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17 pages, 1256 KiB  
Systematic Review
Integrating Artificial Intelligence into Orthodontic Education: A Systematic Review and Meta-Analysis of Clinical Teaching Application
by Carlos M. Ardila, Eliana Pineda-Vélez and Anny Marcela Vivares Builes
J. Clin. Med. 2025, 14(15), 5487; https://doi.org/10.3390/jcm14155487 - 4 Aug 2025
Abstract
Background/Objectives: Artificial intelligence (AI) is rapidly emerging as a transformative force in healthcare education, including orthodontics. This systematic review and meta-analysis aimed to evaluate the integration of AI into orthodontic training programs, focusing on its effectiveness in improving diagnostic accuracy, learner engagement, [...] Read more.
Background/Objectives: Artificial intelligence (AI) is rapidly emerging as a transformative force in healthcare education, including orthodontics. This systematic review and meta-analysis aimed to evaluate the integration of AI into orthodontic training programs, focusing on its effectiveness in improving diagnostic accuracy, learner engagement, and the perceived quality of AI-generated educational content. Materials and Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Embase through May 2025. Eligible studies involved AI-assisted educational interventions in orthodontics. A mixed-methods approach was applied, combining meta-analysis and narrative synthesis based on data availability and consistency. Results: Seven studies involving 1101 participants—including orthodontic students, clinicians, faculty, and program directors—were included. AI tools ranged from cephalometric landmarking platforms to ChatGPT-based learning modules. A fixed-effects meta-analysis using two studies yielded a pooled Global Quality Scale (GQS) score of 3.69 (95% CI: 3.58–3.80), indicating moderate perceived quality of AI-generated content (I2 = 64.5%). Due to methodological heterogeneity and limited statistical reporting in most studies, a narrative synthesis was used to summarize additional outcomes. AI tools enhanced diagnostic skills, learner autonomy, and perceived satisfaction, particularly among students and junior faculty. However, barriers such as limited curricular integration, lack of training, and faculty skepticism were recurrent. Conclusions: AI technologies, especially ChatGPT and digital cephalometry tools, show promise in orthodontic education. While learners demonstrate high acceptance, full integration is hindered by institutional and perceptual challenges. Strategic curricular reforms and targeted faculty development are needed to optimize AI adoption in clinical training. Full article
(This article belongs to the Special Issue Orthodontics: State of the Art and Perspectives)
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25 pages, 2807 KiB  
Article
Drivers of Population Dynamics in High-Altitude Counties of Sichuan Province, China
by Xiangyu Dong, Mengge Du and Shichen Zhao
Sustainability 2025, 17(15), 7051; https://doi.org/10.3390/su17157051 - 4 Aug 2025
Viewed by 68
Abstract
The population dynamics of high-altitude mountainous areas are shaped by a complex interplay of socioeconomic and environmental drivers. Despite their significance, such regions have received limited scholarly attention. This research identifies and examines the principal determinants of population changes in the high-altitude mountainous [...] Read more.
