Search Results (5,545)

Background: Nutrition during the perinatal period, including pregnancy, childbirth, postpartum, and lactation, is a critical determinant of maternal and neonatal health. While the importance of balanced nutrition is well established, the integration of nutritional counseling into midwifery care remains inconsistent across settings. Evidence suggests that midwives are uniquely positioned to deliver nutrition-related support, yet gaps persist in their formal training and in the availability of structured guidance. These gaps are particularly evident in certain regions, such as Greece, where dedicated national guidelines for perinatal nutrition are lacking. Methods: This systematized narrative review synthesises evidence from studies published between 2010 and 2025, retrieved through PubMed, CINAHL, Scopus, and relevant national guidelines. Although the synthesis draws on diverse study designs to provide contextual depth, randomized controlled trials (RCTs) were prioritized and synthesized separately to evaluate the effectiveness of midwife-led interventions. In total, ten randomized controlled trials were included in the evidence synthesis, alongside additional observational and qualitative studies that informed the narrative analysis. Both international and Greek literature were examined to capture current practices, challenges, and knowledge gaps in the nutritional dimension of midwifery care. Results: Findings indicate that adequate intake of macronutrients and micronutrients, including iron, folic acid, vitamin D, iodine, calcium, and omega-3 fatty acids, is essential for optimal maternal and neonatal outcomes. Despite this, studies consistently report insufficient nutritional knowledge among midwives, limited confidence in providing counseling, and variability in clinical practice. Socio-cultural factors, such as dietary traditions and migration-related challenges, further influence nutritional behaviors and access to guidance. Emerging approaches, including e-health tools, group counseling models, and continuity-of-care frameworks, show promise in enhancing midwives’ capacity to integrate nutrition into perinatal care. Conclusion: Nutrition is a cornerstone of perinatal health, and midwives are strategically placed to address it. However, gaps in training, inconsistent guidelines, and cultural barriers limit the effectiveness of current practices. Strengthening midwifery education in nutrition, developing context-specific tools, and fostering interdisciplinary collaboration are essential steps toward more comprehensive and culturally sensitive perinatal care. Future research should focus on longitudinal and intervention studies that assess the impact of midwife-led nutritional counseling on maternal and neonatal outcomes. Full article

