Search Results (9,343)

Midwifery philosophy promotes optimising physiological processes for all women. However, when complications arise, women may be offered increased monitoring and/or admission to hospital. Research demonstrates negative experiences associated with this. Virtual care presents the opportunity for more individualised care and has shown higher satisfaction with comparable outcomes to standard care, at similar or lower cost. Virtual pregnancy care is established in many countries, but implementation has been slow in Australia. The aim of this review is to evaluate the safety and effectiveness of antenatal virtual care models that incorporate telemonitoring of maternal and/or fetal wellbeing. A systematic search of the literature published since 2010 was conducted. Quantitative and mixed-methods studies were reviewed to provide a summary of contemporary evidence. Evidence on virtual care (with telemonitoring) delivered in the antenatal period was synthesised. Postpartum virtual care models were outside the scope of this review. Twenty-five publications were included. Studies examined diverse telemonitoring interventions, often supported by telehealth consultations with health professionals. Compared with standard care, including hospital admission, virtual models were associated with higher maternal satisfaction, reduced costs and service use, and were not associated with increased adverse perinatal outcomes. Further implementation research is needed to support broader adoption and ensure women can access flexible models of care. Full article

The brewing industry generates substantial organic waste, prompting interest in sustainable valorization because these by-products retain significant residual nutritional and nutraceutical value. Based on these premises, this scoping review aims to evaluate whether DES- and NADES-mediated extractions can represent a green alternative to conventional organic solvents, assessing their capacity to yield stable, biocompatible extracts with potential nutritional relevance for athletic supplementation. Following PRISMA-ScR guidelines and prospectively registered on OSF, we screened PubMed, Scopus, and Web of Science databases in June 2026, including 22 primary studies. Results show that DES and NADES can effectively dismantle brewing by-products, recovering antioxidants—specifically ferulic acid, p-coumaric acid, and xanthohumol (up to 285.92 mg GAE/100 g dw)—protein concentrates (up to 54.7 wt% total protein) rich in essential amino acids and branched-chain amino acids (BCAAs), as well as immunomodulatory prebiotic fibers (β-glucans, arabinoxylans) and liquid phases that bio-ferment into polyunsaturated fatty acids (PUFAs). Non-conventional technologies such as ultrasound and microwave-assisted extraction accelerate extraction kinetics by reducing solvent viscosity. It should be emphasized that the included studies are exclusively in vitro and characterize extracted compounds without evaluating effects on human subjects or athletic performance. However, several safety and regulatory gaps remain, including the presence of gluten in barley-derived extracts, the potential co-ingestion of antinutritional factors (e.g., oxalic acid), and the lack of toxicological data on intact eutectic phases. While DES- and NADES-derived extracts show promising in vitro bioactivities, further research is needed to validate their safety, bioavailability, and efficacy before they can be considered for human consumption or sports nutrition applications. Full article

Three-dimensional (3D) and four-dimensional (4D) printing expand the design space for nano-enabled soft robots intended for cancer diagnosis and therapy. This structured narrative review separates three evidence classes: core systems satisfying all scope criteria, adjacent technologies satisfying only part of the definition, and enabling technologies not yet integrated as oncology soft robots. The revised evidence set contains 12 core reports, 7 adjacent comparators and 68 enabling methods, standards or background reports. Study-level analysis using independent manufacturing, biological, workflow and safety (M/B/W/S) axes shows that the core literature is dominated by single-platform, in vitro therapeutic demonstrations with absent or short-term safety evidence (S0-S1). No core study established cancer-specific diagnostic sensitivity or specificity, no human validation was identified, and only two systems were classified as genuine or candidate 4D platforms under a strict programmed-transformation definition. Hydrogel, magnetic, photothermal, conductive, imaging-active and melanin-based materials are evaluated together with printability, dose, localization, sterilization, retrieval, degradation and nanoparticle fate. Translation requires reproducible manufacture, quantitative application endpoints, exposure-matched safety testing and comparison with established oncology workflows. The principal gap is not the availability of additional functions, but the lack of integrated evidence connecting controlled manufacture to clinically meaningful diagnosis or therapy. These findings apply only to the studies identified within the predefined search and eligibility framework and do not establish the absence of relevant evidence elsewhere. Full article

