Search Results (178)

The global expansion of healthcare services has made medical waste management an increasingly critical and complex issue. Medical wastes require specialized management due to their high infection risk, potential for environmental pollution, and adverse effects on public health. The correct collection, transportation, and final disposal are vital for protecting environmental health and ensuring the safety of hospital personnel and the community. Numerous disposal methods exist. Selecting the appropriate one, however, is a multi-dimensional decision-making problem, necessitating the simultaneous evaluation of various conflicting criteria. Adana, one of Turkey’s largest provinces, generates significant medical waste volumes due to its dense population and developed health infrastructure. Therefore, choosing the most suitable disposal method for hospitals in Adana is crucial for establishing an effective and sustainable waste management system. Making this decision using traditional methods is difficult. The multitude of criteria prevents any single method from being optimal across all aspects. This complexity mandates the use of Multi-Criteria Decision-Making (MCDM) methodologies. In this study, MCDM methods were applied, based on expert opinions, to select the disposal method at a university hospital in Adana. The research examined twelve criteria and four alternatives. The CRITIC (Criteria Importance Through Intercriteria Correlation) method was employed to objectively weigh the criteria. For the rigorous evaluation and ranking of the alternatives, three robust MCDM methods were utilized: PROMETHEE (Preference Ranking Organization Method for Enrichment Evaluation), TOPSIS (Technique for Order Preference by Similarity to Ideal Solution), and EDAS (Evaluation based on Distance from Average Solution). The final results conclusively identified incineration as the most appropriate disposal method for the hospital. Full article

The increasing accumulation of medical waste, especially discarded pharmaceutical blister packs, poses both environmental risks and missed opportunities for resource recovery. In this work, we demonstrate, for the first time, the direct upcycling of tablet blister waste into a potential frictional layer in triboelectric nanogenerators (TENGs). The polymer structure of blister packs, combined with Silicone rubber as a counter frictional layer, enabled the fabrication of durable TENG devices (TS-TENGs). Systematic electrical testing revealed that the TS-TENG achieved an open-circuit voltage of approximately 300 V, a short-circuit current of about 40 μA, and a peak power density of 3.54 W/m² at an optimal load resistance of 4 MΩ. The devices maintained excellent stability over 10,000 mechanical cycles, confirming their durability. Practical demonstrations included powering 240 LEDs, four LED lamps, and portable electronic devices, such as calculators and hygrometers, through capacitor charging. This study shows that not only can tablet blister waste be used as a triboelectric material but it also presents a sustainable method to reduce pharmaceutical waste while advancing self-powered systems. The approach offers a scalable and low-cost means to integrate medical waste management with renewable energy technologies. Full article

Effective medical waste planning relies on the reliable estimation of waste volumes. As operational factors diversify, traditional linear regressions often fail to capture the underlying structure, whereas latent variable–based and ensemble approaches can better represent this complexity. In this study, fine-tuned Partial Least Squares (PLS), scikit-learn–based Gradient Boosting regression (GBR), and a baseline Ordinary Least Squares (OLS) model were compared for estimating medical waste generation using 48 months (2021–2024) of approximate data from Dental Clinics affiliated with the Provincial Health Directorate in Kastamonu. The model inputs were the monthly procedure counts for endodontics, treatment, prosthetics, periodontology, orthodontics, pedodontics, and surgery. Performance was evaluated using Root Mean Square Error (RMSE), Mean Absolute Error (MAE) and R-squared (R²). All models produced accurate predictions; however, PLS provided the strongest fit (R² = 0.979; MAE = 30.488; RMSE = 37.043), outperforming GBR (R² = 0.962; MAE = 36.544; RMSE = 48.990) and the OLS baseline (R² = 0.927; MAE = 41.762; RMSE = 59.013). The findings demonstrate that modern, data-driven waste-management planning is feasible in healthcare institutions and highlight PLS as a robust option, particularly under conditions of small sample size and collinearity. Full article

