Search Results (1,071)

A substantial body of evidence supports the role of exercise in mitigating many effects of cancer and its treatments. However, services for survivors remain scarce, highlighting a significant research-to-practice gap. To address this gap, it is essential to explore strategies that could enhance the dissemination of evidence, supporting the translation of exercise oncology trial findings into clinical practice. To this end, this qualitative study aimed to explore the viewpoints of stakeholders (patients/healthcare professionals (HCPs)/policy makers/researchers) on the dissemination of exercise oncology trials. Stakeholders were invited to take part in a one-to-one semi-structured interview exploring their experiences of and preferences for exercise oncology trial dissemination. Interviews were audio-recorded, transcribed verbatim, and analysed using a thematic approach. Thirty stakeholders were recruited: patients with a history of cancer (n = 14), healthcare professionals (HCPs) (n = 3), researchers (n = 10), and policy makers/healthcare management (n = 3). Median interview length was 14 min and 10 s (range 8 min 16 s to 37 min and 23 s). Three main themes were identified: (i) the need for enhanced dissemination strategies, (ii) engaging stakeholders throughout the study lifespan as key to facilitating effective dissemination, and (iii) tools to support closing the research-to-practice gap. Results indicate that stakeholders want dissemination approaches tailored to the intended audience and presented in formats that are accessible both linguistically and practically, recognising the individuality of each stakeholder group. To support this, three main recommendations were generated: (i) engage all stakeholders throughout the entire research project, from planning to dissemination, to ensure that dissemination avenues are appropriately targeted; (ii) implement a multi-component dissemination strategy that incorporates multiple avenues, blending traditional and innovative approaches to address the priorities of specific stakeholder groups; (iii) adopt multiple communication approaches that extend beyond written format alone and use stakeholder-specific language which is understandable to target audience while maintaining credibility and rigour. Full article

Background: Hydrolyzed collagen peptides (HCP) are widely used as bioactive ingredients in anti-aging and skin rejuvenation formulations due to their role in supporting skin hydration, elasticity, and extracellular matrix integrity. However, their high hydrophilicity limits effective incorporation into lipid-based systems, and restricts controlled release from formulations. Objective: In this study, ethosomal nanocarriers were designed as a phospholipid–ethanol-based system to promote favorable molecular interactions with hydrophilic peptides, aiming to enhance the encapsulation, stability, and controlled release of HCP for dermocosmetic applications. Methods: HCP-loaded ethosomes were prepared using phospholipid (Lipoid P75) and ethanol and optimized by varying high-pressure homogenization cycles. Physicochemical properties, including vesicle size, distribution uniformity, zeta potential, pH, and long-term stability, were monitored for up to 180 days. Vesicle morphology and peptide–lipid interactions were characterized using cryo-scanning electron microscopy and FTIR spectroscopy. Encapsulation efficiency was determined by ultrafiltration, while cytocompatibility was assessed in HaCaT keratinocyte cells. In vitro release behavior was investigated using Franz diffusion cells and compared with aqueous HCP solutions. Results: All formulations exhibited nanoscale size distribution and high colloidal stability, with negative zeta potentials ranging from −42.9 to −76.7 mV. The optimized formulation demonstrated sustained encapsulation efficiency (73% after 180 days) and preservation of peptide structure, as confirmed by FTIR, indicating effective chemical stabilization within the ethosomal matrix. Cytotoxicity studies confirmed good skin cell compatibility. In vitro release studies revealed a controlled and prolonged release profile from ethosomal carriers compared with free HCP solutions, suggesting improved topical bioavailability of collagen peptides. Conclusions: To the best of our knowledge, this work provides one of the first systematic investigations of optimized ethosomal systems for the stabilization of hydrophilic collagen peptides as anti-aging dermocosmetic ingredients. These findings demonstrate that optimized HCP-loaded ethosomes represent a promising ingredient formulation platform enabling bioactive preservation, formulation stability, and controlled topical performance for collagen-based skin rejuvenation applications. Full article

