Search Results (4,787)

Although organizational resilience is well established, refining the systematic quantitative evaluation of health systems resilience (HSR) remains an ongoing opportunity for advancement. Research either focuses on individual HSR indicators, such as social welfare policy, public expenditure, health insurance, healthcare quality, and technology, or broadly examines socio-economic factors, highlighting the need for a more comprehensive methodological approach. This study employed the Slacks-Based Measure (SBM) within Data Envelopment Analysis (DEA) to analyze efficiency by maximizing outputs. It systematically examined key HSR factors across countries, providing insights for improved policymaking and resource allocation. Taking a five-year (2016–2020) dataset that covered 55 to 56 countries and evaluating 17 indicators across governance, health systems, and economic aspects, the paper presents that all sixteen top-ranked countries with a perfect efficiency score of 1 belonged to the high-income group, with ten in Europe, highlighting regional HSR differences. This paper concludes that adequate economic resources form the foundation of HSR and ensure stability and sustained progress. A properly supported healthcare workforce is essential for significantly enhancing health systems and delivering quality care. Last, effective governance and the equitable allocation of resources are crucial for fostering sustainable development and strengthening HSR. Full article

The increasing use of pharmaceutically active compounds (PhACs), endocrine-disrupting compounds (EDCs), and personal care products (PCPs) has led to the widespread presence of organic micropollutants (OMPs) in aquatic environments, posing a significant global challenge for environmental conservation. In recent years, advanced materials-based nanofiltration (NF) technologies have emerged as a promising solution for water and wastewater treatment. This review begins by examining the sources of OMPs, as well as the risk of OMPs. Subsequently, the key criteria of NF membranes for OMPs are discussed, with a focus on the roles of pore size, charge property, molecular interaction, and hydrophilicity in the separation performance. Against that background, this review summarizes and analyzes recent advancements in materials such as metal organic frameworks (MOFs), covalent organic frameworks (COFs), graphene oxide (GO), MXenes, hybrid materials, and environmentally friendly materials. It highlights the porous nature and structural diversity of organic framework materials, the advantage of inorganic layered materials in forming controllable nanochannels through stacking, the synergistic effects of hybrid materials, and the importance of green materials. Finally, the challenges related to the performance optimization, scalable fabrication, environmental sustainability, and complex separation of advanced materials-based membranes for OMP removal are discussed, along with future research directions and potential breakthroughs. Full article

The rapid growth of electric vehicles (EVs) and new energy systems has put lithium-ion batteries at the center of the clean energy change. Nevertheless, to achieve the best battery performance, safety, and sustainability in many changing circumstances, major innovations are needed in Battery Management Systems (BMS). This review paper explores how artificial intelligence (AI) and digital twin (DT) technologies can be integrated to enable the intelligent BMS of the future. It investigates how powerful data approaches such as deep learning, ensembles, and models that rely on physics improve the accuracy of predicting state of charge (SOC), state of health (SOH), and remaining useful life (RUL). Additionally, the paper reviews progress in AI features for cooling, fast charging, fault detection, and intelligible AI models. Working together, cloud and edge computing technology with DTs means better diagnostics, predictive support, and improved management for any use of EVs, stored energy, and recycling. The review underlines recent successes in AI-driven material research, renewable battery production, and plans for used systems, along with new problems in cybersecurity, combining data and mass rollout. We spotlight important research themes, existing problems, and future drawbacks following careful analysis of different up-to-date approaches and systems. Uniting physical modeling with AI-based analytics on cloud-edge-DT platforms supports the development of tough, intelligent, and ecologically responsible batteries that line up with future mobility and wider use of renewable energy. Full article

This work aimed to advance the knowledge in the field of eco-friendly dielectrics with applicative relevance for future energy-related technologies. New multicomponent composites were prepared by using a cellulose ether/citric acid mixture as the matrix, which was gradually filled with strontium titanate nanoparticles (5–20 wt%). In this case, citric acid can act as a crosslinking agent for the polymer but also can react differently with the other counterparts from the composite as a function of the solvent used (H₂O and H₂O₂). This led to considerable differences in the morphological, thermal, optical, and electrical characteristics due to distinct solvent-driven interactions, as revealed by the infrared spectroscopy investigation. Hence, in contrast to H₂O, the oxidizing activity of H₂O₂ led to changes in the surface morphology, a greater transparency, a greater yellowness, an enhanced refractive index, and higher permittivity. These data provide new pathways to advance the optical and dielectric behavior of eco-compatible materials for energy devices by the careful selection of the composite’s components and the modulation of the molecular interactions via solvent features. Full article

