Search Results (106)

The acoustic environment of dental clinics plays a critical role in shaping patient experience, staff performance, and overall clinical effectiveness. This comprehensive review, supported by systematic search procedures, investigates how soundscapes in dental settings influence psychological, physiological, and operational outcomes. A total of 60 peer-reviewed studies were analyzed across dental, healthcare, architectural, and environmental psychology disciplines. Findings indicate that mechanical noise from dental instruments, ambient reverberation, and inadequate acoustic zoning contribute significantly to patient anxiety and professional fatigue. The review identifies emerging strategies for acoustic optimization, including biophilic and sustainable design principles, sound-masking systems, and adaptive sound environments informed by artificial intelligence. Special attention is given to the integration of lean management and circular economy practices for sustainable dental architecture. A design checklist and practical framework are proposed for use by dental professionals, architects, and healthcare planners. Although limited by the predominance of observational studies and geographic bias in the existing literature, this review offers a comprehensive, interdisciplinary synthesis. It highlights the need for future clinical trials, real-time acoustic assessments, and participatory co-design methods to enhance acoustic quality in dental settings. Overall, the study positions sound design as a foundational element in creating patient-centered, ecologically responsible dental environments. Full article

Hazardous medical waste (HMW) presents significant environmental and public health challenges, particularly in the context of rising healthcare demands and the global push for sustainable resource management. This study investigates the evolution of HMW management through a bibliometric and thematic analysis of 1703 articles published between 2020 and 2025, retrieved from the Web of Science database. Using VOSviewer, co-occurrence mapping and term clustering reveal six major conceptual domains, including thermal treatment technologies, operational optimization, environmental indicators, and behavioral dimensions. This study adds value by applying a dual bibliometric–thematic lens to provide new insights into the operational, technological, and sustainability dimensions of HMW. The analysis identifies a gradual shift from traditional disposal methods to circular models focused on resource valorization through pyrolysis, gasification, and sterilization. Lean management principles—such as process efficiency, waste minimization, and the promotion of recovery and reuse—emerge as complementary to circular economy goals. Additional visualizations outline international collaboration trends, highlighting established research hubs and emerging contributors. The findings emphasize the role of data-driven decision tools, sustainability assessment methods, and cross-sectoral integration in enhancing medical waste systems. Full article

The adoption of healthcare technologies has grown significantly, with real-time location systems (RTLSs) gaining particular attention. Despite decades of research, gaps persist in understanding the current state of the field and its future directions. This scoping review, conducted by PRISMA guidelines, identified 1718 articles retrieved from six databases, from which 83 were included. The findings reveal a dominance of U.S.-based case studies and a lack of systematic literature reviews. While RFID is the most commonly used technology, alternative solutions are emerging, though few studies explore their combined use. The emergency department is the most studied setting, focusing on patient flow. However, case study quality varies, which affects replicability, and literature reviews often fail to justify technological choices adequately. RTLS benefits include improved efficiency, enhanced patient safety, and cost reduction, but challenges such as precision issues and signal interference persist. RTLS also serves as a foundation for digital twins, integrating AI and Industry 4.0 technologies for more sustainable healthcare operations. Technological advancements may shift perceptions of RTLS challenges and benefits, highlighting the need for analysis by technology type and release date. Additionally, current MeSH terms fail to adequately cover healthcare technologies, resulting in the exclusion of relevant studies. Full article

Prostate cancer is the most common cancer in men in 112 countries, accounting for 1 in 14 diagnosed cancer cases worldwide. For this reason, the diagnosis and treatment of prostate cancer changed significantly, becoming a multidisciplinary process. Since 2015 in Poland, measures have been taken to accelerate the diagnosis and treatment of cancers, including shortening patients’ diagnosis and treatment waiting times. Background/Objectives: The aim of this study was to characterize the current clinical pathway of patients with prostate cancer and to establish standard times for various steps of treatment, as well as to develop a visualization of the steps involved in diagnosis and treatment. Methods: The research covers 2018 to 2022 in a large oncological hospital in Poland (EU area). The source data, in the form of 10 fully anonymized CSV files generated from the hospital’s medical statistics, have been converted to the target data model. Results: The time limits for diagnosing and commencing the treatment of patients with diagnosed prostate cancer specified by legal regulations and by guidelines of scientific associations are not met in 42% of cases. The greatest delays concern the initiation of the steps of treatment (53%) and comprehensive diagnostics (37%). The diagnostic pathways should be modified to facilitate early and rapid detection of prostate cancer and to allow further therapy within the time limit strictly defined by regulations and guidelines of scientific associations. Full article

