Search Results (2,826)

Background: Electrocardiograms (EKGs) are essential tools in emergency medicine, often used to evaluate chest pain, dyspnea, and other symptoms suggestive of cardiac dysfunction. Yet, EKGs are not universally administered to all emergency department (ED) patients. Understanding and predicting which patients receive an EKG may offer insights into clinical decision making, resource allocation, and potential disparities in care. This study examines whether integrating structured clinical data with free-text patient narratives can improve prediction of EKG utilization in the ED. Methods: We conducted a retrospective observational study to predict electrocardiogram (EKG) utilization using data from 13,115 adult emergency department (ED) visits in the nationally representative 2021 National Hospital Ambulatory Medical Care Survey–Emergency Department (NHAMCS-ED), leveraging both structured features—demographics, vital signs, comorbidities, arrival mode, and triage acuity, with the most influential selected via Lasso regression—and unstructured patient narratives transformed into numerical embeddings using Clinical-BERT. Four supervised learning models—Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF) and Extreme Gradient Boosting (XGB)—were trained on three inputs (structured data only, text embeddings only, and a late-fusion combined model); hyperparameters were optimized by grid search with 5-fold cross-validation; performance was evaluated via AUROC, accuracy, sensitivity, specificity and precision; and interpretability was assessed using SHAP values and Permutation Feature Importance. Results: EKGs were administered in 30.6% of adult ED visits. Patients who received EKGs were more likely to be older, White, Medicare-insured, and to present with abnormal vital signs or higher triage severity. Across all models, the combined data approach yielded superior predictive performance. The SVM and LR achieved the highest area under the ROC curve (AUC = 0.860 and 0.861) when using both structured and unstructured data, compared to 0.772 with structured data alone and 0.823 and 0.822 with unstructured data alone. Similar improvements were observed in accuracy, sensitivity, and specificity. Conclusions: Integrating structured clinical data with patient narratives significantly enhances the ability to predict EKG utilization in the emergency department. These findings support a personalized medicine framework by demonstrating how multimodal data integration can enable individualized, real-time decision support in the ED. Full article

Blood-based biomarkers allow monitoring of an individual’s health status and provide insights into metabolic and inflammatory processes in conditions like obesity, cardiovascular, and liver diseases. However, selecting suitable biomarkers and optimizing analytical assays presents challenges, is time-consuming and laborious. Moreover, knowledge of potential sex differences remains incomplete as research is often carried out in men. This study aims at enabling researchers to make informed choices on the type of biomarkers, analytical assays, and dilutions being used. More specifically, we analyzed plasma concentrations of >90 biomarkers using commonly available ELISA or electrochemiluminescence-based multiplex methods, comparing normal weight (BMI < 25; n = 40) with obese (BMI > 30; n = 40) adult blood donors of comparable age. To help choose optimal biomarker sets, we grouped frequently employed biomarkers into biological categories (e.g., adipokines, acute-phase proteins, complement factors, cytokines, myokines, iron metabolism, vascular inflammation), first comparing normal-weight with obese persons, and thereafter exploratively comparing women and men within each BMI group. Many biomarkers linked to chronic inflammation and dysmetabolism were elevated in persons with obesity, including several adipokines, interleukins, chemokines, acute-phase proteins, complement factors, and oxidized LDL. Further exploration suggests sex disparities in biomarker levels within both normal-weight and obese groups. This comprehensive dataset of biomarkers across diverse biological domains constitutes a reference resource that may provide valuable guidance for researchers in selecting appropriate biomarkers and analytical assays for own studies. Moreover, the dataset highlights the importance of taking possible sex differences into account. Full article