In this paper, we show that the sphere-in-contact model can predict long-range surface adsorption phenomena based on adsorbate-adsorbate repulsions and their geometric distance, assuming that their negative surface-induced charge is smeared on the surface of the adsorbate atoms. Additionally, it can be used to model collective surface diffusion mechanisms such as the domino-type surface diffusion of adsorbate rows on close-packed metal HCP and FCC surfaces. We have recently shown that the sphere-in-contact model can be used as an educational and research tool in various contexts, such as the visualization of carbon structures (e.g., graphene, carbon nanotubes, carbon nanocones, and graphite), heterogeneous catalysts, metal nanoparticles, and organic molecules. Here we present how it can be used to model the adsorbate structure of monoatomic elements on the hexagonal close-packed surface of HCP and FCC metals to study long-range ordering phenomena of monoatomic adsorbates on metals. We have used atoms of varying radius and color to represent the metal surface atoms and the adsorbate atoms. The study reveals that many surface configurations are possible for a fixed adsorbate coverage (θ) by the movement of the adsorbate atoms in response to surface adsorbate-adsorbate repulsions. The movement of the particles (e.g., particle diffusion) can be seen directly in the model, and this is caused by the user intervention. This has great educational and research value, as one can directly see how the adsorbate atoms reorder on the surface of a metal and therefore study diffusion mechanisms. We calculate the repulsive interaction energy of adsorbates using the sphere-in-contact model and can identify which surface-adsorbed configuration is the lowest energy. We find that at a surface coverage of 1/3 (0.333 ML), the most stable adsorbate configuration places adsorbates at the third nearest neighbor 3-fold hollow sites, forming a hexagonal pattern. We find that this model will be useful in the rational design of catalytic materials and material coatings with new technological applications where long-range ordering of surface adsorbates is essential and adsorbate interactions are mainly repulsive interatomic interactions. Full article

Background: Host cell proteins (HCPs) are process-related impurities that must be monitored in biopharmaceutical products due to their potential impact on product quality and patient safety. Targeted LC–MS/MS approaches such as multiple reaction monitoring (MRM) enable protein-specific HCP quantification but are difficult to apply in highly multiplexed assays because of retention time (RT) variability across complex bioprocess matrices. Methods: Here, we show that conventional RT-scheduled MRM workflows lack transferability when applied to heterogeneous drug substances and process intermediates. Using a targeted assay comprising 240 peptides corresponding to 97 CHO-derived HCPs, RT shifts of several minutes resulted in truncated chromatographic peaks and peptide signal loss, even when wide scheduling windows were used. To overcome this limitation, a scout-triggered MRM (st-MRM) acquisition strategy based on event-driven monitoring was implemented. Results: This approach enabled robust peptide detection across diverse matrices within a single injection, without method re-optimization. Absolute quantification using stable isotope-labeled peptides spanned six orders of magnitude, with HCPs quantified down to 2.9 ppm in purified drug substances. Conclusion: Overall, st-MRM improves the robustness and transferability of highly multiplexed targeted proteomics workflows for HCP analysis. Full article

Background: Hepatic ischemia-reperfusion injury (HIRI) is a major complication in liver surgery with limited therapeutic options. Houttuynia cordata polysaccharide (HCP), a key bioactive component of the traditional anti-inflammatory herb, has demonstrated immunomodulatory potential, but its effect on HIRI remains unclear. Methods: A murine model of 70% hepatic ischemia for 60 min followed by reperfusion was established. Mice were administered low-dose (50 mg/kg) or high-dose (100 mg/kg) HCP or the positive control N-acetylcysteine (150 mg/kg). Liver injury was assessed by serum ALT/AST levels, histopathology, oxidative stress markers, and inflammatory cytokines. Macrophage polarization and the TLR4/NF-κB pathway were analyzed using flow cytometry, qPCR, and Western blot. The TLR4 inhibitor TAK-242 was used for reverse validation, and molecular docking was performed to predict HCP binding to the TLR4/MD-2 complex. Results: HCP significantly attenuated HIRI-induced liver injury, as shown by reduced ALT/AST, improved histopathological scores, decreased MDA, increased SOD, and lower TNF-α and IL-6 levels. Mechanistically, HCP promoted a shift from M1 to M2 macrophage polarization, with increased CD206⁺ cells and Arg-1/IL-10 expression and decreased CD86⁺ cells and iNOS/IL-1β expression. HCP also suppressed TLR4/MyD88/NF-κB pathway activation, inhibiting NF-κB p65 phosphorylation and nuclear translocation. These protective effects were largely reversed by TAK-242 in vivo and in vitro. Molecular docking indicated stable binding between HCP and TLR4/MD-2. Conclusions: HCP protects against HIRI by targeting TLR4 to inhibit NF-κB signaling, thereby reprogramming macrophage polarization toward the M2 phenotype and alleviating inflammation and oxidative stress. These findings highlight HCP as a promising natural agent for HIRI intervention. Full article

