Search Results (3,233)

The integration of 5G technology with cloud and edge computing is redefining the digital landscape by enabling ultra-fast connectivity, low-latency communication, and scalable solutions across diverse application domains. This paper investigates the synergistic impact of 5G on cloud-to-edge architectures, emphasizing its transformative role in revolutionizing sectors such as healthcare, smart cities, industrial automation, and autonomous systems. Key advancements in 5G—including Enhanced Mobile Broadband (eMBB), Ultra-Reliable Low-Latency Communication (URLLC), and Massive Machine-Type Communications (mMTC)—are examined for their role in enabling real-time data processing, edge intelligence, and IoT scalability. In addition to conceptual analysis, the paper presents simulation-based evaluations comparing 5G cloud-to-edge systems with traditional 4G cloud models. Quantitative results demonstrate significant improvements in latency, energy efficiency, reliability, and AI prediction accuracy. The study also explores challenges in infrastructure deployment, cybersecurity, and latency management while highlighting the growing opportunities for innovation in AI-driven automation and immersive consumer technologies. Future research directions are outlined, focusing on energy-efficient designs, advanced security mechanisms, and equitable access to 5G infrastructure. Overall, this study offers comprehensive insights and performance benchmarks that will serve as a valuable resource for researchers and practitioners working to advance next-generation digital ecosystems. Full article

Hand hygiene is a key measure to prevent healthcare-associated infections (HAIs), yet compliance remains low in Sub-Saharan Africa (SSA), due to limited resources, insufficient training, and behavioral challenges. Simulation-based education offers a promising approach to enhance technical and non-technical skills in safe learning environments, promoting behavioral change and patient safety. This study aimed to develop and pilot a contextually adapted hand hygiene simulation-based learning scenario for nursing students in SSA. Grounded in the Medical Research Council (MRC) Framework and Design-Based Research principles, a multidisciplinary team from European and African higher education institutions (HEIs) co-created this scenario, integrating international and regional hand hygiene guidelines. Two iterative pilot cycles were conducted with expert panels, educators, and students. Data from structured observation and post-simulation questionnaires were analyzed using descriptive statistics. The results confirm the scenario’s feasibility, relevance, and educational value. The participants rated highly the clarity of learning objectives (M = 5.0, SD = 0.0) and preparatory materials (M = 4.6, SD = 0.548), reporting increased knowledge/skills and confidence and emphasizing the importance of clear roles, structured facilitation, and real-time feedback. These findings suggest that integrating simulation in health curricula could strengthen HAI prevention and control in SSA. Further research is needed to evaluate long-term outcomes and the potential for wider implementation. Full article

Facial emotion recognition has become increasingly important in healthcare, where understanding delicate cues like pain, discomfort, or unconsciousness can support more timely and responsive care. Yet, recognizing facial expressions in real-world settings remains challenging due to varying lighting, facial occlusions, and hardware limitations in clinical environments. To address this, we propose TriViT-Lite, a lightweight yet powerful model that blends three complementary components: MobileNet, for capturing fine-grained local features efficiently; Vision Transformers (ViT), for modeling global facial patterns; and handcrafted texture descriptors, such as Local Binary Patterns (LBP) and Histograms of Oriented Gradients (HOG), for added robustness. These multi-scale features are brought together through a texture-aware cross-attention fusion mechanism that helps the model focus on the most relevant facial regions dynamically. TriViT-Lite is evaluated on both benchmark datasets (FER2013, AffectNet) and a custom healthcare-oriented dataset covering seven critical emotional states, including pain and unconsciousness. It achieves a competitive accuracy of 91.8% on FER2013 and of 87.5% on the custom dataset while maintaining real-time performance (~15 FPS) on resource-constrained edge devices. Our results show that TriViT-Lite offers a practical and accurate solution for real-time emotion recognition, particularly in healthcare settings. It strikes a balance between performance, interpretability, and efficiency, making it a strong candidate for machine-learning-driven pattern recognition in patient-monitoring applications. Full article

Background/Objectives: Hypodermoclysis has gained increasing recognition as a safe, effective, and minimally invasive method for administering medication and fluids in palliative care. Despite its advantages, its adoption remains limited, primarily due to a lack of structured training resources for healthcare professionals. This study aimed to develop and validate an educational tool for training clinical nurses in hypodermoclysis administration in palliative care. Methods: This is a methodological study with a multi-methods approach. Study development involved a needs assessment with 48 professionals, a literature review, and the creation of a manual enriched with visual aids. Results: The material was validated by expert judges, technical reviewers, and the target audience. Organized into 21 chapters, the manual comprehensively addresses technical, theoretical, and ethical dimensions of the practice. Content validation by 14 experts yielded an outstanding global Content Validity Index (CVI) of 0.95. An independent evaluation of visual design by four communication specialists produced consistently high scores (91–96%), classifying the material as “superior” in quality. Feedback from target users (12 nurses) highlighted the manual’s clarity, applicability, and relevance. All constructive suggestions were incorporated into the final version. Conclusions: The resulting manual demonstrates strong validity as an educational resource, with significant potential to standardize and enhance hypodermoclysis training in palliative nursing, promoting both safety and humanized care. Full article

