Search Results (2,238)

Assisted Reproductive Technology Units (ARTUs) constitute a rapidly growing sector in healthcare, where service quality and patient safety are closely intertwined with ethical principles, technological precision, and managerial efficiency. This study aims to explore quality management practices and certification standards—such as ISO 9001, ISO 15189, and ISO 13485—within ARTUs, with the goal of developing a model that enhances patient-centered outcomes. The analysis focuses on the roles of leadership, staff training, and internal auditing mechanisms as key factors for the successful implementation of quality management systems (QMSs). Through a structured literature review and thematic synthesis, this study identifies challenges that ARTUs face in aligning with international standards and highlights strategies that strengthen patient trust, transparency, and continuous improvement. The proposed model connects measurable quality indicators with patient perceptions and experiences, providing a comprehensive framework for sustainable quality development. This article contributes to the academic discourse on healthcare quality governance and offers practical insights for policymakers and administrators seeking to improve patient experience and organizational resilience in reproductive medicine. Full article

Nanoparticle-mediated photothermal conversion exploits the unique light-to-heat transduction properties of engineered nanomaterials to address challenges in energy, water, and healthcare. This review first examines fundamental mechanisms—localized surface plasmon resonance (LSPR) in plasmonic metals and broadband interband transitions in semiconductors—demonstrating how tailored nanoparticle compositions can achieve >96% absorption across 250–2500 nm and photothermal efficiencies exceeding 98% under one-sun illumination (1000 W·m⁻², AM 1.5G). Next, we highlight advances in solar steam generation and desalination: floating photothermal receivers on carbonized wood or hydrogels reach >95% efficiency in solar-to-vapor conversion and >2 kg·m⁻²·h⁻¹ evaporation rates; three-dimensional architectures recapture diffuse flux and ambient heat; and full-spectrum nanofluids (LaB₆, Au colloids) extend photothermal harvesting into portable, scalable designs. We then survey photothermal-enhanced thermal energy storage: metal-oxide–paraffin composites, core–shell phase-change material (PCM) nanocapsules, and MXene– polyethylene glycol—PEG—aerogels deliver >85% solar charging efficiencies, reduce supercooling, and improve thermal conductivity. In biomedicine, gold nanoshells, nanorods, and transition-metal dichalcogenide (TMDC) nanosheets enable deep-tissue photothermal therapy (PTT) with imaging guidance, achieving >94% tumor ablation in preclinical and pilot clinical studies. Multifunctional constructs combine PTT with chemotherapy, immunotherapy, or gene regulation, yielding synergistic tumor eradication and durable immune responses. Finally, we explore emerging opto-thermal nanobiosystems—light-triggered gene silencing in microalgae and poly(N-isopropylacrylamide) (PNIPAM)–gold nanoparticle (AuNP) membranes for microfluidic photothermal filtration and control—demonstrating how nanoscale heating enables remote, reversible biological and fluidic functions. We conclude by discussing challenges in scalable nanoparticle synthesis, stability, and integration, and outline future directions: multicomponent high-entropy alloys, modular photothermal–PCM devices, and opto-thermal control in synthetic biology. These interdisciplinary innovations promise sustainable solutions for global energy, water, and healthcare demands. Full article

Background/Objectives: Providing children with information about their treatment can help reduce uncertainty and anxiety associated with hospital procedures. The aim of this study was to develop and evaluate an app designed to prepare young children and their parents for a hearing examination in a playful and engaging way. Methods: This exploratory study adopted a participatory design approach. Children, parents, and clinicians co-created the app, and evaluations were conducted through focus group meetings, dialogue meetings, and surveys. Results: Children, parents, and clinicians evaluated the app positively. Findings indicated that children who used the app before their hearing examination met audiologists’ expectations to a greater extent than those who did not. However, no significant differences were found between the two groups regarding satisfaction with the examination, the children’s sense of safety, or parents’ prior knowledge of the procedure. The study also revealed implementation challenges: only 20% of children visiting the department had used the app beforehand, and funding for ongoing maintenance was not adequately addressed. Conclusions: Preparing children for hearing examinations with an app appears promising. However, to ensure the quality, accessibility, and sustainability of digital healthcare solutions, challenges related to implementation and maintenance must be considered in future studies. Full article