Background: The progression of Alzheimer’s Disease (AD) deeply affects not only the diagnosed person but also their close relatives, who are often called to take on the role of informal caregivers. This transition is frequently unplanned and emotionally complex, yet poorly understood in its deeper processual dimensions. This study aims to explore and theorize the transition experienced by a family member becoming the primary informal caregiver for a person with advanced AD. Methods: A qualitative study based on the Constructivist Grounded Theory according to Charmaz’s approach (2006) was conducted. In-depth interviews were carried out with 10 participants who had become informal caregivers for a loved one with advanced AD. Data were analyzed using initial coding, focused coding, the constant comparative method, and theoretical coding. Results: Ten caregivers (mean age 39 years, range 35–54; nine females) of patients with advanced AD participated in the study. The analysis revealed a complex, emotionally intense caregiving experience marked by sacrifice, feelings of powerlessness, identity loss, and the necessity of sharing caregiving responsibilities. A core category emerged: A Silent and Certain Willingness to Care, representing the caregivers’ deep, often unconscious commitment to prioritize the care of their loved ones above their own needs. Four interconnected phases characterized the caregiving process: (1) The Changing Daily Life—involving significant sacrifices in personal and social life; (2) Feeling Powerless—confronting the inevitable decline without means to alter the course; (3) Losing Oneself—experiencing physical and psychological exhaustion and a sense of identity loss; and (4) Sharing with Others—seeking external support to sustain caregiving. These findings highlight the evolving nature of becoming a caregiver and the enduring dedication that sustains this role despite the challenges. Conclusions: The progression of AD deeply transforms the lives of caregivers, who become co-sufferers and active participants in the disease’s management. The results underscore the urgency of designing integrative care strategies—including psychological, social, and potentially technological support—that can enhance both patient outcomes and caregiver resilience. Grounded in real-world experiences, this study contributes to the broader neurodegeneration discourse by emphasizing caregiving as a critical factor in long-term disease management and therapeutic success. Full article

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

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

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

In recent years, digital microfluidic biochips (DMFBs), based on microfluidic technology, have attracted attention as compact and flexible experimental devices. DMFBs are widely applied in biochemistry and medical fields, including point-of-care clinical diagnostics and PCR testing. Among them, micro electrode dot array (MEDA) biochips, composed of numerous microelectrodes, have overcome the limitations of conventional chips by enabling finer droplet manipulation and real-time sensing, thus significantly improving experimental efficiency. While various studies have been conducted to enhance the utilization of MEDA biochips, few have considered the shape-dependent velocity characteristics of droplets in routing. Moreover, methods that do take such characteristics into account often face significant challenges in solving time. This study proposes a fast droplet routing method for MEDA biochips that incorporates shape-dependent velocity characteristics by utilizing the distance information to the target cell. The experimental results demonstrate that the proposed method achieves approximately a 67.5% reduction in solving time compared to existing methods, without compromising solution quality. Full article

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

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

Background/Objectives: Evidence-based nursing practice (EBNP) is essential in high-acuity settings such as intensive care units (ICUs) and emergency departments (EDs), where nurses are frequently required to make time-critical, high-stakes clinical decisions that directly influence patient safety and outcomes. Despite its recognized importance, the implementation of EBNP remains inconsistent, with frontline nurses often facing barriers to accessing and applying current evidence. Methods: This descriptive, cross-sectional study systematically mapped and prioritized clinical questions generated by ICU and ED nurses at a tertiary hospital in South Korea. Using open-ended questionnaires, 204 clinical questions were collected from 112 nurses. Each question was coded and classified according to the Nursing Interventions Classification (NIC) taxonomy (8th edition) through a structured cross-mapping methodology. Inter-rater reliability was assessed using Cohen’s kappa coefficient. Results: The majority of clinical questions (56.9%) were mapped to the Physiological: Complex domain, with infection control, ventilator management, and tissue perfusion management identified as the most frequent areas of inquiry. Patient safety was the second most common domain (21.6%). Notably, no clinical questions were mapped to the Family or Community domains, highlighting a gap in holistic and transitional care considerations. The mapping process demonstrated high inter-rater reliability (κ = 0.85, 95% CI: 0.80–0.89). Conclusions: Frontline nurses in high-acuity environments predominantly seek evidence related to complex physiological interventions and patient safety, while holistic and community-oriented care remain underrepresented in clinical inquiry. Utilizing the NIC taxonomy for systematic mapping establishes a reliable framework to identify evidence gaps and support targeted interventions in nursing practice. Regular protocol evaluation, alignment of continuing education with empirically identified priorities, and the integration of concise evidence summaries into clinical workflows are recommended to enhance EBNP implementation. Future research should expand to multicenter and interdisciplinary settings, incorporate advanced technologies such as artificial intelligence for automated mapping, and assess the long-term impact of evidence-based interventions on patient outcomes. Full article