Frailty is a complex biological process that is associated with adverse outcomes in community-dwelling and hospitalized patients. While clinical evaluation is the current gold standard for screening and diagnosis, such an approach is not without its limitations (such as personnel and resource requirement). In this review, we will discuss prospective biomarkers for frailty. Opportunistic and deliberate radiological testing could provide important information that complements clinical frailty evaluation. Novel biochemical panels may yield additional methods for frailty screening in the future. It is known that early frailty intervention could lead to better outcomes for patients. Integration of electronic medical records, laboratory and radiological results, as well as clinical informatics infrastructure could result in augmented clinical decision-making and more optimized healthcare resources utilization. Full article

China’s healthcare expenditure tripled during 2010–2019, prompting the nationwide implementation of centralized volume-based procurement (CVBP). While effective in reducing drug prices, CVBP introduces sustainability challenges including supply chain vulnerabilities and welfare trade-offs. This study develops a pharmaceutical sector-embedded computable general equilibrium (CGE) model to quantify CVBP’s multidimensional sustainability impacts. Using China’s 2020 Social Accounting Matrix (SAM) with simulated 10–50% price reductions, key findings reveal that (1) >40% price reductions trigger sectoral output reversal; (2) GDP exhibits an inverted U-shape; (3) household income declines despite corporate/government gains; and (4) industrial contraction impairs innovation capacity and employment stability. Our analysis identifies potential sustainability risks, emphasizing the need for rigorous empirical validation prior to implementing aggressive price reduction policies, and underscores the importance of integrating supply chain considerations into procurement policy design. This approach maximizes resource allocation efficiency while advancing socioeconomic resilience in healthcare systems. Full article

Background: The COVID-19 pandemic caused lasting disruption to healthcare systems and the mental health of frontline workers. Though the acute crisis has passed, many healthcare workers (HCWs) continue to experience long-term psychological effects, including anxiety, grief, and burnout. This mixed-methods study investigates the enduring effects of the COVID-19 pandemic on the mental health of physicians in a low-resource country. Methods: Drawing on data from the ear, nose, and throat (ENT) or otolaryngology department at a tertiary care hospital in Pakistan, the study employed an explanatory mixed-methods design, combining structured surveys and semi-structured interviews. The Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the Brief COPE Inventory were administered to 42 ENT specialists, trainees, and house officers, alongside semi-structured interviews with eight ENT physicians. Results: Survey results revealed moderate to high levels of anxiety, depression, and stress that persisted beyond the acute crisis phase of the pandemic. Interviews provided nuanced insights into the emotional burden experienced by physicians, including persistent concerns about contagion risk, professional isolation, and increased workload. Physicians described maladaptive responses and employed active coping strategies, such as seeking peer support and utilizing adaptive problem solving. Conclusions: The COVID-19 pandemic has had enduring effects on the mental well-being of physicians. Targeted interventions and policy reforms that address the ongoing pressures frontline physicians face in resource-constrained environments may help mitigate these burdens, support healthcare professionals more effectively, and improve their mental health. Full article

Background and Clinical Significance: Pituitary adenomas, also termed pituitary neuroendocrine tumors, pose a significant risk of hypogonadotropic hypogonadism (HH) after surgical resection, with profound consequences for fertility and sexual function in young patients. Case Presentation: We present the case of a 29-year-old man from rural Japan who developed severe HH and azoospermia following two transsphenoidal resections for a large pituitary adenoma. Despite early engagement with neurosurgery teams, fertility management was delayed by the absence of on-site endocrinology expertise and limited local oncofertility resources. After comprehensive endocrine evaluation and counseling, the patient began combined human chorionic gonadotropin and recombinant follicle-stimulating hormone therapy, resulting in full recovery of sexual function and normalization of semen parameters, ultimately leading to spontaneous conception and the birth of a healthy child. Building on this real-world case, we provide a narrative review of current practical management strategies for HH after pituitary surgery, including the utility of hormone-stimulation tests, Japanese guideline-based subsidy systems, and best-practice approaches to hormonal replacement. Conclusions: This case underscores not only the necessity for early, interdisciplinary collaboration and preoperative counseling but also highlights a rare instance in which a patient with a benign tumor received care that did not address his fertility-related needs, emphasizing that such considerations should be integrated into preoperative counseling even for non-malignant conditions. Strengthening regional oncofertility networks and improving healthcare providers’ awareness of fertility-preservation options remain essential for improving outcomes. Full article

