact symptoms (NISs) among CRC patients in Kuwait. It evaluated the diagnostic performance of the PG-SGA Short Form (PG-SGA SF) in comparison to the full PG-SGA and the Malnutrition Screening Tool (MST). Methods: A cross-sectional study was conducted among 65 CRC outpatients at the Kuwait Cancer Control Center. Nutritional status was assessed using the full PG-SGA, PG-SGA SF, and MST. Dietary intake, anthropometry, biochemical parameters, and NISs were collected. Logistic regression identified independent predictors of malnutrition, and the performance of the tool was evaluated using kappa statistics and diagnostic accuracy metrics. Results: Malnutrition (PG-SGA B/C) was identified in 61.4% of patients. Loss of appetite, dry mouth, and nausea were significantly associated with malnutrition (p < 0.00385); dry mouth independently predicted malnutrition (OR: 17.65, 95% CI: 2.02–154.19, p = 0.009). BMI was not predictive, but reduced mid-arm circumference was significantly associated. PG-SGA SF showed strong agreement with the full PG-SGA (κ = 0.75), with high sensitivity (87.2%) and specificity (88.5%), outperforming MST (κ = 0.38). Only 23.5% of moderately malnourished patients were referred to a dietitian. Conclusions: Malnutrition and NIS are highly prevalent among Kuwaiti CRC patients. PG-SGA SF is a valid and efficient screening tool that should replace MST in oncology settings. Symptom-informed screening and structured referral protocols are crucial for enhancing nutrition care. Full article

Recreational noise-induced hearing loss (RNIHL) is a significant factor contributing to hearing loss in young people. Its process is irreversible, and early symptoms are hidden. Therefore, early identification is of great significance. Otoacoustic emissions (OAEs) are commonly used to detect the function of outer hair cells. It is widely used for early diagnosis of occupational noise-induced hearing loss, but it remains underutilized in RNIHL detection. In order to explore the characteristics of RNIHL and the early detection value of different types of OAEs, this study reviewed the detection results of OAEs in previous studies on noise-induced hearing loss and analyzed the differences and causes among the studies. The study found that, through the detection of distortion product otoacoustic emissions (DPOAEs), there were differences in the sensitive frequency bands of outer hair cell damage between recreational noise and occupational noise, particularly in the high-frequency region. Transient-evoked otoacoustic emissions (TEOAEs) can fully reflect the damage to cochlear outer hair cells caused by RNIHL. This study indicates that OAEs, particularly TEOAEs, can serve as a highly sensitive and objective detection tool for RNIHL, whereas DPOAEs are more appropriate for the early screening of occupational noise-induced hearing loss. Full article

Background: CF transmembrane conductance regulator (CFTR) modulators are available for 90% of people with cystic fibrosis (PWCF), which has contributed to substantial nutritional changes. PWCF identify differences in their relationship with food, as well as alterations in body size and image when taking CFTR modulators. This has led to increasing risks relating to issues with body image, disordered eating behaviors (DEBs), and eating disorders (EDs). DEBs can be an early indication of an ED. CF care has traditionally emphasized body mass index and weight gain, which may have heightened the critical focus of body habitus. Prior to CFTR modulators, the “legacy diet” was often promoted and after years of encouragement to eat high volumes of calorically dense foods, PWCF on modulators have shared that the subsequent body changes have been challenging. Given the body changes that PWCF may have experienced, CF care team nutritional guidelines are evolving. The prevalence and etiology of EDs is largely unknown. Therefore, interventions designed to reduce risk factors for EDs and enhance protective factors against the development of DEBs need to be prioritized. To date, there are no reliable and validated screening tools in the United States to identify DEBs for PWCF. The purpose of this paper is to (1) review eating behaviors and disordered eating in PWCF, and (2) discuss important future directions for the assessment and treatment of DEBs to improve quality of life for PWCF. Full article

