Search Results (4,830)

Inflammatory Bowel Diseases (IBDs) are complex, multifactorial disorders with no known cure, necessitating lifelong care and often leading to surgical interventions. This ongoing healthcare requirement, coupled with the increased use of biological drugs and rising disease prevalence, significantly increases the financial burden on the healthcare systems. Thus, a number of novel technological approaches have emerged in order to face some of the pivotal questions still associated with IBD. In navigating the intricate landscape of IBD, biosensors act as indispensable allies, bridging the gap between traditional diagnostic methods and the evolving demands of precision medicine. Continuous progress in biosensor technology holds the key to transformative breakthroughs in IBD management, offering more effective and patient-centric healthcare solutions considering the One Health Approach. Here, we will delve into the landscape of biomarkers utilized in the diagnosis, monitoring, and management of IBD. From well-established serological and fecal markers to emerging genetic and epigenetic markers, we will explore the role of these biomarkers in aiding clinical decision-making and predicting treatment response. Additionally, we will discuss the potential of novel biomarkers currently under investigation to further refine disease stratification and personalized therapeutic approaches in IBD. By elucidating the utility of biosensors across the spectrum of IBD care, we aim to highlight their importance as valuable tools in optimizing patient outcomes and reducing healthcare costs. Full article

Hospital in the Home (HITH) programs are emerging as a key pillar of smart city healthcare infrastructure, leveraging technology to extend care beyond traditional hospital walls. The global healthcare sector has been conceptualizing the notion of a care without walls hospital, also called HITH, where virtual care takes precedence to address the multifaceted needs of an increasingly aging population grappling with a substantial burden of chronic disease. HITH programs have the potential to significantly reduce hospital bed occupancy, enabling hospitals to better manage the ever-increasing demand for inpatient care. Although many health providers and hospitals have established their own HITH programs, there is a lack of research that provides healthcare executives and HITH program managers with management models and frameworks for such initiatives. There is also a lack of research that provides strategies for improving HITH management in the health sector. To fill this gap, the current study ran a systematic literature review to explore state-of-the-art with regard to this topic. Out of 2631 articles in the pool of this systematic review, 20 articles were deemed to meet the eligibility criteria for the study. After analyzing these studies, nine management models were extracted, which were then categorized into three categories, namely, governance models, general models, and virtual models. Moreover, this study found 23 strategies and categorized them into five groups, namely, referral support, external support, care model support, technical support, and clinical team support. Finally, implications of findings for practitioners are carefully provided. These findings provide healthcare executives and HITH managers with practical frameworks for selecting appropriate management models and implementing evidence-based strategies to optimize program effectiveness, reduce costs, and improve patient outcomes while addressing the growing demand for home-based care. Full article

Cardiovascular–Kidney–Metabolic (CKM) syndrome symbolizes a single pathophysiologic entity including obesity, type 2 diabetes, chronic kidney disease, and cardiovascular disease. These conditions altogether accelerate adverse outcomes when they coexist. Recent evidence has shown that the function of glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium–glucose cotransporter-2 inhibitors (SGLT2i) alleviate stress on multiple organs. SGLT2i has been demonstrated to benefit heart failure, hemodynamic regulation, and renal protection while GLP-1RA on the other hand has been shown to demonstrate a strong impact on glycemic management, weight loss, and atherosclerotic cardiovascular disease. This review will aim to understand and evaluate the mechanistic rationalization, clinical evidence, and the potential therapeutic treatment of SGLT2 inhibitors and GLP-1 receptor agonists to treat individuals who have CKM syndrome. This analysis also assesses whether combination therapy can be a synergistic approach that may benefit patients but is still underutilized because of the lack of clear guidelines, the associated costs, and disparities in accessibility. Therefore, in this review, we will be discussing the combination therapy’s additive and synergistic effects, current recommendations and clinical evidence, and mechanistic insights of these GLT2 inhibitors and GLP-1 receptor agonists in CKM syndrome patients. Overall, early and combination usage of GLP-1RA and SGLT2i may be essential to demonstrating a significant shift in modern cardiometabolic therapy toward patient-centered care. Full article