Background: Transfection is vital for gene therapy, mRNA treatments, CAR-T cell therapy, and regenerative medicine. While viral vectors are effective, non-viral systems like lipid nanoparticles (LNPs) offer safer, more flexible alternatives. This work explores emerging non-viral transfection technologies to improve delivery efficiency and therapeutic outcomes. Methods: This review synthesizes the current literature and recent advancements in non-viral transfection technologies. It focuses on the mechanisms, advantages, and limitations of various delivery systems, including lipid nanoparticles, biodegradable polymers, electroporation, peptide-based carriers, and microfluidic platforms. Comparative analysis was conducted to evaluate their performance in terms of transfection efficiency, cellular uptake, biocompatibility, and potential for clinical translation. Several academic search engines and online resources were utilized for data collection, including Science Direct, PubMed, Google Scholar Scopus, the National Cancer Institute’s online portal, and other reputable online databases. Results: Non-viral systems demonstrated superior performance in delivering mRNA, siRNA, and antisense oligonucleotides, particularly in clinical applications. Biodegradable polymers and peptide-based systems showed promise in enhancing biocompatibility and targeted delivery. Electroporation and microfluidic systems offered precise control over transfection parameters, improving reproducibility and scalability. Collectively, these innovations address key challenges in gene delivery, such as stability, immune response, and cell-type specificity. Conclusions: The continuous evolution of transfection technologies is pivotal for advancing gene and cell-based therapies. Non-viral delivery systems, particularly LNPs and emerging platforms like microfluidics and biodegradable polymers, offer safer and more adaptable alternatives to viral vectors. These innovations are critical for optimizing therapeutic efficacy and enabling personalized medicine, immunotherapy, and regenerative treatments. Future research should focus on integrating these technologies to develop next-generation transfection platforms with enhanced precision and clinical applicability. Full article

This study explores the role of artificial intelligence (AI) in human resource management (HRM), with a focus on recruitment, employee retention, and performance optimization. Through a PRISMA-based systematic literature review, the paper examines many machine learning algorithms including XGBoost, SVM, random forest, and linear regression in decision-making related to employee-attrition prediction and talent management. The findings suggest that these technologies can automate HR processes, reduce bias, and personalize employee experiences. However, the implementation of AI in HRM also presents challenges, including data privacy concerns, algorithmic bias, and organizational resistance. To address these obstacles, the study highlights the importance of adopting ethical AI frameworks, ensuring transparency in decision-making, and developing effective integration strategies. Future research should focus on improving explainability, minimizing algorithmic bias, and promoting fairness in AI-driven HR practices. Full article

Background/Objectives: Cognitive impairment is one of the most common and debilitating clinical features of Multiple Sclerosis (MS). Neuropsychological assessment, however, is time-consuming and requires personal resources, so, due to limited resources in daily clinical practice, information on cognitive profiles is often lacking, despite its high prognostic relevance. Time-saving and effective tools are required to bridge this gap. This study evaluates the sensitivity and specificity of a revised version of TRACK-MS (TRACK-MS-R), a recently published screening tool to identify cognitive impairment in MS in a fast and reliable way, offering a balance between efficiency and diagnostic yield for the individual patient. Methods: In this prospective cross-sectional study, 102 MS patients and 94 age-, sex-, and education-matched healthy controls (HC) completed an extensive neuropsychological assessment, including TRACK-MS-R, to test for cognitive processing speed (Symbol Digit Modalities Test, SDMT) and verbal fluency (Regensburger Word Fluency Test, RWT). Sensitivity of TRACK-MS-R was assessed by using the BICAMS-M battery as a reference, and specificity was determined by comparing MS patients to HC. Results: TRACK-MS-R demonstrated high sensitivity (97.44%) when compared to the gold standard as represented by BICAMS-M for early and accurately detecting cognitive impairment in MS patients. Additionally, as a potential cognitive marker, TRACK-MS-R showed a specificity of 82.98% in distinguishing MS patients from healthy controls. Conclusions: TRACK-MS-R proves to be a highly sensitive and time-efficient screening tool for detecting cognitive impairment in patients with MS, while demonstrating good specificity compared to HC. Whereas high sensitivity is a prerequisite for a valid screening tool, its relatively modest specificity compared to BICAMS-M (62.9%) calls for caution in interpreting standalone results but instead indicates more extensive neuropsychological testing. Its briefness and diagnostic accuracy support its implementation in routine clinical practice, particularly in time-constrained settings. Full article

Job stress and burnout are major challenges in today’s workplaces. While most interventions adopt a clinical or deficit-based approach, this meta-analysis takes a positive perspective by examining the effectiveness of Positive Psychological Interventions (PPIs). A total of 24 studies conducted in workplace settings were analyzed to assess the impact of PPIs on psychological well-being, subjective well-being, and job performance. The results showed significant and sustained improvements across all three outcomes, with moderate effect sizes: subjective well-being (g = 0.50, 95% CI [0.18, 0.81]), psychological well-being (g = 0.46, 95% CI [0.15, 0.78]), and performance (g = 0.42, 95% CI [0.21, 0.62]). Higher effects were found for in-person interventions and those conducted in Western contexts. No significant moderation was observed for structural factors (e.g., implementation level: Individual, Group, Leader, or Organization [IGLO]) or sample characteristics (e.g., gender), among other variables examined. These findings highlight the relevance of PPIs for promoting well-being and sustaining performance, which may reflect the preservation of personal resources in the face of occupational stressors. Regardless of type, well-designed interventions may be key to fostering healthier workplace environments—especially when delivered face-to-face. Full article