Introduction: Massage therapy delivers structured mechanosensory input that can influence brain function, yet the central mechanisms and potential for neuroplastic change have not been synthesized across neuroimaging modalities. This mechanistic review integrates evidence from electroencephalography (EEG), functional MRI (fMRI), and functional near-infrared spectroscopy (fNIRS) to map how massage alters human brain activity acutely and over time and to identify signals of longitudinal adaptation. Materials and Methods: We conducted a scoping, mechanistic review informed by PRISMA/PRISMA-ScR principles. PubMed/MEDLINE, Cochrane Library, Google Scholar, and ResearchGate were queried for English-language human trials (January 1990–July 2025) that (1) delivered a practitioner-applied manual massage (e.g., Swedish, Thai, shiatsu, tuina, reflexology, myofascial techniques) and (2) measured brain activity with EEG, fMRI, or fNIRS pre/post or between groups. Non-manual stimulation, structural-only imaging, protocols, and non-English reports were excluded. Two reviewers independently screened and extracted study, intervention, and neuroimaging details; heterogeneity precluded meta-analysis, so results were narratively synthesized by modality and linked to putative mechanisms and longitudinal effects. Results: Forty-seven studies met the criteria: 30 EEG, 12 fMRI, and 5 fNIRS. Results: Regarding EEG, massage commonly increased alpha across single sessions with reductions in beta/gamma, alongside pressure-dependent autonomic shifts; moderate pressure favored a parasympathetic/relaxation profile. Connectivity effects were state- and modality-specific (e.g., reduced inter-occipital alpha coherence after facial massage, preserved or reorganized coupling with hands-on vs. mechanical delivery). Frontal alpha asymmetry frequently shifted leftward (approach/positive affect). Pain cohorts showed decreased cortical entropy and a shift toward slower rhythms, which tracked analgesia. Somatotopy emerged during unilateral treatments (contralateral central beta suppression). Adjuncts (e.g., binaural beats) enhanced anti-fatigue indices. Longitudinally, repeated programs showed attenuation of acute EEG/cortisol responses yet improvements in stress and performance; in one program, BDNF increased across weeks. In preterm infants, twice-daily massage accelerated EEG maturation (higher alpha/beta, lower delta) in a dose-responsive fashion; the EEG background was more continuous. In fMRI studies, in-scanner touch and reflexology engaged the insula, anterior cingulate, striatum, and periaqueductal gray; somatotopic specificity was observed for mapped foot areas. Resting-state studies in chronic pain reported normalization of regional homogeneity and/or connectivity within default-mode and salience/interoceptive networks after multi-session tuina or osteopathic interventions, paralleling symptom improvement; some task-based effects persisted at delayed follow-up. fNIRS studies generally showed increased prefrontal oxygenation during/after massage; in motor-impaired cohorts, acupressure/massage enhanced lateralized sensorimotor activation, consistent with use-dependent plasticity. Some reports paired hemodynamic changes with oxytocin and autonomic markers. Conclusions: Across modalities, massage reliably modulates central activity acutely and shows convergent signals of neuroplastic adaptation with repeated dosing and in developmental windows. Evidence supports (i) rapid induction of relaxed/analgesic states (alpha increases, network rebalancing) and (ii) longer-horizon changes—network normalization in chronic pain, EEG maturation in preterm infants, and neurotrophic up-shifts—consistent with trait-level recalibration of stress, interoception, and pain circuits. These findings justify integrating massage into rehabilitation, pain management, mental health, and neonatal care and motivate larger, standardized, multimodal longitudinal trials to define dose–response relationships, durability, and mechanistic mediators (e.g., connectivity targets, neuropeptides). Full article

Background: Identification of patients at risk and prevention of acute postoperative pain (APOP) are central to individualized anesthesia and analgesia. Venous cannulation pain (VCP) has shown promise as a predictor of APOP. In the PeriOPerative Individualization Trial (POPIT), VCP was evaluated as a pain-sensitivity stratification method to guide anesthesia and reduce postoperative pain. This report presents a predefined secondary analysis with the primary aim to evaluate VCP as a method for postoperative pain prediction. As a secondary aim, we sought to explore factors that influence VCP. Methods: 271 patients were stratified into two cohorts, high-risk (VCP ≥ 2.0) and low-risk (VCP < 2.0), for APOP, based on their VCP. Within each group, patients were randomized to receive either: standard care or opioid-free anesthesia (low-risk cohort), and standard care or multimodal anesthesia with opioids (high-risk cohort). Differences in acute and persistent pain, quality of recovery, postoperative opioid consumption, and proportion of patients experiencing moderate to severe APOP depending on VCP levels were investigated. The predictive capacity of VCP was evaluated and adjusted for in terms of potential confounders. Results: High-risk patients, grading VCP ≥ 2.0 (VAS units) experienced more APOP on the day of surgery (difference 0.9 NRS-units, 95% CI 0.2–1.6, p = 0.009) and after 24 h during movement (difference 0.6 NRS-units, 95% CI 0.0–1.3, p = 0.048). Patients grading VCP < 2.0 had better quality of recovery after 24 hr (difference 7, 95% 1–13, p = 0.002) and lower postoperative opioid consumption (difference 7.5 mg, 95% 5.7–9.3, p < 0.001). The OR for VCP ≥ 2.0 to predict APOP in PACU was 1.76 (95% CI 1.02–3.04, p = 0.043), but in a multivariate model, adjusted for age, VCP ≥ 2, gender, pain catastrophizing, preoperative pain, and pain on the day of surgery, female gender was the only independent predictor of APOP (OR 2.65 (95% CI 1.33–5.29), p = 0.006). Conclusions: Pain during venous cannulation as a predictor of acute pain after surgery was significant in univariate regression, but the results were lost when adjusting for confounders like gender and current pain. However, VCP continues to show potential in associated postoperative recovery outcomes such as opioid consumption. The level of pain associated with venous cannulation is influenced by gender, preoperative pain, and current pain on the day of surgery. Pain sensitivity stratification needs refinement before implementation in clinical practice. Full article

