Search Results (592)

Background and Objective: Gastric cancer (GC) is a serious public health problem in southeastern Mexico. Some cases go undiagnosed or are diagnosed at advanced stages of the tumors. Borrmann classification is the method used by endoscopists to classify gastric lesions and identify tumor stage. This study aimed to characterize GC patients treated at a specialized hospital in the Yucatan Peninsula, Mexico, according to the Borrmann endoscopic classification, with a focus on clinicopathological characteristics and survival differences. Materials and Methods: A retrospective cohort study was conducted among patients aged 18 years or older who underwent an endoscopic procedure at the hospital to confirm a diagnosis of GC between January 2019 and December 2024. Clinical data were collected, including medical history, blood type, non-communicable diseases, tumor type, tumor location (primary or metastatic), and details of medical and/or surgical treatment. Survival curves were generated for all patients and stratified by the Borrmann classification. Results: A total of 209 cases of GC were included, with 115 men with a mean age of 59.3 years and 94 women with a mean age of 52.2 years. Acid peptic disease (70.3%), followed by wasting syndrome (66.9%), was the most common medical condition in patients with GC. Blood type O with a positive Rh factor was the most frequent (66.5%). According to the Borrmann classification, localized tumors (p = 0.001) were observed at lower Borrmann levels, whereas Helicobacter pylori (p = 0.040) was more frequent at higher levels. The overall survival time was 18 months for all patients; specifically, 18 months at higher Borrmann levels and 20 months at lower levels. Conclusions: GC is a highly prevalent malignancy in southeastern Mexico. The Borrmann classification remains a valuable and practical tool for evaluating GC. The association between Borrmann endoscopic classification and the clinicopathological and survival characteristics may contribute to accurate diagnosis assessment and improved prognostic stratification in future GC cases. 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: As safe, eco-friendly, and legally compliant solutions for the disposal of unwanted medications, drug take-back systems have attracted extensive research attention. However, there is a lack of systematic mapping of global trends, collaborative networks, research themes, and hotspots in this field. This study aimed to conduct a comprehensive bibliometric analysis and review of global academic research on drug take-back programs. Methods: Peer-reviewed research articles on drug take-back programs, published between 2005 and 2025, were retrieved from the Web of Science Core Database. Microsoft Office Excel 2019, VOSviewer (v.1.6.17), and CiteSpace (v.6.1.R3 Advanced) were used to assess publication/citation trends, countries, institutions, authors, journals, disciplines, references, and keywords. Narrative analysis was employed to synthesize data from the included articles and identify core research themes. Results: A total of 149 eligible articles with 4520 citations were included, involving 619 authors, 52 countries/regions, 310 institutions, and 95 journals. Publication/citation counts increased significantly between 2005 and 2025. The United States led in both publication output and collaborative research; Mercer University was the most influential institution, but international and cross-institutional collaboration remained limited. Environmental Sciences ranked first among disciplinary categories in drug take-back research, followed by Pharmacology/Pharmacy. Core research themes underpinning this field included stakeholders’ knowledge–attitude–practice assessment (76 articles), returned medication treatment (37 articles), intervention evaluation (25 articles), policy analysis (7 articles), and the role of drug take-back programs in mitigating environmental and public health hazards caused by medicine wastes (4 articles). Conclusions: Scholarly attention to drug take-back programs has grown steadily. Future research should prioritize cross-sectoral and international cooperation, develop and adopt evidence-based interventions to optimize the safety, sustainability, and accessibility of drug take-back systems on a global scale. Full article

Smart devices and emerging technologies are highly popular devices and technologies that considerably improve our daily living by reducing or replacing human workforces, treating disease, monitoring healthcare, enhancing service performance, improving quality, and protecting the natural environment, and promoting non-gas emissions, sustainable working, green technologies, and renewable energy. Triboelectric nanogenerators (TENGs) have recently emerged as a type of advanced energy harvesting technology that is simple, green, renewable, flexible, and endurable as an energy resource. High-performance TENGs, denoted as advanced TENGs, have potential for use in many practical applications such as in self-powered sensors and sources, portable electric devices, power grid penetration, monitoring manufacturing processes for quality control, and in medical and healthcare applications that meet the criteria for smart devices and emerging technologies. Advanced TENGs are used as highly efficient energy harvesters that can convert many types of wasted mechanical energy into the electric energy used in a range of practical applications in our daily lives. This article reviews recently advanced TENGs and their potential for use with smart devices and emerging technology applications. The work encourages and strengthens motivation to develop new smart devices and emerging technologies to serve us in many fields of our daily living. When TENGs are introduced into smart devices and emerging technologies, they can be applied in a variety of practical applications such as the food processing industry, information and communication technology, agriculture, construction, transportation, marine technology, the energy sector, mechanical processing, manufacturing, self-powered sensors, Industry 4.0, drug safety, and robotics due to their sustainable and renewable energy, light weight, cost effectiveness, flexibility, and self-powered portable energy sources. Their advantages, disadvantages, and solutions are also discussed for further research. Full article

