Search Results (6,090)

Background: Immersive virtual reality (VR) may support rehabilitation and patient engagement; however, little is known about how frontline healthcare professionals perceive its clinical relevance and feasibility in post-acute community care settings. This study explored healthcare professionals’ perceptions of the potential clinical uses, usability, and implementation requirements of patient-facing immersive VR in a community hospital providing post-acute care in Singapore. Methods: Using purposive sampling, nineteen healthcare professionals from a subacute hospital in Singapore participated in individual semi-structured interviews. Participants discussed their expectations of VR, experienced approximately 10–15 min of a reminiscence-oriented virtual tour of a local (now defunct) village, using an Oculus Quest head-mounted display, and subsequently reflected on its usability and potential applications. The Unified Theory of Acceptance and Use of Technology 2 informed the interview guide and was used as a sensitising framework. Interviews were transcribed verbatim and analysed using hybrid deductive–inductive framework analysis. Results: Four themes were identified: (1) clinical value was conditional on therapeutic relevance; (2) anticipated patient acceptability depended on person–content fit and social context; (3) simple navigation did not remove physical and sensory barriers; and (4) clinical integration required a supporting service model. Conclusions: Healthcare professionals viewed immersive VR as potentially useful but not yet ready for routine clinical implementation. Adoption in post-acute care should be guided by therapeutic purpose, accessibility, and integration into existing workflows rather than technological novelty alone. Future research and development should prioritise co-designed therapeutic content, patient selection, accessibility, workflow integration, and implementation support. Full article

Several decades of intensive research into antidiabetic therapeutics have yielded an expansive, mechanism-driven pharmacopeia. Yet, the clinical endpoint for these diverse agents remains singular and superficial: the reduction in glycated hemoglobin (HbA1c). By focusing primarily on downstream glucose lowering, current therapeutic paradigms treat the symptom rather than the etiology. This approach persists despite definitive consensus that the foundational pathology of type 2 diabetes is much more complex which paves the way to insulin resistance, not merely the spillover of glucose into the bloodstream. This systemic misalignment raises a critical question for the scientific community: are we collectively “agreeing to disagree” on a biological fact or a clinical myth? The Myth is that ‘Persistent hyperglycemia’ is the disease itself, but the fact is: hyperglycemia is a late-stage biomarker of systemic insulin resistance. By managing the biomarker rather than the root cause, clinical medicine has normalized an incomplete treatment model. This review aims to deliberately provoke a shift in rational thinking. We challenge the comfortable status quo of accepting hyperglycemia as the primary definition of diabetes. True therapeutic innovation requires moving past this consensus of convenience. We must reorient basic and clinical science toward reversing the cellular mechanisms of insulin resistance itself, rather than settling for the cosmetic management of blood glucose levels. Rather than merely recounting established therapeutic mechanisms, this review systematically bridges classical antidiabetic pharmacology with the specific pharmacogenomic determinants likely driving hyperglycemia and phenotypic insulin resistance. Mechanisms of action and pharmacogenomic perspectives of α-glucosidase inhibitors, Sulfonylureas, SGLT2 inhibitors, GLP-1 agonists, Meglitinides, Insulins, Metformin, Thiazolidinediones, and DPP4 inhibitors are discussed in this review. In conclusion, mapping the pharmacogenetic landscape of antidiabetic therapies reveals how distinct genetic variations likely dictate drug metabolism and insulin receptor kinetics. Decoding these patient-specific mechanisms is essential to reverse tissue-specific insulin resistance and transition from empirical prescribing to precise, genotype-directed diabetes management. Full article

Immersive virtual reality (IVR) is increasingly investigated in stroke rehabilitation. However, its clinical implementation remains limited by the absence of standardized, theory-driven instruments assessing acceptability from both patient and therapist perspectives. This study aimed to develop two parallel Virtual Reality Acceptability Questionnaires for Stroke Rehabilitation: a patient version (VRAQ-SR-P) and a therapist version (VRAQ-SR-T), based on the Theoretical Framework of Acceptability (TFA), and to evaluate their preliminary expert-based content validity. A methodological instrument-development study was conducted. Two 14-item questionnaires were developed through a theory-driven process informed by the seven TFA constructs and contextualized for IVR-based stroke rehabilitation. Content validity was evaluated by nine Occupational Therapists (OTs) with expertise in stroke rehabilitation and technology-based interventions. Experts rated item relevance using a four-point scale, and item-level (I-CVI), scale-level (S-CVI/Ave), and modified kappa coefficients were calculated, while qualitative feedback informed item refinement. The VRAQ-SR-P demonstrated an S-CVI/Ave of 0.841, and the VRAQ-SR-T demonstrated an S-CVI/Ave of 0.826. Both exceeded the prespecified threshold of 0.80. Expert feedback identified construct overlaps, insufficient contextual specificity, ambiguity in ethicality items, and therapist-perspective issues, resulting in the revision of 12 of the 28 items, while no items were deleted. These findings provide preliminary evidence of acceptable scale-level content validity based on expert ratings and establish a theory-informed foundation for future psychometric evaluation. Full article