Background/Objectives: Von Hippel–Lindau (VHL) disease is a rare autosomal dominant hereditary disorder. Central nervous system hemangioblastomas are one of the most common tumor types associated with VHL disease. Although these tumors are histologically benign, delayed diagnosis and treatment may result in severe neurological dysfunction, permanent disability, and even death. However, little is known about the experiences of patients with VHL disease. The aim of this study was to gain a better understanding of the illness experiences and psychological responses of patients with VHL disease accompanied by central nervous system hemangioblastomas. Methods: A qualitative study based on a semi-structured guide was conducted. Twelve participants were recruited. Data were collected through face-to-face interviews and analyzed using the constant comparative method. Results: Four themes and their subthemes were identified: 1. powerlessness—unpredictable disease progression and uncontrollable continuity; 2. negative emotional experiences—guilt and self-blame, depression, and low self-esteem; 3. compromise—acceptance of fate, positive outlook, and sense of hope; and 4. persistent worry—worries about family members, anxiety regarding finances and employment, and uncertainty regarding the future. Conclusions: This study identified four major themes in the illness experiences of patients with VHL disease accompanied by central nervous system hemangioblastomas, which provided deep insights into the care needs of individuals with VHL disease. Healthcare providers should develop effective measures to enhance patients’ ability to maintain a good quality of life and confront the future with resilience. Full article

Background: Thrombocytopenia (platelet count < 100 × 10⁹/L) occurs in 20–40% of critically ill patients with sepsis and is associated with adverse outcomes. Most prior studies have treated thrombocytopenia as a static risk indicator rather than a dynamic process. We investigated whether platelet recovery within 7 days provides independent prognostic information in patients with sepsis. Methods: We performed a retrospective cohort study using the MIMIC-IV database. Among 22,513 adults with sepsis admitted to intensive care units, 5401 developed thrombocytopenia within 24 h of admission and had sufficient follow-up data. The primary exposure was sustained platelet recovery to ≥100 × 10⁹/L within 7 days. The primary outcomes were 28-day and in-hospital mortality. Propensity-score matching and overlap weighting were used to adjust for demographic characteristics, comorbid conditions, illness severity, and organ-support therapies. Results: Among 5401 septic ICU patients with thrombocytopenia, 3193 (59%) achieved platelet recovery within 7 days. A total of 2056 patients (38%) recovered by day 3, and 1137 (21%) recovered between days 4 and 7. After multivariable adjustment, platelet recovery was independently associated with markedly lower mortality (adjusted risk ratio, 0.56; 95% CI, 0.53–0.67 for in-hospital death; and 0.60; 95% CI, 0.53–0.67 for 28-day death) and more than a doubling of survival time (adjusted ratio, 2.08; 95% CI, 1.65–2.63). Early and intermediate recovery conferred similar benefits. Higher baseline platelet counts, antiplatelet therapy, and heparin use were associated with recovery, whereas cirrhosis, greater illness severity, and continuous renal replacement therapy were associated with non-recovery. Conclusions: In patients with sepsis and thrombocytopenia, platelet recovery within 7 days was a strong and independent predictor of survival. Exploratory timing-stratified analyses yielded similar associations across subgroups. These findings support platelet recovery as a useful prognostic marker reflecting broader physiologic stabilization in sepsis. Full article