Today, pharmaceutical sciences rely on a wide range of innovative therapeutics of varying sizes: nanoparticles, proteins, antibodies, and nanocarriers for drug delivery. Measuring their size is one of the crucial parameters in their characterization, to ensure drug safety, stability, and effectiveness. Over the past two decades, Taylor Dispersion Analysis has emerged as an important sizing method. Its scope of application is perfectly suited to the sizes of these therapeutics. By design, it can be coupled with a wide range of detectors, and extensive research has been conducted in this field. In this review, we will present an overview of the studies conducted, and discuss how the application drives the choice of one detector or another (size measurement, aggregation studies, interaction studies, and other analyses, performed in both simple biological buffers and in more complex media, particularly serum) and makes Taylor Dispersion Analysis a highly versatile tool. Full article

Oxide dispersion strengthened (ODS) austenitic steels exhibit superior high-temperature stability and mechanical properties, which are attributed to the strong pinning effect of nano-oxide particles on dislocations and grain boundaries. The microstructure and properties of ODS steels are intrinsically governed by their fabrication techniques. While powder metallurgy (PM) serves as the predominant synthesis route, the fabrication of austenitic ODS steels faces distinct technical challenges compared to their ferritic counterparts, primarily due to issues such as powder sticking to the milling media. Conversely, although traditional melting processes often lead to oxide agglomeration, coarsening, or flotation, which makes it difficult to achieve a uniform dispersion, they remain of significant interest because of their scalability and cost-effectiveness. Furthermore, emerging technologies such as additive manufacturing (AM) have also been employed for the preparation of ODS steels. This review provides a systematic and comprehensive overview of the recent progress in the fabrication technologies of ODS austenitic steels. The scope encompasses a critical analysis of the merits and limitations of techniques including PM, in situ internal oxidation, melting, and AM, alongside an examination of the potential impacts of adding process control agents (PCA) to mitigate powder sticking during mechanical alloying. Additionally, the microstructural characteristics resulting from different processing routes are discussed in detail, followed by a consolidated evaluation of their mechanical properties. Full article

Digital twins (DTs) are increasingly proposed for nuclear-reactor monitoring, diagnosis, prediction, control, and decision support, but the maturity of reported systems is difficult to compare because DT realization, physical anchoring, synchronization, adaptation, validation, real-time execution, and trustworthiness are often conflated. This systematic scoping review maps substantive DT research for nuclear fission reactors and nuclear power plants using a strict substantive-DT definition and a multidimensional evidence-coding framework covering DT realization, physical anchoring, adaptation, validation, real-time capability, and trustworthiness. Scopus, Web of Science Core Collection, and IEEE Xplore yielded 845 database records and 590 unique records after deduplication. A multi-pass title/abstract workflow classified 182 records as Include, 397 as excluded from the primary-study stream, and 11 as Uncertain, yielding 193 reports sought for retrieval. Despite iterative multi-source retrieval attempts, 96 reports could not be retrieved. One additional Uncertain conference report was linked to an already retained journal report and was not treated as an independent report; 96 retrieved reports underwent primary full-text eligibility assessment. Seventy-one retrieved and eligible peer-reviewed primary reports met the inclusion criteria. Of these, 44/71 (62%) were Tier A implemented or integrated DT systems. Physical anchoring ranged from P0 simulation-only realization (39/71, 55%) to P3 operating-reactor or plant evidence (9/71, 13%); within P3, four reports used retrospective/offline operating data and five demonstrated live or near-live reactor/plant linkage. Validation evidence comprised 40/71 reports (56%) with development-linked validation (V1), 26/71 (37%) with separated empirical or benchmark validation (V2), and 5/71 (7%) with prospective, challenge-based, or independently confirmed validation (V3). Adaptation was limited: 51/71 reports (72%) demonstrated no adaptation (A0), 3/71 (4%) episodic or intermittent recalibration (A1), 5/71 (7%) online state synchronization/estimation (A2-S), 12/71 (17%) online parameter/model adaptation (A2-P), and none met the A3 criterion. Computational real-time capability was supported in 42/71 reports (59%), whereas integrated real- or near-real-time execution was demonstrated in 27/71 (38%); live physical-data ingestion, explicit recurring physical-to-digital synchronization, and automatic DT-to-physical actuation were demonstrated in 11/71 (15%), 5/71 (7%), and 1/71 (1%), respectively. Hybrid modelling was the dominant paradigm (34/71, 48%). Trustworthiness was asymmetric: calibration and robustness/OOD assessment were much more common than uncertainty quantification, explainability, cybersecurity, traceability, human oversight, or demonstrated regulatory readiness. A targeted data audit identified only four reports linked to clearly open and reusable benchmark or downloadable resources. Family-aware, quality, physical-evidence, temporal, and data-access sensitivity analyses did not materially change the central conclusions. Nuclear-DT maturity is best understood as multidimensional; future progress requires staged physical validation, bounded adaptive synchronization, trustworthy decision support, reproducible data/model provenance, and independent deployment-oriented validation. Full article

