Search Results (643)

Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping review of reviews of AI/ML applications spanning reproductive, prenatal, postpartum, neonatal, and early child-development care. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus through April 2025. Two reviewers independently screened records, extracted data, and assessed methodological quality using AMSTAR 2 for systematic reviews, ROBIS for bias assessment, SANRA for narrative reviews, and JBI guidance for scoping reviews. Results: Thirty-nine reviews met our inclusion criteria. In preconception and fertility treatment, convolutional neural network-based platforms can identify viable embryos and key sperm parameters with over 90 percent accuracy, and machine-learning models can personalize follicle-stimulating hormone regimens to boost mature oocyte yield while reducing overall medication use. Digital sexual-health chatbots have enhanced patient education, pre-exposure prophylaxis adherence, and safer sexual behaviors, although data-privacy safeguards and bias mitigation remain priorities. During pregnancy, advanced deep-learning models can segment fetal anatomy on ultrasound images with more than 90 percent overlap compared to expert annotations and can detect anomalies with sensitivity exceeding 93 percent. Predictive biometric tools can estimate gestational age within one week with accuracy and fetal weight within approximately 190 g. In the postpartum period, AI-driven decision-support systems and conversational agents can facilitate early screening for depression and can guide follow-up care. Wearable sensors enable remote monitoring of maternal blood pressure and heart rate to support timely clinical intervention. Within neonatal care, the Heart Rate Observation (HeRO) system has reduced mortality among very low-birth-weight infants by roughly 20 percent, and additional AI models can predict neonatal sepsis, retinopathy of prematurity, and necrotizing enterocolitis with area-under-the-curve values above 0.80. From an operational standpoint, automated ultrasound workflows deliver biometric measurements at about 14 milliseconds per frame, and dynamic scheduling in IVF laboratories lowers staff workload and per-cycle costs. Home-monitoring platforms for pregnant women are associated with 7–11 percent reductions in maternal mortality and preeclampsia incidence. Despite these advances, most evidence derives from retrospective, single-center studies with limited external validation. Low-resource settings, especially in Sub-Saharan Africa, remain under-represented, and few AI solutions are fully embedded in electronic health records. Conclusions: AI holds transformative promise for perinatal care but will require prospective multicenter validation, equity-centered design, robust governance, transparent fairness audits, and seamless electronic health record integration to translate these innovations into routine practice and improve maternal and neonatal outcomes. Full article

Background: This study aims to compare the logistical challenges of Home Health Care (HHC) services in Portugal and Brazil, highlighting the structural and operational differences between both systems. Methods: Guided by an abductive research approach, data were collected using a semi-structured survey with open-ended questions, applied to 13 HHC teams in Portugal and 18 in Brazil, selected based on national coordination recommendations. The data collection process was conducted in person, and responses were analyzed using descriptive statistics and qualitative content analysis. Results: The results reveal that Portugal demonstrates higher productivity, stronger territorial coverage, and a more integrated inventory management system, while Brazil presents greater multidisciplinary team integration, more flexible fleet logistics, and more advanced digital health records. Despite these strengths, both countries continue to address key logistical aspects, such as scheduling, supply distribution, and data management, largely through empirical strategies. Conclusions: This research contributes to the theoretical understanding of international HHC logistics by emphasizing strategic and systemic aspects often overlooked in operational studies. In practical terms, it offers insights for public health managers to improve resource allocation, fleet coordination, and digital integration in aging societies. Full article