Transgender and gender-expansive (TGE) communities face persistent health inequities that are reproduced through everyday administrative and clinical encounters across care systems. A feedback-focused lens can clarify how those inequities are generated and sustained. Objective: To identify and validate feedback loops that create policy exposure and institutional gatekeeping in TGE healthcare and to surface leverage points to stabilize their continuity of care. Methods: Two facilitated, Zoom-based Group Model Building (GMB) sessions were conducted in March 2021 with eight TGE participants (mean age 38 years; range 22–63; transfeminine and transmasculine identities; multiracial, White, and SWANA racial identities) recruited through a Lesbian Gay Bisexual and Transgender (LGBT) community center, followed by a participant member-checking session to validate loop structure, causal direction, and interpretive accuracy. Analysis focused explicitly on identifying reinforcing and balancing feedback structures, rather than isolated barriers, to explain how policy exposure and institutional gatekeeping are generated over time. Results: Participants co-constructed a nine-variable Causal Loop Diagram (CLD) with six feedback structures, four reinforcing and two balancing that interact dynamically to amplify or dampen policy exposure, institutional gatekeeping, and continuity of care, which were organized across structural, institutional/clinical, and individual/community tiers. Reinforcing dynamics linked structural stigma, exclusion from formal employment, institutionalized provider bias, and enacted stigma to degraded care experience, increased trauma and distrust, and disrupted continuity, manifesting as policy exposure (e.g., coverage volatility, denials) and gatekeeping (e.g., discretionary documentation, referral hurdles). Community-based supports and peer/elder navigation functioned as balancing loops that reduced trauma, improved continuity and encounters, and, over time, dampened provider bias. A salient theme was the visibility/invisibility paradox: symbolic inclusion without workflow redesign can inadvertently increase exposure and reinforce harmful loops. Full article

The objectives of this work were (i) to evaluate the incidence of complications in male horses after orchiectomy performed in the field, i.e., away from a veterinary hospital, (ii) to describe the post-operative complications that occurred in these animals and (iii) to study the potential predictors for the development of such complications. This study involved 612 animals, on which orchiectomy was performed. The operative part of the study was carried out by one of three experienced veterinary surgeons. Standard pre-operative procedures were followed. Orchiectomy was performed using one of three principal surgical techniques, open, semi-closed or closed, and hemostasis was achieved by means of one of the various procedures, specifically the use of the Henderson instrument, the use of the Reimer emasculator, the ligation of the testicular artery or combinations thereof. In cases of reported complications, these were verified and identified appropriately. At least one (any) post-operative complication was recorded in 145 horses (23.7%). The most frequently observed complication was scrotal swelling/seroma formation, which was observed in 130 animals (21.2% of all animals; 89.7% of animals with at least one (any) complication). Another six different complications were observed, specifically colic, continued stallion-like behavior, evisceration, funiculitis, hemorrhage and scrotal infection. The median age of horses with complications was significantly older than that of animals with no complications: 11 versus 9 years. Animals in which the open technique was applied developed post-operative complications more frequently (30.1% of animals thus operated); further, complications were observed more frequently in animals on which operations were performed by using the Henderson instrument (84.6% of animals) versus animals on which any of the various other procedures were applied (22.4%). In multivariable analysis, the following predictors emerged for the development of complications: the surgical technique employed, the procedure applied for hemostasis, older animal age, and heavier animal bodyweight. The findings confirm that orchiectomy in stallions, even when performed in field conditions, is, in general, a safe procedure. The identification of predictors suggests that veterinarians should take additional care when planning to operate on animals at higher risk or when using surgical approaches that increase the potential for the development of complications. Full article