Acute lymphoblastic leukemia (ALL) represents the most common type of cancer in the pediatric population. The (1;19)(q23;p13) translocation is a primary chromosomal abnormality present in 3–12% of ALL cases. The current study aims to develop a label-free innovative nanodevice for the ultrasensitive diagnosis of the TCF3-PBX1 chimeric oncogene, featuring simplified operation and rapid analysis using minimal sample volumes, which positions it as a superior alternative for clinical diagnostics and early leukemia identification. The biosensor system was engineered on a nanostructured platform composed of polypyrrole (PPy) and a novel chemically functionalized hybrid nanocomposite of platinum nanospheres and titanium dioxide nanoparticles (TiO₂@Pt). Single-stranded oligonucleotide sequences were chemically immobilized on the nanoengineered transducer to enable biospecific detection. Cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), ultraviolet-visible spectroscopy (UV-Vis), and atomic force microscopy (AFM) were used to characterize each stage of the biotechnological device fabrication process. The analytical properties of the sensing tool were explored using recombinant plasmids containing the TCF3-PBX1 oncogenic sequence and clinical specimens from pediatric patients with B-cell ALL. After exposing the molecular monitoring system to the genetic target, significant variations were observed in the voltammetric oxidation current (∆I = 33.08% ± 0.28 to 124.91% ± 17.08) and in the resistance to charge transfer (ΔR_CT = 19.73% ± 0.96 to 83.51% ± 0.84). Data analysis revealed high reproducibility, with a relative standard deviation of 3.66%, a response range from 3.58 aM to 357.67 fM, a detection limit of 19.31 aM, and a limit of quantification of 64.39 aM. Therefore, a novel nanosensor for multiparametric electrochemical screening of the TCF3-PBX1 chimeric oncogene was described for the first time, potentially improving the quality of life for leukemic patients. Full article

Background: Globally, socioeconomic disparities persist across the trajectory of chronic kidney disease and are pronounced among people with kidney failure. Unmet health-related social needs contribute to these disparities, but limited guidance exists about how best to address them. To guide implementation, we conducted a rapid scoping review to identify and characterize interventions that address health-related social needs among people with kidney failure. Methods: We adapted established scoping review methods to conduct a rapid review. We searched Embase, PubMed, CINAHL, SCOPUS, and PsychInfo for articles and conference abstracts published since 2013 that described interventions to address health-related social needs as identified in the Centers for Medicare and Medicaid Services’ Accountable Health Communities Health-Related Social Needs Screening Tool. We applied the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) to synthesize findings and characterize intervention components. Results: Our review identified three articles and five conference abstracts that described diverse interventions to address health-related social needs among people with kidney failure. Six targeted social support, one addressed food insecurity, and one addressed transportation needs. Two pilot studies to address social support reported high recruitment and retention rates. One study formally tested an intervention to address social support among adolescents with kidney failure and reported negative findings (no change in social exclusion). The level of detail about intervention implementation varied across studies, but none described excluded participants or intervention fidelity, adaptations, or cost. Conclusions: Despite recent attention, there remains a lack of evidence to guide interventions addressing health-related social needs among people with kidney failure. From limited available data, interventions to address social support may be feasible and acceptable. Full article

Background: Early detection and prevention of colorectal cancer (CRC) are key goals of population-based screening. Several diagnostic tests have been proposed for CRC screening. This study compares the diagnostic accuracy of colon capsule endoscopy (CCE), colonoscopy (COL) and computed tomographic colonography (CTC), focusing on risk factors such as polyps. Methods: We conducted a systematic review with meta-analyses and network meta-analysis. Pooled estimates of sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) were calculated using a random-effects model. Diagnostic performance was assessed for first- and second-level screening based on effect size estimates. Results: For first-level screening, sensitivity was 0.79 (95% CI: 0.60–0.91) and specificity 0.95 (95% CI: 0.88–0.98); PPV and NPV were 0.89 and 0.97, respectively. In second-level screening, sensitivity was 0.75 (95% CI: 0.65–0.83), specificity 0.95 (95% CI: 0.92–0.97), PPV 0.76 and NPV 0.95. The indirect sensitivity estimate of CCE vs. COL (SMD = 0.30; 95% CI: 0.12–0.47) was lower than the direct estimate for CTC (SMD = 0.44; 95% CI: 0.29–0.59). CCE showed better comparative performance than CTC relative to COL (CCE SMD = −0.18; 95% CI: −0.29 to −0.06 vs. CTC SMD = −0.98; 95% CI: −1.07 to −0.90). However, both CCE and CTC had lower specificity than COL. Conclusions: CCE represents a valuable tool for early CRC detection. Test selection should be guided by clinical and epidemiological settings to optimize screening strategies. Full article

