Search Results (258)

As global populations age, there is increasing demand for effective, person-centered healthcare solutions that support older adults to age in place. Home healthcare has emerged as a crucial strategy to address the complex health and social needs of older adults while reducing reliance on institutional care. This umbrella review aimed to synthesize evidence from existing systematic reviews and meta-analyses on home healthcare services and interventions targeting older adults. A comprehensive search was conducted across five databases and gray literature sources, including Google Scholar, for reviews published between 2000 and 2025. The review followed the Joanna Briggs Institute methodology and PRISMA statement. Twenty reviews met the inclusion criteria, encompassing a total of over 3.1 million participants. Interventions were grouped into four categories: integrated and multidisciplinary care, preventive and supportive home visits, technological and digital interventions, and physical, transitional, and environmental support. Results indicated that many interventions led to improved health outcomes, including enhanced functional ability, reduced hospital readmissions, and increased satisfaction. However, effectiveness varies depending on the intervention type, delivery model, and population. Challenges such as caregiver burden, digital exclusion, and implementation in diverse settings were noted. This review highlights the promise of home healthcare interventions and underscores the need for context-sensitive, equitable, and scalable models to support aging populations. Full article

Hypercholesterolemia is a major modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD), affecting a significant proportion of the adult population worldwide. This narrative review provides a comprehensive and up-to-date overview of hyperlipidemia management, spanning from epidemiological trends and underlying pathophysiological mechanisms to the limitations of conventional therapies such as statins and ezetimibe. Particular emphasis is placed on cardiovascular risk assessment, current stratification tools, and international guideline-based interventions. The present paper, focusing primarily on the biological mechanisms of dyslipidemia and the clinical use of traditional lipid-lowering agents, serves as the first part of a two-part series, preceding a forthcoming review of novel pharmacological approaches. Our data synthesis is based on a structured literature search conducted across Google Scholar, PubMed, and Scopus, including studies published up to June 2025. The review also includes aspects related to non-pharmacological strategies, pharmacoeconomic considerations, and pharmacogenetic influences on treatment response. Ultimately, this work aims to equip clinicians with evidence-based, nuanced insights essential for optimizing lipid management and reducing cardiovascular risk, while setting the foundation for understanding how emerging therapies may overcome current therapeutic limitations. Full article

Plants of the Annona genus have garnered increasing scientific interest due to their rich phytochemical profile and broad spectrum of biological activities, which include antimicrobial, antiproliferative, and cytotoxic effects. Among the most studied compounds are acetogenins and Annonacins, which exhibit potent bioactivity and have been identified as key agents in the green synthesis and stabilization of nanomaterials. In recent years, the integration of Annona plant extracts—particularly from leaves—into nanotechnology platforms has opened new avenues in the development of eco-friendly and biocompatible nanostructures for biomedical applications. This review provides a comprehensive overview of the current knowledge regarding the antimicrobial properties of nanomaterials synthesized using extracts from Annona species. This review encompasses 74 indexed articles published between 2012 and 2023, focusing on the synthesis of nanomaterials using extracts from this genus that exhibit antimicrobial and biomedical properties. The search was conducted in databases such as Google Scholar, Web of Science, and Scopus. Emphasis is placed on their antibacterial, antifungal, and anthelmintic effects, as well as additional therapeutic potentials, such as antidiabetic, antihypertensive, antiproliferative, and cytotoxic activities. The analysis of the recent literature highlights how Annona-derived phytochemicals contribute significantly to the functionalization and enhanced biological performance of these nanomaterials. This work aims to support future research focused on the rational design of Annona-based nanostructures as promising candidates in antimicrobial and therapeutic strategies. Full article

In recent years, the number of fake news stories has significantly increased in the world of media, especially with the widespread use of social media. It has impacted several industries, including tourism. From a tourism point of view, the spread of fake news can contribute to the reduction of the popularity of a destination. It may influence travel decisions by discouraging tourists from visiting certain places and thus damage the reputation of the destination, contributing to economic loss. After a literature review on the communication aspect of fake news and a general introduction of fake news in the tourism and hospitality industry, we conducted a systematic literature review (SLR), a research methodology to collect, identify, and analyse available research studies through a systematic procedure. The current SLR is based on the Scopus, Web of Science, and Google Scholar databases of existing literature on the topic of fake news in the tourism and hospitality industry. The study identifies, lists, and examines existing papers and conference proceedings from a vast array of disciplines, in order to give a well-rounded view on the issue of fake news in the tourism and hospitality industry. After selecting a total of 54 previous studies from more than 20 thousand results for the keywords ‘fake news’ and ‘tourism,’ we have analysed 39 papers in total. The SLR aimed to highlight existing gaps in the literature and areas that may require further exploration in future primary research. We have found that there is relatively limited academic literature available on the subject of fake news affecting tourism destinations, compared to studies focused on hospitality services. Full article