Background/Objectives: Myopathies are acquired or genetic muscle diseases causing weakness and wasting, leading to poor posture, impaired coordination, reduced daily function, and scoliosis. The objective of this ambispective study was to compare clinical, radiological, and functional outcomes of patients with myopathic scoliosis treated surgically or non-surgically. Methods: We identified 118 patients (55% male) with myopathy and scoliosis from ALYN Rehabilitation Hospital’s database (1990–2022). Mean age at first visit was 5.45 ± 5.27 years. Seventeen (14%) underwent scoliosis surgery; others were managed non-surgically. Due to unbalanced group sizes, comparative group analyses used propensity score matching (15 surgical, 30 non-surgical patients). Retrospective data included demographics, medical history, respiratory and mobility status, Cobb angle (CA), pelvic obliquity (PO), and surgical details when applicable. Prospective telephone interviews were conducted including SRS-22r Quality of Life (QoL), WHO-QoL, and Functional Independence Measure for Children (WeeFIM). Results: Longitudinal analysis showed significant or near-significant worsening over time in CA (p = 0.03) and PO (p = 0.08), regardless of treatment type but no significant difference between surgical and non-surgical groups in progression rates. Interview data, for 7 surgical and 6 non-surgical patients, revealed that surgical patients reported higher overall QoL, FIM, and SRS-22r self-image scores, but lower scores for SRS-22r pain, general function, and activity levels. Conclusions: Existing research and this study suggest that despite surgical risks, scoliosis correction in neuromuscular conditions generally leads to improved QoL. Findings highlight the complexity of surgical decision-making for myopathic scoliosis, where medical risks must be weighed against potential long-term functional and QoL outcomes. Full article

Medical waste management is a growing concern in Kazakhstan. Despite the presence of a regulatory framework, the current medical waste disposal system suffers from fragmentation, lack of transparency, and inefficient communication between stakeholders. These limitations result in illegal dumping, environmental pollution, and increased health risks. This paper presents the development and validation of an integrated Internet of Things (IoT)-based system designed to optimize and automate the monitoring, collection, and disposal of medical waste. The proposed architecture includes Global Positioning System (GPS) tracking, real-time sensor monitoring, cloud data analytics, and predictive routing algorithms, enabling efficient logistics and regulatory compliance. Utilizing a microcontroller and sensors, the system continuously transmits data to a centralized server for monitoring. Experimental deployments across urban and suburban routes in the Zhambyl region demonstrate that the system achieves a Circular Error Probable (CEP₅₀) of 11 m and a 95% positioning accuracy within 23 m, which aligns acceptably with the requirements for city-level route optimization. Statistical analysis confirms that the observed positioning accuracy is consistent with an urban propagation model and adequate for municipal dispatching, though it remains below automotive-grade precision. The system is further supported by a robust power supply solution, allowing up to 49 h of autonomous operation. Full article

Cationic polyelectrolytes, characterized by positively charged functional groups, play an essential role in industries ranging from food solutions, water treatment, medical, cosmetic, textiles and agriculture due to their electrostatic interactions, biocompatibility, and functional versatility. This paper critically examines the transition from petroleum-based synthetic polymers such as poly(diallyldimethylammonium chloride) and cationic polyacrylamides to sustainable natural alternatives derived from agri-forestry resources like starch derivatives and cellulose. Through a cradle-to-gate life cycle assessment, we highlight the superior renewability, biodegradability, and lower carbon footprint of bio-based polycations, despite challenges in agricultural sourcing and processing. This study examines cationization processes by comparing the environmental limitations of traditional chemical methods, such as significant waste production and limited scalability, with those of second-generation reactive extrusion (REX), which enables solvent-free and rapid modification. REX also allows for adjustable degrees of substitution and ensures uniform charge distribution, thereby enhancing overall functional performance. Groundbreaking research and optimization achieved through the integration of artificial intelligence and machine learning for parameter regulation and targeted mechanical energy management underscore REX’s strengths in precision engineering. By methodically addressing current limitations and articulating future advancements, this work advances sustainable innovation that contributes to a circular economy in materials science. Full article