Cardiovascular disease (CVD) remains Europe’s leading cause of mortality, responsible for >45% of deaths. Beyond established risk factors (hypertension, diabetes, dyslipidaemia, smoking, obesity), psychosocial elements—depression, anxiety, financial stress, personality traits, and trauma—significantly influence CVD development and progression. Behavioural Cardiology addresses this connection by systematically incorporating psychosocial factors into prevention and rehabilitation protocols. This review examines the HEARTBEAT model, developed by Greece’s first Behavioural Cardiology Unit, which aligns with current European guidelines. The model serves dual purposes: primary prevention (targeting at-risk individuals) and secondary prevention (treating established CVD patients). It is a personalised medicine approach that integrates psychosocial profiling with traditional risk assessment, utilising tailored evaluation tools, caregiver input, and multidisciplinary collaboration to address personality traits, emotional states, socioeconomic circumstances, and cultural contexts. The model emphasises three critical implementation aspects: (1) digital health integration, (2) cost-effectiveness analysis, and (3) healthcare system adaptability. Compared to international approaches, it highlights research gaps in psychosocial interventions and advocates for culturally sensitive adaptations, particularly in resource-limited settings. Special consideration is given to older populations requiring tailored care strategies. Ultimately, Behavioural Cardiology represents a transformative systems-based approach bridging psychology, lifestyle medicine, and cardiovascular treatment. This integration may prove pivotal for optimising chronic disease management through personalised interventions that address both biological and psychosocial determinants of cardiovascular health. Full article

Background/Objectives: There is a growing need for autism spectrum disorder (ASD) assessment tools that are diagnostically aligned, clinically usable, and accessible across diverse service contexts. The Diagnostic Autism Spectrum Interview—Version 2 (DASI-2) is a freely available, semi-structured clinical interview mapped directly to DSM-5 and ICD-11 criteria. This pilot study aimed to adapt DASI-2 into Hungarian and explore the (1) acceptability of DASI-2 administration, (2) agreement with prior clinical ASD diagnoses, and (3) relationship between DASI-2 observational ratings and ADOS-2 classifications. Methods: Following a multistep translation procedure, DASI-2 was administered to seven children previously assessed for ASD in a multidisciplinary Hungarian clinical setting. The assessment included a parent interview, direct assessment with the child or young person, and completion of the DASI observational record (OR1–OR4). DASI diagnostic outcomes were compared with prior clinical decisions, and OR scores were analyzed in relation to ADOS-2 classifications. Results: All participants completed the DASI-2 interview in full. Agreement with prior clinical diagnosis was found in six of seven cases (κ = 0.70, indicating substantial agreement). When exploring the one non-aligned case, the divergence in diagnostic outcome was due to broader contextual information considered by the initial clinical team which influenced clinical opinion. The five participants diagnosed with ASD showed substantially higher DASI observational scores (mean = 15.26) than the two who were not diagnosed (mean = 1.57), mirroring ADOS-2 severity classifications. Conclusions: These findings support the acceptability and preliminary validity of DASI-2. Its inclusive structured observational record may provide a practical complement to resource-intensive tools such as the ADOS-2; however, further validation in larger and more diverse samples is needed. Full article

Neurodevelopmental disorders (NDDs) significantly impact children’s health and development. They pose a substantial burden to families and the healthcare system. Challenges in early identification, accurate and timely diagnosis, and effective treatment persist due to overlapping symptoms, lack of appropriate diagnostic biomarkers, significant stigma and discrimination, and systemic barriers. Generative Artificial Intelligence (GenAI) offers promising solutions to these challenges by enhancing screening, diagnosis, personalized treatment, and research. Although GenAI is already in use in some aspects of NDD management, effective and strategic leveraging of evolving AI tools and resources will enhance early identification and screening, reduce diagnostic processing by up to 90%, and improve clinical decision support. Proper use of GenAI will ensure individualized therapy regimens with demonstrated 36% improvement in at least one objective attention measure compared to baseline and 81–84% accuracy relative to clinician-generated plans, customize learning materials, and deliver better treatment monitoring. GenAI will also accelerate NDD-specific research and innovation with significant time savings, as well as provide tailored family support systems. Finally, it will significantly reduce the mortality and morbidity associated with NDDs. This article explores the potential of GenAI in transforming NDD management and calls for policy initiatives to integrate GenAI into NDD management systems. Full article