Heart failure (HF) is a major global health challenge, characterized by high morbidity, mortality, and frequent hospital readmissions. Despite the advent of guideline-directed medical therapies (GDMTs), the burden of HF continues to grow, necessitating a shift toward comprehensive, multidisciplinary care models. Heart Failure Disease Management Programs (HF-DMPs) have emerged as structured frameworks that integrate evidence-based medical therapy, patient education, telemonitoring, and support for social determinants of health to optimize outcomes and reduce healthcare costs. This review outlines the key components of HF-DMPs, including patient identification and risk stratification, pharmacologic optimization, team-based care, transitional follow-up, remote monitoring, performance metrics, and social support systems. Incorporating tools such as artificial intelligence, pharmacist-led titration, and community health worker support, HF-DMPs represent a scalable approach to improving care delivery. The success of these programs depends on tailored interventions, interdisciplinary collaboration, and health equity-driven strategies. Full article

Paper-based colorimetric biosensors represent a promising class of low-cost diagnostic tools that do not require external instrumentation. However, their broader applicability is limited by the environmental concerns associated with conventional metal-based nanomaterials and the subjectivity of visual interpretation. To address these challenges, this study introduces a proof-of-concept platform—using CA19-9 as a model biomarker—that integrates naturally derived melanin nanoparticles (MNPs) with machine learning-based image analysis to enable environmentally sustainable and analytically robust colorimetric quantification. Upon target binding, MNPs induce a concentration-dependent color transition from yellow to brown. This visual signal was quantified using a machine learning pipeline incorporating automated region segmentation and regression modeling. Sensor areas were segmented using three different algorithms, with the U-Net model achieving the highest accuracy (average IoU: 0.9025 ± 0.0392). Features extracted from segmented regions were used to train seven regression models, among which XGBoost performed best, yielding a Mean Absolute Percentage Error (MAPE) of 17%. Although reduced sensitivity was observed at higher analyte concentrations due to sensor saturation, the model showed strong predictive accuracy at lower concentrations, which are especially challenging for visual interpretation. This approach enables accurate, reproducible, and objective quantification of colorimetric signals, thereby offering a sustainable and scalable alternative for point-of-care diagnostic applications. Full article

Multiple myeloma (MM) is predominantly a disease of the elderly. In recent years, a surge of highly effective plasma cell therapies has revolutionized the care of elderly multiple myeloma (MM) patients, for whom frailty and age-related competing causes of mortality determine management. Traditionally, the treatment of newly diagnosed elderly patients has centered on doublet or triplet combinations composed of immunomodulators (IMIDs), proteasome inhibitors (PIs), anti-CD38 monoclonal antibodies (mAbs), and corticosteroids producing median progression-free survival (PFS) rates between 34 and 62 months. However, recently, a series of large phase III clinical trials examining quadruplet regimens of PIs, IMIDs, corticosteroids, and anti-CD38 mAbs have shown exceptional outcomes, with median PFS exceeding 60 months, albeit with higher rates of peripheral neuropathy (≥Grade 2: 27% vs. 10%) when PIs and IMIDs are combined, and infections (≥Grade 3: 40% vs. 29–41%) with the addition of anti-CD38mAbs. The development of T-cell redirecting therapies including T-cell engagers (TCEs) and CAR-T cells has further expanded the therapeutic arsenal. TCEs have shown exceptional activity in relapsed disease and are being explored in the newly diagnosed setting with promising early results. However, concerns remain regarding the logistical challenges of step-up dosing, which often necessitates inpatient admission, the infectious risks, and the financial burden associated with TCEs in elderly patients. CAR-T, the most potent commercially available therapy for MM, offers the potential of a ‘one and done’ approach. However, its application to elderly patients has been tempered by significant concerns of cytokine release syndrome, early and delayed neurological toxicity, and its overall tolerability in frail patients. Robust data in frail patients are still needed. How CAR-T and TCEs will be sequenced among the growing therapeutic armamentarium for elderly MM patients remains to be determined. This review explores the safety, efficacy, cost, and logistical barriers associated with the above treatments in elderly MM patients. Full article