The rapid advancement of artificial intelligence (AI) has introduced unprecedented opportunities and challenges, necessitating a robust ethical and regulatory framework to guide its development. This study reviews key ethical concerns such as algorithmic bias, transparency, accountability, and the tension between automation and human oversight. It discusses the concept of algor-ethics—a framework for embedding ethical considerations throughout the AI lifecycle—as an antidote to algocracy, where power is concentrated in those who control data and algorithms. The study also examines AI’s transformative potential in diverse sectors, including healthcare, Insurtech, environmental sustainability, and space exploration, underscoring the need for ethical alignment. Ultimately, it advocates for a global, transdisciplinary approach to AI governance that integrates legal, ethical, and technical perspectives, ensuring AI serves humanity while upholding democratic values and social justice. In the second part of the paper, the author offers a synoptic view of AI governance across six major jurisdictions—the United States, China, the European Union, Japan, Canada, and Brazil—highlighting their distinct regulatory approaches. While the EU’s AI Act as well as Japan’s and Canada’s frameworks prioritize fundamental rights and risk-based regulation, the US’s strategy leans towards fostering innovation with executive directives and sector-specific oversight. In contrast, China’s framework integrates AI governance with state-driven ideological imperatives, enforcing compliance with socialist core values, whereas Brazil’s framework is still lacking the institutional depth of the more mature ones mentioned above, despite its commitment to fairness and democratic oversight. Eventually, strategic and governance considerations that should help chief data/AI officers and AI managers are provided in order to successfully leverage the transformative potential of AI for value creation purposes, also in view of the emerging international standards in terms of AI. Full article

Background/Objectives: Clinical laboratories are fundamental to healthcare systems, contributing to over 70% of clinical decisions while accounting for only 2–3% of hospital budgets. Among them, microbiology laboratories provide critical information that directly influences patient outcomes and satisfaction. This study presents a structured review of the current state of Lean Six Sigma (LSS) implementation in microbiology and comparable laboratory environments. The objective is to identify relevant contributions within the state of the art to highlight potential benefits applicable to microbiology laboratories and to detect persistent gaps and unresolved needs. Methods: A systematic literature review was performed across six databases (Web of Science, ScienceDirect, Scopus, ProQuest, PubMed, and Google Scholar) to identify studies published between 2012 and September 2024. After screening, 33 studies were selected for full-text analysis. Results: The selected literature was analyzed to assess the extent to which LSS methodologies have been applied in microbiology laboratories. Particular attention was given to the definition and use of key performance indicators (KPIs). While industry-adapted metrics such as cost reduction and turnaround time are commonly employed, clinical indicators, such as patient impact, satisfaction, and diagnostic accuracy, are underutilized. Additionally, the analysis revealed a frequent omission of the control phase in LSS projects, limiting long-term process monitoring. The review also identifies the most suitable LSS tools and evaluates how laboratories manage interruptions in routine workflows. Conclusions: Future research should prioritize the integration of clinical KPIs into LSS frameworks, establish robust control phases for sustained monitoring, and systematically address the impact of process interruptions on optimization efforts. Full article

Background/Objectives: Diabetic kidney disease (DKD) is a significant concern for global healthcare, particularly in individuals with diabetes. The Zucker rat strain is a commonly used model of type 2 diabetes, despite awareness that this animal can develop hydronephrosis. In this study, we present novel imaging data evaluating the accuracy of this animal model in replicating the vascular aspects of human DKD while examining the impact of hydronephrosis on its validity as a disease model. Methods: This study reused data from a population of male Zucker Diabetic Fatty (ZDF; n = 22) rats and Zucker Lean (ZL) rats (n = 22) aged 12 to approximately 40 weeks. Vascular casting was performed to enable visualisation of the renal vasculature. Anatomical regional volumes and vascular density data were obtained from μCT scans using image thresholding and manual analysis. The effects of hydronephrosis were evaluated using renal functional parameters and histological examination. Results: A significantly lower cortical vascular density, as well as lower total renal vascular density, was seen in ZDF rats compared to ZL rats, independent of age. We identified that hydronephrosis affected 92% of ZDF rats and 69% of ZL rats. Hydronephrosis cavity size was significantly correlated with the degree of hyperglycaemia and rate of diuresis but had no other detected impact on renal function, vascularity, or tissue histological architecture. Conclusions: These findings support using the Zucker rat strain as a model for vascular changes in DKD. Despite identifying severe hydronephrosis in this population, it had minimal quantifiable impact on renal function or diabetes modelling. Full article