This study compares certification systems for green healthcare facilities implemented worldwide. Healthcare facilities are complex structures designed to provide uninterrupted service while involving substantial resources, high energy consumption, and heavy human and material traffic. The COVID-19 pandemic emphasized the importance of designs that ensure hygiene, reduce environmental impact, and improve energy efficiency, making green certification systems for healthcare facilities increasingly critical. Eight certification systems currently in use across eight countries were examined, four from advanced economies (LEED in the U.S., BREEAM in the U.K., Green Star in Australia, and CASBEE in Japan) and four from developing economies (YeS-TR in Türkiye, IGBC in India, GBI in Malaysia, and GREENSHIP in Indonesia). Country selection considered regional diversity, similarities in environmental policies, and the potential for healthcare infrastructure development. A literature-based comparative analysis was conducted, and seven key categories were identified for evaluating sustainability: sustainable land and transport, water and waste management, energy efficiency, material and life cycle impact, indoor environmental quality, project management process, and innovation. The comparison revealed considerable overlap among the systems but also highlighted shortcomings in addressing healthcare-specific needs. This paper contributes to the advancement of sustainability assessment in the healthcare sector by highlighting the need for certification schemes specifically designed for medical facilities. The findings emphasize the necessity of developing healthcare-tailored frameworks that not only address environmental performance but also capture the unique operational, functional, and clinical dynamics of this sector. Full article

Polymeric reverse osmosis (RO) membranes are critical for producing ultrapure water for hemodialysis process, but once they reach their end-of-life (EoL) stage, mainly due to fouling, they are usually discarded—adding to the growing challenges of medical waste management. This study explores a sustainable alternative by rehabilitating EoL thin-film composite (TFC) membrane and its reuse in recovery of spent dialysate. Using different cleaning agents that included citric acid (CA), EDTA, sodium lauryl sulfate (SLS), and sodium dodecyl sulfate (SDS), the mixture of CA and SLS (1:1) exhibited the most effective combination for balanced flux recovery, salt rejection, and creatinine clearance at lower TMP, achieving 90% conductivity reduction, 46.89 L/m²/h water flux, and 1.24 L/m²/h/bar permeance. FTIR, SEM, and EDX results confirmed the removal of both organic and inorganic foulants, while further process optimization revealed the critical role of cleaning temperature, SLS ratio and pressure on water permeability and improving creatinine removal. Under the optimal operational conditions, 99.89% creatinine removal, while restoring up to 80% hydraulic performance, yielding water flux and permeance of 59.36 L/m²/h and 1.79 L/m²/h/bar, respectively. These findings suggest that reduced dialysate production costs and minimize environmental impact can be significantly, achieved by extending the useful life of dialysate membranes, thereby opening a pathway toward implementing closed-loop water management and circular economy practices at dialysis centers. Full article

To address the limitations of traditional hospital energy management strategies in responding to real-time medical demands, this study proposes a coordinated optimization approach for multi-timescale scheduling in diversified hospital energy systems. The long-term scheduling problem is first formulated as a Markov Decision Process, with fine-grained short-term energy supply plans embedded in each decision step through an optimal model. Deep reinforcement learning is then employed to reduce the dimensionality of long-term decision variables, while hybrid integer linear programming is integrated to strictly enforce critical load operation constraints. A hybrid data- and model-driven framework is constructed to simultaneously enhance computational efficiency and power supply reliability. Empirical studies demonstrate that, compared with traditional scenario-based and robust optimization methods, the proposed approach significantly improves energy resource utilization—raising the distributed renewable energy utilization rate from 82.45% to 96.72%—and reduces the power interruption rate for critical loads from 2.8% to 0.15%. This ensures the continuity of medical services while minimizing energy waste. The proposed method provides both theoretical and practical guidance for intelligent scheduling and energy management in complex hospital integrated energy systems. Full article