Background/Objectives: This study aims to determine the indirect costs associated with the disease process in patients hospitalized for acute coronary syndrome and to analyze the sociodemographic and clinical factors influencing these costs. Methods: This prospective, single-center, observational cost-of-illness study evaluated 146 ACS patients at a tertiary cardiology clinic over an index episode extending from admission to 30 days after discharge, from a patient and household perspective that excludes direct medical costs. Excluding six patients (one death, five early retirements), 140 patients were analyzed. Productivity losses were measured with the iMTA Productivity Cost Questionnaire and valued using the Human Capital Approach; SCORE2, GRACE and MIDAS scores were also recorded. Costs are reported in 2025 international dollars (Int$, OECD PPP factor 16.20). Factors associated with total indirect cost were examined with a Gamma generalized linear model with a log link, containing five prespecified covariates: sex, occupational group, age, GRACE and MIDAS. Results: The mean age was 61 ± 12 years, and 69.9% of the cohort were male. The median total indirect cost per patient was 1007 Int$. In the actively employed subgroup, the median absenteeism cost was 1450 Int$, while the median household production loss for the entire cohort was 340 Int$. The multivariate Gamma GLM identified occupational status (p < 0.001) and female sex (p = 0.004) as variables independently associated with total indirect costs, whereas age and clinical/prognostic scores (GRACE, MIDAS) lacked statistical significance. Compared to patients outside the labor force, total costs were 4.8 and 4.1 times higher for white-collar and blue-collar workers, respectively. Conclusions: ACS imposes a significant short-term indirect cost burden at the patient and household levels, driven by absenteeism among actively employed patients and by household production losses among those outside the labor force. These findings indicate that the early post-discharge economic burden is patterned primarily by labor force position and by the distribution of unpaid domestic work rather than by clinical severity. Full article

Background: Iron deficiency anaemia is a major public health problem. Oral iron is generally recommended as first-line treatment because it is inexpensive and easily administered, but its use may be limited by gastrointestinal adverse effects, poor adherence, or inadequate absorption. Intravenous (IV) iron is an effective alternative when oral treatment is ineffective or poorly tolerated, or when rapid iron repletion is required. High-dose IV iron formulations may reduce the number of outpatient visits required to complete treatment. Materials and Methods: We retrospectively evaluated patients receiving IV iron therapy in seven outpatient clinics managed by the Department of Transfusion Medicine of the Province of Venice (North-East Italy) between January 2020 and December 2025. Ferric carboxymaltose (FCM) 100 mg and 500 mg and ferric derisomaltose (FDI) 1000 mg were used. An Activity-Based Costing (ABC) analysis was performed considering the cost of the iron preparation, the number of IV administrations and the associated healthcare and estimated non-healthcare costs required to complete a treatment cycle. A separate Patient Blood Management (PBM) analysis estimated the number of red blood cell (RBC) units and associated costs that would have been required under a predefined hypothetical transfusion scenario. Results: During the study period, 29,614 IV iron administrations were recorded in 13,683 patients. The mean number of administrations required to complete a treatment cycle was 9.1 with FCM 100 mg, 1.9 with FCM 500 mg and 1.1 with FDI 1000 mg, corresponding to approximately 79% and 88% reductions in outpatient visits compared with FCM 100 mg, respectively. The mean cost per treatment cycle was €1820.91 for FCM 100 mg, €444.79 for FCM 500 mg and €342.21 for FDI 1000 mg. Under the predefined hypothetical transfusion scenario, 5149 RBC units would have been required for patients with haemoglobin concentrations of <80 g/L or 81–90 g/L, corresponding to an estimated cost of €2,067,323.50. No RBC transfusions were recorded in the available Department of Transfusion Medicine of the District of Venice (DIMT) outpatient database during the study period. Conclusions: In this real-world outpatient network, the use of high-dose IV iron formulations was associated with substantially fewer outpatient visits and lower estimated treatment-cycle costs than low-dose FCM. The reduction in the number of administrations may also increase outpatient treatment capacity and facilitate the management of iron deficiency within a PBM-oriented model. The estimated RBC requirements and associated costs should be interpreted as a hypothetical scenario rather than as observed transfusion avoidance or realised cost savings. Full article