(1) Background: trays are surgery-specific sets of required materials and medical devices, assembled in consultation between manufacturer and user, and provided in a sterile package. (2) Methods: in a high-volume urological center performing 11,920 operations/procedures annually (2023), we prospectively evaluated the effect of trays compared with the standard approach in a comparative study of 64 operations conducted between 29 October and 30 November 2024. The primary endpoints were the amount of operating room (OR) waste (volume/cm³, weight/g) and setup time (minutes). The secondary endpoint was the workflow assessment by nursing staff, rated on a numerical score (0–10) across seven relevant domains. (3) Results: for endourological procedures, setup time was reduced by 35%, operating room (OR) waste by 34%, and waste volume by 19.0%. Workflow was positively rated with a mean score of 9.75/10. For major open procedures, setup time was reduced by 43%, waste weight by 24.8%, and waste volume by 32%. Workflow was positively rated with a mean score of 8.9/10. (4) Conclusions: Trays have a sustainable and significant impact on reducing OR waste, save nursing staff preparation time, and facilitate improved workflow in the operating room. 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

Bioactive peptides have garnered increasing interest in recent years due to their potential applications in the medical field, for example, as promising adjuvant therapeutic agents to modulate the host immune response and counteract microbial dysbiosis in chronic pathologies. Primarily derived from protein hydrolysates of food waste, these components exhibit beneficial properties, such as anti-inflammatory, antimicrobial, antioxidant, and antidiabetic effects. This narrative review focuses on bioactive peptides with antimicrobial and anti-inflammatory properties, highlighting their mechanisms of action, sources, and therapeutic potential in the context of chronic conditions, particularly periodontal disease, especially when comorbidities are present (i.e., type 2 diabetes mellitus). The mechanisms of action and sources, as well as preclinical and clinical studies evaluating bioactive peptides efficacy, are discussed. Further research is warranted to establish their clinical viability and integration into conventional therapeutic strategies. Full article

Background/Objectives: Healthcare accounts for approximately 4.4% of global carbon emissions. Gastroenterology is a particularly heavy producer, with professional organisations outlining targets to move towards carbon neutrality. Missed hospital appointments, associated with poor medical outcomes, also represent physical and economic waste to the sector. COVID-19 expedited the shift toward virtual clinics, but tele-diagnostics have not expanded similarly. We aimed to assess the feasibility of a virtual C13 urea breath test clinic for H. pylori in Ireland. Methods: C13 urea breath test kits were provided to patients in the community, who were subsequently invited to book an online video appointment with a GI lab technician to assist them in performing the test at home. Completed tests were returned to the hospital via local GP, by post, or a specified hospital drop-off point, and analysed using our standard protocol. Results: 423 virtual appointments were reviewed. 135 (32%) were male, and the mean age was 42 years. The test positivity rate was 22%, similar to a matched in-person testing cohort (21%). In all, there were no non-attenders, and two cancellations. Virtual patients were more likely to attend their appointments (OR = 153.9, p = 0.0004) than in-person patients. Virtual UBT appointments saved 9943.5 Km of road journeys, equivalent to 254 person-hours of travel time and 1.24 metric tonnes of CO₂. Additionally, 300 (71%) patients returned a feedback questionnaire, of which 276 (92%) rated the overall home breath test experience as ‘good’ or ‘excellent’. Conclusions: Home testing for H. pylori is effective, acceptable, and reduces both reliance on invasive procedures such as endoscopy and carbon emissions. Full article

Bacterial cellulose (BC) is a high-purity biopolymer with excellent physicochemical and mechanical properties, including high crystallinity, water absorption, biocompatibility, and structural tunability. However, its large-scale production is hindered by high substrate costs and limited sustainability. In this study, spent black tea waste was utilized as a low-cost and eco-friendly carbon source for BC synthesis by Komagataeibacter xylinus ATCC 53524 under varying initial pH conditions (4–9). Six different BC membranes were produced and systematically characterized in terms of mechanical strength, water absorption capacity, electrical conductivity, antimicrobial performance, and polyvinyl alcohol (PVA) attachment efficiency. Morphological and chemical analyses were conducted using SEM and FTIR techniques to investigate pH-induced structural variations. The results revealed that the BC6 sample (pH 6) exhibited the highest tensile strength (2.4 MPa), elongation (13%), PVA incorporation (12%), and electrical conductivity, confirming the positive impact of near-neutral conditions on nanofiber assembly and functional integration. In contrast, the BC4 sample (pH 4) demonstrated strong antimicrobial activity (log reduction = 3.5) against E. coli, suggesting that acidic pH conditions enhance bioactivity. SEM images confirmed the most cohesive and uniform fiber morphology at pH 6, while FTIR spectra indicated the preservation of characteristic cellulose functional groups across all samples. Overall, this study presents a sustainable and efficient strategy for BC production using food waste and demonstrates that synthesis pH is a key parameter in tuning its functional performance. The optimized BC membranes show potential for biomedical, flexible electronic, and antibacterial material applications, particularly in wearable electrode technologies. Full article

Background/Objectives: Mesenchymal stem cells (MSCs) offer promising prospects for novel treatment modalities in cellular therapies and artificial organ production. Despite a surge in artificial tissue research, there is a dearth of comprehensive studies detailing the entire process from stem cells to tissue production, coupled with a scarcity. This study, however, presents the utility of extra-embryonic MSCs derived from placental tissue, traditionally considered as medical waste. Methods: Within a 3-dimensional cell culture system, histological assessments, and comprehensive optimization studies, the entire process required for artificial tissue production is addressed. Results: The results obtained are encouraging regarding the advancement of cellular therapies and artificial tissue engineering. However, challenges such as biopolymer degradation highlight the necessity for multistep approaches. Each analysis within this study delves into the discussion and optimization of key steps in artificial tissue production. Conclusions: Consequently, this study not only represents one of the first of its kind but also lays the groundwork for future investigations into relevant clinical applications. 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