The population dynamics of high-altitude mountainous areas are shaped by a complex interplay of socioeconomic and environmental drivers. Despite their significance, such regions have received limited scholarly attention. This research identifies and examines the principal determinants of population changes in the high-altitude mountainous zones of Sichuan Province, China. Utilizing a robust quantitative framework, we introduce the Sustainable Population Migration Index (SPMI) to systematically analyze the migration potential over two decades. The findings indicate healthcare accessibility as the most significant determinant influencing resident and rural population changes, while economic factors notably impact urban populations. The SPMI reveals a pronounced deterioration in migration attractiveness, decreasing by 0.27 units on average from 2010 to 2020. Furthermore, a fixed-effects panel regression confirmed the predictive capability of SPMI regarding population trends, emphasizing its value for demographic forecasting. We also develop a Digital Twin-based Simulation and Decision-support Platform (DTSDP) to visualize policy impacts effectively. Scenario simulations suggest that targeted enhancements in healthcare and infrastructure could significantly alleviate demographic pressures. This research contributes critical insights for sustainable regional development strategies and provides an effective tool for informed policymaking. Full article
(This article belongs to the Special Issue Advanced Studies in Sustainable Urban Planning and Urban Development)
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27 pages, 747 KiB  
Review
An Insight into the Disease Prognostic Potentials of Nanosensors
by Nandu K. Mohanan, Nandana S. Mohanan, Surya Mol Sukumaran, Thaikatt Madhusudhanan Dhanya, Sneha S. Pillai, Pradeep Kumar Rajan and Saumya S. Pillai
Inorganics 2025, 13(8), 259; https://doi.org/10.3390/inorganics13080259 - 4 Aug 2025
Viewed by 72
Abstract
Growing interest in the future applications of nanotechnology in medicine has led to groundbreaking developments in nanosensors. Nanosensors are excellent platforms that provide reliable solutions for continuous monitoring and real-time detection of clinical targets. Nanosensors have attracted great attention due to their remarkable [...] Read more.
Growing interest in the future applications of nanotechnology in medicine has led to groundbreaking developments in nanosensors. Nanosensors are excellent platforms that provide reliable solutions for continuous monitoring and real-time detection of clinical targets. Nanosensors have attracted great attention due to their remarkable sensitivity, portability, selectivity, and automated data acquisition. The exceptional nanoscale properties of nanomaterials used in the nanosensors boost their sensing potential even at minimal concentrations of analytes present in a clinical sample. Along with applications in diverse sectors, the beneficial aspects of nanosensors have been exploited in healthcare systems to utilize their applications in diagnosing, treating, and preventing diseases. Hence, in this review, we have presented an overview of the disease-prognostic applications of nanosensors in chronic diseases through a detailed literature analysis. We focused on the advances in various nanosensors in the field of major diseases such as cancer, cardiovascular diseases, diabetes mellitus, and neurodegenerative diseases along with other prevalent diseases. This review demonstrates various categories of nanosensors with different nanoparticle compositions and detection methods suitable for specific diagnostic applications in clinical settings. The chemical properties of different nanoparticles provide unique characteristics to each nanosensors for their specific applications. This will aid the detection of potential biomarkers or pathological conditions that correlate with the early detection of various diseases. The potential challenges and possible recommendations of the applications of nanosensors for disease diagnosis are also discussed. The consolidated information present in the review will help to better understand the disease-prognostic potentials of nanosensors, which can be utilized to explore new avenues in improved therapeutic interventions and treatment modalities. Full article
(This article belongs to the Section Bioinorganic Chemistry)
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21 pages, 1147 KiB  
Review
Recent Advances in Developing Cell-Free Protein Synthesis Biosensors for Medical Diagnostics and Environmental Monitoring
by Tyler P. Green, Joseph P. Talley and Bradley C. Bundy
Biosensors 2025, 15(8), 499; https://doi.org/10.3390/bios15080499 - 3 Aug 2025
Viewed by 201
Abstract
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, [...] Read more.
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
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38 pages, 1194 KiB  
Review
Transforming Data Annotation with AI Agents: A Review of Architectures, Reasoning, Applications, and Impact
by Md Monjurul Karim, Sangeen Khan, Dong Hoang Van, Xinyue Liu, Chunhui Wang and Qiang Qu
Future Internet 2025, 17(8), 353; https://doi.org/10.3390/fi17080353 - 2 Aug 2025
Viewed by 413
Abstract
Data annotation serves as a critical foundation for artificial intelligence (AI) and machine learning (ML). Recently, AI agents powered by large language models (LLMs) have emerged as effective solutions to longstanding challenges in data annotation, such as scalability, consistency, cost, and limitations in [...] Read more.