Heart failure remains a major cause of morbidity and mortality despite advances in guideline-directed medical therapy and device-based treatment. Cardiac resynchronization therapy delivered by conventional biventricular pacing constitutes an established therapeutic strategy for selected patients with heart failure with reduced ejection fraction and electrical desynchrony. Left bundle branch area pacing has emerged as a physiological pacing strategy that directly engages the conduction system, providing more effective electrical and mechanical resynchronization. Current evidence from observational studies, randomized pilot trials, and recent multicentre data suggest that left bundle branch pacing may achieve greater QRS narrowing, more favourable pacing thresholds, improved left ventricular ejection fraction, and reduced heart failure hospitalizations compared with conventional biventricular pacing in selected patients. This review summarizes the rationale, implantation criteria, patient selection, and current clinical evidence supporting left bundle branch pacing as an alternative pacing modality in heart failure patients. Despite encouraging available data, larger randomized trials with longer follow-up and broader patient populations are required to clarify long-term safety and to determine whether left bundle branch pacing should be adopted as a routine alternative to conventional cardiac resynchronization therapy. From a personalized medicine perspective, the choice between conduction system pacing and conventional biventricular pacing should be guided by individual patient characteristics, including conduction phenotype, QRS morphology and duration, myocardial scar burden, heart failure aetiology, coronary venous anatomy, and the chance of achieving confirmed conduction-system capture. This review therefore renders left bundle branch pacing within an individualized, phenotype-guided resynchronization strategy rather than as a universal replacement for biventricular pacing. Full article

Background/Objectives: CD20×CD3 bispecific antibodies (BsAbs) have changed the management of relapsed/refractory (R/R) B-cell non-Hodgkin lymphoma. Whether and how radiotherapy (RT) can be safely and usefully combined with BsAb therapy remains undefined. This Perspective reviews the biological rationale and the available clinical evidence, distinguishing the established findings from the hypotheses. Methods: We conducted a targeted, non-systematic review of RT combined with CD20×CD3 BsAbs in B-cell lymphoma, searching PubMed/MEDLINE, the Cochrane Library, and ClinicalTrials.gov, supplemented by conference abstracts and a post hoc verification search. Given the immaturity and heterogeneity of the field, we used a narrative synthesis rather than a systematic search. Sources were classified as direct evidence, mixed/indirect (non-disaggregable) evidence, or registered trials without results; only the first category was used to support clinical claims. Results: Direct evidence comprises three case reports, a 7-patient lymphoma subgroup, and a 29-patient cohort with disaggregated CRS/neurotoxicity data. Additional mixed/indirect evidence comes from a 12-patient series. Three registered trials have not yet reported results. Five partially overlapping rationales are proposed: cytoreduction, the modulation of the tumour microenvironment, the management of tumour flare, the consolidation of residual disease, and urgent local control during BsAb step-up dosing. The potential antagonistic effects, including CD20 loss and T-cell depletion, have received comparatively little study. Whether RT-induced lymphopenia could blunt BsAb efficacy remains a key open question. Conclusions: The available evidence indicates only that RT has occasionally been delivered around BsAb therapy in small, non-comparative series, without a consistent toxicity signal. It does not establish the benefit, synergy, or optimal sequencing. Prospective studies are needed to define the role of RT in this setting. Full article

Despite decades of clinical experience, the physiological rationale for extracorporeal life support (ECLS) in acute respiratory distress syndrome (ARDS) remains incompletely defined. Existing trials have primarily evaluated ECLS as a rescue intervention, with limited attention to the physiological adaptations required to sustain extracorporeal gas exchange. We propose that the maternal–fetal circulation, the only naturally occurring example of prolonged extracorporeal gas exchange, provides a hypothesis-generating physiological analogy. In this paradigm, gas exchange is externalized through a low-resistance, high-flow circuit while systemic physiology reorganizes to unload the native lung. Translating this concept to severe ARDS suggests that ECLS should be viewed not simply as an adjunct to conventional support, but as a transition to an alternative physiological state centered on extracorporeal gas exchange. This perspective may inform physiology-based patient selection, management strategies, and the design of future clinical trials. Full article

