Search Results (80)

Background and Objectives: Thailand’s demographic shift toward an aging population increases vulnerability among older adults to the long-term mental health effects of childhood trauma. While childhood adversity is linked to heightened risks of late-life depression and PTSD, the moderating role of resilience remains underexplored in Thai older adults. This study investigated whether resilience moderates the association between childhood trauma and depressive or PTSD symptoms in this population. Materials and Methods: A cross-sectional survey was conducted with 201 older patients (mean age 68.6 years) from the Family Medicine and Geriatric Psychiatry Clinics at Maharaj Nakorn Chiang Mai Hospital. Participants completed validated measures on trauma history, resilience, depression, and PTSD symptoms. A moderation analysis was performed, adjusting for covariates including education, family support, and psychiatric history. Results: The findings revealed that resilience significantly buffered the impact of childhood trauma on depression but did not mitigate PTSD symptoms. Conclusions: These results underscore the protective role of resilience against depression following childhood trauma in older adults, yet also point to its limitations in alleviating trauma-specific responses such as PTSD. This study highlights the need for trauma-informed geriatric mental health strategies and calls for further research on resilience, focusing on cultural context and adaptive mechanisms, including emotion regulation and social connectedness, in older populations. Full article

Healthcare abuse is a critical human rights and public health issue, particularly impacting medical interns and trainees who are vulnerable to mistreatment during their formative professional years. This cross-sectional study, conducted from February to June 2024, evaluated the prevalence and psychological impact of harassment and discrimination among 463 healthcare interns in Saudi Arabia from various specialties, including medicine, nursing, pharmacy, and dentistry. Using a self-administered online questionnaire, we found that mistreatment was widely reported, with female interns experiencing significantly higher rates of sexual harassment and gender-based discrimination. Common perpetrators included residents, lecturers, professors, nurses, and patients, with incidents most frequently occurring in surgical and internal medicine departments. Despite high prevalence, only 9% of interns reported the abuse due to mistrust in reporting systems or failure to recognize the behavior as abuse. These experiences were associated with significant psychological distress, including frustration, reduced motivation to learn, and higher DASS scores, particularly among female interns. The study underscores the need for institutional reforms, including policy development, cultural change, and effective reporting systems to ensure a safe and supportive learning environment for future healthcare professionals. Addressing abuse in medical training is essential for individual well-being and the sustainability and integrity of healthcare systems. Full article

Background and Objectives: The spontaneous reporting (SR) of adverse drug events (ADEs) is a cornerstone of pharmacovigilance and a critical mechanism for safeguarding patient safety. However, underreporting remains a persistent global challenge. In Korea, despite the widespread use of herbal medicines (HMs), adverse event reports from traditional Korean medicine doctors (KMDs) are remarkably scarce. This study aimed to assess the knowledge, attitudes, and experiences of KMDs regarding SR, identify key barriers, and suggest strategies to strengthen the safety culture within traditional Korean medicine. Materials and Methods: A cross-sectional, anonymous online survey was distributed to licensed KMDs registered with the Association of Korean Medicine. The questionnaire collected information on respondents’ sociodemographic characteristics and assessed their knowledge, attitudes, and experiences related to ADE reporting. Descriptive statistics and multivariate logistic regression were used to analyze the associations between the variables. Results: Of the 1021 KMDs who completed the survey, the vast majority acknowledged the importance of SR and recognized their role in pharmacovigilance. Nevertheless, only 5% had ever submitted an ADE report. A widespread lack of awareness about the national spontaneous reporting system (SRS), particularly its inclusion of licensed HMs, was evident. Although many respondents expressed support for expanding the scope of SR to cover all HMs, significant gaps in pharmacovigilance knowledge and limited access to relevant training were major barriers. KMDs affiliated with academic institutions or specialist groups showed higher levels of awareness, education, and reporting behavior. Conclusions: While KMDs exhibit positive attitudes toward patient safety and understand the importance of SR, their participation in it remains low due to knowledge deficits and insufficient training. Addressing these gaps through targeted education and expanding the national SRS to comprehensively include herbal medicines are essential steps toward enhancing pharmacovigilance and cultivating a proactive safety culture in Korean medicine. Full article