Background/Objectives: Endometriosis affects ~10% of women, causing chronic pain, reduced quality of life, and, often, infertility. As endometriosis literacy and awareness are low in society and among health care providers (HCPs), patients are often on their own. The aim of this study was to identify information needs of patients, their social networks and HCPs based on the perspective of the patients as experts. Methods: Four participatory workshops (two online, two in-person) with 45 Austrian women (ages 20–50) diagnosed with endometriosis were conducted. Using pinboards for target groups (patients, partners/social networks, HCPs) and reviews of existing materials, we explored gaps and co-created ideas for information material and dissemination. Results: Participants emphasized the need for comprehensive, up-to-date, evidence-based information on disease progression, multimodal treatment options, and life-stage-specific topics such as fertility, surgical aftercare, or menopause. The necessity of legal and financial guidance (e.g., disability rights or prescription fee exemptions) was highlighted, alongside clear pathways to specialized care. Some of the existing materials or contents were criticized as outdated, inconsistent, or difficult to read. For their social networks, participants requested simple, empathetic materials explaining disease chronicity, intimacy/fertility challenges, and practical support during pain episodes. HCPs were urged to update clinical knowledge, proactively address symptoms, validate pain experiences, and be transparent about treatment side effects and psychosocial burdens. Conclusions: A centralized, co-created, and easily accessible information ecosystem could support patient autonomy, improve trust, and reduce diagnostic delays. Strengthening self-help groups and life-stage-tailored information are critical to improving self-management and mitigating endometriosis’s socioeconomic impact. Full article

Seasonal influenza remains a major threat to healthcare facilities, where introduction of the virus can cause disproportionate morbidity and mortality among high-risk inpatients. This narrative review synthesizes current evidence and practice-oriented guidance on the prevention of hospital-acquired influenza. We conducted a targeted literature search using PubMed, guideline repositories for English-language publications from 2000 to 2025, prioritizing systematic reviews, clinical trials, and authoritative guidelines. A multifaceted strategy is emphasized: annual vaccination of healthcare personnel and eligible patients; consistent implementation of standard and transmission-based precautions; attention to environmental cleaning and disinfection; and occupational-health policies that limit presenteeism and workplace exposure. Evidence demonstrates that higher healthcare personnel (HCP) vaccination coverage is associated with lower patient influenza rates and improved survival. Reliable hand hygiene, respiratory source control, early initiation of droplet precautions, and cohorting when single rooms are limited all contribute to interrupting in-facility transmission. Ensuring that ill HCP can remain off duty without penalty further reduces the likelihood of staff-to-patient spread. Collectively, these coordinated measures provide a protective framework and underscore the central role of clinicians and infection-prevention teams in sustaining influenza control within acute-care settings. Full article