Background/Objectives: Caring behaviors are key components of nursing practice and contribute to patient outcomes and satisfaction. In emergency departments (EDs), where care is delivered under time pressure, caring behaviors may be shaped by organizational constraints. Patients and nurses may perceive caring behaviors differently. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the CBI-24 and CBI-24-P for use in Slovenian EDs, assess the level of caring behaviors among ED nurses, examine differences in perception between nurses and patients, and explore whether selected sociodemographic factors are associated with perceived caring behaviors in the ED. Methods: A multicenter cross-sectional study was conducted between October 2025 and January 2026 in ten EDs in Slovenia. Descriptive and inferential statistical methods were applied. Results: A total of 354 nurses completed the Slovenian CBI-24, and 288 patients completed the Slovenian patient version, designated the CBI-24-P. Caring behaviors were rated highly by both nurses and patients. Among patients, the highest ratings were observed for safety-related aspects of care, such as giving medication (M = 5.42; SD = 0.85) and treating patient information confidentially (M = 5.53; SD = 0.83). Among patients, caring behaviors showed weak positive correlations with age (r_s= 0.131) and weak negative associations with waiting time (r_s = −0.299). Conclusions: Caring behaviors in Slovenian EDs are perceived as high, with emphasis placed on technical competence. Communication, responsiveness, and workflow organization remain relevant areas for further investigation and quality improvement. Full article

Background/Objectives: The integration of artificial intelligence (AI) and digital technologies into dental practice is reshaping clinical workflows, administrative processes, and, increasingly, the patient experience and the doctor–patient relationship. While prior research has documented the attitudes of clinicians and practice managers, the perspective of the patient remains comparatively underexplored. This study examined how dental patients perceive AI integration and digital tools across the dental care pathway, together with the associated implications for data security, cost, and the human dimension of care. Methods: A cross-sectional, questionnaire-based study was conducted among 200 dental patients in Bucharest, Romania, and the surrounding region. The instrument assessed perceived difficulty and availability regarding digital technology, current use of digital tools, demographic and educational characteristics (age, gender, practice environment, educational level), and two attitudinal dimensions, namely digital prudence and concern for technological sustainability, across five subdomains of the dental care pathway: scheduling, diagnosis, treatment planning, feedback, and follow-up (dispensarization). Responses were analyzed using non-parametric tests and exploratory principal component analysis with internal-consistency validation. Results: Patients expressed moderate-to-high interest in AI support during the diagnostic (median = 3.3, IQR = 2.7–3.9) and feedback (median = 3.11, IQR = 2.78–3.67) stages and the lowest interest in scheduling (median = 2.7, IQR = 2.0–3.3). A marked level of digital prudence was observed (median = 3.24, IQR = 2.82–3.61), reflecting concerns about data security, automation, and a possible weakening of the clinician–patient bond. Younger and academically educated patients reported lower perceived difficulty, higher availability, and greater current use of digital tools (all p ≤ 0.001); counterintuitively, the same patients scored significantly higher on digital prudence (Spearman’s ρ = −0.260, p < 0.001). Greater familiarity with digital tools was therefore accompanied by a more critical awareness of their informational risks rather than by uncritical acceptance. Conclusions: Dental patients approach AI through a dual lens of openness and informed caution, welcoming efficiency gains in the clinical and continuity-of-care stages while voicing measured concerns about data security, affordability, and the preservation of human contact. To interpret this profile, we propose two conceptual contributions: a mapping of patient needs onto Maslow’s hierarchy in the context of AI-mediated care and the Informational VUCA framework, which characterizes the volatility, uncertainty, complexity, and ambiguity that patients face when navigating AI-generated information. The findings point to a clear practical agenda of transparent communication, robust data governance, and education strategies adapted to patients’ educational and demographic profiles, so that AI-enhanced workflows strengthen rather than erode the doctor–patient relationship. Full article