Background/Objectives: Despite high breastfeeding initiation rates nationwide, disparities in breastfeeding continuation among Black mothers remain a public health issue. The BreastFeed Iowa Black Immigrant Project aimed to improve breastfeeding rates among low-income Black immigrant mother-infant dyads in Johnson County, Iowa by exploring factors influencing breastfeeding retention and developing a framework for culturally sensitive breastfeeding interventions. Methods: Using a descriptive cross-sectional study design, we employed a convergent, parallel mixed-methods approach to explore factors that influence breastfeeding duration among Black immigrant mothers with children 0–2 years old. Nine focus group discussions (FGDs) were conducted on Zoom among 40 participants with a semi-structured guide on breastfeeding beliefs, experiences, and feeding practices. Additionally, a 22-item survey was administered to 33 participants. Results: Based on the survey, one out of five participants indicated that they were unable to breastfeed for as long as they had planned. The top five reasons why mothers stopped breastfeeding included having received formula from the Supplemental Nutrition Program for Women, Infants and Children; being sick and having to take medicine; the baby was hungry too often; the baby was sick and could not breastfeed; and not producing enough milk. The top five themes that emerged from FGDs as barriers to breastfeeding included lack of lactation support, knowledge gaps on breastfeeding benefits, perception of inadequate milk supply, lack of comfort with breast milk expression, and work-related barriers. Conclusions: The community needs assessment identified the elements needed to develop a culturally sensitive framework with targeted interventions to address breastfeeding barriers in the Black immigrant community. Full article

In the last years, considerable innovation has been made regarding bioprinting, particularly in the development of cell-loaded hydrogels. The specific properties of the bioinks are crucial for printing an adequate cell-laden hydrogel structure. In this research, we aimed to develop a 3D-printable hydrogel using a natural biocompatible polymer. The process is based on the use of sodium alginate subjected to calcium ion cross-linking for immediate stiffness after printing. Using the Cellink INKREDIBLE+ printer (Cellink Inc., Goteborg, Sweden), 3D structures were successfully produced. The developed bioink exhibited a viscosity suitable for extrusion printing while ensuring its structural integrity at the same time. Next, 3D spheroids developed by using bioinks were morphologically characterized by using light, a fluorescent microscope, and field emission scanning electron microscopy (FESEM). In conclusion, the properties of the construct obtained using the lab-formulated biocompatible polymer hydrogel suggest its potential use as a framework for three-dimensional cell culture, with possible applications in both fields of research and regenerative medicine. Full article

Indigenous top-priority fruit trees, like Vangueria infausta subsp. infausta. Burch (wild medlar), are essential for food security, climate resilience, and biodiversity. However, they remain underutilized due to limited documentation and integration into agricultural systems. This study presents the first ethnobotanical assessment of the wild medlar in Oyemeni, northeastern KwaZulu-Natal, South Africa. Surveys and interviews were conducted with 100 rural participants to explore its traditional uses, commercialization potential, and knowledge transmission. The findings reveal that the fruit is widely used in porridges, juices, and traditional beer, offering nutritional benefits such as vitamin C. Medicinally, it is valued for promoting oral health, wound healing, and spiritual protection. However, traditional knowledge is declining, particularly among the youth, due to generational shifts and modernization. The study highlights sustainable commercialization opportunities, such as value-added products and agroforestry integration, while emphasizing the need to preserve indigenous knowledge. These findings contribute to food security, biodiversity conservation, and cultural preservation in a changing socio-economic landscape. Future research should focus on biochemical evaluation of the plant’s medicinal properties and cross-regional comparisons. Full article