Data annotation serves as a critical foundation for artificial intelligence (AI) and machine learning (ML). Recently, AI agents powered by large language models (LLMs) have emerged as effective solutions to longstanding challenges in data annotation, such as scalability, consistency, cost, and limitations in domain expertise. These agents facilitate intelligent automation and adaptive decision-making, thereby enhancing the efficiency and reliability of annotation workflows across various fields. Despite the growing interest in this area, a systematic understanding of the role and capabilities of AI agents in annotation is still underexplored. This paper seeks to fill that gap by providing a comprehensive review of how LLM-driven agents support advanced reasoning strategies, adaptive learning, and collaborative annotation efforts. We analyze agent architectures, integration patterns within workflows, and evaluation methods, along with real-world applications in sectors such as healthcare, finance, technology, and media. Furthermore, we evaluate current tools and platforms that support agent-based annotation, addressing key challenges such as quality assurance, bias mitigation, transparency, and scalability. Lastly, we outline future research directions, highlighting the importance of federated learning, cross-modal reasoning, and responsible system design to advance the development of next-generation annotation ecosystems. Full article
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15 pages, 2440 KiB  
Article
An Ultra-Robust, Highly Compressible Silk/Silver Nanowire Sponge-Based Wearable Pressure Sensor for Health Monitoring
by Zijie Li, Ning Yu, Martin C. Hartel, Reihaneh Haghniaz, Sam Emaminejad and Yangzhi Zhu
Biosensors 2025, 15(8), 498; https://doi.org/10.3390/bios15080498 - 1 Aug 2025
Viewed by 111
Abstract
Wearable pressure sensors have emerged as vital tools in personalized monitoring, promising transformative advances in patient care and diagnostics. Nevertheless, conventional devices frequently suffer from limited sensitivity, inadequate flexibility, and concerns regarding biocompatibility. Herein, we introduce silk fibroin, a naturally occurring protein extracted [...] Read more.
Wearable pressure sensors have emerged as vital tools in personalized monitoring, promising transformative advances in patient care and diagnostics. Nevertheless, conventional devices frequently suffer from limited sensitivity, inadequate flexibility, and concerns regarding biocompatibility. Herein, we introduce silk fibroin, a naturally occurring protein extracted from silkworm cocoons, as a promising material platform for next-generation wearable sensors. Owing to its remarkable biocompatibility, mechanical robustness, and structural tunability, silk fibroin serves as an ideal substrate for constructing capacitive pressure sensors tailored to medical applications. We engineered silk-derived capacitive architecture and evaluated its performance in real-time human motion and physiological signal detection. The resulting sensor exhibits a high sensitivity of 18.68 kPa−1 over a broad operational range of 0 to 2.4 kPa, enabling accurate tracking of subtle pressures associated with pulse, respiration, and joint articulation. Under extreme loading conditions, our silk fibroin sensor demonstrated superior stability and accuracy compared to a commercial resistive counterpart (FlexiForce™ A401). These findings establish silk fibroin as a versatile, practical candidate for wearable pressure sensing and pave the way for advanced biocompatible devices in healthcare monitoring. Full article
(This article belongs to the Special Issue Wearable Biosensors and Health Monitoring)
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24 pages, 624 KiB  
Systematic Review
Integrating Artificial Intelligence into Perinatal Care Pathways: A Scoping Review of Reviews of Applications, Outcomes, and Equity
by Rabie Adel El Arab, Omayma Abdulaziz Al Moosa, Zahraa Albahrani, Israa Alkhalil, Joel Somerville and Fuad Abuadas
Nurs. Rep. 2025, 15(8), 281; https://doi.org/10.3390/nursrep15080281 - 31 Jul 2025
Viewed by 143
Abstract
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 [...] Read more.
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
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17 pages, 876 KiB  
Article
Feasibility and Perceptions of Telerehabilitation Using Serious Games for Children with Disabilities in War-Affected Ukraine
by Anna Kushnir, Oleh Kachmar and Bruno Bonnechère
Appl. Sci. 2025, 15(15), 8526; https://doi.org/10.3390/app15158526 (registering DOI) - 31 Jul 2025
Viewed by 139
Abstract
This study aimed to evaluate the feasibility of using serious games for the (tele)rehabilitation of children with disabilities affected by the Ukrainian war. Additionally, it provides requirements for technologies that can be used in war-affected areas. Structured interviews and Likert scale assessments were [...] Read more.