Background/Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication in patients treated with antiresorptive or antiangiogenic agents, particularly those with cancer-related comorbidities. This systematic review and meta-analysis aimed to estimate the prevalence of free flap failure in patients undergoing microvascular reconstruction for MRONJ. Methods: A comprehensive literature search was conducted across Medline/PubMed, Scopus, and Web of Science up to 30 January 2025. Inclusion criteria were observational studies involving MRONJ patients treated with free flap reconstruction. Risk of bias was assessed using the Newcastle–Ottawa Scale. The pooled prevalence of free flap failure was calculated using a random-effects model with Freeman–Tukey double arcsine transformation. Results: Twelve studies were included in the quantitative analysis. The fibula free flap was the most frequently used flap. The pooled prevalence of free flap failure was 0.1% (95% CI: 0–2.3%), with no significant associations observed in meta-regression analyses for publication year, patient age, or sex. All included studies were of moderate methodological quality. Conclusions: These findings suggest that free flap reconstruction is a reliable and effective surgical option for managing advanced MRONJ in well-resourced and specialized healthcare settings; however, limitations such as small sample sizes and heterogeneity in protocols must be considered. Further high-quality, multicenter studies are needed to evaluate long-term outcomes and refine perioperative management strategies. Full article

Over the past two decades, patient safety and clinical risk management have become strategic priorities for healthcare systems worldwide. In this context, the London Protocol has emerged as one of the most influential methodologies for investigating adverse events through a systemic, non-punitive lens. The 2024 edition, curated by Vincent, Adams, Bellandi, and colleagues, represents a significant evolution of the original 2004 framework. It integrates recent advancements in safety science, human factors, and digital health, while placing a stronger emphasis on resilience, proactive learning, and stakeholder engagement. This article critically examines the structure, key principles, and innovations of the London Protocol 2024, highlighting its departure from incident-centered analysis toward a broader understanding of both failures and successes. The protocol encourages fewer but more in-depth investigations, producing actionable and sustainable recommendations rather than generic reports. It also underscores the importance of involving patients and families as active partners in safety processes, recognizing their unique perspectives on communication, care pathways, and system failures. Beyond its strengths—holistic analysis, multidisciplinary collaboration, and cultural openness—the systemic approach presents challenges, including methodological complexity, resource requirements, and cultural resistance in blame-oriented environments. This paper discusses these limitations and explores how leadership, staff engagement, and digital technologies (including artificial intelligence) can help overcome them. Ultimately, the London Protocol 2024 emerges not only as a methodological tool but as a catalyst for cultural transformation, fostering healthcare systems that are safer, more resilient, and committed to continuous learning. Full article

Background: Healthcare systems are increasingly strained by limited operating room resources and rising demand, a situation intensified by the COVID-19 pandemic. These pressures have resulted in overcrowded surgical departments, prolonged waiting times for elective procedures, worsened patient health outcomes, and increased hospital expenditure costs. Methods: To address these challenges, this study proposes a multi-objective mathematical optimization model as the analytical core of a decision support approach for OR resource allocation. The model considers multiple constrained resources, including OR time, intensive care units, medium care units, and nursing staff, and aims to minimize both elective patients’ waiting times and total incurred costs over a one-week planning horizon. Developed using real hospital data from a large facility in Thailand, the model was implemented in LINGO version 16.0, and a sensitivity analysis was conducted to assess the impact of surgical department priorities and overtime allowances. Results: Compared to current practices, the optimized OR schedule reduced average waiting times by approximately 7% and total costs by 5%, while balancing resource utilization. Conclusions: This study provides a data-driven tool to support hospital resource planning, improve OR efficiency, and respond effectively to future healthcare crises. Full article

Particulate matter (PM), a complex mixture of solid particles and liquid droplets, originates from both natural sources, such as sand, pollen, and marine salts, and anthropogenic activities, including vehicle emissions and industrial processes. While PM itself is not inherently toxic in all its forms, it often acts as a carrier of xenobiotic toxicants, such as heavy metals and organic pollutants, which adhere to its surface. This combination can result in synergistic toxic effects, significantly enhancing the potential harm to biological systems. Due to its small size and composition, PM can penetrate deep into the respiratory tract, acting as a physical “shuttle” that facilitates the distribution and bioavailability of toxic substances to distant organs. The omnipresence of PM in the environment leads to unavoidable and constant exposure, contributing to increased morbidity and mortality rates, particularly among vulnerable populations like the elderly, children, and individuals with pre-existing health conditions. This exposure also imposes a substantial financial burden on healthcare systems, as treating PM-related illnesses requires significant medical resources and leads to higher healthcare costs. Addressing these challenges necessitates effective mitigation strategies, including reducing PM exposure, improving air quality, and exploring novel approaches such as AI-based exposure prediction and nutritional interventions to protect public health and minimize the adverse effects of PM pollution. Full article