Public health restrictions during COVID-19 disproportionately affected older adults, especially those in long-term care (LTC) and their families. Family caregivers (FCs) are essential care partners in LTC settings, yet pandemic policies largely excluded them, creating emotional and systemic consequences. This study explored FCs’ experiences of visitation restrictions in British Columbia, Canada, using an arts-based qualitative approach within a larger mixed-methods project. Eight FCs participated in completing a total of twelve artworks, including photographs, collages, and creative writing that reflected their experiences. Virtual talking circles were used to facilitate the sharing and description of their experiences. Findings revealed three interconnected theme categories with eleven sub-themes. These themes suggest a plausible pathway: infection-control rules may lead to caregiver exclusion, disrupting relational continuity and oversight and contributing to distress and task-centered care. While context-specific and exploratory, results underscore the need for trauma-informed, family-inclusive policies and cultural safety in LTC. Arts-based research methods provided a powerful lens for capturing emotional realities often missed by conventional research. Full article

Background/Objectives: Endocrine therapy (ET) is a common treatment for hormone-dependent breast cancer and is associated with a significant reduction in recurrence and mortality rates. However, the decision to initiate endocrine therapy is a critical and often distressing juncture for patients. The need to weigh its survival benefits against the potential burden of side effects, including mood changes, pain, muscle stiffness, and fatigue, can render this decision-making phase a source of significant distress. The present systematic review aimed to identify and synthesize the sociodemographic and psychosocial predictors of the decision-making process related to ET adherence among women with breast cancer. Methods: A systematic literature search was conducted in three electronic databases—PubMed Central, ProQuest, and Scopus—to identify studies examining the association between sociodemographic and psychosocial factors and the decision-making process regarding ET among women with breast cancer. Inclusion criteria encompassed cross-sectional studies published between 2000 and 2025. Data were extracted and analyzed to identify recurring predictors across studies. The findings were synthesized through a narrative synthesis. Results: Twelve cross-sectional studies met the inclusion criteria, comprising a total of 8510 women diagnosed with breast cancer and undergoing ET. Ten studies (83%) identified sociodemographic variables—such as age, marital status, educational level, and ethnicity—as significant predictors of decision-making. Moreover, nine studies (75%) reported psychosocial factors, including quality of life (QoL), fear of progression, infertility concerns, and social support, as influential in the decision to initiate or continue ET. Specifically, the decision to adhere to ET is generally supported by younger age, higher education, better perceived quality of life, and greater social support. Conversely, it is hindered by lower income, lower education, fertility concerns related to marital status, and diminished quality of life. Conclusions: The findings of this review indicate that both sociodemographic and psychosocial factors play key roles in shaping women’s decisions regarding adherence to ET. Understanding these predictors can facilitate decision-making and inform the development of targeted interventions aimed at improving treatment adherence and supporting patient-centered care in breast cancer treatment. The focus on decision-making processes, rather than on adherence rates, is what distinguishes this review from other systematic reviews. Full article

Background: Pre-exposure prophylaxis (PrEP) offers over 99% protection against HIV when used consistently, but stigma continues to undermine persistence in care. While much research has described the external manifestations of PrEP-related stigma, less is known about how individuals cope with these stigmas and how such coping processes influence persistence. Guided by Social Cognitive Theory, this study examined the psychosocial strategies men who have sex with men (MSM) in Tanzania use to cope with PrEP-related stigma and sustain persistence in care. Methods: Thirty-two in-depth interviews were conducted with purposefully selected MSM aged 18–38 years at Ngamiani Health Centre in Tanga region. The sampling included both persistent and non-persistent PrEP users with variation in age and sexual position preferences. Participants were sampled for variation in persistence status (persistent and non-persistent), age, and sexual position preference to capture heterogeneity in stigma experiences and coping processes. Interviews were conducted in Kiswahili, audio-recorded, transcribed, translated, and analyzed using reflexive thematic analysis. Results: Participants described PrEP-related stigma as socially constructed through narratives that equated PrEP with HIV treatment, labeled it a “gay pill,” associated it with promiscuity, or linked it to bodily harm or increased HIV risk. These stigmas impact persistence in care through discouraging clinic visits and daily pill taking. However, some participants remained persistent in care despite stigma by using protective mental strategies such as personal agency, mental time travel, and affirmation from supportive social connections, which buffered emotional impacts and sustained persistence. Conclusions: Persistence in PrEP care is shaped not only by stigma in the social environment but also by how individuals interpret and respond to it. Interventions should therefore combine structural stigma-reduction efforts with mental health-informed strategies that strengthen agency and supportive social relationships to sustain PrEP engagement among MSM. Full article