This study aimed to evaluate the feasibility of using serious games for the (tele)rehabilitation of children with disabilities affected by the Ukrainian war. Additionally, it provides requirements for technologies that can be used in war-affected areas. Structured interviews and Likert scale assessments were conducted on-site and remotely with patients of the tertiary care facility in Ukraine. All participants used the telerehabilitation platform for motor and cognitive training. Nine serious games were employed, involving trunk tilts, upper limb movements, and head control. By mid-September 2023, 186 positive user experiences were evident, with 89% expressing interest in continued engagement. The platform’s accessibility, affordability, and therapeutic benefits were highlighted. The recommendations from user feedback informed potential enhancements, showcasing the platform’s potential to provide uninterrupted rehabilitation care amid conflict-related challenges. This study suggests that serious games solutions that suit the sociopolitical and economic context offer a promising solution to rehabilitation challenges in conflict zones. The positive user experiences towards using the platform with serious games indicate its potential in emergency healthcare provision. The findings emphasize the role of technology, particularly serious gaming, in mitigating the impact of armed conflicts on children’s well-being, thereby contributing valuable insights to healthcare strategies in conflict-affected regions. Requirements for technologies tailored to the context of challenging settings were defined. Full article
(This article belongs to the Special Issue Novel Approaches of Physical Therapy-Based Rehabilitation)
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11 pages, 1219 KiB  
Article
The Church and Academia Model: New Paradigm for Spirituality and Mental Health Research
by Marta Illueca, Samantha M. Meints, Megan M. Miller, Dikachi Osaji and Benjamin R. Doolittle
Religions 2025, 16(8), 998; https://doi.org/10.3390/rel16080998 (registering DOI) - 31 Jul 2025
Viewed by 208
Abstract
Ongoing interest in the intersection of spirituality and health has prompted a need for integrated research. This report proposes a distinct approach in a model that allows for successful and harmonious cross-fertilization within these latter two areas of interest. Our work is especially [...] Read more.
Ongoing interest in the intersection of spirituality and health has prompted a need for integrated research. This report proposes a distinct approach in a model that allows for successful and harmonious cross-fertilization within these latter two areas of interest. Our work is especially pertinent to inquiries around the role of spirituality in mental health, with special attention to chronic pain conditions. The latter have become an open channel for novel avenues to explore the field of spirituality-based interventions within the arena of psychological inquiry. To address this, the authors developed and implemented the Church and Academia Model, a prototype for an innovative collaborative research project, with the aim of exploring the role of devotional practices, and their potential to be used as therapeutic co-adjuvants or tools to enhance the coping skills of patients with chronic pain. Keeping in mind that the church presents a rich landscape for clinical inquiry with broad relevance for clinicians and society at large, we created a unique hybrid research model. This is a new paradigm that focuses on distinct and well-defined studies where the funding, protocol writing, study design, and implementation are shared by experts from both the pastoral and clinical spaces. A team of theologians, researchers, and healthcare providers, including clinical pain psychologists, built a coalition leveraging their respective skill sets. Each expert is housed in their own environs, creating a functional network that has proven academically productive and pastorally effective. Key outputs include the creation and validation of a new psychometric measure, the Pain-related PRAYER Scale (PPRAYERS), an associated bedside prayer tool and a full-scale dissemination strategy through journal publications and specialty society conferences. This collaborative prototype is also an ideal fit for integrated knowledge translation platforms, and it is a promising paradigm for future collaborative projects focused on spirituality and mental health. Full article
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30 pages, 3898 KiB  
Article
Application of Information and Communication Technologies for Public Services Management in Smart Villages
by Ingrida Kazlauskienė and Vilma Atkočiūnienė
Businesses 2025, 5(3), 31; https://doi.org/10.3390/businesses5030031 - 31 Jul 2025
Viewed by 213
Abstract
Information and communication technologies (ICTs) are becoming increasingly important for sustainable rural development through the smart village concept. This study aims to model ICT’s potential for public services management in European rural areas. It identifies ICT applications across rural service domains, analyzes how [...] Read more.