Against the background of the vigorous development of materials science and the deep cross-infiltration in many fields, a new medicine food homology, carbon dots (herein combined and abbreviated as MFH-CDs), has sprung up, showing great potential. This review used ChatGPT 4.0 to collect background information related to carbon dots, focusing on the common rich medicinal and food resources such as Lycium barbarum, Chinese yam, honeysuckle, and Ganoderma lucidum. These carbon dots are synthesized by hydrothermal synthesis, microwave radiation, and pyrolysis, which have the advantages of small particle size, high quantum yield, and low cytotoxicity. Recent studies have found that MFH-CDs have great application potential in biosensors, biological imaging, and drug delivery. In this paper, the characteristics of preparing carbon dots from different medicinal and edible resources and their applications in biology in recent years are reviewed, which provides in-depth guidance for the research and application of carbon dots from medicinal and edible biomass, helps it shine in multidisciplinary fields, and opens a brand-new journey from traditional medicinal and edible culture to cutting-edge technology application. Full article

Hyaluronic acid (HA) is an unbranched polysaccharide particularly abundant in the extracellular matrix (ECM) of soft connective tissues. In humans, about 50% of the total HA in the organism is localized in the skin. HA plays an essential role in the hydration of the ECM, in the regulation of tissue homeostasis, in the resistance to mechanical stimuli/forces, and in the modulation of tissue regeneration. For these reasons, HA is widely used in regenerative medicine and cosmetics. In this study we used an innovative fluid dynamic system to investigate the effects of a cross-linked macrostructural HA formulation on dermal collagen of healthy human skin explants. The good preservation of skin explants provided by the bioreactor allowed applying refined high-resolution microscopy techniques to analyze in situ the HA-induced modifications on the ECM collagen fibrils up to 48 h from the application on the skin surface. Results demonstrated that this HA formulation, commercially proposed for subcutaneous injection, may act on dermal ECM also when applied transcutaneously, improving ECM hydration and modifying the organization of the collagen fibrils. These findings, obtained by the original combination of explanted human skin use with an advanced culture system and multiscale imaging techniques, are consistent with the volumizing and anti-aging effect of HA. Full article

Forensic medicine has increasingly integrated advanced imaging technologies to improve the accuracy and efficiency of investigations. Techniques such as virtual autopsy, multi-detector computed tomography (MDCT), and artificial intelligence (AI)-driven imaging have revolutionized the identification of injuries and causes of death. Despite these advancements, the field faces operational, ethical, and legal challenges that hinder widespread adoption. Objectives: This systematic review aimed to explore the role of emerging imaging technologies in forensic medicine, identify key challenges in their implementation, and provide insights into optimizing their use in forensic practice, with particular attention to cultural, ethical, and interdisciplinary aspects. Methods: A systematic review was conducted following PRISMA guidelines. Literature searches were performed across six databases, including PubMed, Scopus, Web of Science, and others, focusing on studies discussing imaging technologies in forensic contexts. A total of 10 studies were included after applying eligibility criteria. The data were synthesized using narrative synthesis and thematic analysis. Results: Four key themes emerged: (1) advancements in AI and imaging technologies, (2) operational and financial barriers, (3) ethical and legal considerations, and (4) interdisciplinary collaboration and training. Emerging imaging modalities enhance diagnostic precision and facilitate non-invasive examinations, offering culturally sensitive alternatives to traditional autopsies. However, high costs, algorithmic biases, data security risks, and the lack of standardized forensic imaging protocols present significant challenges. The potential for cross-cultural and international forensic collaborations through AI-enabled imaging was also identified as a promising future direction. Conclusions: Advanced imaging technologies hold transformative potential in forensic medicine. Addressing financial, ethical, and operational challenges through interdisciplinary collaboration, standardized guidelines, and culturally sensitive practices is crucial for maximizing their utility and global acceptance Full article

In October 2023, a Knowledge Exchange Forum was established, bringing together arts therapies staff and students from three different palliative and end-of-life care (PEoLC) settings: St Columba’s Hospice Care in Edinburgh, the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai Hospital and the Mount Sinai Kravis Children’s Hospital in New York. Adopting a practice-led approach, the Forum offers a space to unpack questions and challenges that arts therapists face in PEoLC. In this dialogical paper, we outline the development of the Forum and share emerging insights from our cross-cultural discussions. When working in PEoLC settings, arts therapists are commonly required to work across a continuum of care. This continuum extends from individual sessions with patients, families and bereaved carers, to groups and community-oriented initiatives. It often requires a capacity to work flexibly and fluidly with regard to, for example, therapeutic boundaries, consistency of location, and time. Discussion of emerging insights leads to a consideration of their implications for education and practice, and for future directions in professional networking and knowledge exchange. Full article