The rapid increase in the global population of older adults presents a significant challenge, but also a unique opportunity to leverage technological advancements for promoting independent living and well-being. This study introduces the CIREI framework, which is a comprehensive model designed to enhance the integration of smart home and assistive technologies specifically for pre-frail older adults. Developed through a systematic literature review and innovative and comprehensive co-design activities, the CIREI framework captures the nuanced needs, preferences, and challenges faced by older adults, caregivers, and experts. Key findings from the co-design workshop highlight critical factors such as usability, privacy, and personalised learning preferences, which directly influence technology adoption. These insights informed the creation of an intelligent middleware prototype named WISE-WARE, which seamlessly integrates commercial off-the-shelf (COTS) devices to support health management and improve the quality of life for older adults. The CIREI framework’s adaptability ensures it can be extended and refined to meet the ever-changing needs of the ageing population, providing a robust foundation for future research and development in user-centred technology design. All workshop materials, including tools and methodologies, are made available to encourage the further exploration and adaptation of the CIREI framework, ensuring its relevance and effectiveness in the dynamic landscape of ageing and technology. This research contributes significantly to the discourse on ageing in place, digital inclusion, and the role of technology in empowering older adults to maintain independence. Full article

As global populations age, there is increasing demand for effective, person-centered healthcare solutions that support older adults to age in place. Home healthcare has emerged as a crucial strategy to address the complex health and social needs of older adults while reducing reliance on institutional care. This umbrella review aimed to synthesize evidence from existing systematic reviews and meta-analyses on home healthcare services and interventions targeting older adults. A comprehensive search was conducted across five databases and gray literature sources, including Google Scholar, for reviews published between 2000 and 2025. The review followed the Joanna Briggs Institute methodology and PRISMA statement. Twenty reviews met the inclusion criteria, encompassing a total of over 3.1 million participants. Interventions were grouped into four categories: integrated and multidisciplinary care, preventive and supportive home visits, technological and digital interventions, and physical, transitional, and environmental support. Results indicated that many interventions led to improved health outcomes, including enhanced functional ability, reduced hospital readmissions, and increased satisfaction. However, effectiveness varies depending on the intervention type, delivery model, and population. Challenges such as caregiver burden, digital exclusion, and implementation in diverse settings were noted. This review highlights the promise of home healthcare interventions and underscores the need for context-sensitive, equitable, and scalable models to support aging populations. Full article

Background: Stigma associated with tuberculosis (TB) continues to undermine patient well-being, treatment adherence, and public health goals and objectives. This study aims to systematically review the literature to identify and synthesize TB stigma reduction interventions published between 2015 and 2025. Methods: Following the PRISMA guidelines, we conducted a comprehensive literature search across PubMed, Scopus, Science Direct, ProQuest, and Google Scholar. Eligible studies included those with qualitative, quantitative, and mixed-methods designs that focused on interventions related to TB-related stigma. We categorized the studies into three groups: (1) intervention development studies, (2) TB treatment programs with stigma reduction outcomes, (3) stigma-specific interventions. Data extraction and quality appraisal were conducted independently by two reviewers using the Mixed Methods Appraisal Tool (MMAT). Results: A total of 15 studies met the inclusion criteria. Five studies focused on co-developing stigma interventions, which incorporated multi-level and multicomponent strategies targeting internalized, enacted, anticipated, and intersectional stigma. Two studies assessed TB treatment-related interventions (e.g., home-based care, digital adherence tools) with incidental stigma reduction effects. The remaining seven studies implemented stigma-targeted interventions, including educational programs, video-based therapy, peer-led support, and anti-self-stigma toolkits. Interventions addressed stigma across individual, interpersonal, institutional, community, and policy levels. Conclusions: This review highlights the evolution and diversification of TB stigma interventions over the past decade. While earlier interventions emphasized education and support, recent strategies increasingly integrate peer leadership, digital platforms, and socio-ecological frameworks. The findings underscore the need for comprehensive, contextually grounded interventions that reflect the lived experiences of people affected by TB. Full article