Background/Objectives: Stage 5 chronic kidney disease (CKD), or end-stage renal disease (ESRD), requires renal replacement therapy, commonly hemodialysis (HD). This treatment necessitates dietary changes due to impaired excretory function and protein-energy wasting (PEW). A structured diet with adequate energy, protein, electrolytes, and fluids is essential. The aim was to characterize habitual dietary intake in adults on HD relative to KDOQI and ESPEN recommendations. Methods: In this cross-sectional study, 50 adults on maintenance HD at the Medical University of Warsaw completed a validated Food Frequency Questionnaire (55 items, nine frequency categories). The study was questionnaire-based and did not collect, link, or analyze dialysis efficacy indices, residual diuresis, or anthropometric measurements; all dietary estimates are independent of these clinical parameters. Estimated intakes of energy, macronutrients, fiber, electrolytes (Na, K, Ca, P), and fluids were compared with KDOQI 2020 and ESPEN 2021 recommendations. Sensitivity analyses included deterministic scenarios and Monte Carlo simulations. Results: Mean intakes were 2696.9 ± 1392.7 kcal and 87.7 ± 35.3 g protein; 64% and 82% met reference values. Sensitivity analyses revealed per-kg shortfalls in heavier patients (>75 kg): Monte Carlo medians were 37.8 kcal/kg/day and 1.28 g/kg/day. Diets were fat-dominant (~46%E), with low carbohydrates (~40%E) and low fiber, about 8 g per 1000 kcal. Sodium and phosphorus were elevated, about 1119 mg and 498 mg per 1000 kcal, while calcium was low (~346 mg/1000 kcal). Conclusions: Despite adequate mean intake, sensitivity analyses revealed per-kg energy/protein deficits and elevated sodium and phosphorus. Individualized counseling with electrolyte and fluid management, greater dietary diversity, and psychosocial support is warranted in HD. Full article

Objectives: This systematic review investigates clinical and environmental outcomes associated with policy-driven digital health interventions for health promotion and disease prevention. Methods: Following PRISMA 2020 guidelines, six databases (Scopus, Web of Science, PubMed, IEEE Xplore, ScienceDirect, and MDPI) were systematically searched for empirical studies published between January 2020 and June 2025, using keywords including “digital health,” “telemedicine,” “mHealth,” “wearable,” “AI,” “environmental impact,” and “sustainability.” From 1038 unique records screened, 68 peer-reviewed studies met inclusion criteria and underwent qualitative thematic synthesis. Results: Results show digital health interventions such as telemedicine, mobile health (mHealth) apps, wearable devices, and artificial intelligence (AI) platforms improve healthcare accessibility, chronic disease management, patient adherence, and clinical efficiency. Environmentally, these interventions significantly reduce carbon emissions, hospital energy consumption, and medical waste. Conclusion: The studies lacked standardized environmental metrics and predominantly originated from high-income regions. Future research should prioritize the development of uniform sustainability indicators, broaden geographic representation, and integrate rigorous life-cycle assessments. Policymakers are encouraged to embed environmental considerations into digital health strategies to support resilient, sustainable healthcare systems globally. Full article