Cell sheet technology has evolved into a unique scaffold-free and biomaterial-free regenerative medicine platform that enables transplantation of intact cellular constructs while preserving extracellular matrix and cell–cell interactions. Clinical applications of cell sheet technology have demonstrated successful tissue and organ regeneration in the cornea, esophagus, heart, cartilage, and retina. More recently, the therapeutic scope of cell sheet technology has expanded beyond tissue replacement toward stem cell-based regenerative therapy, in which paracrine signaling, anti-fibrotic activity, and microenvironment remodeling play important roles. In this review, we use the term “functional regeneration” as an integrative therapeutic framework of a regenerative medicine platform capable of promoting the regenerative processes that modify disease pathophysiology and may alter the natural history of a disease, irrespective of complete anatomical reconstitution. Liver cirrhosis is a representative target disease for this concept of functional regeneration because the functional regenerative therapy that reverses progressive fibrosis and restores hepatic function has the opportunity to prevent the onset of hepatocellular carcinoma. This review discusses the evolution of cell sheet technology, the biological basis of stem cell-based functional regeneration, and the development of KCS-003, a cell sheet-based therapeutic product manufactured from mesenchymal stem/stromal cells preconditioned with IC-2, which has potent anti-fibrotic action and promotes liver regeneration. In addition, clinical investigations, including corneal and retinal reconstitution, esophageal regeneration, cartilage repair, and cardiac patches, were shown as representative clinical cases of cell sheet technology. Full article

Background: Interstitial lung disease (ILD) is an increasingly recognized manifestation of ANCA-associated vasculitis (AAV) and is associated with substantial morbidity and mortality. The marked biological and clinical heterogeneity of AAV-associated ILD (AAV-ILD) poses major challenges for diagnosis, prognostic stratification, and therapeutic decision-making. Circulating biomarkers have emerged as promising tools for improving disease characterization; however, the available evidence remains limited and fragmented. Methods: We performed a scoping review to summarize the current evidence on circulating biomarkers investigated in AAV-ILD. Peer-reviewed studies evaluating biomarkers associated with ILD occurrence, disease activity, radiological progression, pulmonary function decline, mortality, or treatment response were systematically identified and qualitatively analyzed. Results: Seven observational studies met the inclusion criteria. The identified biomarkers could be broadly classified into three biological categories: epithelial injury biomarkers (KL-6 and SP-D), immune–fibrotic biomarkers (CCL2, CXCL6, CXCL13, and IL-13), and epithelial remodelling biomarkers (CA19-9, CA125, and CYFRA21-1). KL-6 and SP-D were associated across individual studies with pulmonary involvement, disease activity, or relapse, whereas CCL2, CXCL6, CXCL13, and IL-13 were associated with inflammatory and profibrotic processes, radiological abnormalities, or disease progression. Tumour-associated biomarkers were associated with radiological abnormalities and mortality, suggesting that they may reflect aberrant epithelial remodelling rather than malignancy. Across studies, circulating biomarkers showed preliminary associations with disease detection, prognosis, longitudinal disease behaviour, and treatment response; however, their clinical utility has not been prospectively established. Overall, the current evidence is limited by small sample sizes, retrospective study designs, and substantial clinical heterogeneity. Conclusions: Circulating biomarkers represent a promising approach for improving the biological characterization of AAV-ILD and may contribute to the future characterization of inflammatory and fibrotic disease phenotypes. Prospective multicentre studies with independent validation cohorts are required before biomarker-guided management can be implemented in routine clinical practice. Full article