The microbiome plays a crucial role in maintaining physiological homeostasis and is intricately linked to various diseases. Traditional culture-based microbiological experiments are expensive and time-consuming. Therefore, it is essential to prioritize the development of computational methods that enable further experimental validation of disease-associated microorganisms. Existing computational methods often struggle to effectively capture nonlinear interactions and heterogeneous network structures when predicting microbiome–disease associations. To address this issue, we propose HG-LGBM, an innovative joint prediction framework that combines heterogeneous graph neural networks with a gradient boosting mechanism. We employ a hierarchical heterogeneous graph transformer (HGT) encoder, which utilizes a multi-head attention mechanism to learn higher-order node representations, while LightGBM optimizes the classification task using gradient-boosted decision trees. Evaluated through five-fold cross-validation on the HMDAD and Disbiome datasets, HG-LGBM demonstrated a state-of-the-art performance. The experimental results showed that combining heterogeneous network learning with gradient boosting strategies effectively revealed potential microbiome–disease interactions, providing a powerful tool for biomedical research and precision medicine. Finally, case studies on colorectal cancer and inflammatory bowel disease (IBD) further validated the effectiveness of HG-LGBM. Full article

In this paper, we investigated the role of generative AI in education in academic publications extracted from Web of Science (3506 records; 2019–2024). The proposed methodology included three main streams: (1) Monthly analysis trends; top-ranking research areas, keywords and universities; frequency of keywords over time; a keyword co-occurrence map; collaboration networks; and a Sankey diagram illustrating the relationship between AI-related terms, publication years and research areas; (2) Sentiment analysis using a custom list of words, VADER and TextBlob; (3) Topic modeling using Latent Dirichlet Allocation (LDA). Terms such as “artificial intelligence” and “generative artificial intelligence” were predominant, but they diverged and evolved over time. By 2024, AI applications had branched into specialized fields, including education and educational research, computer science, engineering, psychology, medical informatics, healthcare sciences, general medicine and surgery. The sentiment analysis reveals a growing optimism in academic publications regarding generative AI in education, with a steady increase in positive sentiment from 2023 to 2024, while maintaining a predominantly neutral tone. Five main topics were derived from AI applications in education, based on an analysis of the most relevant terms extracted by LDA: (1) Gen-AI’s impact in education and research; (2) ChatGPT as a tool for university students and teachers; (3) Large language models (LLMs) and prompting in computing education; (4) Applications of ChatGPT in patient education; (5) ChatGPT’s performance in medical examinations. The research identified several emerging topics: discipline-specific application of LLMs, multimodal gen-AI, personalized learning, AI as a peer or tutor and cross-cultural and multilingual tools aimed at developing culturally relevant educational content and supporting the teaching of lesser-known languages. Further, gamification with generative AI involves designing interactive storytelling and adaptive educational games to enhance engagement and hybrid human–AI classrooms explore co-teaching dynamics, teacher–student relationships and the impact on classroom authority. Full article