Background: The management of difficult airways is one of the most critical and challenging aspects of emergency and ICU care. Despite technological advances, unanticipated airway difficulty can result in serious complications, including hypoxia, brain injury, and death. This comprehensive narrative review aims to consolidate current algorithms and evidence-based strategies to guide clinicians in the assessment and management of difficult airways. Methods: A comprehensive literature review was conducted using PubMed, Embase, and Google Scholar to identify relevant studies, clinical guidelines, and expert consensus documents related to difficult airway management. The focus was placed on both pre-intubation assessment tools and intervention strategies used in various clinical contexts. Results: Airway difficulty is best anticipated through a combination of history, physical examination, and validated tools such as the Mallampati score. Several algorithms, including those from the American Society of Anesthesiologists (ASA) and the Difficult Airway Society (DAS), provide structured approaches that emphasize preoxygenation, preparedness for failed intubation, and the use of adjuncts such as video laryngoscopy, supraglottic airway devices, and awake intubation techniques. Crisis algorithms such as the Vortex approach help simplify decision-making during emergencies. It is important to have adjuncts available in cases of anticipated difficult airways, such as fiberoptic intubation, while surgical airway access is an important component of a stepwise airway management algorithm when critical scenarios are encountered. Conclusions: Effective difficult airway management requires anticipation, a structured plan, familiarity with advanced airway tools, and adherence to validated algorithms. Training in crisis resource management and multidisciplinary rehearsal of airway scenarios are essential to improving outcomes. Full article

The Italian market for non-alcoholic beer is very small, with a volume per capita of around 0.7 L. However, there are interesting prospects for future growth for reasons ranging from strict traffic code rules on the quantity of alcohol ingested to simple curiosity. This research aimed to investigate the willingness of Italian consumers/potential consumers to pay for non-alcoholic beer. To accomplish this, a questionnaire was administered using the Google Forms application. Three hundred and ninety-two people participated in this survey voluntarily and without monetary compensation. A probit regression model was used to estimate the impact of certain sociodemographic characteristics (number of inhabitants of the place of residence, region of residence, age group, gender, education level, employment situation, and annual net income), participants’ consumption habits with respect to alcoholic beer, and participants’ knowledge of and preference for non-alcoholic beers with respect to willingness to pay for non-alcoholic beers. The prices respondents were willing to pay ranged from EUR 1.51 to 2.00 for a 33 cL glass bottle. Only two factors significantly affected (p < 0.1) non-alcoholic beer WTP, namely, “Age” and “Non-alcoholic beer color”. WTP decreased as the age of the respondents increased and was higher for the darker beer. Full article

Background: The atlanto-axial segment is highly mobile and, therefore, prone to instability in the setting of inflammatory disease, infection, tumor or trauma. While minimally invasive surgical (MIS) techniques have gained acceptance in the thoracolumbar spine due to their advantages over traditional approaches, their use at the atlanto-axial segment is controversial due to the surgical risk associated with its complex anatomy. To evaluate the current evidence on MIS atlanto-axial fixation, we carried out a systematic review of the literature and compared the reported results with those of open procedures. Methods: This systematic review follows PRISMA-DTA 2020 guidelines. A comprehensive search was conducted in November 2023 across PubMed/Medline, Google Scholar and clinicaltrials.gov using specific keywords related to minimally invasive atlanto-axial fixation. Data regarding study characteristics, patient demographics, surgical techniques, and outcomes were extracted from included studies. Results: This systematic review included 13 articles reporting on the results of surgery in 305 patients, in whom a total of 683 screws were inserted through a posterior MIS approach. N = 162 screws were inserted using the Harms–Goel technique, while N = 521 were placed using the Magerl technique. N = 40 screws were inserted using navigation guidance, while N = 643 were introduced with fluoroscopy assistance. Eight screws were misplaced. A Vertebral Artery (VA) injury was reported in three patients. With a mean value of 26.2 ± 15.3 months, the rate of fusion ranged between 80% and 100%. Conclusions: This study highlights the potential of MIS for posterior atlanto-axial fixation, which was achieved using Magerl transarticular screws in a large majority of cases. Despite technical challenges, MIS approaches appear to achieve satisfactory clinical and radiological outcomes with complication rates similar to those of open techniques. Future studies may help refine the indications for MIS and identify those cases better suited for open approaches. Full article

