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Vascular diseases remain a major global health burden despite remarkable technological advances in vascular surgery and endovascular therapies. Conditions such as peripheral arterial disease, abdominal aortic aneurysm, carotid stenosis, chronic venous disease, diabetic vasculopathies, and vascular chronic ulcers are not only biological entities but are deeply shaped by social structures, cultural norms, and economic inequalities. This article introduces Vascular Sociology as an interdisciplinary field that integrates vascular surgery with medical sociology to provide a more comprehensive understanding of vascular health and disease. Drawing on classical and contemporary sociological theory, including concepts such as social determinants of health, embodiment, illness narratives, and the disease–illness–sickness triad, the article argues that vascular pathology reflects cumulative social exposures across the life course. Socially patterned behaviors, work conditions, food environments, healthcare access, gender norms, and geographic inequalities profoundly influence disease onset, progression, treatment decisions, and outcomes. The paper highlights how surgical success is contingent not only on technical excellence but also on patients’ social contexts, including health literacy, trust in institutions, caregiving resources, and the capacity to adhere to long-term follow-up and rehabilitation. By outlining conceptual foundations, epidemiological evidence, and mixed-methods research strategies, the article positions Vascular Sociology as a framework capable of bridging biomedical knowledge with lived experience. This approach expands the definition of vascular outcomes to include social reintegration, identity transformation, and equity of care, ultimately aiming to improve patient-centered practice, reduce disparities, and inform more socially responsive vascular health policies. Full article

Objectives: This study evaluated the analytical and clinical performance of a novel NS1 rapid diagnostic test in a dengue-endemic setting in Thailand. Methods: The K-Dengue NS1 Ag test (K.Bio Sciences, Pathumthani, Thailand) was developed. Analytical performance included determination of LOD, reproducibility, and evaluation against potentially cross-reactive pathogens and interfering substances. Unlike conventional assays employing 40 nm colloidal gold, this test incorporates 80 nm gold nanospheres to enhance detection sensitivity. The LOD was determined by serial dilution of recombinant NS1 proteins representing all four dengue virus serotypes. Clinical performance was assessed using 185 archived plasma samples collected between January 2024 and February 2025 from two tertiary care hospitals in Thailand, with a commercial NS1 ELISA serving as the reference standard. Results: The K-Dengue NS1 test demonstrated serotype-specific limits of detection (LODs) for recombinant NS1 antigen, 2.9 ng/mL (DENV-1), 0.5 ng/mL (DENV-2), 25.2 ng/mL 27 (DENV-3), and 4.5 ng/mL (DENV-4). Cross-reactivity testing revealed no false positives against closely related arboviruses or common co-infections, and no interference was observed from frequently encountered pathogens or biochemical substances. In clinical evaluation, the assay achieved a sensitivity of 98.08% (51/52), a specificity of 100% (133/133), and an overall accuracy of 99.37%. Importantly, sensitivity was significantly higher in primary infections (100.00%) than in secondary infections (93.3%, p = 0.288). Conclusions: In this clinically oriented evaluation, the K-Dengue NS1 rapid test showed high specificity and good sensitivity, particularly in primary dengue infections. While the assay may be useful as part of early diagnostic workflows in comparable healthcare settings, reduced sensitivity in secondary infections indicates that negative NS1 results should be interpreted with caution and, where appropriate, supplemented with additional diagnostic methods. Full article

Contemporary medical practitioners increasingly recognize the critical impact of healing-environment design on patients’ recovery, positioning it as a pivotal consideration in healthcare facility planning. While existing research has predominantly focused on enhancing the functionality and efficiency of healthcare environments, it has often overlooked the significance of individual patient needs and their distinct experiences. This paper aims to utilize the principles of epidemiology and empirical analysis to explore the application and research trends of the patient-centered care (PCC) concept in healthcare facility design, to promote interdisciplinary collaboration and achieve customized healthcare environments. Based on bibliometric analysis and key literature review methods, this paper systematically examines and interprets the research development trends of PCC in healing environment design, integrating both macro and micro perspectives, and reveals how design factors in therapeutic environments support the realization of PCC principles, thereby improving patients’ rehabilitation experiences and health outcomes. The results indicate that current research on PCC is trending towards increasingly diversified integration via high-frequency keywords such as recovery, healing environment, and evidence-based design, highlighting the shift from functional optimization to emotional care, technological integration, and nature-based interactions in design. Notably, patient-centered care has become a consensus and core integrating concept in this field. This paper not only reveals the key role of healing environments in constructing PCC practice pathways but also provides theoretical support and strategic reference for the planning of healthcare spaces and the collaborative design of nursing processes, and demonstrates that healing environments have evolved from passive spaces into active rehabilitation mediums through interdisciplinary collaboration, thereby facilitating the implementation of the patient-centered healthcare philosophy. Full article