Introduction/Objective: Post-bariatric surgery patients require long-term, coordinated care to address complex nutritional, physiological, and behavioral challenges. Personalized smart nutrition, combining individualized dietary strategies with targeted monitoring, has emerged as a valuable direction for optimizing recovery and long-term outcomes. This article examines how traditional medical protocols can be enhanced by digital solutions in a multidisciplinary framework. Methods: The study analyzes current clinical practices, including personalized meal planning, physical rehabilitation, biochemical marker monitoring, and psychological counseling, as applied in post-bariatric care. These established approaches are then analyzed in relation to the NutriMonitCare system, a digital health system developed and tested in a laboratory environment. Used here as an illustrative example, the NutriMonitCare system demonstrates the potential of digital tools to support clinicians through real-time monitoring of dietary intake, activity levels, and physiological parameters. Results: Findings emphasize that medical protocols remain the cornerstone of post-surgical management, while digital tools may provide added value by enhancing data availability, supporting individualized decision making, and reinforcing patient adherence. Systems like the NutriMonitCare system could be integrated into interdisciplinary care models to refine nutrition-focused interventions and improve communication across care teams. However, their clinical utility remains theoretical at this stage and requires further validation. Conclusions: In conclusion, the integration of digital health tools with conventional post-operative care has the potential to advance personalized smart nutrition. Future research should focus on clinical evaluation, real-world testing, and ethical implementation of such technologies into established medical workflows to ensure both efficacy and patient safety. Full article

Plasma-activated water (PAW), enriched with reactive oxygen and nitrogen species (RONS), presents oxidative and antimicrobial characteristics with potential in cosmetic applications. This study examined the effects of two PAW formulations—nitrate-rich (PAW-N) and peroxide-rich (PAW-P)—on human hair types classified as straight (Type 1), wavy (Type 2), and coily/kinky (Type 4). The impact of PAW on hair structure and chemistry was evaluated using Fourier-transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), UV–Vis spectrophotometry, and physicochemical analyses of the liquids (pH, ORP, conductivity, and TDS). PAW-N, with high nitrate content (~500 mg/L), low pH (2.15), and elevated conductivity (6244 µS/cm), induced significant damage to porous hair types, including disulfide bond cleavage, protein oxidation, and lipid degradation, as indicated by FTIR and EDS data. SEM confirmed severe cuticle disruption. In contrast, PAW-P, containing >25 mg/L of hydrogen peroxide and exhibiting milder acidity and lower ionic strength, caused more localized and controlled oxidation with minimal morphological damage. Straight hair showed greater resistance to both treatments, while coily and wavy hair were more susceptible, particularly to PAW-N. These findings suggest that the formulation and ionic profile of PAW should be matched to hair porosity for safe oxidative treatments, supporting the use of PAW-P as a gentler alternative in hair care technologies. Full article

In response to the stress commonly experienced by young people in high-pressure daily environments, a music-based stress-relief interactive system was developed by integrating music-assisted care with emotion-sensing technology. The design principles of the system were established through a literature review on stress, music listening, emotion detection, and interactive devices. A prototype was created accordingly and refined through interviews with four experts and eleven users participating in a preliminary experiment. The system is grounded in a four-stage guided imagery and music framework, along with a static activity model focused on relaxation-based stress management. Emotion detection was achieved using a wearable EEG device (NeuroSky’s MindWave Mobile device) and a two-dimensional emotion model, and the emotional states were translated into visual representations using seasonal and weather metaphors. A formal experiment involving 52 users was conducted. The system was evaluated, and its effectiveness confirmed, through user interviews and questionnaire surveys, with statistical analysis conducted using SPSS 26 and AMOS 23. The findings reveal that: (1) integrating emotion sensing with music listening creates a novel and engaging interactive experience; (2) emotional states can be effectively visualized using nature-inspired metaphors, enhancing user immersion and understanding; and (3) the combination of music listening, guided imagery, and real-time emotional feedback successfully promotes emotional relaxation and increases self-awareness. Full article