This case report presents a multidisciplinary forensic investigation into a cold case involving a missing person in Italy, likely linked to a homicide that occurred in 2008. The investigation applied a standardized protocol integrating satellite imagery analysis, site reconnaissance, vegetation clearance, ground-penetrating radar (GPR), and cadaver dog (K9) deployment. A dedicated decision tree guided each phase, allowing for efficient allocation of resources and minimizing investigative delays. Although no human remains were recovered, the case demonstrates the practical utility and operational robustness of a structured, evidence-based model that supports decision-making even in the absence of positive findings. The approach highlights the relevance of “negative” results, which, when derived through scientifically validated procedures, offer substantial value by excluding burial scenarios with a high degree of reliability. This case is particularly significant in the Italian forensic context, where the adoption of standardized search protocols remains limited, especially in complex outdoor environments. The integration of geophysical, remote sensing, and canine methodologies—rooted in forensic geoarchaeology—provides a replicable framework that enhances both investigative effectiveness and the evidentiary admissibility of findings in court. The protocol illustrated in this study supports the consistent evaluation of large and morphologically complex areas, reduces the risk of interpretive error, and reinforces the transparency and scientific rigor expected in judicial settings. As such, it offers a model for improving forensic search strategies in both national and international contexts, particularly in long-standing or high-profile missing persons cases. Full article

In manufacturing environments, the proper use of Personal Protective Equipment (PPE) is essential to prevent workplace accidents. Despite this need, existing PPE monitoring methods remain largely manual and suffer from limited coverage, significant errors, and inefficiencies. This article focuses on addressing this deficiency by designing a computer vision desktop application for automated monitoring of PPE use. This system uses lightweight YOLOv8 models, developed to run on the local system and operate even in industrial locations with limited network connectivity. Using a Lean UX approach, the development of the system involved creating empathy maps, assumptions, product backlog, followed by high-fidelity prototype interface components. C4 and physical diagrams helped define the system architecture to facilitate modifiability, scalability, and maintainability. Usability was verified using the System Usability Scale (SUS), with a score of 87.6/100 indicating “excellent” usability. The findings demonstrate that a user-centered design approach, considering user experience and technical flexibility, can significantly advance the utility and adoption of AI-based safety tools, especially in small- and medium-sized manufacturing operations. This article delivers a validated and user-centered design solution for implementing machine vision systems into manufacturing safety processes, simplifying the complexities of utilizing advanced AI technologies and their practical application in resource-limited environments. Full article

As voice cloning technology rapidly advances, the risk of personal voices being misused by malicious actors for fraud or other illegal activities has significantly increased, making the collection of speech data increasingly challenging. To address this issue, this study proposes a data augmentation method based on XText-to-Speech (XTTS) synthesis to tackle the challenges of small-sample, multi-class speech recognition, using profanity as a case study to achieve high-accuracy keyword recognition. Two models were therefore evaluated: a CNN model (Proposed-I) and a CNN-Transformer hybrid model (Proposed-II). Proposed-I leverages local feature extraction, improving accuracy on a real human speech (RHS) test set from 55.35% without augmentation to 80.36% with XTTS-enhanced data. Proposed-II integrates CNN’s local feature extraction with Transformer’s long-range dependency modeling, further boosting test set accuracy to 88.90% while reducing the parameter count by approximately 41%, significantly enhancing computational efficiency. Compared to a previously proposed incremental architecture, the Proposed-II model achieves an 8.49% higher accuracy while reducing parameters by about 98.81% and MACs by about 98.97%, demonstrating exceptional resource efficiency. By utilizing XTTS and public corpora to generate a novel keyword speech dataset, this study enhances sample diversity and reduces reliance on large-scale original speech data. Experimental analysis reveals that an optimal synthetic-to-real speech ratio of 1:5 significantly improves the overall system accuracy, effectively addressing data scarcity. Additionally, the Proposed-I and Proposed-II models achieve accuracies of 97.54% and 98.66%, respectively, in distinguishing real from synthetic speech, demonstrating their strong potential for speech security and anti-spoofing applications. Full article