Medicinal plants remain vital in the Phu Tai community in Amnat Charoen in Thailand. Traditional healers’ knowledge is largely undocumented in the literature. Our objective was to document their medicinal plant practices to preserve this valuable knowledge. Our informants were 15 Phu Tai healers. We calculated use values (UV), family importance values (FIV), and informant agreement ratios (IAR) to gauge the significance of the 211 medicinal plants used by the healers. The most important plant families were Fabaceae and Zingiberaceae (FIV = 93). Kha min (Curcuma longa) was the most important medicinal species (UV = 0.66). The decoction was the most common preparation method (85%). Skin/subcutaneous cellular tissue disorders had the highest informant agreement ratio (IAR = 0.73). Shrubs were the most common life form (36%) among the medicinal plants; the majority were collected from community forests (51%) and were native to Thailand (86%). The most frequently used plant part for medicine was the leaf (27%). Medicinal plants that can be purchased were Ueang mai na (Hellenia speciosa), Thep tharo (Cinnamomum parthenoxylon), and Som khon (Talinum paniculatum). Interestingly, monks served as traditional healers. The healer’s age and education were not correlated with the number of medicinal plants they knew. The Amnat Charoen healers possess a rich traditional knowledge of medicinal plants. The information reported here is invaluable for further research in the field of cross-cultural ethnobotany and ethnopharmacology. Full article

Objectives: Ethical considerations are central to deciding on resuscitation in a prehospital setting. A systematic study of ethical views can enlighten the area and potentially reveal variations in decision-making. We aimed to explore the ethical views on resuscitation and their impact on the reasoning of prehospital healthcare professionals using a qualitative approach and a structured questionnaire. This study describes the validation of a structured questionnaire designed to explore the ethical views on resuscitation and its impact on the reasoning of prehospital healthcare professionals. Methods: This observational cross-sectional study used a mixed-methods approach. The questionnaire included qualitative free-text fields and quantitative scales. Its first version was developed based on data from a systematic review and an ethnographic study. Validation involved face-to-face interviews and a two-round Delphi process with experts in qualitative research, philosophy, epidemiology, and prehospital medicine. The final questionnaire was field-tested among Danish prehospital physicians. Exploratory factor analysis assessed underlying relationships, and Cronbach’s alpha measured internal consistency. Results: 216 out of 380 invited Danish prehospital physicians completed the questionnaire. The ethical aspects addressed in the cases included “do-not-attempt cardiopulmonary resuscitation,” “socioeconomic status,” “quality of life,” “the patient and family’s cultural background,” and “relatives’ emotional reaction.” The questionnaire demonstrated satisfactory internal consistency, with a Cronbach’s alpha of 0.71. Conclusions: The questionnaire was validated as a tool for assessing moral reasoning and variations in perspectives in prehospital decision-making. The survey can be used to assess the moral reasoning and variations therein in prehospital resuscitation decision-making. Full article

Background: This study aimed to adapt and validate the Attitudes to Patient Safety Questionnaire (APSQ-III) for Brazilian Portuguese and to compare patient safety attitudes between medical and nursing students. Given the critical role of assessing safety attitudes in shaping future healthcare professionals, this research addresses a significant gap in the Brazilian educational context. Materials and Methods: The cross-cultural adaptation process adhered to the guidelines of for the Process of Cross-Cultural Adaptation of Self-Report Measures, encompassing translation, synthesis, back-translation, and expert committee evaluation. The adapted APSQ-III was administered to a sample of 423 undergraduate students from medicine and nursing courses. Confirmatory factor analysis (CFA) was conducted to verify the factor structure, while reliability was assessed using Cronbach’s alpha, McDonald’s omega, and composite reliability measures. Results: The CFA supported an acceptable fit for the nine-factor model with 26 items, following the exclusion of 4 items (χ²/df = 1.92; CFI = 0.90; TLI = 0.89; RMSEA = 0.05; SRMR = 0.07). Factor loadings ranged from 0.30 to 0.82, with satisfactory reliability indices, except for factors 4 (α = 0.47; ω = 0.48) and 9 (α = 0.54; ω = 0.54). Significant differences were discovered between medical and nursing students in four factors, and gender differences were noted in five items, highlighting the diverse perceptions of patient safety across these groups. Conclusions: The Brazilian version of the APSQ-III demonstrated adequate validity and reliability for seven out of the nine original factors. It is recommended to use the scale with modifications, such as developing a reduced version excluding factors with low reliability, to enhance its applicability. This study contributes to advancing patient safety research and education in Brazil, providing a robust tool for evaluating and improving safety attitudes among healthcare students. Future research should focus on refining the instrument and exploring its application in diverse healthcare educational settings across Brazil. Full article