Background: The emergency medical services (EMS) sector, as a complex system, presents substantial hurdles in providing excellent treatment while operating within limited resources, prompting greater adoption of artificial intelligence (AI) as a tool for improving operational efficiency. While AI models have proved beneficial in healthcare operations, there is limited explainability and interpretability, as well as a lack of data used in their application and technological advancement. Methods: The scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews, using PubMed, IEEE Xplore, and Web of Science, with a procedure of double screening and extraction. The search included articles published from 2018 to the beginning of 2025. Studies were excluded if they did not explicitly identify an artificial intelligence (AI) component, lacked relevance to emergency department (ED) or prehospital contexts, failed to report measurable outcomes or evaluations, or did not exploit real-world data. We analyzed the data source used, clinical subclasses, AI domains, ML algorithms, their performance, as well as potential roles for large language models (LLMs) in future applications. Results: A comprehensive PRISMA-guided methodology was used to search academic databases, finding 1181 papers on prehospital emergency treatment from 2018 to 2025, with 65 articles identified after an extensive screening procedure. The results reveal a significant increase in AI publications. A notable technological advancement in the application of AI in EMS using different types of data was explored. Conclusions: These findings highlighted that AI and ML have emerged as revolutionary innovations with huge potential in the fields of healthcare and medicine. There are several promising AI interventions that can improve prehospital emergency care, particularly for out-of-hospital cardiac arrest and triage prioritization scenarios. Implications for EMS Practice: Integrating AI methods into prehospital care can optimize the use of available resources, as well as triage and dispatch efficiency. LLMs may have the potential to improve understanding and assist in decision-making under pressure in emergency situations by combining various forms of recorded data. However, there is a need to emphasize continued research and strong collaboration between AI experts and EMS physicians to ensure the safe, ethical, and effective integration of AI into EMS practice. Full article

Background: Patients with acute leukemia (AL) are at heightened risk of cardiovascular complications due to both disease-related and treatment-related factors. These complications include heart failure, arrhythmias, myocardial infarction, and thromboembolic events which may significantly impact morbidity and mortality. Objective: To identify the risk factors contributing to cardiovascular complications in patients with acute leukemia. Methods: This systematic review was conducted according to the PRISMA reporting guideline. Multiple databases including PubMed, Scopus, IEEE Xplore, the Cochrane Library, Web of Science, ProQuest, and Google Scholar were searched for studies published between 2020 and 2024. Eligible studies included those analyzing cardiovascular risk factors in AL patients across various subtypes and treatment stages. A total of 75 studies were included following rigorous screening and critical appraisal using tools appropriate for different study designs. Results: The results showed that cardiovascular complications in AL patients are multifactorial including demographic factors (e.g., age, sex, BMI), comorbidities (e.g., hypertension, diabetes, dyslipidemia), treatment exposures (e.g., anthracyclines, tyrosine kinase inhibitors, hematopoietic stem cell transplantation, radiation), and genetic predispositions (e.g., somatic and germline variants). Cardiac biomarkers (e.g., troponins, BNP), imaging (strain echocardiography), and electrocardiogram (ECG) abnormalities were key factors in detecting early or subclinical damage. Complications occurred both during and years after treatment, especially in childhood and long-term survivors. Conclusions: Cardiovascular complications are prevalent, and serious consequences in AL patients necessitate a personalized, multidisciplinary approach to risk stratification and monitoring. Considering clinical, genetic, and biomarker data can improve early detection and preventive strategies, ultimately enhancing patient outcomes. Full article

The significant development of technology has greatly influenced crucial sectors of society, including health, economy, public health, and business. Technological tools have become essential in daily life, impacting the educational process across all age groups. Previous research has demonstrated the pervasive integration of technology into everyday activities, emphasizing the compelling attraction that screens and mobile devices provide, particularly among younger generations. However, earlier studies have often overlooked the detailed impact and practical applications of these technologies within the educational sector, particularly through computer games. This study employs a comprehensive analysis of scientific articles available on the internet, examining global research on the use of computer games in education. The research methods include a systematic review of publications, focusing on primary education while also considering other educational levels to provide a holistic view. The analytical approach highlights the practices employed during the implementation of educational computer games and their effects on the learning process. The major findings reveal that educational computer games have become a highly popular pedagogical method, effectively capturing the interest of both students and educators. The study underscores the growing demand for these educational tools and the promise of continuous improvements and additions to this type of teaching. The results suggest that integrating computer games into education not only enhances engagement but also signifies a progressive shift in teaching methodologies, paving the way for innovative educational practices. Full article