Information and communication technologies (ICTs) are becoming increasingly important for sustainable rural development through the smart village concept. This study aims to model ICT’s potential for public services management in European rural areas. It identifies ICT applications across rural service domains, analyzes how these technologies address specific rural challenges, and evaluates their benefits, implementation barriers, and future prospects for sustainable rural development. A qualitative content analysis method was applied using purposive sampling to analyze 79 peer-reviewed articles from EBSCO and Elsevier databases (2000–2024). A deductive approach employed predefined categories to systematically classify ICT applications across rural public service domains, with data coded according to technology scope, problems addressed, and implementation challenges. The analysis identified 15 ICT application domains (agriculture, healthcare, education, governance, energy, transport, etc.) and 42 key technology categories (Internet of Things, artificial intelligence, blockchain, cloud computing, digital platforms, mobile applications, etc.). These technologies address four fundamental rural challenges: limited service accessibility, inefficient resource management, demographic pressures, and social exclusion. This study provides the first comprehensive systematic categorization of ICT applications in smart villages, establishing a theoretical framework connecting technology deployment with sustainable development dimensions. Findings demonstrate that successful ICT implementation requires integrated urban–rural cooperation, community-centered approaches, and balanced attention to economic, social, and environmental sustainability. The research identifies persistent challenges, including inadequate infrastructure, limited digital competencies, and high implementation costs, providing actionable insights for policymakers and practitioners developing ICT-enabled rural development strategies. Full article
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21 pages, 716 KiB  
Review
Improving Hemorrhoid Outcomes: A Narrative Review and Best Practices Guide for Pharmacists
by Nardine Nakhla, Ashok Hospattankar, Kamran Siddiqui and Mary Barna Bridgeman
Pharmacy 2025, 13(4), 105; https://doi.org/10.3390/pharmacy13040105 - 30 Jul 2025
Viewed by 259
Abstract
Hemorrhoidal disease remains a prevalent yet often overlooked condition, affecting millions worldwide and imposing a substantial healthcare burden. Despite the availability of multiple treatment options, gaps persist in patient education, early symptom recognition, and optimal treatment selection. Recent advancements are evolving the pharmacist’s [...] Read more.
Hemorrhoidal disease remains a prevalent yet often overlooked condition, affecting millions worldwide and imposing a substantial healthcare burden. Despite the availability of multiple treatment options, gaps persist in patient education, early symptom recognition, and optimal treatment selection. Recent advancements are evolving the pharmacist’s role in hemorrhoid management beyond traditional over-the-counter (OTC) and prescription approaches. The 2024 American Society of Colon and Rectal Surgeons (ASCRS) guidelines introduce updates on the use of phlebotonics, a class of venoactive drugs gaining recognition for their role in symptom management, yet largely underutilized in U.S. clinical practice. In parallel, novel clinical tools are reshaping how pharmacists engage in assessment and care. The integration of digital decision-support platforms and structured evaluation algorithms now empowers them to systematically evaluate symptoms, identify red flag signs, and optimize patient triage. These tools reduce diagnostic variability and improve decision-making accuracy. Given their accessibility and trusted role in frontline healthcare, pharmacists are well-positioned to bridge these critical gaps by adopting emerging treatment recommendations, leveraging algorithm-driven assessments, and reinforcing best practices in patient education and referral. This narrative review aims to equip pharmacists with updated insights into evidence-based hemorrhoid management strategies and provide them with structured assessment algorithms to standardize symptom evaluation and treatment pathways. By integrating these innovations, pharmacists can enhance treatment outcomes, promote patient safety, and contribute to improved quality of life (QoL) for individuals suffering from hemorrhoidal disease. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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17 pages, 263 KiB  
Article
Tuberculosis-Related Knowledge, Attitudes, and Practices Among Healthcare Workers in Atlantic Canada: A Descriptive Study
by Harold Joonkeun Oh, Moira A. Law and Isdore Chola Shamputa
Trop. Med. Infect. Dis. 2025, 10(8), 214; https://doi.org/10.3390/tropicalmed10080214 - 30 Jul 2025
Viewed by 289
Abstract
Introduction: Despite the key role of healthcare workers (HCWs) in tuberculosis (TB) prevention and control, there is a lack of regional data on their knowledge, attitudes, and practices (KAPs) regarding the disease in Atlantic Canada. Objectives: To assess the KAPs of HCWs and [...] Read more.