Background/Objectives: The global population is undergoing a significant demographic shift characterised by an increasing proportion of older individuals. Healthy aging has become a priority for personal well-being and sustainable healthcare systems, with nutrition playing a pivotal role. However, the rise in non-communicable diseases (NCDs), malnutrition, and a shift in eating behaviour underscore the need for tailored, effective nutrition communication strategies. This research is intended to provide the basic data needed to support the development of tailored nutritional communication strategies and practices. Methods: To investigate these aspects, a cross-national survey about nutrition and nutrition communication was conducted within the framework of the Innovative Training Network SmartAge, focusing on older adults aged 60 years and above in Germany, Switzerland, Spain, and France (each 25%; N = 1000 persons). This paper specifically focuses on the development, methodology, and discussion of the survey and aims to investigate the characteristics of the sample in relation to their dietary patterns and food choices within the European context. Results: The analysis identified significant associations between various plant- and animal-based food items and the variables gender, age group, and country. Spanish participants showed a dietary pattern towards the Mediterranean Diet, while German participants showed tendencies towards the Western Diet. Furthermore, the findings revealed that protein-rich foods such as meat, fish, nuts and seeds, legumes, and (whole) grains were infrequently consumed, particularly among German and Swiss participants. Conclusions: This study highlights the need to promote adequate protein intake among older adults, emphasising diverse sources like legumes, nuts and seeds, (whole) grains, and lean meats to support healthy aging. For the development of future nutrition communication strategies, the influence of the specific social, cultural, and traditional factors needs to be considered. Full article

Normal weight obesity (NWO) is a body composition phenotype that is associated with increased cardiometabolic risk and is characterized by a normal weight body mass index but elevated body fat. The purpose of this study was to determine sex differences in aerobic capacity across body composition phenotypes, including normal weight lean (NWL), NWO, and traditional obesity (OB). We recruited 60 participants according to three body composition phenotypes: NWL (n = 10 females, n = 10 males), NWO (n = 10 females, n = 10 males), and OB (n = 10 females, n = 10 males). Measurements included fasting metabolic risk factors, body composition X-ray scan, and peak exercise test on a cycle ergometer to determine aerobic capacity (VO_2peak). Across groups, males (34.5 ± 11.7 mL/kg/min) exhibited greater VO_2peak than females (28.8 ± 8.8 mL/kg/min; p = 0.04). There were no differences in VO_2peak between sexes within the same body composition phenotype, but NWL (42.7 ± 9.0 mL/kg/min) exhibited greater VO_2peak than NWO (27.9 ± 4.4 mL/kg/min; p < 0.0001) and OB (24.4 ± 7.3 mL/kg/min; p < 0.0001). VO_2peak was inversely correlated with relative body fat in the full sample (r = −0.67; p < 0.0001), but was stronger in males (r = −0.78; p < 0.0001) than females (r = −0.53; p = 0.0028). Visceral adipose tissue was not significantly correlated with VO_2peak in the full sample (r = −0.25; p = 0.05) or in males (r = −0.23; p = 0.25), although they were inversely correlated in females (r = −0.36; p = 0.048). Our results suggest low aerobic capacity in both men and women with NWO, similar to men and women with OB. The relationship between body composition and aerobic capacity is strong across body composition phenotypes, but appears to be more consistent in females than males. For healthcare professionals aiming to lower cardiometabolic risk, attention should be given to improving aerobic fitness in both men and women with elevated body fat, including those with NWO. Full article

This study investigates the transformation of e-commerce warehouse operations by integrating Lean Six Sigma tools to enhance efficiency and sustainability. Beginning with Value Stream Mapping (VSM) to identify inefficiencies, followed by a Hoshin Kanri plan to align improvement initiatives with strategic objectives, the study implemented measures such as pallet pooling, process standardization, automation in inspection and picking, layout optimization, and Kanban systems for continuous improvement. A case study of a local e-commerce warehouse specializing in medical devices and healthcare products identified 29 activities across receiving, inspection, storing, picking, packing, and shipping, highlighting inefficiencies addressed through Lean-driven initiatives. These efforts resulted in a 23% reduction in total lead time, doubled value-added time, and significant improvements in inspection, picking, packing, and automation, reducing delays, lowering costs, and enhancing workflow. The study fills a gap in the literature by integrating multiple Lean tools and utilizing the Critical to Quality (CTQ) matrix to ensure sustainable improvements in e-commerce warehousing, emphasizing the strategic value of Lean Six Sigma in creating efficient, customer-focused operations. Full article

The increasing focus on environmental sustainability has prompted the healthcare sector, including dentistry, to reconsider waste management practices. Dental offices generate various waste streams from outdated technologies, including single-use plastics, hazardous materials, and digital waste. This scoping review explores how integrating circular economy principles with lean management practices can enhance sustainability and operational efficiency in dental clinics. Using the PRISMA methodology, the review identifies 30 articles that passed the Cochrane Risk of Bias Tool and the Critical Appraisal Skills Program (CASP) checklist from 2000. Circular economy principles focus on reducing waste and maximizing resource reuse, while lean management seeks to improve efficiency and minimize process waste. Together, these approaches can significantly reduce resource consumption and enhance recycling efforts in dental practices. Despite barriers such as high technology costs, regulatory constraints, and limited recycling infrastructure, case studies highlight successful implementation in healthcare settings, demonstrating improved environmental and operational outcomes. Collaboration between dental professionals, policymakers, and industry leaders is essential for promoting the adoption of these sustainable practices. Full article