Background: Monitoring and managing gestational weight gain (GWG) during antenatal care (ANC) is linked to better maternal and neonatal outcomes. The Institute of Medicine (IOM) guidelines are based on pre-pregnancy BMI and reduce obstetric risks. Pregnant women’s views and healthcare providers’ (HCPs) practices are key to effective GWG counseling. This study aims to: (1) investigate the proportion of women who received GWG advice per IOM guidelines, and (2) explore HCP practices and views on GWG counseling. Methods: This is a cross-sectional study of Saudi pregnant women who delivered within one year of the study and HCPs who provided ANC. Women provided data on demographics, pre-pregnancy BMI, recall of GWG advice, and their target GWG. HCPs rated their knowledge and counseling practices. Results: Of 1151 women, 48.8% were pre-pregnancy overweight or obese, 47.6% were normal weight, and 3.6% were underweight. Most women (74.5%) received no GWG advice, and only 8.8% followed IOM guidelines. Women with obesity and overweight were more likely to receive correct advice (15.5% and 11.5%), compared to 5.3% of normal-weight and 2.4% underweight women. Overweight and obese women were more likely to define the correct GWG (AOR = 2.84 and 5.85). Receiving proper advice greatly increased the likelihood of proper GWG definition (AOR = 7.13). Among 28 HCPs, 53.6% reported that women rarely ask about the GWG target. Nearly 93% of them weigh women at each visit, but only 21.4% set personalized GWG targets. Most HCPs (82.2%) viewed discussing GWG as a high priority, and 70% felt confident providing guidance on GWG, diet, and exercise. Conclusions: Many women receive no GWG guidance, and most advice does not align with IOM guidelines. Enhancing Saudi women’s knowledge regarding GWG targets through health education, in conjunction with ongoing medical education for healthcare professionals concerning guidelines for GWG, represents modifiable factors and a critical opportunity to foster healthier pregnancy outcomes. Full article

This study examines in situ induction-heating thermal field assistance during laser cladding of Stellite 6 on 17-4PH stainless steel. Single-layer, multi-track coatings (~2.3 mm) were produced at induction powers of 0, 300, 600, and 900 W while keeping laser parameters constant. Surface morphology, phase constituents, and microstructures were characterized by LSCM, OM, XRD, SEM, EDS, and EBSD, and nanoscale features were probed by TEM for the 600 W condition; microhardness and coating-only tensile properties were evaluated. Thermal assistance improved surface finish (minimum Sa = 16.67 μm at 600 W) and suppressed hot cracking. XRD/EBSD revealed a γ-Co matrix with interdendritic carbides and an increased ε-Co fraction under thermal assistance; TEM further showed stacking-fault lamellae and a distinct FCC/HCP interface, supporting a fault-assisted, diffusionless γ → ε transformation. Increasing induction power coarsened the microstructure (larger D_E and SDAS), decreasing hardness from 537.1 to 461.5 HV_0.1 and lowering yield/ultimate strengths from 1046 MPa and 1512 MPa to 849 MPa and 1423 MPa, while elongation increased from 4.37% to 6.27%. Considering crack-free valve hardfacing with acceptable strength loss and improved ductility, 600 W provides the best overall performance. Full article

Background: Clinical Ethics Consultation (CEC) helps healthcare professionals, patients, and families address ethically complex situations in clinical practice. Since 2016, requests for CEC at the Fondazione Policlinico Universitario “A. Gemelli” IRCCS (FPG) have been entered into the hospital IT system like other consulting services. This has increased both the number of requests and the need to monitor and evaluate the service. Aims: This qualitative study investigates how the CEC service at FPG is perceived in terms of its value, role, and impact, and further aims to identify appropriate strategies for evaluating the service. Methods: Semi-structured interviews were conducted with 28 healthcare professionals who had used or taken part in the service within the previous two years. Data were examined using reflective thematic analysis, leading to the development of codes and themes. Results: Five main themes emerged: (1) Role and identity of the clinical ethics consultant the, (2) Benefits of CEC for clinical practice, (3) How to evaluate the CEC Service, (4) HCPs’ Evaluation, and (5) CEC Service Improvement Strategies. Participants saw the consultant as an “active third party” who combines ethical, clinical, and communication skills to mediate conflicts, support teamwork, and guide shared care planning. The service was viewed as strengthening patient-centered care by improving communication with patients and families, clarifying treatment proportionality, and reducing clinicians’ decisional isolation. Interviewees emphasized the need for structured evaluation tools that include both quantitative indicators and qualitative feedback. Satisfaction with the service was consistently high, with recommendations to expand consultant availability, improve timeliness, and enhance training. Conclusions: CEC appears to serve as a clinical, relational, and training resource that fosters ethically grounded, collaborative, and person-centered care. Full article