Introduction: Despite the key role of healthcare workers (HCWs) in tuberculosis (TB) prevention and control, there is a lack of regional data on their knowledge, attitudes, and practices (KAPs) regarding the disease in Atlantic Canada. Objectives: To assess the KAPs of HCWs and identify targets for educational interventions to enhance TB care and control. Methods: A cross-sectional study was conducted among HCWs in Atlantic Canada aged 19 years from October 2023 to February 2024. Participants were recruited via multiple channels such as social media, collegiate email lists, and snowball sampling. Survey data were collected using an online platform and analyzed using IBM SPSS Statistics v29. KAPs were assessed using Likert-type scales and internal consistency was evaluated using Cronbach’s alpha. Results: A total of 157 HCWs participated in this study (age range: 19 to 69 years); most were women (n = 145, 92%), born in Canada (n = 134, 85.4%), with nearly three-quarters (n = 115, 73.2%) who had never lived outside of Canada. Study participants demonstrated moderately high knowledge (M = 29.32, SD = 3.25) and positive attitudes (M = 3.87, SD = 0.37) towards TB and strong practices (M = 4.24, SD = 0.69) in TB care; however, gaps were identified in HCW abilities to recognize less common TB symptoms (e.g., rash and nausea), as well as inconsistent practices in ventilation and pre-treatment initiation. Internal consistency analysis indicated suboptimal reliability across all three KAP domains, with Cronbach’s alpha values falling below 0.7, thwarting further planned analyses. Conclusions: This study found overall moderate-to-strong TB-related KAPs among HCWs in Atlantic Canada; however, critical gaps in knowledge and practice were noted. This new information can now guide future educational initiatives and targeted training to enhance TB preparedness and ensure equitable care for patients in the region. Full article
17 pages, 1540 KiB  
Article
Evaluating a Nationally Localized AI Chatbot for Personalized Primary Care Guidance: Insights from the HomeDOCtor Deployment in Slovenia
by Matjaž Gams, Tadej Horvat, Žiga Kolar, Primož Kocuvan, Kostadin Mishev and Monika Simjanoska Misheva
Healthcare 2025, 13(15), 1843; https://doi.org/10.3390/healthcare13151843 - 29 Jul 2025
Viewed by 343
Abstract
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 [...] Read more.
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
(This article belongs to the Special Issue Application of Digital Services to Improve Patient-Centered Care)
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10 pages, 258 KiB  
Article
COVID-19 Clinical Predictors in Patients Treated via a Telemedicine Platform in 2022
by Liliane de Fátima Antonio Oliveira, Lúcia Regina do Nascimento Brahim Paes, Luiz Claudio Ferreira, Gabriel Garcez de Araújo Souza, Guilherme Souza Weigert, Layla Lorena Bezerra de Almeida, Rafael Kenji Fonseca Hamada, Lyz Tavares de Sousa, Andreza Pain Marcelino and Cláudia Maria Valete
Trop. Med. Infect. Dis. 2025, 10(8), 213; https://doi.org/10.3390/tropicalmed10080213 - 29 Jul 2025
Viewed by 195
Abstract
Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus, whose 2020 outbreak was characterized as a pandemic by the World Health Organization. Restriction measures changed healthcare delivery, with telehealth providing a viable alternative throughout the pandemic. This study analyzed a [...] Read more.
Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus, whose 2020 outbreak was characterized as a pandemic by the World Health Organization. Restriction measures changed healthcare delivery, with telehealth providing a viable alternative throughout the pandemic. This study analyzed a telemedicine platform database with the goal of developing a diagnostic prediction model for COVID-19 patients. This is a longitudinal study of patients seen on the Conexa Saúde telemedicine platform in 2022. A multiple binary logistic regression model of controls (negative confirmation for COVID-19 or confirmation of other influenza-like illness) versus COVID-19 was developed to obtain an odds ratio (OR) and a 95% confidence interval (CI). In the final binary logistic regression model, six factors were considered significant: presence of rhinorrhea, ocular symptoms, abdominal pain, rhinosinusopathy, and wheezing/asthma and bronchospasm were more frequent in controls, thus indicating a greater chance of flu-like illnesses than COVID-19. The presence of tiredness and fatigue was three times more prevalent in COVID-19 cases (OR = 3.631; CI = 1.138–11.581; p-value = 0.029). Our findings suggest potential predictors associated with influenza-like illness and COVID-19 that may distinguish between these infections. Full article
13 pages, 216 KiB  
Article
A Pilot Study of Integrated Digital Tools at a School-Based Health Center Using the RE-AIM Framework
by Steven Vu, Alex Zepeda, Tai Metzger and Kathleen P. Tebb
Healthcare 2025, 13(15), 1839; https://doi.org/10.3390/healthcare13151839 - 29 Jul 2025
Viewed by 309
Abstract
Introduction: Adolescents and young adults (AYAs), especially those from underserved communities, often face barriers to sexual and reproductive health (SRH). This pilot study evaluated the implementation of mobile health technologies to promote SRH care, including the integration of the Rapid Adolescent Prevention [...] Read more.
Introduction: Adolescents and young adults (AYAs), especially those from underserved communities, often face barriers to sexual and reproductive health (SRH). This pilot study evaluated the implementation of mobile health technologies to promote SRH care, including the integration of the Rapid Adolescent Prevention ScreeningTM (RAAPS) and the Health-E You/Salud iTuTM (Health-E You) app at a School-Based Health Center (SBHC) in Los Angeles using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Methods: This multi-method pilot study included the implementation of an integrated tool with two components, the RAAPS electronic health screening tool and the Health-E You app, which delivers tailored SRH education and contraceptive decision support to patients (who were sex-assigned as female at birth) and provides an electronic summary to clinicians to better prepare them for the visit with their patient. Quantitative data on tool usage were collected directly from the back-end data storage for the apps, and qualitative data were obtained through semi-structured interviews and in-clinic observations. Thematic analysis was conducted to identify implementation barriers and facilitators. Results: Between April 2024 and June 2024, 60 unique patients (14–19 years of age) had a healthcare visit. Of these, 35.00% used the integrated RAAPS/Health-E You app, and 88.33% completed the Health-E You app only. All five clinic staff were interviewed and expressed that they valued the tools for their educational impact, noting that they enhanced SRH discussions and helped uncover sensitive information that students might not disclose face-to-face. However, the tools affected clinic workflows and caused rooming delays due to the time-intensive setup process and lack of integration with the clinic’s primary electronic medical record system. In addition, they also reported that the time to complete the screener and app within the context of a 30-min appointment limited the time available for direct patient care. Additionally, staff reported that some students struggled with the two-step process and did not complete all components of the tool. Despite these challenges, clinic staff strongly supported renewing the RAAPS license and continued use of the Health-E You app, emphasizing the platform’s potential for improving SRH care and its educational value. Conclusions: The integrated RAAPS and Health-E You app platform demonstrated educational value and improved SRH care but faced operational and technical barriers in implementing the tool. These findings emphasize the potential of such tools to address SRH disparities among vulnerable AYAs while providing a framework for future implementations in SBHCs. Full article
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