Food systems interact through multiple dimensions including food security, nutrition, and planetary health. This study aims to associate different dietary patterns with sustainable lifestyles in Latin America and Spain. This was an observational, analytical, multicenter, cross-sectional survey study, with a total of 6412 participants. A self-administered questionnaire was developed in an online format in the Google Docs interface. The questionnaire was divided into sections: (1) sociodemographic background: country of residence, age, sex, educational level, socioeconomic aspects, and place of residence; (2) body mass index classification; (3) dietary patterns (Western, vegetarian, vegan, ketogenic, Mediterranean, prudent, or paleolithic diets); and (4) the Sustainable Lifestyles Survey. Multivariate models were applied to adjust for potential confounding factors. The mean age of the participants was 35.2 years (SD 12.7). The majority of participants identified their dietary pattern as omnivorous (41.5%), followed by the Western diet (21.7%) and the Mediterranean diet (12.7%). Plant-based, vegan (β: 14.90; 95% CI: 9.75–20.05), and lacto egg (β: 12.08; 95% CI: 8.57–15.58) diets are significantly associated with a higher sustainability score compared to an omnivorous diet. In contrast, a Western diet is inversely associated (β: −5.63; 95% CI: −7.20 to −4.06). Finally, a vegan (Sub-score 1: β: 6.19; 95% CI: 4.43–7.96) diet is consistently associated with higher levels of sustainability in all areas assessed. In contrast, the Western diet shows a significant negative association with sustainability in all subcomponents assessed. Conclusions: Plant-based dietary patterns were shown to be associated with sustainable lifestyles, with the vegan diet having the greatest association, while the Western dietary pattern was inversely associated. Full article

Background: Chronic kidney disease (CKD) and its advanced stage, end-stage renal disease (ESRD), affect millions worldwide and are associated with a paradoxical hemostatic imbalance—marked by both increased thrombotic and bleeding risks—which complicates anticoagulant use and demands clearer, evidence-based clinical guidance. Design: This study is a critical review synthesizing the current literature on anticoagulant therapy in CKD and ESRD, with emphasis on altered pharmacokinetics, clinical complications, and therapeutic adjustments. Data Sources: PubMed, Scopus, and Google Scholar were searched for articles discussing anticoagulation in CKD/ESRD, focusing on pharmacokinetics, clinical outcomes, and dosing recommendations. Study Selection: Studies examining the safety, efficacy, and pharmacokinetics of anticoagulants—including heparin, low-molecular-weight heparin (LMWH), warfarin, and direct oral anticoagulants (DOACs)—in CKD and ESRD populations were included. Data Extraction and Synthesis: Key findings were summarized to highlight the dose modifications, therapeutic considerations, and clinical challenges in managing anticoagulation in CKD/patients with ESRD. Emphasis was placed on balancing thrombotic and bleeding risks and identifying gaps in existing guidelines. Results: Patients with CKD and ESRD exhibit a paradoxical hypercoagulable state marked by platelet dysfunction, altered coagulation factors, and vascular endothelial damage. This condition increases the risk of thrombotic events, such as deep vein thrombosis (DVT) and pulmonary embolism (PE), while simultaneously elevating bleeding risks. Hemodialysis and CKD-associated variables further complicate the management of coagulation. Among anticoagulants, unfractionated heparin (UFH) is preferred due to its short half-life and adjustability based on activated partial thromboplastin time (aPTT). Low-molecular-weight heparins (LMWHs) offer predictable pharmacokinetics but require dose adjustments in CKD stages 4 and 5 due to reduced clearance. Warfarin necessitates careful dosing based on the estimated glomerular filtration rate (eGFR) to maintain an international normalized ratio (INR) ≤ 4, minimizing bleeding risks. Direct oral anticoagulants (DOACs), particularly Apixaban, are recommended for patients with eGFR < 15 mL/min or those on dialysis, although data on other DOACs in CKD remain limited. The lack of comprehensive guidelines for anticoagulant use in CKD and ESRD highlights the need for individualized, patient-centered approaches that account for comorbidities, genetics, and clinical context. Conclusions: Managing anticoagulation in CKD/ESRD is challenging due to complex coagulation profiles and altered pharmacokinetics. Judicious dosing, close monitoring, and patient-centered care are critical. High-quality randomized controlled trials are needed to establish clear guidelines and optimize therapy for this vulnerable population. Full article