Background: Monitoring treatment outcomes is central to evaluating drug-resistant tuberculosis (DR-TB) programmes and ensuring accountability, particularly in high-burden settings such as South Africa. However, routine surveillance data are often constrained by small sample sizes and incomplete reporting. The increasing proportion of outcomes classified as “not evaluated” raises critical concerns about the validity and interpretability of reported treatment success rates. This study examines longitudinal trends in DR-TB outcomes in two rural Eastern Cape facilities (2020–2024), conceptualising routine outcomes as governance signals reflecting health system performance and data management capacity, rather than clinical performance alone. Methods: A retrospective analysis of aggregated DR-TB treatment outcomes from 2020 to 2024 was conducted using routine programme data. Outcomes included treatment success, failure, loss to follow-up (LTFU), death, and “not evaluated.” Proportions were estimated using Wilson 95% confidence intervals, and year-to-year differences were assessed using chi-square tests, with cautious interpretation due to small sample sizes. Bounding analyses were applied to assess the sensitivity of treatment success estimates to alternative assumptions about incomplete outcome reporting. Results: Treatment success declined over time for both rifampicin-resistant TB (RR-TB) and multidrug-resistant TB (MDR-TB), with a significant decrease observed in MDR-TB (80.9% in 2021 to 38.5% in 2024; p = 0.007). Concurrently, the proportion of outcomes classified as “not evaluated” increased substantially from 2023 onward, reaching 25.8% in RR-TB and 30.8% in MDR-TB by 2024 (p < 0.001). Mortality remained persistently high in RR-TB, while MDR-TB exhibited higher levels of treatment failure and LTFU. Analyses for pre-XDR-TB and XDR-TB were limited by small sample sizes. Bounding analyses demonstrated that treatment success estimates were highly sensitive to incomplete reporting of outcomes. Conclusions: Declining DR-TB treatment success in this setting is closely associated with increasing incomplete outcome reporting, suggesting that observed trends may reflect challenges in surveillance and governance systems rather than clinical deterioration alone. Interpreting routine DR-TB outcomes as governance signals provides a novel systems-based perspective for programme evaluation. Strengthening data completeness, patient tracking, and surveillance systems is essential to improve the reliability of programme indicators and support effective TB control in resource-constrained rural settings. Full article

From a health perspective, the 21st century has witnessed the emergence and global impact of several major viral diseases, most notably coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2, which has been associated with a substantial burden of secondary fungal infections. Patients suffering from COVID-19 illnesses frequently developed fungal co-infections, which can worsen clinical outcomes and complicate therapeutic efforts. Hospitalized individuals with viral infections are particularly susceptible to invasive fungal pathogens, including Aspergillus, Candida, and Mucorales species. The co-pathogenesis between respiratory virus and fungi is complex, involving dynamic interactions among the pathogens and the host immune system. Opportunistic fungal infections were found to be more prevalent in COVID-19-infected individuals, who require mechanical ventilation, have diabetes, or exhibit neutropenia. This review aims to provide a comprehensive overview of fungal co-infections associated with COVID-19 disease, with a focus on their pathogenesis, biomarkers, diagnostic approaches, and potential treatment strategies. Overall, the available evidence indicates that viral-induced immune dysregulation, epithelial barrier damage, and clinical risk factors contribute to the development and severity of fungal co-infections in COVID-19 patients. Early recognition using reliable biomarkers and standardized diagnostic approaches, together with timely and pathogen-directed antifungal therapy, are essential for improving clinical outcomes. Full article