Pharmacy-based point-of-care (POC) services have evolved from pilot initiatives to an essential component of decentralized healthcare delivery. These services—ranging from rapid infectious-disease screening to chronic-disease monitoring—improve access, reduce diagnostic delays and empower pharmacists as front-line healthcare providers. The present paper is an updated, in-depth review of the evolution of pharmacy POC services worldwide, combined with the analysis of the regulatory and educational frameworks supporting implementation, technological drivers such as biosensors, mobile health and artificial intelligence and in-depth socioeconomic considerations. Benefits for patients, pharmacies and healthcare systems are contrasted with challenges including variable reimbursement, uneven regulatory oversight and workforce preparedness. Full article

Background/Objectives: Assessment of disease-specific knowledge levels among children with coeliac disease (CD) is essential to support self-management of their condition. A suitable knowledge assessment tool has not yet been identified that is appropriate for children. The aim of this study was to develop and validate a tool for this purpose. Materials and methods: Using content synthesis of available literature, a CD knowledge assessment tool (CD-Know) was developed to include items shown to be relevant to the management of CD for children. CD-Know went through development stages of expert review, two rounds of pilot/validation testing, and item response analysis. CD-Know scores were compared between participant groups using a univariate linear model. Results: CD-Know was developed using content synthesis and review by international CD experts. CD-Know was initially piloted among adults/children with CD (n = 12) and underwent the first validation study (n = 330 participants) among adults/children with CD, cohabitants, healthcare professionals (HCPs), and groups without CD. Based on item response analysis the tool was modified. The phases of the pilot (n = 7) and validation studies were repeated among refined groups (n = 230). The final 15-item CD-Know demonstrated an appropriate hierarchy of knowledge between testing groups. Children with CD scored lower than cohabitants of someone with CD (mean difference (MD) −3.0, SD 0.4, p < 0.001) and HCPs (MD −1.7, p = 0.009), at a similar level to adults without CD (MD 0.6, p = 0.88), and higher than children without CD (MD 5.8, p < 0.001). The CD-Know score of children with CD was positively associated with their adherence level to a gluten-free diet (R 0.30, p = 0.017). Test–retest reliability had a good intraclass correlation coefficient (R 0.73, p = 0.003). Internal consistency was good (Cronbach’s alpha 0.71). Conclusions: CD-Know is a validated tool to assess disease-related knowledge in children diagnosed with CD. Its potential applications include identifying areas for knowledge enhancement within the population and assessment of CD interventions. Full article

Background/Objectives: Respiratory syncytial virus (RSV) is a major cause of infant respiratory morbidity, yet real-world data on healthcare utilization following universal immunoprophylaxis remain limited. Methods: We retrospectively analyzed RSV-positive inpatient and emergency department (ED) encounters from two German tertiary pediatric centers across six seasons (2019/20–2024/25). Augsburg contributed inpatient data for 2022/23–2024/25, including immunization status and severity metrics, while Erlangen provided inpatient and ED data across all seasons. Results: In Augsburg, RSV hospitalizations were higher in pre-immunization seasons than in 2024/25, accompanied by a reduced proportion of infants < 1 year. RSV season onset occurred later in 2024/25, while severity metrics remained stable. Among infants < 1 year hospitalized in 2024/25, all severe cases occurred in unimmunized infants; no severe outcomes were observed among the small number of immunized cases. Conclusions: Integrated multicenter data descriptively coincide with reduced RSV hospitalization burden following immunoprophylaxis introduction, without evidence of increased disease severity. Full article