The study site, a major teaching hospital in Dublin, Ireland, addressed significant challenges within its dermatology service through a comprehensive improvement initiative using a person-centred Lean Six Sigma methodology. Initially, the hospital’s dermatology department faced excessive outpatient waiting times, with 3736 patients awaiting appointments, and 1615 waiting over 12 months. The person-centred Lean Six Sigma approach, which combines Lean techniques to reduce non-value add and Six Sigma methods to eliminate variation through a person-centred lens, was applied to overhaul the referral, triage, and scheduling processes. Key interventions included standardising triage categories, centralising the triage process, and redistributing referrals equitably among consultants. A new centralised triage system was established, leading to a more efficient allocation of appointments and better management of urgent cases. Post-implementation data showed a 40% reduction in the overall waiting list and a 60% reduction in the number of patients waiting over 12 months. The initiative significantly decreased the wait times across all urgency categories, with the most notable improvements in soon and urgent referrals. These changes were also the impetus for a follow-up design-led innovation phase, where the team worked with partners across the educational and healthcare system to enable disruptive change. The success of this project provides a scalable model for improvements in similar healthcare settings. Full article

Introduction: The healthcare sector significantly contributes to environmental degradation, highlighting the need for sustainable practices. Green Lean Six Sigma (GLSS) offers a relevant and impactful approach to reduce healthcare’s environmental footprint while improving efficiency. By incorporating environmental considerations into Lean Six Sigma, GLSS has the potential to mitigate healthcare’s environmental impact and promote environmental sustainability. This study aims to gain insight into healthcare professionals’ experiences with GLSS at their workplace. Materials and Methods: This qualitative exploratory study employed semi-structured surveys based on theory of training evaluation from Kirkpatrick with Dutch healthcare professionals in the first six to eight months after completing GLSS training. Results: Even though 76% (N = 16) of trained healthcare professionals applied GLSS at their workplace and 43% of them (N = 9) completed a project within the first six to eight months after training, they all experienced one or more barriers. The most frequently reported barriers were lack of time, difficulties with project selection and a lack of management support. GLSS project results included reduction of products, energy, costs and travel, green choices in procurement and sustainable food choices. GLSS also helped to create awareness on the environmental impact of healthcare and to optimize processes by reducing costs, waiting time, workload and defects. Discussion: This is the first study to report experiences from applying GLSS in healthcare. Furthermore, it is the first study presenting GLSS training evaluation results in terms of participant behaviour and organizational outcomes. Conclusions: Results of this study can be used to enhance GLSS deployment programs and to optimize organizational settings for successful GLSS implementation in healthcare. Full article

The integration of Green Lean Six Sigma (GLSS) within healthcare systems presents an opportunity to improve operational efficiency, environmental sustainability, and the quality of patient care. This study examines healthcare professionals’ initial perceptions of GLSS adoption in their work environments, especially in the context of Industry 4.0, the COVID-19 pandemic, and economic constraints. Through semi-structured interviews with healthcare workers and academics, the study reveals a cautious yet optimistic outlook. Participants recognize the potential for significant efficiency gains and waste reduction but also voice concerns about resource limitations and the need for comprehensive training. These preliminary findings provide important insights into the opportunities and challenges associated with implementing GLSS in healthcare, laying a foundation for future research and practical applications aimed at enhancing hospital operations through sustainable practices. Full article

Background: Ankle fractures, comprising about 10% of musculoskeletal injuries, pose a significant healthcare burden with an increasing incidence, particularly among an aging population. This study focuses on isolated Danis-Weber type B fractures. Recent trends lean towards surgical intervention for anatomical restoration and quicker recovery, albeit with associated complications. This report aims to assess the safety and efficacy of the NewClip narrow locking plate system with early weight-bearing in treating isolated fibular fractures. Methods: The study includes patients with Danis-Weber type B fractures surgically treated with the NewClip narrow locking plate system. Exclusions involved nondisplaced fractures, open fractures, or those requiring additional fixation. Results: Fifteen patients were enrolled in this study. Minor complications, including wound swelling, were observed in two cases. The Visual Analogue Scale (VAS) for pain exhibited a steady decline postoperatively, with almost complete resolution by the third month. At three months, the FAOS demonstrated excellent results, and a final follow-up at twelve months revealed complete osseous healing without complications. Conclusions: The use of this type of plate in treating isolated fibular fractures with early weight-bearing shows promising results in terms of fracture healing, pain resolution, and functional outcomes, warranting further investigation with larger cohorts. Full article