Collagen implants in neurosurgery are widely used due to their biocompatibility, biodegradability, and ability to support tissue regeneration, but their mechanical properties, such as low tensile strength and susceptibility to enzymatic degradation, remain challenging. Current technologies are improving these implants through cross-linking, synthetic reinforcements, and advanced manufacturing techniques such as 3D bioprinting to improve durability and predictability. Industry 4.0 is contributing to this by automating production, using data analytics and machine learning to optimize implant properties and ensure quality control. In Industry 5.0, the focus is shifting to personalization, enabling the creation of patient-specific implants through human–machine collaboration and advanced biofabrication. eHealth integrates digital monitoring systems, enabling real-time tracking of implant healing and performance to inform personalized care. Despite progress, challenges such as cost, material property variability, and scalability for mass production remain. The future lies in smart biomaterials, AI-driven design, and precision biofabrication, which could mean the possibility of creating more effective, accessible, and patient-specific collagen implants. The aim of this article is to examine the current state and determine the prospects for the development of mechanical properties of collagen implant used in neurosurgery towards Industry 4.0/5.0, including ML model. Full article

Cardiovascular disease (CVD) remains Europe’s leading cause of mortality, responsible for >45% of deaths. Beyond established risk factors (hypertension, diabetes, dyslipidaemia, smoking, obesity), psychosocial elements—depression, anxiety, financial stress, personality traits, and trauma—significantly influence CVD development and progression. Behavioural Cardiology addresses this connection by systematically incorporating psychosocial factors into prevention and rehabilitation protocols. This review examines the HEARTBEAT model, developed by Greece’s first Behavioural Cardiology Unit, which aligns with current European guidelines. The model serves dual purposes: primary prevention (targeting at-risk individuals) and secondary prevention (treating established CVD patients). It is a personalised medicine approach that integrates psychosocial profiling with traditional risk assessment, utilising tailored evaluation tools, caregiver input, and multidisciplinary collaboration to address personality traits, emotional states, socioeconomic circumstances, and cultural contexts. The model emphasises three critical implementation aspects: (1) digital health integration, (2) cost-effectiveness analysis, and (3) healthcare system adaptability. Compared to international approaches, it highlights research gaps in psychosocial interventions and advocates for culturally sensitive adaptations, particularly in resource-limited settings. Special consideration is given to older populations requiring tailored care strategies. Ultimately, Behavioural Cardiology represents a transformative systems-based approach bridging psychology, lifestyle medicine, and cardiovascular treatment. This integration may prove pivotal for optimising chronic disease management through personalised interventions that address both biological and psychosocial determinants of cardiovascular health. Full article

Background: Minimally invasive cardiac surgery (MICS) via right minithoracotomy is a safe, reproducible approach with excellent outcomes and reduced costs compared to median sternotomy. Despite careful patient selection, conversion to sternotomy occurs in 1–3% of cases and is associated with significantly higher morbidity and mortality. Small body habitus, particularly a short anteroposterior (AP) diameter, may increase the risk of conversion, but this has not been previously studied. This study aims to identify preoperative factors associated with conversion to improve patient selection for MICS. As cardiovascular surgery becomes increasingly personalized, identifying anatomical factors that predict technical complexity is essential. Methods: This retrospective study included 254 adult patients who underwent elective MICS between 2015 and 2024 at a tertiary hospital. Patient characteristics, computed tomography (CT) scans, intraoperative parameters, and postoperative outcomes were reviewed. AP diameter was defined as the distance from the posterior sternum to the anterior vertebral body at the mitral valve level on CT. Statistical analyses included Mann−Whitney and Fisher’s exact/chi-square tests. Results: Conversion to sternotomy occurred in 1.6% of patients (n = 4). All converted patients were female. The converted group had a significantly shorter median AP diameter (100 mm vs. 124 mm, p = 0.020). Conversion was associated with higher rates of stroke and infection (25.0% vs. 0.8%, p = 0.047 for both), but no significant differences in hospital stay, bleeding, or renal failure. Conclusions: An AP diameter of less than 100 mm was associated with a higher risk of conversion to sternotomy in MICS. Incorporating simple, reproducible preoperative imaging metrics into surgical planning may advance precision-guided cardiac surgery and optimize patient outcomes. Full article