Chronic pain is inherently multifactorial, with biological, psychological, and social factors contributing to neuropathic pain (NP) and central sensitization (CS) syndromes. Comorbidity between functional disorders and the lack of clinical biomarkers adds to the challenge of diagnosis and treatment, leading to frustration for healthcare professionals and patients. Available treatments are limited, increasing patient suffering with personal and financial costs. This systematic review examined multisensory processing alterations in chronic pain and reviewed current pharmacological and non-pharmacological interventions. A structured search was conducted on the PubMed database using the keywords Central Sensitization, Fibromyalgia, Complex Regional Pain Syndrome, and Neuropathic Pain, combined with the keywords Vision, Audition, Olfaction, Touch, Taste, and Proprioception. Papers were then filtered to discuss current treatment approaches. Articles within the last five years, from 2018 to 2023, have been included. Papers were excluded if they were animal studies; investigated tissue damage, disease processes, or addiction; or were conference proceedings or non-English. Results were summarized in table form to allow synthesis of evidence. As this study is a systematic review of previously published research rather than a clinical trial or experimental investigation, the risk of bias was assessed independently by at least two reviewers. 138 studies were identified and analyzed. Of these, 96 focused primarily on treatment options for chronic pain and were analyzed for this systematic review. There were a few emerging themes. No one therapy is effective, so a multidisciplinary approach to diagnosis, including pharmacological, somatic, and psychological treatment, is generally predicted to achieve the best outcomes. Cranial neurovascular compromise, especially of the trigeminal, glossopharyngeal, and potentially the vestibulocochlear nerve, is being increasingly revealed with the advancement of neuroimaging. Cortical and deep brain stimulation to evoke neuroplasticity is an emerging and promising therapy and warrants further investigation. Finally, including patients in their treatment plan allows them control and offers the ability to self-manage their pain. Risk of bias limits the ability to judge the quality of evidence. Full article

Background: Mental illness stigma among healthcare professionals can adversely affect patient care and recovery. While attitudes are shifting globally, limited data exist on stigma among non-psychiatrist doctors (NPDs) in India. This study aimed to assess the attitudes of NPDs toward mental illness and psychiatry using the Mental Illness Clinicians’ Attitudes Scale (MICA-4), and to explore associated sociodemographic and clinical factors. Methods: A cross-sectional online survey was conducted across India over six months in 2022, following ethics approval. The survey link was distributed via professional social media platforms using convenience and snowball sampling. Non-psychiatrist doctors with at least an MBBS degree were eligible. The MICA-4 scale assessed stigma across five domains. Descriptive statistics, correlation analyses, and multiple regression analysis were conducted. Results: A total of 102 responses were analysed. The mean MICA-4 score was 48.37, indicating moderately positive attitudes. Domain-wise analysis revealed higher stigma in knowledge/misconception and self-disclosure domains, while attitudes towards ethics and patient care were more favourable. No significant differences were found by gender, specialty, or practice setting. Weekly psychiatric caseload was not associated with reduced stigma. Internal consistency of the scale was low (Cronbach’s α = 0.46), raising concerns about cultural fit. The regression model was statistically significant F (5, 96) = 661.95, p < 0.001, explaining 97.18% of the variance in overall attitudes toward mental illness. Among the five domains, Respect for Psychiatry and Knowledge and Misconceptions emerged as the strongest predictors, highlighting their critical role in shaping positive professional attitudes in the public sector. Conclusions: Stigma toward mental illness persists among NPDs, particularly around misconceptions and help-seeking attitudes. These biases are culturally embedded and may not be significantly influenced by clinical exposure alone. While stigma was generally moderate, persistent misconceptions and self-stigma point to the importance of further developing culturally adapted tools and systemic interventions to promote reflective practice and ethical parity in clinical settings. Full article

Objective: Dynamic allocation of emergency medical resources is a critical task in the prevention and control of respiratory infectious diseases (RIDs). This study aims to address the challenge of a “run on the healthcare system” by proposing an effective resource allocation strategy to curb the spread of RIDs. Methods: Considering the infection severity of RIDs, the capacity of emergency medical resources (hospitalization rate), and vaccination status, we construct an S_VIⁿR dynamic model of RIDs that considers vaccine failure. Under the constraint of emergency medical resources and with the goal of minimizing the basic reproduction number, we propose a dynamic allocation strategy for distributing emergency medical resources among different types of infected individuals. Results: Simulation results demonstrate that improving the hospitalization efficiency of emergency medical resources significantly contributes to the effective control of RIDs. The model shows that targeted dynamic allocation helps reduce disease transmission. Conclusions: Validation using real-world data confirms that the model is effective and practical. It offers theoretical guidance for dynamically allocating emergency medical resources and supports informed decision-making in response to major emerging RIDs. Full article