Background: Quality assurance (QA) is a cornerstone of safe and effective postgraduate training in gynecological laparoscopic surgery, where clinical outcomes depend on procedural complexity, equipment sophistication, and the coordinated competence of an entire surgical team. This article is a narrative review of the conceptual, professional, and regulatory foundations of QA in healthcare education, complemented by a structured synthesis of the collective teaching and clinical experience of the author group. It is not an empirical study, and the sections that follow present a conceptual mapping supported by expert perspective rather than original outcome data. Methods: Sources were identified through targeted searches of PubMed/MEDLINE and Google Scholar, supplemented by hand-searching of policy and curriculum documents issued by professional bodies and by backward citation tracking, without date restriction. Approximately 480 records were screened at title and abstract level, 112 were assessed as full text, and 41 sources were retained against predefined inclusion and exclusion criteria, with five further sources added during peer review. In a second and separate step, the ten co-authors, who hold teaching and supervisory roles in gynecological laparoscopy across academic centers in Romania and Germany, each completed the same six-item written prompt on training provision, trainer development, trainee assessment, and institutional QA practice; responses were coded thematically by two authors independently and consolidated into explicit points of convergence and divergence. Results: We describe how QA principles, originally articulated in general quality-management and health-promotion literature, have been adapted by professional and regulatory bodies, including the European Board and College of Obstetrics and Gynecology (EBCOG), European Society for Gynecological Endoscopy (ESGE), American Society for Gastrointestinal Endoscopy (ASGE), and the UK General Medical Council, into concrete standards for training providers, trainers, and trainees. We outline the structures used to monitor and audit training quality, including Kirkpatrick’s four-level evaluation model and periodic institutional review cycles, alongside documentation and certification pathways such as the Gynecological Endoscopic Surgical Education and Assessment (GESEA) program, with governance and financing as cross-cutting determinants of sustainability. The author synthesis converged on a consistent gap between documented standards and their routine enforcement and diverged on whether external review and formal certification should become mandatory. Conclusions: The conceptual architecture of QA in gynecological laparoscopy is coherent and broadly fit for purpose, but we identified no study linking the implementation of a specific QA standard to measurable gains in trainee competency or patient outcomes in this field. Proposals for harmonized, outcome-oriented, and where appropriate, mandatory external review should therefore be read as reasoned positions awaiting prospective evaluation rather than as evidence-based recommendations; generating that evidence, with the trainee’s own perspective collected rather than inferred, is the principal task for future research. Full article

The clinical integration of artificial intelligence has outpaced the development of robust evaluative frameworks, raising critical safety concerns. This perspective establishes a clear taxonomy distinguishing probabilistic language models from deterministic classifiers and applies a multi-dimensional combinatorial model to calculate the requirements for complete diagnostic coverage. Our analysis demonstrates that comprehensive diagnostic coverage requires between 50,000 and 150,000 distinct, task-specific classifiers under subspecialty-level clinical granularity; conservative aggregated estimates (4500–18,750 binary classifiers) do not reflect the multiplicative expansion introduced by subtype differentiation, severity staging, temporal variants, demographic stratification, and equipment variation, whereas currently cleared devices cover less than one percent of this clinical space. More fundamentally, although population-trained models can generate conditional patient-specific risk estimates when predictors are informative and calibration is adequate, these statistical parameters optimized on population-scale data cannot provide the categorical certainty required for individual diagnostic decisions, which is a gap that clinical judgment must bridge. Because clinical AI tools are inherently statistical and perform reliably only on common, highly represented presentations while failing on rare, atypical cases rare in their training data, attempting to automate routine tasks leaves human clinicians with only the most challenging diagnostics. Furthermore, selective automation of these low-complexity cases introduces severe occupational hazards, including cognitive surrender, diagnostic complacency, and rapid expertise atrophy. Rather than pursuing the computationally and logistically unfeasible goal of complete diagnostic classification, developers should prioritize predictive, prognostic trajectory modeling. This paradigm shift aligns the probabilistic nature of machine learning with clinical utility, reinforcing clinical judgment as the irreplaceable diagnostic integrator. Full article

Intrauterine adhesion (IUA) is a fibrotic disorder resulting from aberrant repair following injury to the endometrial basal layer, leading to menstrual abnormalities, infertility, recurrent miscarriage, and pregnancy complications. Although hysteroscopic adhesiolysis remains the primary clinical treatment, the rate of postoperative re–adhesion is still high, especially in patients with moderate–to–severe IUA. Moreover, mechanical separation alone is often insufficient to restore intact endometrial architecture and reproductive function. Hydrogels, with their hydrated three–dimensional networks, extracellular matrix (ECM)–mimicking properties, injectability, biodegradability, tissue adhesion, and tunable delivery capacity, have evolved from passive barrier materials into multifunctional therapeutic platforms capable of regulating the pathological microenvironment and promoting tissue regeneration. Recent advances in responsive, self–healing, adhesive, antioxidant, and bioactive cargo–loaded hydrogels have expanded their applications from preventing adhesion formation toward functional endometrial reconstruction. In this review, we summarize recent progress in hydrogel–based IUA therapy, focusing on material composition, structural design, functional modification, therapeutic mechanisms, and translational considerations. Particular emphasis is placed on disease–informed hydrogel engineering strategies that integrate the unique anatomical characteristics of the uterine cavity, injury–associated microenvironment, and dynamic stages of endometrial repair. This perspective provides insights into the development of next–generation hydrogel systems for preventing re–adhesion and restoring reproductive function. Full article