Background: The COVID-19 pandemic has put other infectious diseases, especially in children, into a new perspective. Our study focuses on two important viral infections: COVID-19 and influenza, which often present with similar clinical symptoms. Taking into consideration that the pathophysiology and systemic impact of the two viruses are distinct, which can lead to measurable differences in laboratory values, this study aimed to analyze laboratory features that differentiate between COVID-19 and influenza virus infections in pediatric patients. Methods: We statistically analyzed the routinely available laboratory data of 98 patients with influenza virus and 78 patients with COVID-19. Afterwards, the classification and regression tree (CART) method was performed to identify specific clinical scenarios, based on multilevel interactions of different features that could assist clinicians in evidence-based differentiation. Results: Significant differences between the two groups were observed in ALT, eosinophils, hemoglobin, and creatinine. Influenza-infected infants presented significantly higher leukocyte, neutrophil, and basophil counts compared to infants infected with COVID-19. Regarding children (over 12 months), significantly lower levels of ALT and eosinophil counts were observed in those with influenza compared to those with COVID-19. Furthermore, the CART decision tree model identified distinct profiles based on a combination of features such as age, leukocytes, lymphocytes, platelets, and neutrophils. Conclusions: After further refinement and application, such machine learning-based, evidence-driven models, considering the large scale of clinical and laboratory variables, might help to improve, support, and sustain healthcare practices. The differential decision tree may contribute to enhanced clinical risk assessment and decision making. Full article

Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings. Full article

Background: Pancreatic cancer is the least survivable malignancy, with five-year survival below 10%. Its vague, non-specific symptoms contribute to late diagnosis and poor outcomes. Targeted education for healthcare professionals, students, patients, carers, and the public may improve awareness, confidence, and early help-seeking. This scoping review aimed to map and synthesize peer-reviewed evidence on pancreatic cancer education, identifying intervention types, outcomes, and gaps in knowledge. Methods: A scoping review was undertaken using the Joanna Briggs Institute (JBI) framework and the Arksey and O’Malley framework and reported in accordance with PRISMA-ScR guidelines. The protocol was registered on the Open Science Framework. Four databases (MEDLINE, Embase, CINAHL, PsycINFO) were searched for English-language, peer-reviewed studies evaluating educational interventions on pancreatic cancer for healthcare students, professionals, patients, carers, or the public. Grey literature was excluded to maintain a consistent methodological standard. Data were charted and synthesised narratively. Results: Nine studies (2018–2024) met inclusion criteria, predominantly from high-income countries. Interventions targeted students and professionals (n = 3), patients (n = 2), the public (n = 2), or mixed groups (n = 2), using modalities such as team-based learning, workshops, virtual reality, serious games, and digital animations. Four interrelated themes were identified, encompassing (1) Self-efficacy; (2) Knowledge; (3) Behavior; and (4) Acceptability. Digital and interactive approaches demonstrated particularly strong engagement and learning gains. Conclusions: Pancreatic cancer education shows clear potential to enhance knowledge, confidence, and engagement across diverse audiences. Digital platforms offer scalable opportunities but require quality assurance and long-term evaluation to sustain impact. The evidence base remains limited and fragmented, highlighting the need for validated outcome measures, longitudinal research, and greater international representation to support the integration of education into a global pancreatic cancer control strategy. Future studies should also evaluate how educational interventions influence clinical practice and real-world help-seeking behaviour. Full article

Real-time emotion monitoring is increasingly relevant in healthcare, automotive, and workplace applications, where adaptive systems can enhance user experience and well-being. This study investigates the feasibility of classifying emotions along the valence–arousal dimensions of the Circumplex Model of Affect using EEG signals acquired from a single mastoid channel positioned near the ear. Twenty-four participants viewed emotion-eliciting videos and self-reported their affective states using the Self-Assessment Manikin. EEG data were recorded with an OpenBCI Cyton board and both spectral and temporal features (including power in multiple frequency bands and entropy-based complexity measures) were extracted from the single ear-channel. A dual analytical framework was adopted: classical statistical analyses (ANOVA, Mann–Whitney U) and artificial neural networks combined with explainable AI methods (Gradient × Input, Integrated Gradients) were used to identify features associated with valence and arousal. Results confirmed the physiological validity of single-channel ear-EEG, and showed that absolute $\beta$- and $\gamma$-band power, spectral ratios, and entropy-based metrics consistently contributed to emotion classification. Overall, the findings demonstrate that reliable and interpretable affective information can be extracted from minimal EEG configurations, supporting their potential for wearable, real-world emotion monitoring. Nonetheless, practical considerations—such as long-term comfort, stability, and wearability of ear-EEG devices—remain important challenges and motivate future research on sustained use in naturalistic environments. Full article