Nosocomial infections caused by ESKAPE pathogens represent a significant burden to global health. These pathogens may exhibit multidrug resistance (MDR) mechanisms, of which mechanisms such as efflux pumps and biofilm formation are gaining significant importance. Multidrug resistance mechanisms in ESKAPE pathogens have led to an increase in the effective costs in health care and a higher risk of mortality in hospitalized patients. These pathogens utilize antimicrobial efflux pump mechanisms and bacterial biofilm-forming capabilities to escape the bactericidal action of antimicrobials. ESKAPE bacteria forming colonies demonstrate increased expression of efflux pump-encoding genes. Efflux pumps not only expel antimicrobial agents but also contribute to biofilm formation by bacteria through (1) transport of molecules and transcription factors involved in biofilm quorum sensing, (2) bacterial fimbriae structure transport for biofilm adhesion to surfaces, and (3) regulation of a transmembrane gradient to survive the difficult conditions of biofilm microenvironments. The synergistic role of these mechanisms complicates treatment outcomes. Given the mechanistic link between biofilms and efflux pumps, therapeutic strategies should focus on targeting anti-biofilm mechanisms alongside efflux pump inactivation with efflux pump inhibitors. This review explores the molecular interplay between efflux pumps and biofilm formation, emphasizing potential therapeutic strategies such as efflux pump inhibitors (EPIs) and biofilm-targeting agents. Full article

Introduction and Objectives: Risk-sharing agreements (RSAs) have emerged as a key strategy for financing high-cost medical technologies while ensuring financial sustainability. These payment mechanisms mitigate clinical and financial uncertainties, optimizing pricing and reimbursement decisions. Despite their widespread adoption globally, Latin America has reported limited implementation, particularly for high-cost medical devices. This study aims to share insights from designing RSAs in the form of Outcome Protection Programs (OPPs) for medical devices in Latin America from the perspective of a medical devices company. Methods: The report follows a structured approach, defining key OPP dimensions: payment base, access criteria, pricing schemes, risk assessment, and performance incentives. Risks were categorized as financial, clinical, and operational. The framework applied principles from prior models, emphasizing negotiation, program design, implementation, and evaluation. A multidisciplinary task force analyzed patient needs, provider motivations, and payer constraints to ensure alignment with health system priorities. Results: Over two semesters, a panel of seven experts from the manufacturer designed n = 105 innovative payment programs implemented in Argentina (n = 7), Brazil (n = 7), Colombia (n = 75), Mexico (n = 9), Panama (n = 4), and Puerto Rico (n = 3). The programs targeted eight high-burden conditions, including Coronary Artery Disease, atrial fibrillation, Heart Failure, and post-implantation arrhythmias, among others. Private providers accounted for 80% of experiences. Challenges include clinical inertia and operational complexities, necessitating structured training and monitoring mechanisms. Conclusions: Outcome Protection Programs offer a viable and practical risk-sharing approach to financing high-cost medical devices in Latin America. Their implementation requires careful stakeholder alignment, clear eligibility criteria and endpoints, and robust monitoring frameworks. These findings contribute to the ongoing dialogue on sustainable healthcare financing, emphasizing the need for tailored approaches in resource-constrained settings. Full article