Sustainable education requires addressing the challenges posed by digital transformation, including technostress among university students. This study evaluates technostress levels in higher education through the validation of the TS4US scale and its implications for sustainable learning environments. A cross-sectional study was conducted with 328 university students from four districts in Lima, Peru, using an online survey to measure technostress. Confirmatory factor analysis (CFA) was performed to assess the psychometric properties of the TS4US scale, resulting in a refined model with two latent factors and thirteen validated items. Findings indicate that 28% of students experience high technostress levels, while 5% report very high levels, though no significant associations were found between technostress and sociodemographic variables such as campus location, employment status, gender, and academic level. The TS4US instrument had been previously validated in Chile; this study confirms its structure in a new sociocultural context, reinforcing its cross-cultural applicability. These results highlight the need for sustainable strategies to mitigate technostress in higher education, including institutional support, digital literacy programs, and policies fostering a balanced technological environment. Addressing technostress is essential for promoting sustainable education (SDG4) and enhancing student well-being (SDG3). This study directly contributes to the achievement of Sustainable Development Goals 3 (Good Health and Well-being) and 4 (Quality Education) by providing validated tools and evidence-based recommendations to promote mental health and equitable access to digital education in Latin America. Future research should explore cross-country comparisons and targeted interventions, including digital well-being initiatives and adaptive learning strategies, to ensure a resilient and sustainable academic ecosystem. Full article

This paper presents a case study of the Local Care Ecosystems developed by the provincial government of Gipuzkoa (Basque Country, Spain) to strengthen coordination between social services, health services, and community-based initiatives at the municipal level. The initiative seeks to personalize care, enhance service integration, and support community-based care with the overarching goal of improving the quality of life for older adults living at home. These ecosystems incorporate social, institutional, and technological innovations aimed at supporting individuals who are frail or vulnerable throughout the care cycle. At present, 18 Local Care Ecosystems are active, providing services to 1202 people over the age of 65 and 167 families. The model addresses a growing global challenge linked to population aging, which has led to increasing demand for care and support services that are often fragmented, under-resourced, and constrained by outdated regulatory frameworks. These structural issues can compromise both the quality and efficiency of care for dependent individuals. Based on the findings, the paper offers policy recommendations to support the transfer and adaptation of this model, with the aim of improving the well-being of older adults who wish to remain in their own homes. Full article

Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping review of reviews of AI/ML applications spanning reproductive, prenatal, postpartum, neonatal, and early child-development care. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus through April 2025. Two reviewers independently screened records, extracted data, and assessed methodological quality using AMSTAR 2 for systematic reviews, ROBIS for bias assessment, SANRA for narrative reviews, and JBI guidance for scoping reviews. Results: Thirty-nine reviews met our inclusion criteria. In preconception and fertility treatment, convolutional neural network-based platforms can identify viable embryos and key sperm parameters with over 90 percent accuracy, and machine-learning models can personalize follicle-stimulating hormone regimens to boost mature oocyte yield while reducing overall medication use. Digital sexual-health chatbots have enhanced patient education, pre-exposure prophylaxis adherence, and safer sexual behaviors, although data-privacy safeguards and bias mitigation remain priorities. During pregnancy, advanced deep-learning models can segment fetal anatomy on ultrasound images with more than 90 percent overlap compared to expert annotations and can detect anomalies with sensitivity exceeding 93 percent. Predictive biometric tools can estimate gestational age within one week with accuracy and fetal weight within approximately 190 g. In the postpartum period, AI-driven decision-support systems and conversational agents can facilitate early screening for depression and can guide follow-up care. Wearable sensors enable remote monitoring of maternal blood pressure and heart rate to support timely clinical intervention. Within neonatal care, the Heart Rate Observation (HeRO) system has reduced mortality among very low-birth-weight infants by roughly 20 percent, and additional AI models can predict neonatal sepsis, retinopathy of prematurity, and necrotizing enterocolitis with area-under-the-curve values above 0.80. From an operational standpoint, automated ultrasound workflows deliver biometric measurements at about 14 milliseconds per frame, and dynamic scheduling in IVF laboratories lowers staff workload and per-cycle costs. Home-monitoring platforms for pregnant women are associated with 7–11 percent reductions in maternal mortality and preeclampsia incidence. Despite these advances, most evidence derives from retrospective, single-center studies with limited external validation. Low-resource settings, especially in Sub-Saharan Africa, remain under-represented, and few AI solutions are fully embedded in electronic health records. Conclusions: AI holds transformative promise for perinatal care but will require prospective multicenter validation, equity-centered design, robust governance, transparent fairness audits, and seamless electronic health record integration to translate these innovations into routine practice and improve maternal and neonatal outcomes. Full article