Carbapenem-resistant Klebsiella pneumoniae (CRKP) has become one of the most serious problems confronting modern healthcare, particularly in intensive care units where patients are highly susceptible, procedures are frequent, and antibiotic exposure is often prolonged. In this review, carbapenem resistance in K. pneumoniae is presented not as a fixed feature of individual bacteria, but as a process that is constantly changing and closely interconnected. We bring together evidence showing how the spread of successful bacterial lineages, the exchange of resistance genes, and gradual genetic adjustment combine to drive both the rapid spread and the long-lasting presence of resistance. A major focus is placed on mobile genetic elements, including commonly encountered plasmid backbones, transposons, and insertion sequences that carry carbapenemase genes such as blaKPC, blaNDM, and blaOXA-48-like. These elements allow resistance genes to move easily between bacteria and across different biological environments. The human gut plays a particularly important role in this process. Its microbial community serves as a largely unseen reservoir where resistance genes can circulate and accumulate well before infection becomes clinically apparent, making prevention and control more difficult. This review also discusses the key biological factors that shape resistance levels, including carbapenemase production, changes in the bacterial cell membrane, and systems that expel antibiotics from the cell, and explains how these features work together. Advances in molecular testing have made it possible to identify resistance more quickly, supporting earlier clinical decisions and infection control measures. Even so, current tests remain limited by narrow targets and may miss low-level carriage, hidden genetic reservoirs, or newly emerging resistance patterns. Finally, we look ahead to approaches that move beyond detection alone, emphasizing the need for integrated surveillance, thoughtful antibiotic use, and coordinated system-wide strategies to lessen the impact of CRKP. Full article

Modern healthcare systems increasingly depend on wearable Internet of Medical Things (IoMT) devices for the continuous monitoring of patients’ physiological parameters. It remains challenging to differentiate between genuine physiological anomalies, sensor faults, and malicious cyber interference. In this work, we propose a hybrid fusion framework designed to attribute the most plausible source of an anomaly, thereby supporting more reliable clinical decisions. The proposed framework is developed and evaluated using two complementary datasets: CICIoMT2024 for modelling security threats and a large-scale intensive care cohort from MIMIC-IV for analysing key vital signs and bedside interventions. The core of the system combines a supervised XGBoost classifier for attack detection with an unsupervised LSTM autoencoder for identifying physiological and technical deviations. To improve clinical realism and avoid artefacts introduced by quantised or placeholder measurements, the physiological module incorporates quality-aware preprocessing and missingness indicators. The fusion decision policy is calibrated under prudent, safety-oriented constraints to limit false escalation. Rather than relying on fixed fusion weights, we train a lightweight fusion classifier that combines complementary evidence from the security and clinical modules, and we select class-specific probability thresholds on a dedicated calibration split. The security module achieves high cross-validated performance, while the clinical model captures abnormal physiological patterns at scale, including deviations consistent with both acute deterioration and data-quality faults. Explainability is provided through SHAP analysis for the security module and reconstruction-error attribution for physiological anomalies. The integrated fusion framework achieves a final accuracy of 99.76% under prudent calibration and a Matthews Correlation Coefficient (MCC) of 0.995, with an average end-to-end inference latency of 84.69 ms (p95 upper bound of 107.30 ms), supporting near real-time execution in edge-oriented settings. While performance is strong, clinical severity labels are operationalised through rule-based proxies, and cross-domain fusion relies on harmonised alignment assumptions. These aspects should be further evaluated using realistic fault traces and prospective IoMT data. Despite these limitations, the proposed framework offers a practical and explainable approach for IoMT-based patient monitoring. Full article

Conversational agents are transforming digital interactions across various domains, including healthcare, education, and customer service, thanks to advances in large language models (LLMs). As these systems become more autonomous and ubiquitous, understanding what constitutes high-quality interaction from a user perspective is increasingly critical. Despite growing empirical research, the field lacks a unified framework for defining, measuring, and designing user-perceived interaction quality in human–artificial intelligence (AI) dialogue. Here, we present an integrative review of 125 empirical studies published between 2017 and 2025, spanning text-, voice-, and LLM-powered systems. Our synthesis identifies three consistent layers of user judgment: a pragmatic core (usability, task effectiveness, and conversational competence), a social–affective layer (social presence, warmth, and synchronicity), and an accountability and inclusion layer (transparency, accessibility, and fairness). These insights are formalised into a four-layer interpretive framework—Capacity, Alignment, Levers, and Outcomes—operationalised via a Capacity × Alignment matrix that maps distinct success and failure regimes. It also identifies design levers such as anthropomorphism, role framing, and onboarding strategies. The framework consolidates constructs, positions inclusion and accountability as central to quality, and offers actionable guidance for evaluation and design. This research redefines interaction quality as a dialogic construct, shifting the focus from system performance to co-orchestrated, user-centred dialogue quality. Full article