Although the impact of COVID-19, caused by SARS-CoV-2, may appear to have diminished in recent years, the emergence of new variants still continues to cause significant global health and economic challenges. While numerous metabolomic studies have explored serum-based alterations linked to the infection, investigations utilizing urine as a biological matrix remain notably limited. This gap is especially significant given the potential advantages of urine, a non-invasive and easily obtainable biofluid, in clinical settings. In the context of patients in intensive care units (ICUs), temporal monitoring through such non-invasive samples may offer a practical and effective approach for tracking disease progression and tailoring therapeutic interventions. This study retrospectively explored the longitudinal metabolomic alterations in COVID-19 patients admitted to the ICU, stratified into three prognostic outcome groups: healthy discharged (HD), polyneuropathic syndrome (PS), and Exitus. A total of 32 urine samples, collected at four distinct time points per patient during April 2020 and preserved at −80 °C, were analyzed by proton nuclear magnetic resonance (¹H-NMR) spectroscopy for comprehensive metabolic profiling. Statistical evaluation using two-way ANOVA and ANOVA–Simultaneous Component Analysis (ASCA) identified significant prognostic variations (p < 0.05) in the levels of taurine, 3-hydroxyvaleric acid and formic acid. Complementary supervised classification via random forest modeling yielded moderate predictive performance with out-of-bag error rate of 40.6% based on prognostic categories. Particularly, taurine, 3-hydroxyvaleric acid and formic acid levels were highest in the PS group. However, no significant temporal changes were observed for any metabolite in analyses. Additionally, metabolic pathway analysis conducted using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database highlighted the “taurine and hypotaurine metabolism” pathway as the most significantly affected (p < 0.05) across prognostic classifications. Harnessing urinary metabolomics, as indicated in our preliminary study, could offer valuable insights into the dynamic metabolic responses of ICU patients, thereby facilitating more personalized and responsive critical care strategies in COVID-19 patients. Full article

In this paper I aim to draw attention to the continued emphasis on ‘moral tales in stories of family construction. In research projects on both conventional family practices such as marriage and non-conventional ones such as living apart together (LAT) and mixed-sex civil partnerships, morality continues to emerge as a core guiding principle for how relationships are organised and maintained. Yet beyond the importance of children in these moral tales, little consideration is given to the other dimensions and shapes that this ‘morality’ may take. Here I bring together three qualitative research projects to illustrate the strong drive of moral obligations in the face of family fluidity, relationship plurality, and individualised therapeutic discourse. With this data I argue that obligations continue to organise relationship decision-making, and we can imagine these obligations as formed of three interrelated dimensions: (1) social ‘oughts’, formed of culture, norms, and values (e.g., we ought to get married because that is the normal thing to do in our society), (2) relational ‘oughts’, including children, family, friends, life/family course, death, health (e.g., we ought to live apart to protect the children), and (3) individual ‘oughts’, which involve strongly held personal beliefs, and an ethic of self-care (e.g., we ought to get a civil partnership because it aligns with my feminist values). Understanding the shape of contemporary intimate morality is an important step in developing future theory, policy, and practice in the field. Full article