Whether it is asking Alexa to set a reminder or having Google Assistant place a call, AI-powered assistants are becoming an increasingly seamless part of our daily lives. This study aims to address what predicts the users’ satisfaction with Alexa by analyzing the using motives, cognitive involvement, and emotional involvement of its consumers. The variables include using motives, attention, elaboration, emotional involvement, and usage satisfaction. Alexa users (N = 299) completed a brief online survey, including Scales of Using Motives for Media, the Perceived Attention Scale, the Elaboration Scale, the Mood Adjective Check List Scale, and Television Viewing Satisfaction Scale. Participants who were at least eighteen years of age and owned and used Alexa were included in this study. An exploratory factor analysis revealed four distinct types of motivation for using Alexa: Companionship, Entertainment–Information, Work-Efficiency, and Pastime. The results from hierarchical regressions showed that Alexa usage satisfaction was predicted by Entertainment–Information and feeling positive emotions while using. Full article

Background and objective: Menopause is a significant physiological milestone in a woman’s life, coinciding with increased cardiovascular disease (CVD) risk due to various health-related changes. This narrative review focuses on cardiovascular health-related alterations during menopause and their implications on vascular function. Methods: An electronic database search was performed, drawing from sources such as PubMed and Google Scholar. Publications were included if they addressed CVD risk in peri- and postmenopausal women, and examined the impact of hormonal changes, traditional risk factors (e.g., hypertension, hyperlipidemia, diabetes), or lifestyle factors (e.g., diet, physical activity) on CVD. Results: Estrogen deficiency is pivotal, leading to adverse effects such as endothelial dysfunction, increased arterial stiffness, and lipid profile deterioration. Characteristics of menopause, including the age at onset, type or stage of menopause, and severity of symptoms, further modulate CVD risk. Additionally, the impact of traditional risk factors is amplified during this period. Strategies for the prevention of CVD in menopausal women are critically assessed, with a focus on lifestyle modifications, dietary interventions, and physical activity. Conclusions: This narrative review describes the potential benefits and risks of hormone therapy, alongside lipid-lowering therapies. Emphasis is placed on individualized risk assessment and management, highlighting the need for regular cardiovascular screenings and proactive management of risk factors. Full article

(1) Background: Adolescents living with HIV (ALHIVs) experience significant challenges in adhering to treatment and remaining engaged in care as they transition from pediatric to adult HIV care programs. The aim of this qualitative evidence synthesis (QES) was to review qualitative studies that describe how ALHIVs experience transition practices in low- and middle-income countries. (2) Methods: The following databases were searched: PubMed, Wiley Library Online, EbscoHost (PsychARTICLES, MEDLINE, Scopus, CINAHL), the WHO database, Google Scholar, and reference mining of the included studies. The inclusion criteria were as follows: ALHIV 10–19 years old, interventions on the transition period or studies describing transition practices, published between 2012 and 2023, conducted in low- and middle-income countries, English language, and qualitative and mixed-method studies. This review adheres to the PRISMA guidelines. CASP and MMAT were used for methodological quality assessment, and GRADE CERQual was used for the confidence in review findings. (3) Results: Seven articles were included in the final review. The five overarching themes described: (1) transition readiness during the pre-transition phase; (2) structural (health systems) barriers and treatment literacy as challenges during the transition period; and (3) provided accounts of successful post-transition experiences and recommendations for improving the transition process (when these were not experienced as positive), while also describing the individual and collective contexts in which transition took place, as they outlined (4) individual (psychological) barriers and the facilitative role that (5) a supportive environment played in the outcome of the transition process. There was a high level of confidence in transition readiness, while the other themes were assessed as having moderate confidence due to methodological limitations and minor concerns about adequacy or relevance. (4) Conclusions: There is a dearth of qualitative studies on the transition experiences of ALHIVs and on how the transition process impacts adherence, retention in care, and mental well-being. We recommend the development of interventions in the form of a guided transition protocol to improve the transition experiences of ALHIVs. Full article