Background: Online postgraduate (PG) public health education must develop higher-order competence and readiness for practice. Generative artificial intelligence (genAI) may enhance feedback, simulation and scaffolding, but may also substitute for learner reasoning. This review examined pedagogical conditions supporting higher-order learning and how AI interacts with them to influence competence and real-world readiness in online PG public health education. Methods: Following JBI guidance and PRISMA-ScR, PubMed and Scopus were searched for literature published from 2010 to 2026, with the final search conducted on 20 August 2026. Eligible sources addressed higher-order learning, authentic learning, competence or professional readiness in PG public health education, or provided transferable evidence from health professions and higher education settings. Of 5777 records identified, 253 duplicates were removed and 5524 screened. Data were charted using a structured evidence matrix and stratified into direct, transferable, synthesis, and contextual evidence layers. Results: Of 401 records undergoing detailed eligibility and analytic-role assessment, 338 were retained. Core evidence comprised 92 studies: 27 direct and 65 transferable; 32 syntheses provided triangulation. AI featured in 11.1% of direct versus 87.7% of transferable studies. Applied competence/skills occurred in 59.8%, synthesis/integration in 44.6%, critical thinking in 26.1%, and real-world cases/scenarios in 51.1%. Practice/workplace transfer was more prominent in direct than in transferable evidence (66.7% vs. 13.8%). Direct AI evidence in PG public health was limited, and heterogeneity across studies constrained direct comparison and precluded quantitative pooling. Conclusions: Higher-order learning depended more on pedagogical architecture than modality or AI adoption. AI may amplify cognition when preserving learner reasoning, verification, and judgement, but may substitute for cognition when generated outputs replace these processes. No external funding was received for this review. Full article

Facility-based birth is an important strategy for reducing maternal and neonatal mortality, yet institutionalization has also been associated with overmedicalized and disrespectful care. Midwifery centers (MCs) may offer an alternative, but evidence on their implementation in low- and middle-income countries (LMICs) remains limited. This study explored barriers and facilitators to MC implementation and functioning in LMICs. A scoping review conducted in 2020 identified 15 publications. Ten key informants were interviewed in 2020 to complement and contextualize the literature findings. Findings were analyzed thematically and organized within a SWOT framework. A literature update conducted in 2026 identified 13 additional publications, resulting in 28 included publications. Facilitators included enabling environments for midwives, internal standards, sustainable financing, community-centered care, and professional collaboration. Barriers included workforce and education gaps, insufficient professional and regulatory recognition, weak health-system integration, and inadequate maternity care infrastructure. Expert insights complemented the literature by highlighting practical implementation challenges. Successful MC implementation requires context-sensitive approaches supported by adequate health-system infrastructure, professional autonomy, and functional referral networks to enable safe and respectful maternity care. Full article

South Africa’s (SA) quadruple disease burden comprises communicable diseases such as HIV/AIDS, tuberculosis, maternal and child mortality, non-communicable diseases (NCDs), and injury and violence. Two of these components, HIV and NCDs, generate demand for long-term medicines and are the focus of the review. To improve access to chronic medicines and to alleviate the pressure on overburdened public health facilities, the National Department of Health launched the Central Chronic Medicines Dispensing and Distribution (CCMDD) programme. Stable, compliant patients were granted access to patient medicine parcels (PMPs) via decentralised community pick-up points (PUPs), thereby reducing clinic congestion and improving patient convenience. Despite considerable scale-up, implementation has been inconsistent among provinces. While regional syntheses of differentiated service delivery models exist, no synthesis has yet consolidated the barriers and facilitators specific to the CCMDD across the full decade of its implementation. To understand the barriers and facilitators, a scoping review was conducted for studies published in English between 2014 and 2024. The search was filtered primarily for duplicates, then title and abstract screening, of which 31 articles met the inclusion and exclusion criteria. Data were analysed using inductive thematic analysis; resulting themes were subsequently mapped to the Consolidated Framework for Implementation Research (CFIR) to contextualise findings within implementation science. A grey literature search was also conducted through Google Scholar and Sabinet. Key facilitators of implementation included decentralised service delivery and community-based distribution, reduced patient waiting times, enhanced treatment adherence, reduced patient-borne transport and time costs and improved access to medicines. Limited access to pick-up points in remote areas, miscommunication regarding pick-up dates and poor staff service were cited as barriers. The findings revealed a gap between planned activities and implementation and have significant implications for policy and practice. It further highlighted the need for ongoing optimisation strategies to enhance the programme. Full article

Large language model (LLM)-based AI agents combine reasoning and planning, memory, external knowledge use, tool calling, and multi-agent collaboration to perform complex tasks. However, they face planning failures, context-maintenance limitations, collaboration instability, vulnerabilities arising from external interactions, bias, unclear attribution of responsibility, and difficulties in oversight and incident tracing. This narrative literature review examined the technological evolution and technical limitations of AI agents and developed a conceptual mapping relating these limitations to selected issues of bias and governance. Selected early theoretical studies were included; the main focus was post-2022 scholarly literature and official institutional and corporate materials through July 2026, with publication-status and evidence updates during revision in September 2026. Sources were categorized into concepts and trends, single- and multi-agent architectures, technical limitations, and socio-ethical issues; limitations were compared using a problem addressed–mitigation approach–residual limitation framework. The analysis suggests that autonomous actions performed on behalf of users, ambiguity in the scope of authority, multi-agent interactions, external knowledge use, observation of external environments, and tool calling may be linked to unclear attribution of responsibility, bias propagation and amplification, and difficulties in oversight and incident tracing. Potential mediators include multiple actors, miscoordination and conformity, inherited external-source biases, and new attack surfaces. This conceptual mapping provides a basis for future research on trustworthy AI-agent design, operation, and governance. Full article