Background/Objectives: Federated learning (FL) offers a way for healthcare institutions to collaboratively train machine learning models without sharing sensitive patient data. This systematic review aims to comprehensively synthesize the ethical dimensions of FL in healthcare, integrating privacy preservation, algorithmic fairness, governance, and equitable access into a unified analytical framework. The application of FL in healthcare between January 2020 and December 2024 is examined, with a focus on ethical issues such as algorithmic fairness, privacy preservation, governance, and equitable access. Methods: Following PRISMA guidelines, six databases (PubMed, IEEE Xplore, Web of Science, Scopus, ACM Digital Library, and arXiv) were searched. The PROSPERO registration is CRD420251274110. Studies were selected if they described FL implementations in healthcare settings and explicitly discussed ethical considerations. Key data extracted included FL architectures, privacy-preserving mechanisms, such as differential privacy, secure multiparty computation, and encryption, as well as fairness metrics, governance models, and clinical application domains. Results: Out of 3047 records, 38 met the inclusion criteria. The most popular applications were found in medical imaging and electronic health records, especially in radiology and oncology. Through thematic analysis, four key ethical themes emerged: algorithmic fairness, which addresses differences between clients and attributes; privacy protection through formal guarantees and cryptographic techniques; governance models, which emphasize accountability, transparency, and stakeholder engagement; and equitable distribution of computing resources for institutions with limited resources. Considerable variation was observed in how fairness and privacy trade-offs were evaluated, and only a few studies reported real-world clinical deployment. Conclusions: FL has significant potential to promote ethical AI in healthcare, but advancement will require the development of common fairness standards, workable governance plans, and systems to guarantee fair benefit sharing. Future studies should develop standardized fairness metrics, implement multi-stakeholder governance frameworks, and prioritize real-world clinical validation beyond proof-of-concept implementations. Full article

Background: Heart failure (HF) remains a major cause of hospitalizations in the United States (US). Respiratory syncytial virus (RSV) has been associated with HF exacerbations. We compared in-hospital outcomes and healthcare utilization among US HF hospitalizations with and without RSV. Methods: Using the Nationwide Readmissions Database (2016–2022), we propensity-matched HF hospitalizations with a secondary diagnosis of RSV (HF-RSV) 1:1 to those without RSV (HF-noRSV). Multivariable logistic and Poisson regression models were used to assess associations between RSV and outcomes. The primary outcome was in-hospital mortality; secondary outcomes included adverse events, length of stay (LOS), hospitalization costs, and 30-day readmissions. Results: Among 11,158,836 HF hospitalizations, 32,419 (0.29%) had RSV. Compared with matched HF-noRSV hospitalizations, HF-RSV was associated with higher odds of in-hospital mortality (adjusted odds ratio [aOR] 1.12; 95% CI 1.04–1.20), septic shock (aOR 1.40; 95% CI 1.29–1.52), acute respiratory failure (aOR 3.43; 95% CI 3.32–3.55), and noninvasive mechanical ventilation (aOR 2.15; 95% CI 2.04–2.26). HF-RSV had lower odds of cardiogenic shock (aOR 0.82; 95% CI 0.73–0.92), ventricular tachycardia/fibrillation (aOR 0.73; 95% CI 0.68–0.78), ischemic stroke (aOR 0.31; 95% CI 0.27–0.36), transient ischemic attack (aOR 0.33; 95% CI 0.25–0.44), and 30-day readmissions (aOR 0.54; 95% CI 0.46–0.56). HF-RSV hospitalizations had higher costs (adjusted coefficient 0.02; 95% CI 0.01–0.02) and longer LOS (adjusted coefficient 0.14; 95% CI 0.13–0.14). Conclusions: Among US HF hospitalizations, RSV was associated with higher mortality and respiratory-related complications and increased healthcare resource utilization. Full article