Mental health disorders represent a substantial global health concern, impacting millions and placing a significant burden on public health systems. Natural Language Processing (NLP) has emerged as a promising tool for analyzing large textual datasets to identify and predict mental health challenges. The aim of this scoping review is to identify the Arabic NLP techniques employed in mental health research, the specific mental health conditions addressed, and the effectiveness of these techniques in detecting and predicting such conditions. This scoping review was conducted according to the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) framework. Studies were included if they focused on the application of NLP techniques, addressed mental health issues (e.g., depression, anxiety, suicidal ideation) within Arabic text data, were published in peer-reviewed journals or conference proceedings, and were written in English or Arabic. The relevant literature was identified through a systematic search of four databases: PubMed, ScienceDirect, IEEE Xplore, and Google Scholar. The results of the included studies revealed a variety of NLP techniques used to address specific mental health issues among Arabic-speaking populations. Commonly utilized techniques included Support Vector Machine (SVM), Random Forest (RF), Decision Tree (DT), Recurrent Neural Network (RNN), and advanced transformer-based models such as AraBERT and MARBERT. The studies predominantly focused on detecting and predicting symptoms of depression and suicidality from Arabic social media data. The effectiveness of these techniques varied, with trans-former-based models like AraBERT and MARBERT demonstrating superior performance, achieving accuracy rates of up to 99.3% and 98.3%, respectively. Traditional machine learning models and RNNs also showed promise but generally lagged in accuracy and depth of insight compared to transformer models. This scoping review highlights the significant potential of NLP techniques, particularly advanced transformer-based models, in addressing mental health issues among Arabic-speaking populations. Ongoing research is essential to keep pace with the rapidly evolving field and to validate current findings. Full article

This paper presents a new approach to optimizing route selection in urban road networks with sparsely placed traffic counters. By leveraging graph theory and Dijkstra’s algorithm, we propose a new method to determine the shortest path between origins and destinations in city traffic networks with sparsely placed counters. The method is based on the similarities between traffic flows recorded at the counter and the streets that generate traffic for a given counter. The advantage of this method is the use of a secondary counter function to obtain data that are built into the shortest path determination model and the free choice of the time of day for which the path is searched. The proposed method is implemented using the programming language AutoLISP 2022 and program AutoCAD 2022, providing a valuable tool for transportation engineers and urban planners. This paper presents a model of the shortest path that integrates one-way streets, the average speed of the car, as well as the delay time at traffic-lighted and non-traffic intersections. The model was applied to the traffic network of the city of Sarajevo (Bosnia and Herzegovina), but there are no restrictions for application to any network equipped with traffic counters. The obtained results show a high agreement with the Google Maps service as a reference system. Full article

Vaccine preventable diseases remain the leading causes of death among children in Sub-Saharan Africa. Background/Objectives: As vaccines provide the best possible protection only when all required doses are received, it is essential to understand how the published literature is designed and conducted regarding the completion of recommended childhood vaccine series for children aged 12–23 months in SSA. Methods: A comprehensive search was conducted across five databases (PubMed, Embase, CINAHL, Web of Science, and Google Scholar) to identify the relevant literature published between January 2000 through December 2023. Results: A total of 53 studies meeting the inclusion criteria were identified from the five databases. Over half of the studies used a cross-sectional design (n = 32, 60.4%), and less than half of the studies were conducted in Ethiopia (n = 23, 43.4%). The prevalence and associated factors of vaccination series completion were the most commonly explored topics in the literature. The most frequently reported factors associated with vaccine series completion included the caregiver’s education level, household wealth status, number of children under five in the household, knowledge of immunization, maternal education, place of residence, gender of the household head or decision maker, utilization of antenatal or postnatal care visits, place of delivery, distance to a healthy facility or travel time, and possession of a vaccination card. Conclusions: This scoping review identified methodological gaps in the published literature, including a lack of publications from many Sub-Saharan Africa countries and insufficient evidence on trends and inequalities in vaccine series completion. Future research on vaccine series completion is recommended to address these gaps. Full article