Background: Individuals spend most of their time indoors, yet the influence of indoor environmental characteristics on cognitive, emotional, and physical health is often underestimated. Indoor Air Quality (IAQ) plays a critical role in preventing discomfort and health issues such as Sick Building Syndrome (SBS). This study proposes a methodological framework integrating quantitative data from low-cost sensors with qualitative assessments of user perception, enabling a comprehensive evaluation of IAQ and its impacts. Methods: To develop a qualitative questionnaire, a Scoping Review was conducted with Scopus, since the aim was to identify questionnaire components from previous studies rather than to synthesize intervention effects, as in a systematic review. Keywords related to IAQ, user perception, wellbeing, and pollutant monitoring in living and working environments were applied. Starting from 281 initial documents, only 35 were selected because they reported relevant surveys or questionnaires within the scope of the analysis. Results: Across the 35 included studies on living and working spaces, the most frequently reported questionnaire items were grouped into five thematic domains—demographic factors, health symptoms, user perceptions, building and occupancy conditions, and monitored pollutants—to support the development of the qualitative questionnaire. These five domains supported the development of the proposed qualitative questionnaire but are also readily scalable to living spaces. Conclusions: Based on these findings, a team designed a structured questionnaire covering lifestyle, demographics, workplace conditions, perceived air quality, and related symptoms. This tool supports parallel analyses of qualitative and quantitative data. The proposed framework fosters multidimensional interpretation and may inform design, management, and AI-driven approaches for improving IAQ assessment across diverse contexts. Full article

Color may influence emotional cognition through perceptual salience, learned affective meaning, and response compatibility, yet task-based evidence has not been synthesized. Reported under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews (PRISMA-ScR) and the PRISMA extension for reporting literature searches (PRISMA-S), we conducted a scoping review of experiments that varied color during emotional attention, cognitive control, or emotional information processing. Five database groups were searched on 26 July 2026 and rerun as a pre-submission update on 17 August 2026; three completed citation-searching rounds were also used. Independent screening yielded 299 included reports. Full-text charting organized these reports into 294 study families and 4923 descriptive result rows. Reported result directions varied across color properties, task roles, emotional materials, comparators, and response levels. Most families contained detected and null results, while 44 internally conflicting rows were retained for descriptive analysis. Although 569 rows from 43 families provided directly weightable effect estimates, no cluster met prespecified homogeneity criteria, so effects were not pooled. In applied settings, color sometimes changed gaze, local task performance, or affect, but transfer to beliefs, sustained attention, or general performance was inconsistent. This descriptive mapping does not establish a general performance benefit or impairment for any named color. Conflict and inhibition paradigms rarely manipulated saturation or lightness independently, leaving a specific design gap in research on color and cognitive control. Full article

Breastfeeding is increasingly recognised as relevant to both public and planetary health, yet evidence on how environmental sustainability can be translated into breastfeeding support and counselling remains limited. This scoping review mapped evidence on the environmental sustainability of breastfeeding and its relevance to support and counselling through a green midwifery lens. Following JBI guidance and PRISMA-ScR, MEDLINE/PubMed, CINAHL Complete, GreenFILE, Scopus, and Web of Science were searched from inception to 3 July 2026. Two reviewers independently screened records and full texts. Thirteen studies were included and synthesised descriptively and thematically. One study directly evaluated a sustainability-focused professional education approach, four provided evidence relevant to breastfeeding support, practice, or policy, and eight provided contextual environmental or system-level evidence. Five themes were identified: environmental evidence informing counselling; environmental awareness and professional capacity; resource-conscious practices, maternal diet, and feeding accessories; climate-resilient support in disasters and emergencies; and health-system, food-system, and policy support. Breastfeeding generally showed lower environmental impacts than commercial milk formula, although estimates varied by system boundaries, maternal diet, household practices, and equipment use. No included study evaluated a parent-facing sustainability-oriented breastfeeding counselling intervention. Environmental considerations may therefore inform future breastfeeding counselling, but current practice implications should be regarded as evidence-informed directions rather than demonstrated intervention effects. Full article