Background/Objectives: The demand for accessible and reliable digital health services has increased significantly in recent years, particularly in regions facing physician shortages. HomeDOCtor, a conversational AI platform developed in Slovenia, addresses this need with a nationally adapted architecture that combines retrieval-augmented generation (RAG) and a Redis-based vector database of curated medical guidelines. The objective of this study was to assess the performance and impact of HomeDOCtor in providing AI-powered healthcare assistance. Methods: HomeDOCtor is designed for human-centered communication and clinical relevance, supporting multilingual and multimedia citizen inputs while being available 24/7. It was tested using a set of 100 international clinical vignettes and 150 internal medicine exam questions from the University of Ljubljana to validate its clinical performance. Results: During its six-month nationwide deployment, HomeDOCtor received overwhelmingly positive user feedback with minimal criticism, and exceeded initial expectations, especially in light of widespread media narratives warning about the risks of AI. HomeDOCtor autonomously delivered localized, evidence-based guidance, including self-care instructions and referral suggestions, with average response times under three seconds. On international benchmarks, the system achieved ≥95% Top-1 diagnostic accuracy, comparable to leading medical AI platforms, and significantly outperformed stand-alone ChatGPT-4o in the national context (90.7% vs. 80.7%, p = 0.0135). Conclusions: Practically, HomeDOCtor eases the burden on healthcare professionals by providing citizens with 24/7 autonomous, personalized triage and self-care guidance for less complex medical issues, ensuring that these cases are self-managed efficiently. The system also identifies more serious cases that might otherwise be neglected, directing them to professionals for appropriate care. Theoretically, HomeDOCtor demonstrates that domain-specific, nationally adapted large language models can outperform general-purpose models. Methodologically, it offers a framework for integrating GDPR-compliant AI solutions in healthcare. These findings emphasize the value of localization in conversational AI and telemedicine solutions across diverse national contexts. Full article

Japan’s 8.5 million vacant homes (Akiyas) represent a paradox of scarcity amid surplus: while rural depopulation leaves properties abandoned, housing shortages and bureaucratic inefficiencies hinder their reuse. This study proposes AKI2ALL, an AI-blockchain framework designed to automate the circular repurposing of Akiyas into ten high-value community assets—guesthouses, co-working spaces, pop-up retail and logistics hubs, urban farming hubs, disaster relief housing, parking lots, elderly daycare centers, exhibition spaces, places for food and beverages, and company offices—through smart contracts and data-driven workflows. By integrating circular economy principles with decentralized technology, AKI2ALL streamlines property transitions, tax validation, and administrative processes, reducing operational costs while preserving embodied carbon in existing structures. Municipalities list properties, owners select uses, and AI optimizes assignments based on real-time demand. This work bridges gaps in digital construction governance, proving that automating trust and accountability can transform systemic inefficiencies into opportunities for community-led, low-carbon regeneration, highlighting its potential as a scalable model for global vacant property reuse. Full article

To enhance social interaction of residents living with dementia and their (in)formal carers in nursing homes, we examined the effects of a digital, person-centred, Photo-Activity (PA) versus a conversation activity (control). An explorative randomized controlled trial was conducted in 81 resident-informal carer (IC) dyads and 51 formal carers (FC) with three measurements (pre/post-test, 2-week follow-up). Intervention effects were tested using Mann–Whitney U’s, and ANCOVA’s with pre-test scores as covariates. Interaction effects were examined between dementia severity (DS; less/more) and condition (PA/control). A post-test effect was observed in social interaction (INTERACT-subscale: Mood [p = 0.037, ηp² = 0.07]), with PA residents showing better mood than controls. Residents with less DS showed more positive effects of PA than residents with more DS (interaction effects: INTERACT-subscales Mood [p = 0.017, ηp² = 0.092], Stimulation Level [p = 0.011, ηp² = 0.106], and Need for Prompting [p = 0.013, ηp² = 0.099]). Higher QUALIDEM Positive Affect scores were observed in the PA group, post-test (p = 0.025, ηp² = 0.082), and follow-up (p = 0.042, d = 0.39). PA FC showed less empathy (IRI; p = 0.006, ηp² = 0.185;) than controls, but reported getting to know the residents better (p = 0.035, r = 0.299). PA improved mood and positive affect of residents with dementia and led to FC knowing the residents better. Less empathy was observed in FC providing PA, requiring further investigation. Full article