Background: In recent years, virtual consultations have emerged as a crucial approach for continuity of chronic care provision, indicating a promising avenue for the future of smart healthcare systems. However, reversions to in-person care highlight persistent limitations, despite notable advantages of remote modalities. In parallel, recent developments in artificial intelligence (AI) indicate the potential to enhance remote chronic care, but user perceptions of such assistance and the corresponding human factors remain underexplored. Objective: This mixed methods study aims to better understand the virtual consultation experiences and attitudes toward AI-assisted tools in remote care among patients with noncommunicable chronic conditions and their healthcare professionals (HCPs). It conducts an in-depth examination of the associated human–computer interaction and usability elements of virtual consultations and of potential AI assistance. Methods: Public and Patient Involvement was integrated to run pilots and refine documentations. Semi-structured interviews with patients (n = 10), focus groups with HCPs (n = 15), and an online survey (n = 83) were conducted. Qualitative data was analysed through a reflexive thematic approach. The survey comprised the Telehealth Usability Questionnaire (TUQ) and bespoke items on user AI views, and the data was used to triangulate the qualitative findings. Nonparametric Kruskal–Wallis tests and ε² effect sizes compared TUQ and AI views scores between current and former virtual consultation user groups. Results: Seven themes emerged from the qualitative data, which were supported by the quantitative findings. The statistical analyses resulted in a mean TUQ total score of 90.6 (SD = 15.0), which indicates high usability and user satisfaction; however, they failed to detect a difference between groups (p > 0.05; ε² = 0.002–0.032). There was a clear preference for hybrid models, while a lack of empathy was identified during remote interactions. While a notable proportion of users indicated a literacy gap towards AI use in healthcare settings, they expressed cautious openness towards AI assistance, contingent upon transparency, human oversight, and data integrity; indicating a potential gap between competence to judge the technology and willingness to use it. Significant differences in views on AI assistance across groups failed to be detected (p > 0.05; ε² = 0.005–0.065). Conclusions: Virtual consultations for chronic conditions are widely usable and acceptable, particularly through hybrid approaches. Addressing empathic engagement, holistic patient status, and transparent AI integration can enhance clinical quality and user experiences during remote interactions. However, the low statistical power and failure to detect a difference between groups (likely due to the small sample size) indicate the need for caution when interpreting the quantitative findings. There is also the implicit need to address potential AI literacy gap among users, indicating the need for robust safeguard measures. This study has also identified evidence-based assistive AI features that can potentially enhance virtual consultations. These insights can inform the co-design of evidence-based virtual care platforms, policies and supportive AI tools to sustain remote chronic care delivery. Full article

Medication adherence following myocardial infarction (MI) is essential for effective secondary prevention, yet adherence rates remain suboptimal. Healthcare professionals (HCPs) are central to promoting adherence through clinical decision-making, patient education, and ongoing behavioural support. Understanding how HCPs perceive and experience the factors’ influencing adherence is key to developing effective, context-specific interventions. This study explored HCPs’ perspectives on medication adherence post-MI and identified behavioural determinants influencing medication management across the care pathway. A qualitative descriptive study was conducted using semi-structured interviews with HCPs in the southwest of Ireland. Participants included hospital pharmacists, community pharmacists, general practitioners (GPs), cardiologists, and nurses, recruited through purposive, convenience, and snowball sampling. Interviews were recorded, transcribed verbatim, and analysed using directed content analysis guided by the Theoretical Domains Framework (TDF). Twelve HCPs (eight female) were interviewed between December 2024 and May 2025, including four pharmacists, two GPs, three cardiologists and three nurses. Interviews lasted 30–50 min (mean 41 min). Analysis identified 15 facilitators, 13 barriers, and 7 dual-role determinants across 10 TDF domains. Novel contributions include demonstrating how HCPs’ real-world experiences contextualise adherence issues in the distinct post-MI setting characterised by abrupt care transitions, polypharmacy, and emotional vulnerability and identifying where HCPs feel most constrained and where their expertise could directly inform targeted intervention design. HCPs’ insights reveal complex, context-specific behavioural determinants influencing post-MI medication adherence and highlight the need for multidisciplinary, tailored, and system-level solutions. Enhancing collaboration, supporting patient-centred communication, and addressing resource barriers could empower HCPs to deliver more effective, personalised adherence support and inform the development of targeted intervention strategies. Full article