Human Activity Recognition (HAR) using wearable sensors is an increasingly relevant area for applications in healthcare, rehabilitation, and human–computer interaction. However, publicly available datasets that provide multi-sensor, synchronized data combining inertial and orientation measurements are still limited. This work introduces a publicly available dataset for Human Activity Recognition, captured using wearable sensors placed on the chest, hands, and knees. Each device recorded inertial and orientation data during controlled activity sessions involving participants aged 20 to 70. A standardized acquisition protocol ensured consistent temporal alignment across all signals. The dataset was preprocessed and segmented using a sliding window approach. An initial baseline classification experiment, employing a Convolutional Neural Network (CNN) and Long-Short Term Memory (LSTM) model, demonstrated an average accuracy of 93.5% in classifying activities. The dataset is publicly available in CSV format and includes raw sensor signals, activity labels, and metadata. This dataset offers a valuable resource for evaluating machine learning models, studying distributed HAR approaches, and developing robust activity recognition pipelines utilizing wearable technologies. Full article

Background/Objectives: Epstein–Barr virus (EBV) detection patterns in lymphoproliferative disorders (LPDs) show significant geographical variation worldwide. Regional epidemiological data are essential for understanding viral distribution patterns and developing appropriate clinical surveillance strategies. This study aimed to determine EBV detection frequency in LPDs using available molecular and immunohistochemical methods in Western Mexico. Methods: We conducted a cross-sectional study of 200 formalin-fixed paraffin-embedded tissue samples from patients diagnosed with LPDs (2015–2019) at Hospital Civil de Guadalajara. EBV detection combined with real-time PCR targeting the BNTp143 gene and immunohistochemistry for LMP-1 protein. Cases were classified following current WHO criteria. Statistical analysis included multivariate logistic regression, diagnostic concordance assessment, and age-stratified analysis. Results: EBV detection frequency reached 35.5% overall, with marked differences between neoplastic (53.9%) and reactive LPDs (24.2%) (OR: 3.515; 95% CI: 1.859–6.645, p < 0.001). Hodgkin lymphoma showed the highest detection rate (80.6%), significantly exceeding non-Hodgkin lymphoma (39.3%) (OR: 6.43; 95% CI: 2.08–19.41, p = 0.001). Age-stratified analysis revealed predominant adult involvement (49.1% vs. 22.0% in young adults, p = 0.025). We identified three epidemiological categories based on detection probability patterns. Conclusions: This study represents the first comprehensive molecular and immunohistochemical characterization of Epstein–Barr virus in lymphoproliferative disorders from Western Mexico, establishing distinct epidemiological patterns that align with Latin American regional characteristics. The validated methodology provides a reproducible framework for multi-center studies, while the epidemiological data serve as an essential baseline for future longitudinal research and resource optimization in similar healthcare settings. Full article

Novel infection control practices are necessary to reduce the incidence of healthcare-associated infections (HAIs). Since 2007, probiotic-based cleaning solutions have been proposed as an alternative to traditional methods using disinfectants and detergents in healthcare settings, including hospitals. We conducted a comprehensive search across Google Scholar, PubMed, Scopus, and Web of Science resources. Studies that assessed the reduction in pathogens on surfaces and the emergence of HAIs after the use of probiotic-based cleaning solutions were eligible for evaluation. A total of 16 studies (13 in clinical settings and 3 on experimental surfaces) were included. The Staphylococcus species were most commonly identified before and after the use of probiotic-based cleaning solutions. All studies showed numerically lower pathogen counts and fewer HAIs after using probiotic-based cleaning solutions compared to disinfectants and detergents. Three studies indicated a reduction in antimicrobial resistance genes after use of probiotic-based cleaning solutions. One of these showed statistically significant differences compared to traditional disinfectants (alcohol, amines, and quaternary ammonium compounds) and detergents (non-ionic and anionic surfactants). The results of the included studies suggest the consideration of probiotic-based cleaning solutions for infection control in healthcare systems. However, given the novelty of this approach, further studies are needed to verify the evaluated findings and investigate the short- and long-term effectiveness, and safety of probiotic-based cleaning solutions on infection control practices in healthcare settings. Full article