Data over sound (DoS) is an established technique that has experienced a resurgence in recent years, finding applications in areas such as contactless payments, device pairing, authentication, presence detection, toys, and offline data transfer. This study introduces CardiaWhisper, a system that extends the DoS concept to the medical domain by using a medical data-over-sound (MDoS) framework. CardiaWhisper integrates wearable biomedical sensors with home care systems, edge or IoT gateways, and telemedical networks or cloud platforms. Using a transmitter device, vital signs such as ECG (electrocardiogram) signals, PPG (photoplethysmogram) signals, RR (respiratory rate), and ACC (acceleration/movement) are sensed, conditioned, encoded, and acoustically transmitted to a nearby receiver—typically a smartphone, tablet, or other gadget—and can be further relayed to edge and cloud infrastructures. As a case study, this paper presents the real-time transmission and processing of ECG signals. The transmitter integrates an ECG sensing module, an encoder (either a PLL-based FM modulator chip or a microcontroller), and a sound emitter in the form of a standard piezoelectric speaker. The receiver, in the form of a mobile phone, tablet, or desktop computer, captures the acoustic signal via its built-in microphone and executes software routines to decode the data. It then enables a range of control and visualization functions for both local and remote users. Emphasis is placed on describing the system architecture and its key components, as well as the software methodologies used for signal decoding on the receiver side, where several algorithms are implemented using open-source, platform-independent technologies, such as JavaScript, HTML, and CSS. While the main focus is on the transmission of analog data, digital data transmission is also illustrated. The CardiaWhisper system is evaluated across several performance parameters, including functionality, complexity, speed, noise immunity, power consumption, range, and cost-efficiency. Quantitative measurements of the signal-to-noise ratio (SNR) were performed in various realistic indoor scenarios, including different distances, obstacles, and noise environments. Preliminary results are presented, along with a discussion of design challenges, limitations, and feasible applications. Our experience demonstrates that CardiaWhisper provides a low-power, eco-friendly alternative to traditional RF or Bluetooth-based medical wearables in various applications. Full article

As the cradle of Jiangnan culture, Suzhou is home to a dense concentration of historical architectural heritage that is currently facing existential threats from rapid urbanization. This study aims to develop a spatial heritage corridor network for conservation and sustainable utilization. Using kernel density estimation, this study identifies 15 kernel density groups, along with the Analytic Hierarchy Process (AHP), to pinpoint clusters of historical architectural heritage and assess the involved resistance factors. Current Effective Conductance (CEC) theory is further applied to model spatial flow relationships among heritage nodes, leading to the delineation of 27 heritage corridors and revealing a spatial structure characterized by one primary core, one secondary core, and multiple peripheral zones. Based on 15 source points, six cultural relics-themed routes are proposed—three land-based and three waterfront routes—connecting historical sites, towns, and ecological areas. The study further recommends a resource management strategy centered on departmental collaboration, digital integration, and community co-governance. By integrating historical architectural types, settlement forms, and ecological patterns, the research builds a multi-scale narrative and experience system that addresses fragmentation while improving coordination and sustainability. This framework delivers practical advice on heritage conservation and cultural tourism development in Suzhou and the broader Jiangnan region. Full article

ICT tools are fundamental for promoting educational inclusion, as they allow for flexible teaching practices adapted to the diversity of students. Their appropriate integration into teaching makes it easier to respond to different paces, styles, and needs, promoting the active and meaningful participation of all learners. However, this inclusive potential is only fulfilled if equitable access to and use of ICT is guaranteed, both at school and at home. This qualitative study explores the digital divide in its three main dimensions: access to technology, digital skills, and the meaningful use of ICT in educational settings. Through focus groups and semi-structured interviews, the study gathers the perceptions of different members of the educational community. The sample consists of 89 participants, including teachers, students, families, and school administrators from the Communities of Madrid and Castilla-La Mancha. The results reveal a common concern about inequalities in ICT access and use, related to economic, geographical, and educational factors. These findings emphasise the need for targeted public policies to bridge digital gaps and highlight the importance of promoting digital competence across the entire educational community to achieve true educational inclusion. Full article