This work aims to enhance the stability of the Mg/Al₃Y interface through first-principles investigations of low-cost dopants. Density functional theory calculations were employed to systematically examine the bulk properties of Mg and Al₃Y, as well as the structural stability, electronic characteristics, and alloying element effects at the Mg(0001)/Al₃Y(0001) interface. The calculated lattice parameters, elastic moduli, and phonon spectra demonstrate that both Mg and Al₃Y are dynamically stable. Owing to the similar hexagonal symmetry and a small lattice mismatch (~1.27%), a low-strain semi-coherent Mg(0001)/(2 × 2)Al₃Y(0001) interface can be constructed. Three representative interfacial stacking configurations (OT, MT, and HCP) were examined, among which the MT configuration exhibits significantly higher work of adhesion, indicating superior interfacial stability. Differential charge density and density of states analyses reveal pronounced charge transfer from Mg to Al/Y atoms and strong orbital hybridization, particularly involving Y-d states, which underpins the enhanced interfacial bonding. Furthermore, the segregation behavior and adhesion enhancement effects of typical alloying elements (Si, Ca, Ti, Mn, Cu, Zn, Zr, and Sn) were systematically evaluated. The results show that Mg-side interfacial sites, especially Mg₂ and Mg₃, are thermodynamically favored for segregation, with Zr and Ti exhibiting the strongest segregation tendency and the most significant improvement in interfacial adhesion. These findings provide fundamental insights into interfacial strengthening mechanisms and offer guidance for the alloy design of high-performance Mg-based composites. Full article

With the wide application of Ni-Al high-temperature materials, the research on their performance has increasingly attracted attention. To further advance the development of Ni-Al high-temperature materials, it is necessary to conduct an in-depth analysis of the brittleness mechanism of Ni-Al intermetallic compounds and elucidate the fundamental nature of their brittleness. In this study, the tensile mechanical behavior and microscopic mechanism of single crystals NiAl (B2) and Ni₃Al (L1₂) at different temperatures were systematically studied by molecular dynamics simulations. It is revealed that although the mechanical properties of both NiAl and Ni₃Al degrade with increasing temperature, their deformation mechanisms exhibit fundamental differences. The high-temperature strength of NiAl is attributed to stable plastic flow dominated by 1/2 <111> screw dislocation. The early softening of Ni₃Al is associated with the formation of stacking fault formation, the phase transition to the HCP, and the slip of various incomplete dislocations (e.g., 1/6 <112> Shockley dislocation). Atomic strain analysis shows that regions of high strain exhibit a strong spatial correlation with the phase-transformed domains. This study reveals the distinct deformation mechanism of the two alloy phases at the atomic scale, providing a key theoretical basis for the rational selection of Ni-Al alloy in specific high-temperature applications. Full article

Healthcare 5.0 and the Internet of Medical Things (IoMT) is emerging as a scalable model for the delivery of customised healthcare and chronic disease management, through Remote Patient Monitoring (RPM) in patient smart home environments. Large-scale RPM initiatives are being rolled out by healthcare providers (HCPs); however, the constrained nature of IoMT devices and proximity to poorly administered smart home technologies create a cyber risk for highly personalised patient data. The recent Network and Information Systems (NIS 2) directive requires HCPs to improve their cyber risk management approaches, mandating heavy penalties for non-compliance. Current research into cyber risk management in smart home-based RPM does not address scalability. This research examines scalability through the lens of the Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework and develops a novel Scalability Index (SI), informed by a PRISMA guided systematic literature review. Our search strategy identified 57 studies across major databases including ACM, IEEE, MDPI, Elsevier, and Springer, authored between January 2016 and March 2025 (final search 21 March 2025), which focussed on cyber security risk management in the RPM context. Studies focussing solely on healthcare institutional settings were excluded. To mitigate bias, a sample of the papers (30/57) were assessed by two other raters; the resulting Cohen’s Kappa inter-rater agreement statistic (0.8) indicating strong agreement on study selection. The results, presented in graphical and tabular format, provide evidence that most cyber risk approaches do not consider scalability from the HCP perspective. Applying the SI to the 57 studies in our review resulted in a low to medium scalability potential of most cyber risk management proposals, indicating that they would not support the requirements of NIS 2 in the RPM context. A limitation of our work is that it was not tested in a live large-scale setting. However, future research could validate the proposed SI, providing guidance for researchers and practitioners in enhancing cyber risk management of large-scale RPM initiatives. Full article