Intravenous push (IVP) administration of controlled substances in hospital settings presents operational challenges related to medication waste, documentation, and diversion risk. This multi-site observational study aimed to quantify the pharmacy workforce time and associated costs linked to IVP waste management across a 16-hospital health system in Southwest Florida. Data were collected from over 4400 controlled substance transactions involving fentanyl, midazolam, hydromorphone, morphine, ketamine, and lorazepam. Methods included automated transaction analysis, manual chart reviews, and software-based compliance case evaluations. Results indicated patterns of partial dose waste, particularly for midazolam (85.2%) and hydromorphone (78.8%), and identified opportunities where documentation efforts could be further optimized through automation. Manual review of 333 incidents required an average of 6 min and 43 s per case, extrapolating to over 496 h of quarterly pharmacy labor or nearly 1985 h annually. Software-based case reviews added another 32 h per quarter or 130 h annually. Additionally, waste receptacle systems incurred over USD 1.1 million in capital costs and USD 322,500 in annual maintenance, with technician labor contributing further operational burden. These findings underscore the resource demands of IVP waste management and support the need for standardized dosing, enhanced documentation workflows, and pharmacy-led interventions to improve efficiency and reduce diversion risk. Full article

Hypomagnesemia is a frequent and often underrecognized electrolyte disturbance with important clinical consequences, especially in hospitalized and critically ill patients. This multifactorial condition arises from impaired intestinal absorption, renal magnesium wasting, and the effects of various medications. Magnesium, the second most abundant intracellular cation, is crucial in enzymatic and physiological processes; its deficiency is associated with neuromuscular, cardiovascular, and metabolic complications. This narrative review focuses on the mechanisms and clinical consequences of drug-induced hypomagnesemia, highlighting the major drug classes involved such as diuretics, antibiotics, antineoplastic agents, and immunosuppressants. Management strategies include magnesium supplementation and adjunctive therapies like amiloride and SGLT2 inhibitors to reduce renal magnesium losses. Recognizing and addressing drug-induced hypomagnesemia is essential to improve patient outcomes and prevent long-term complications. Full article

Recently, solar energy technologies are a cornerstone of the global effort to transition towards cleaner and more sustainable energy systems. However, in many rural areas of developing countries, unreliable electricity severely impacts healthcare delivery, resulting in reduced medical efficiency and increased risks to patient safety. This review explores the transformative potential of solar energy as a sustainable solution for powering healthcare facilities, reducing dependence on fossil fuels, and improving health outcomes. Consequently, energy harvesting is a vital renewable energy source that captures abundant solar and thermal energy, which can sustain medical centers by ensuring the continuous operation of life-saving equipment, lighting, vaccine refrigeration, sanitation, and waste management. Beyond healthcare, it reduces greenhouse gas emissions, lowers operational costs, and enhances community resilience. To address this issue, the paper reviews critical solar energy technologies, energy storage systems, challenges of energy access, and successful solar energy implementations in rural healthcare systems, providing strategic recommendations to overcome adoption challenges. To fulfill the aims of this study, a focused literature review was conducted, covering publications from 2005 to 2025 in the Scopus, ScienceDirect, MDPI, and Google Scholar databases. With targeted investments, policy support, and community engagement, solar energy can significantly improve healthcare access in underserved regions and contribute to sustainable development. Full article

From an occupational health perspective, if not stored, handled, and disposed of properly, laboratory chemicals exhibit hazardous properties such as flammability, corrosion, and explosibility. Additionally, they can also cause a range of health effects in handlers, including irritation, sensitization, and carcinogenicity. Additionally, the chemical waste generated during the planned assay is a significant byproduct and, if left untreated, can cause detrimental effects on both living organisms and non-living elements when released into the environment. Chemically, laboratory waste contains reagents, organic and inorganic compounds, and diagnostic stains. These agents are more toxic and hazardous than residential waste and affect the personnel handling them and the environments in which they are released. Considering this, it is crucial to adhere to waste management regulations during the various stages including generation, segregation, collection, storage, transportation, and treatment. This is extremely important and necessary if we are to avoid harm to individuals and environmental contamination. This review encompasses the examination of laboratory medical waste, various categories of chemical waste, and strategies to minimize and ensure the safe disposal of these toxic agents. As far as the authors are aware, this is the first review that focuses on the effects of laboratory-generated chemical wastes and environmental ethics. This is a neglected topic in healthcare education, and this review will serve as a valuable resource for students. Full article