Healthcare-associated infections (HCAIs) remain a significant global challenge, as pathogenic microorganisms can persist on hospital surfaces and medical equipment, contributing to severe infections and epidemic outbreaks. Conventional preventive measures, including disinfection procedures and personal protective equipment, are often insufficient to ensure complete microbial control, prompting interest in innovative antimicrobial surface technologies. This study reports the design, preparation, and comprehensive characterization of chitosan- and poly(ε-caprolactone)-based antibacterial coatings incorporating chlorhexidine-loaded zirconium phosphate (ZrPCHX) nanoparticles. Coatings were deposited by optimized spray and brush techniques to obtain uniform, adherent, and well-defined films. Their morphological, physicochemical, mechanical, and cytocompatibility properties were systematically evaluated, and antibacterial efficacy was assessed against clinically relevant pathogens following ISO 22196:2011 and additional protocols simulating realistic hospital conditions. Both coating systems demonstrated pronounced antibacterial activity, with the PCL-based formulation exhibiting a faster and broader bactericidal effect while maintaining good cytocompatibility. These findings support the potential of the developed nanostructured coatings as sustainable and scalable materials for the active decontamination of high-touch hospital surfaces, offering continuous antimicrobial protection and contributing to a reduction in HCAI incidence. Full article

This article reviews recent advances in microwave and radar techniques for non-contact measurement of human vital signs in dynamic conditions. The focus is on solutions that work when the subject is moving or performing everyday activities, rather than lying motionless in clinical settings. This review covers innovative biodegradable and flexible antenna designs for wearable devices operating in multiple frequency bands and supporting efficient 5G/IoT connectivity. Particular attention is paid to ultra-wideband (UWB) radar, Doppler sensors, and microwave reflectometry combined with advanced signal-processing and deep learning algorithms for robust estimation of respiration, heart rate, and other cardiopulmonary parameters in the presence of body motion. Applications in telemedicine, home monitoring, sports, and search and rescue are discussed, including localization of people trapped under rubble by detecting their vital sign signatures at a distance. This paper also highlights key challenges such as inter-subject anatomical variability, motion artifacts, hardware miniaturization, and energy efficiency, which still limit widespread deployment. Finally, related developments in microwave imaging and early detection of pathological tissue changes are briefly outlined, highlighting the shared components and processing methods. In general, microwave techniques show strong potential for unobtrusive, continuous, and environmentally sustainable monitoring of human physiological activity, supporting future healthcare and safety systems. Full article

Background/Objectives: Home care plays a crucial role in contemporary healthcare systems, particularly in the long-term care of people with chronic and progressive illnesses. Family caregivers often experience substantial physical, emotional, and organizational burden. Telemedicine and digital health applications have the potential to support home care by improving health monitoring, communication, and care coordination. However, their use among family caregivers remains inconsistent, and little is known about how organizational support structures such as telemedicine centers influence acceptance and everyday use. This study aims to examine the benefits of telemedicine in home care and to evaluate the role of telemedicine centers as supportive infrastructures for family caregivers. Methods: A mixed-methods design was applied. Quantitative data were collected through an online survey of 58 family caregivers to assess the use of telemedicine and digital health applications, perceived benefits, barriers, and support needs. This was complemented by an in-depth qualitative case study exploring everyday caregiving experiences with telemedicine technologies and telemedicine center support. A systematic literature review informed the theoretical framework and the development of the empirical instruments. Results: Most respondents reported not using telemedicine or digital health applications in home care. Among users, telemedicine was associated with perceived improvements in quality of care, particularly through enhanced health monitoring, improved communication with healthcare professionals, and increased feelings of safety and control. Key barriers to adoption included technical complexity, data protection concerns, and limited digital literacy. Both quantitative findings and the qualitative case study highlighted the importance of structured support. Telemedicine centers were perceived as highly beneficial, providing technical assistance, training, coordination, and ongoing guidance that facilitated technology acceptance and sustained use. Conclusions: Telemedicine and digital health applications can meaningfully support home care and reduce caregiver burden when they are embedded in supportive socio-technical structures. Telemedicine centers can function as central points of contact that enhance usability, trust, and continuity of care. The findings suggest that successful implementation of telemedicine in home care requires not only technological solutions but also accessible organizational support and targeted training for family caregivers. Full article