The increasing demand for high-speed internet and advanced digital services necessitates the deployment of robust and scalable broadband infrastructure, particularly in smaller urban and rural areas. This paper presents the design and implementation of a passive optical network (PON) based on a gigabit-capable passive optical network (GPON) standard to deliver fiber-to-the-home (FTTH) services in a small-town setting. The proposed solution prioritizes cost-effectiveness, scalability, and minimal energy consumption by leveraging passive splitters and unpowered network elements. We detail the topology planning, splitter architecture, installation practices, and technical specifications that ensure efficient signal distribution and future network expansion. The results demonstrate the successful implementation of an optical access infrastructure that supports high-speed internet, Internet Protocol television (IPTV), and voice services while maintaining flexibility for diverse urban layouts and housing types. Full article

Many breast cancer patients follow a self-managed treatment pathway, which may lead to gaps in the data available to healthcare professionals, such as information about patients’ everyday symptoms at home. Mobile apps have the potential to bridge this information gap, leading to more effective treatments and interventions, as well as helping breast cancer patients monitor and manage their symptoms. In this paper, we elicit design requirements for breast cancer symptom-management mobile apps using a systematic review following the PRISMA framework. We then evaluate existing cancer symptom-management apps found on the Apple store according to the extent to which they meet these requirements. We find that, whilst some requirements are well supported (such as functionality to record multiple symptoms and provision of information), others are currently not being met, particularly interoperability, functionality related to responses from healthcare professionals, and personalisation. Much work is needed for cancer patients and healthcare professionals to experience the benefits of digital health innovation. The article demonstrates a formal requirements model, in which requirements are categorised as functional and non-functional, and presents a proposal for conceptual design for future mobile apps. Full article

Background: After an older person moves into a nursing home, the next of kin often continues to participate in the care provided there. This participation in care may contribute valuable knowledge of the preferences and wishes of the older person, thereby helping nursing staff deliver personalised care. Objectives: The aim of this study was to explore how next of kin experience their participation in the care of older persons residing in nursing homes after educating nursing staff about participation in palliative care. Methods: This follow-up study used a qualitative design based on semi-structured interviews with 37 next of kin. A thematic analysis was applied. Results: Participation of the next of kin involved active communication and collaboration with nursing staff, expressed in three themes: striving to achieve co-created care, navigating involvement through presence, and building commitment through communication and information. The dual role of being an emotionally close next of kin and a participant in the relative’s care was challenging and became increasingly burdensome and often overwhelming when the older person’s health deteriorated. Conclusions: This study reveals the need to develop and implement a policy for the participation of next of kin in the care of older people living in nursing homes. In addition, support groups can increase well-being through dialogue with other next of kin, thereby alleviating emotional strain. Increased implementation of life stories and the use of digital communication would keep the next of kin informed about the older person’s condition, especially when they cannot be present in person. Life story is a valuable tool for person-centred care and strengthens the relationships between the next of kin, the older person, and the nursing staff. Full article

(1) Background: As digitalisation transforms society, digital competences are increasingly essential. Yet students’ digital competences often vary significantly, largely influenced by socio-economic background. Some schools—termed “resilient schools”—effectively counter these disadvantages and foster high digital competence. This study investigates the prevalence of such schools and examines how they differ from others. (2) Methods: Drawing on representative ICILS 2023 data, quantitative secondary analyses—including descriptive statistics, t-tests, and multiple regression—were conducted. Following the identification of resilient schools, in-depth analyses focus on those countries with substantial proportions of resilient schools above 10 percent (Austria, Italy, and Portugal), as these countries seem to have effective strategies to foster school resilience. (3) Results: The findings highlight considerable cross-national variation, indicating that school resilience is context-dependent. Resilient schools consistently emphasise student learning-related factors—such as ICT-related attitudes and educational aspirations—while the influence of home environments is less pronounced than in other schools. (4) Conclusions: Strengthening student learning-related factors appears to be crucial for building digital resilience. These insights can inform policy and practice aimed at fostering educational equity and closing the digital divide, particularly in socio-economically disadvantaged contexts. Full article