Background: Burnout is a prevalent issue among mental health nurses. While various interventions have been implemented to address burnout, their effectiveness and sustainability remain unclear in specialised mental health settings. This systematic review aims to clearly evaluate the effectiveness of interventions specifically designed to reduce burnout among mental health nurses, focusing on intervention types, their impact, and the sustainability of results. Methods: A comprehensive search of databases (Embase, CINAHL, Medline, PubMed, Scopus, and Web of Science) identified studies on burnout reduction interventions for mental health nurses. Inclusion criteria focused on mental health nursing populations with pre- and post-intervention burnout measures. Methodological quality was assessed using JBI Critical Appraisal Tools. A narrative synthesis guideline was used to analyse data. Results: Among 2502 studies retrieved, only 4 met the inclusion criteria after a rigorous screening process. These studies explored specific intervention types, including a two-day burnout prevention workshop, an eight-week group-based psychoeducational programme, a twelve-week mindfulness-based psychoeducational intervention, and an eight-week guided self-help mindfulness programme delivered via a digital platform. Significant reductions in burnout were observed across these studies; however, the sustainability of these effects varied. Interventions of greater duration, such as the 12-week mindfulness-based programme and the 8-week group psychoeducational intervention, yielded more enduring improvements. In contrast, shorter interventions, like a two-day workshop, showed transient benefits that diminished over time. Conclusions: This review highlights a critical gap in research on burnout interventions for mental health nurses. While the reviewed interventions showed promise in reducing burnout, the findings underscore the need for sustainable, adaptable interventions and more robust research. Full article

Background: Chewing gum is a simple, accessible tool with high user compliance, traditionally associated with oral health benefits. Although its potential effects on different aspects of health and well-being, beyond its oral applications, have been explored, the area remains relatively under-researched. This mapping review and evidence gap map (EGM) aimed to evaluate the existing literature on the non-oral health applications of chewing gum and to identify gaps in the literature. Methods: A comprehensive search was conducted across five databases (Scopus, Embase, PubMed, PsycINFO, and CINAHL) using tailored search strategies. Abstracts were screened against predefined eligibility criteria using EPPI-Reviewer version 6, with full texts reviewed only when relevant information could not be drawn. The included studies were coded by gum type, outcome, and study design, and the EGM was constructed using EPPI-Mapper version 2.4.5. Results: Of the 2614 identified records, 1326 were screened after duplicate removal, and 260 studies were included in the final analysis. Three main areas of application emerged: for enhancing well-being and performance, as a medical aid and as a surgical/procedural aid. The EGM indicated that the most frequently studied uses of chewing gum were in sports performance, smoking cessation, and post-operative recovery. However, notable research gaps were found, particularly in paediatric and geriatric contexts. Conclusions: Chewing gum has been extensively studied as a surgical or procedural aid, particularly for post-operative gastrointestinal recovery, but its broader applications for well-being, performance, and its use in paediatric and elderly populations remain underexplored. Further high-quality research using standardised methodologies is needed to address these gaps. Full article

Background/Objectives: Swallowing disorder(s), or oropharyngeal dysphagia (OPD), are very common in children with cerebral palsy (CP) and pose a significant risk to their health. Behavioural interventions are frequently recommended when targeting OPD in children with CP; however, their efficacy has yet to be determined. This systematic review aimed to synthesise the current evidence for behavioural interventions in the treatment of OPD in children with CP. Methods: A comprehensive search in six databases in October 2024 sought studies that (1) included participants aged 0–18 years with a diagnosis of CP and OPD; (2) utilised and described a behavioural intervention for OPD; and (3) used a randomised controlled trial (RCT) experimental design. Three reviewers independently extracted the data, and results were tabulated. The Revised Cochrane Risk of Bias (ROB-2) tool was used to determine the methodological quality of eligible articles. Results: From an initial yield of 2083 papers, 99 full-text studies were screened for eligibility. Seven RCTs involving 329 participants aged 9.5 months (SD = 2.03) to 10.6 yrs were included. CP description varied. Most studies used a combination of behavioural interventions to treat OPD (n = 6), and oral sensorimotor treatment was the most frequently utilised treatment (n = 4). Positive outcomes were reported in all (n = 7); however, there was high risk of bias in five studies. Conclusions: The use of behavioural interventions to treat OPD in children with CP continues to be supported by low-level evidence. Rigorously designed RCTs with larger samples of children with CP and OPD are needed to evaluate the true effects of behavioural interventions across the developmental phase of childhood. Importantly, consistency in describing and reporting baseline analysis of swallowing and OPD; together with treatment-component data, is a priority in future research. Full article