Autophagy is a well-preserved biological mechanism that is essential for sustaining homeostasis by degradation and recycling damaged organelles, misfolded proteins, and other cytoplasmic detritus. Cannabinoid signaling has emerged as a prospective regulator of diverse cellular functions, including immunological modulation, oxidative stress response, apoptosis, and autophagy. Dysregulation of autophagy contributes to pathogenesis and treatment resistance of several oral diseases, including oral squamous cell carcinoma (OSCC), periodontitis, and gingival inflammation. This review delineates the molecular crosstalk between cannabinoid receptor type I (CB1) and type II (CB2) activation and autophagic pathways across oral tissues. Cannabinoids, including cannabidiol (CBD) and tetrahydrocannabinol (THC), modulate key regulators like mTOR, AMPK, and Beclin-1, thereby influencing autophagic flux, inflammation, and apoptosis. Experimental studies indicate that cannabinoids inhibit the PI3K/AKT/mTOR pathway, promote reactive oxygen species (ROS)-induced autophagy, and modulate cytokine secretion, mechanisms that underline their dual anti-inflammatory and anti-cancer capabilities. In addition, cannabinoid-induced autophagy has been shown to enhance stem cell survival and differentiation, offering promise for dental pulp regeneration. Despite these promising prospects, several challenges remain, including receptor selectivity, dose-dependent variability, limited oral bioavailability, and ongoing regulatory constraints. A deeper understanding of the context-dependent regulation of autophagy by cannabinoid signaling could pave the way for innovative therapeutic interventions in dentistry. Tailored cannabinoid-based formulations, engineered for receptor specificity, tissue selectivity, and optimized delivery, hold significant potential to revolutionize oral healthcare by modulating autophagy-related molecular pathways involved in disease resolution and tissue regeneration. Full article

Smallholder rice farmers in sub-Saharan Africa face persistent livelihood challenges due to declining returns from monocropping, limited diversification opportunities, and vulnerability to climate and market shocks. This study integrated the Drivers–Pressures–State–Impact–Response (DPSIR) framework with the sustainable livelihood approach to evaluate how the transition from rice monocropping to integrated rice–fish farming influences productivity, profitability, and household welfare in Nigeria’s leading rice-producing region. Using a mixed-methods, three-year panel (2021–2023) of 228 households across three communities in Kebbi State, descriptive statistics, regression models, and thematic analyses were combined to assess changes in livelihood capitals, system pressures, and response mechanisms. Adoption of rice–fish systems was associated with substantial improvements: 96.1% of farmers reported increased income, 56.3% improved food security, and 30.6% greater dietary diversity. Regression analyses confirmed that access to more land (p < 0.001 for healthcare and education; p = 0.011 for social status), labor affordability (p < 0.001), and farm size (p < 0.05) were consistent predictors of gains in healthcare, education, and social status, while pesticide and herbicide use negatively affected food access and wellbeing (p < 0.05). The DPSIR assessment revealed that rice–fish integration altered the state of rice production systems through reductions in input-related pressures and generated positive livelihood impacts. The results align with Sustainable Development Goals (SDGs) related to poverty reduction, food and nutrition security, sustainable production, and biodiversity conservation, and provide the first large-scale, longitudinal evidence from West Africa that integrated rice–fish systems support food security, income diversification, and sustainable resource management. Full article