Tuberculosis (TB) remains a leading cause of death in Bangladesh, disproportionately affecting low socio-economic status (SES) populations. This review, guided by the WHO Social Determinants of Health framework and Rockefeller-Lancet Planetary Health Report, examined how social, economic, and ecological factors link SES to TB burden. The first literature search identified 28 articles focused on SES-TB relationships in Bangladesh. A second search through snowballing and conceptual mapping yielded 55 more papers of diverse source types and disciplines. Low-SES groups face elevated TB risk due to smoking, biomass fuel use, malnutrition, limited education, stigma, financial barriers, and hazardous housing or workplaces. These factors delay care-seeking, worsen outcomes, and fuel transmission, especially among women. High-SES groups more often face comorbidities like diabetes, which increase TB risk. Broader contextual drivers include urbanisation, weak labour protections, cultural norms, and poor governance. Recommendations include housing and labour reform, gender parity in education, and integrating private providers into TB programmes. These align with the WHO End TB Strategy, UN SDGs and Planetary Health Quadruple Aims, which expand the traditional Triple Aim for health system design by integrating environmental sustainability alongside improved patient outcomes, population health, and cost efficiency. Future research should explore trust in frontline workers, reasons for consulting informal carers, links between makeshift housing and TB, and integrating ecological determinants into existing frameworks. Full article

Although technological innovations are often intended to improve quality and efficiency, they can exacerbate systemic challenges when not aligned with the principles of value-based care. As a result, healthcare systems in many countries face persistent inefficiencies stemming from the overuse, underuse, misuse, and waste associated with the adoption of health technology. This narrative review examines the dual impact of healthcare technology and evaluates how contract mechanisms can serve as strategic tools for promoting cost-effective, outcome-oriented integration. Drawing from healthcare management, and supply chain literature, this paper analyzes various payment and contract models, including performance-based, bundled, cost-sharing, and revenue-sharing agreements, through the lens of stakeholder alignment. It explores how these mechanisms influence provider behavior, patient access, and system sustainability. The study contends that well-designed contract mechanisms can align stakeholder incentives, reduce inefficiencies, and support the delivery of high-value care across diverse healthcare settings. We provide concrete examples to illustrate how various contract mechanisms impact the integration of health technologies in practice. Full article

Monitoring position and movements of preterm infants is important to ensure their well-being and optimal development. This study evaluates the feasibility of a pressure-sensitive fiber-optic mattress (FM), made entirely of plastic, for two-dimensional analysis of preterm infant movements and positioning. Before clinical use, we developed a simple, replicable, and cost-effective test protocol to simulate infant movements and positions, enabling early identification of technical limitations. Using data from 20 preterm infants, we assessed the FM’s potential to monitor posture and limb motion. FM-derived pressure patterns were compared with camera-based manual annotations to distinguish between different positions and out-of-bed moments, as well as limb-specific movements. Bench-test results demonstrated the FM’s sensitivity to motion and pressure changes, supporting its use in preclinical validation. Clinical data confirmed the FM’s reliability in identifying infant positions and movement patterns, showing an accuracy comparable to camera annotations. However, limitations such as calibration, sensitivity to ambient light, and edge-related artifacts were noted, indicating areas for improvement. In conclusion, the test protocol proved effective for early-stage evaluation of smart mattress technologies. The FM showed promising clinical feasibility for non-obtrusive monitoring of preterm infants, though further optimization is needed for robust performance in neonatal care. Full article

Cell-free biosensors harness the selectivity of cellular machinery without living cells’ constraints, offering advantages in environmental monitoring, medical diagnostics, and biotechnological applications. This review examines recent advances in cell-free biosensor development, highlighting their ability to detect diverse analytes including heavy metals, organic pollutants, pathogens, and clinical biomarkers with high sensitivity and specificity. We analyze technological innovations in cell-free protein synthesis optimization, preservation strategies, and field deployment methods that have enhanced sensitivity, and practical applicability. The integration of synthetic biology approaches has enabled complex signal processing, multiplexed detection, and novel sensor designs including riboswitches, split reporter systems, and metabolic sensing modules. Emerging materials such as supported lipid bilayers, hydrogels, and artificial cells are expanding biosensor capabilities through microcompartmentalization and electronic integration. Despite significant progress, challenges remain in standardization, sample interference mitigation, and cost reduction. Future opportunities include smartphone integration, enhanced preservation methods, and hybrid sensing platforms. Cell-free biosensors hold particular promise for point-of-care diagnostics in resource-limited settings, environmental monitoring applications, and food safety testing, representing essential tools for addressing global challenges in healthcare, environmental protection, and biosecurity. Full article