Background. Enhanced Recovery After Surgery (ERAS) is a structured, multidisciplinary programme designed to optimise the entire perioperative pathway through evidence-based, patient-centred, standardised care. The objective of this report is to determine whether it is feasible to implement an ERAS^® program in orthopaedic surgery within our institution for primary THA and TKA. Methods. This single-centre quality-improvement project followed the ERAS^® Society certification framework to create and implement an enhanced-recovery pathway for primary total hip and knee arthroplasty. The three-phase roadmap comprised baseline pathway mapping and audit, pilot implementation and refinement, and full roll-out, punctuated by four multidisciplinary seminars. Key aspects of this programme included preoperative education, minimal fasting and early return to feeding, rational choice of regional anaesthesia techniques, administration of multimodal analgesia, reduction in urinary and surgical catheterization, active management of the risk of blood loss and deep vein thrombosis, optimisation of surgical workflow and techniques, and early mobilisation of patients. Global- and element-level compliance was tracked prospectively; ≥70% compliance was required for certification. External ERAS^® Society review at month 15 confirmed data integrity, sustainability planning, and successful certification. Continuous feedback loops drove micro-teaching and order-set optimisation throughout deployment phases. Results. Our ERAS programme for primary THA and TKA was introduced in April 2022. The definitive programme contained 24 mandatory elements grouped into three perioperative areas. After the fourth seminar, the rate of compliance was 81%. The certification was obtained in June 2023. Conclusions. Implementing an ERAS^® programme for primary total hip and knee arthroplasty is feasible within a high-volume academic institution when supported by multidisciplinary teamwork, robust data collection, and iterative feedback mechanisms. Further high-quality outcome-focused research is required to evaluate the clinical impact of individual ERAS components and to validate a personalised ERAS programme incorporating emerging technologies. Full article

Non-communicable diseases (NCDs) impose an overwhelming burden on global health systems. Prevailing healthcare for NCDs remains largely hospital-centered, episodic, and reactive, rendering them poorly suited to address the long-term, heterogeneous, and multifactorial nature of NCDs. Rapid advances in digital technologies, artificial intelligence (AI), and precision medicine have catalyzed the development of an integrative framework for digital-intelligent precision health management, characterized by the functional integration of data, models, and decision support. It is best understood as an integrated health management framework operating across three interdependent dimensions. First, it is grounded in multidimensional health-related phenotyping, enabled by continuous digital sensing, wearable and ambient devices, and multi-omics profiling, which together allow for comprehensive, longitudinal characterization of individual health states in real-world settings. Second, it leverages intelligent risk warning and early diagnosis, whereby multimodal data are fused using advanced machine learning algorithms to generate dynamic risk prediction, detect early pathological deviations, and refine disease stratification beyond conventional static models. Third, it culminates in health management under intelligent decision-making, integrating digital twins and AI health agents to support personalized intervention planning, virtual simulation, adaptive optimization, and closed-loop management across the disease continuum. Framed in this way, digital-intelligent precision health management enables a fundamental shift from passive care towards proactive, anticipatory, and individual-centered health management. This Perspectives article synthesizes recent literature from the past three years, critically examines translational and ethical challenges, and outlines future directions for embedding this framework within population health and healthcare systems. Full article

Population aging is driving the need for unobtrusive, continuous monitoring solutions in residential care environments. Radio-frequency (RF)-based technologies such as Ultra-Wideband (UWB) and millimeter-wave (mmWave) radar are particularly attractive for providing detailed information on presence and movement while preserving privacy. Building on a UWB–mmWave localization system deployed in a senior living residence, this paper focuses on the data-processing methodology for extracting quantitative mobility indicators from long-term indoor monitoring data. The system combines a device-free mmWave radar setup in bedrooms and bathrooms with a tag-based UWB positioning system in common areas. For mmWave data, an adaptive short-term average/long-term average (STA/LTA) detector operating on an aggregated, normalized radar energy signal is used to classify micro- and macromovements into bedroom occupancy and non-sedentary activity episodes. For UWB data, a partially constrained Kalman filter with a nearly constant velocity dynamics model and floor-plan information yields smoothed trajectories, from which daily gait- and mobility-related metrics are derived. The approach is illustrated using one-day samples from three users as a proof of concept. The proposed methodology provides individualized indicators of bedroom occupancy, sedentary behavior, and mobility in shared spaces, supporting the feasibility of combined UWB and mmWave radar sensing for longitudinal routine analysis in real-world elderly care environments. Full article