Background/Objectives: To analyze the financial impact of the ERAS program in two major surgical procedures (colon resection for cancer and hip replacement) in two second-level healthcare centers. Methods: A cost–benefit analysis was carried out on four hypothetical scenarios, based on the rate of compliance with the ERAS program, focusing on the additional costs and the additional benefits deriving from the decrease in hospital stay caused by the application of the ERAS protocol, with particular regard to the interventions envisaged by the National Waiting List Management Plan (PNGLA). Results: In the most optimistic scenario, with a coefficient of application of ERAS of 100% and a number of 800 days of hospitalization gained per year, the revenue–cost ratio was equal to 2.92. In the least favorable scenario, with a coefficient of application of ERAS of 50% and a number of 400 days of hospitalization gained per year, the revenue–cost ratio was equal to 1.11. Conclusions: In all the scenarios, the revenue–cost ratio was higher than 1. Implementation of the ERAS program is feasible also in second-level centers with the costs for additional healthcare professionals. Application of the ERAS program leads to a more sustainable health policy with an improvement in the number of treated patients per year and an advantage in the waiting list. Full article

Millions of healthcare workers experience percutaneous exposure to bloodborne communicable infectious disease pathogens annually, with the risk of contracting occupationally acquired infections. In this study, we aimed to assess the status of occupational safety and outbreak preparedness in Congolese nurses and laboratory technicians in Kongo central and the Katanga area, amidst multiple ongoing public health emergencies in the Democratic Republic of the Congo (DRC). This was a multicenter analytical cross-sectional study conducted in five referral hospitals located in Kongo central province and the Katanga area between 2019 and 2020 amidst Ebola, Yellow fever, Cholera and Chikungunya outbreaks. Participants were adult A0 grade nurses, A1 nurses, A2 nurses and medical laboratory technicians (N = 493). They answered a structured, self-administered questionnaire related to hospital hygiene and standard precautions for occupational infection prevention. The majority of the respondents were females (53.6%), and 30.1% of them have never participated in a training session on hospital infection prevention during their career. The proportions of those who have been immunized against hepatitis B virus (HBV) was markedly low, at 16.5%. Of the respondents, 75.3% have been using safety-engineered medical devices (SEDs), whereas 93.5% consistently disinfected medical devices after use. Moreover, 78% of the respondents used gloves during medical procedures and 92.2% wore masks consistently. A large majority of the respondents, 82.9%, have been recapping the needles after use. Regarding participation in outbreak response, 24.5% and 12.2% of the respondents were Chikungunya and Cholera epidemic responders, respectively; 1.8% have served in Ebola outbreak sites. The proportion of the respondents who sustained at least one percutaneous injury by needlestick or sharp device, blood/body fluid splash or both in the previous 12-month period was high, 89.3% (41.8% for injury, 59.2% for BBF event), and most of them (73%) reported over 11 events. Compared to laboratory technicians, nurses had higher odds for sustaining percutaneous injury and BBF events [OR = 1.38 (0.16); p < 0.01], whereas respondents with longer working experience were less likely to sustain those events [OR = 0.47 (0.11); p < 0.001]. Findings from this study suggest that Congolese nurses and laboratory technicians experience a high frequency of injury and BBF events at work, and remain at high risk for occupationally acquired infection. There is a need for periodic capacity-building training for the healthcare workforce to improve infection prevention in health settings, the provision of sufficient and appropriate PPE and SEDs, post-exposure follow-up and keeping records of occupational injuries in hospitals in Congolese healthcare settings. Full article

With advances in scope and imaging technology, the use of single-use flexible bronchoscopy (SUFB) has broadened beyond intensive care units and operating rooms to bronchoscopy units, with an expanding body of literature suggesting adequate and comparable procedure outcomes, including airway inspection, bronchoalveolar lavage, endobronchial brushing and endobronchial biopsy, in comparison to standard reusable flexible bronchoscopy (RFB). Advantages such as mobility, ease of use and lack of requirement for cleaning staff during the COVID-19 pandemic led to a global increase in usage, with many companies developing SUFB as part of their bronchoscopy portfolio. In parallel, there has been more attention and initiatives to minimise the risk of infection transmission related to bronchoscopy. RFB requires maximum adherence to manufacturer-recommended cleaning protocols. However, evidence of transmissible organisms after cleaning is reported in healthcare settings of all types. After initial benchtop, retrospective and single-arm studies, comparative bronchoscopy studies are identifying that SUFB are as versatile and non-inferior to RFB. However, cost-effectiveness and sustainability factors have to be included in deciding the use of SUFB in routine practice. Full article