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BACKGROUND: The field of robotic-assisted surgery is rapidly growing as many robotic surgical devices are in development and about to enter the market. Currently, there is no universally accepted language for labeling the different robotic systems. To facilitate this communication, we created what is, to our knowledge, the first classification of surgical robotic technologies that organizes and classifies surgical robots used for endoscopy, laparoscopy and thoracoscopy. METHODS: We compiled a list of surgical robots intended to be used for endoscopy, laparoscopy, and/or thoracoscopy by searching United States, European, Hong Kong, Japan, and Korean databases for approved devices. Devices showcased at the 2023 Annual Meeting for the Society of Robotic Surgery were added. We also systematically reviewed the literature for any existing surgical robotic classifications or categorizations. We then created a multidisciplinary committee of 8 surgeons and 2 engineers to construct a proposed classification of the devices included in our search. RESULTS: We identified 40 robotic surgery systems intended to be used for endoscopy, laparoscopy and/or thoracoscopy. The proposed classification organizes robotic devices with regard to architecture, port design, and configuration (modular carts, multi-arm integrated cart, table-attachable or arm-table integration). CONCLUSION: This 3-level classification of robotic surgical devices used for endoscopy, laparoscopy and/or thoracoscopy describes important characteristics of robotic devices systematically.

Purpose: To determine the accuracy of dental implant placement using haptic robotic guidance in a large clinical series. Materials and Methods: In a prospective single-arm clinical study, 108 patients received 273 individual endosteal implants. A virtual preoperative restorative and surgical plan was created from a CBCT scan and matched to the surgical workspace on the day of surgery via either a tooth-based or bone-based fiducial splint. Intraoperatively, the surgeon manipulated a handpiece attached to a haptic robotic guidance arm. A variety of drills and implants were used. Both the osteotomy and the implant placement were guided by 3D haptic constraints according to the virtual plan. Postoperative CBCT scans permitted the calculation of the actual implant placement deviations compared to the plan for accuracy. Precision was calculated by comparing SDs from published literature. Results: The implants were evenly distributed by arch, with 47% placed in the maxilla and 53% in the mandible. The mean ± SD signed depth deviation was 0.14 ± 0.87 mm proud. The global angular deviation averaged 1.42 ± 1.53 degrees, with 95% confidence limits of 1.24 and 1.60 degrees. The crown of the actual placed implant showed an average deviation from the plan of 1.10 ± 0.69 mm and the apex of the placed implant showed a deviation of 1.12 ± 0.69 mm. Haptic robotic guidance showed greater precision than freehand, static computer-guided, and dynamic computer-guided implant placement. Conclusions: This large clinical series of 273 implants shows a high accuracy of implant placement compared to the published accuracy for angular deviations for any technology, as well as demonstrating statistically greater precision. Long-term clinical studies are necessary to establish the true effect of increased accuracy on clinical outcomes. Using haptic robotic guidance provides accurate implant placement while allowing additional benefits compared to computer-guided surgery, namely full visualization of the surgical field and the ability to change the plan intraoperatively. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to evaluate the performance of implants placed with the All-on-4 technique after a mean time in function of 9 years. A total of 34 patients with 156 implants were selected for this study: 18 patients underwent tooth extraction on the day of implant placement (Group D), and 16 patients were already edentulous (Group E). A periapical radiograph was taken at a mean follow-up of 9 years (range: 5 to 14 years). Success and survival rates and the prevalence of peri-implantitis were calculated. Statistical analysis was used to assess comparisons between groups. After a mean follow-up of 9 years, the cumulative survival rate was 97.4% and the success rate was 77.4%. The difference between the initial and final radiographs resulted in a mean marginal bone loss (MBL) of 1.3 ± 1.06 mm (range: 0.1 to 5.3 mm). No differences were seen between Groups D and E. Peri-implantitis affected 15 implants (9.6%) in 9 patients (26.5%). This study shows that the All-on-4 technique is a reliable treatment method for both edentulous patients and patients requiring tooth extractions, with results maintained over a long follow-up period. The present MBL results are similar to those around implants in other rehabilitation types. [ABSTRACT FROM AUTHOR]

Radiological findings play an essential and complementary role in diagnosing Covid-19, assessing its severity, and managing its patients. Artificial intelligence technology based on medical imaging, which has made exciting developments by being applied in many areas, has become an area of interest for the rapid and accurate detection of the disease in the fight against the Covid-19 pandemic. The main difficulty is the inability to obtain a large dataset size with quality and standard images that neural networks need to perform well. Aiming at this problem, this study proposes a Siamese neural network-based deep learning framework for accurate diagnostics of Covid-19 using chest X-ray (CXR) images. The pre-trained VGG16 architecture, based on the transfer learning approach, forms the backbone of the Siamese neural network. The outputs of the backbones are joined together by a merging layer, and then the output passes through a fully connected layer. Based on this structure, category-aware Siamese-based models are produced for each class. The predictions from the models are combined using a voting mechanism to reduce the possibility of misclassification and to make better decisions. The framework was evaluated using a publicly available dataset for the 4-class classification task for Covid-19 pneumonia, lung opacity, normal, and non-Covid-19 viral pneumonia images. The findings reveal the high discrimination ability of the framework, trained using only 10 images per class in less training time, achieving an average test accuracy of 92%. Our framework, which learns a single Siamese-based pairwise model for each class, effectively captures class-specific features. Additionally, it has the potential to deal with data scarcity and long training time problems in multi-class classification tasks. [ABSTRACT FROM AUTHOR]

Objectives: Published literature has levied criticism against the cost-minimisation analysis (CMA) approach to economic evaluation over the past two decades, with multiple papers declaring its 'death'. However, since introducing the requirements for economic evaluations as part of health technology (HTA) decision-making in 1992, the cost-minimisation analysis (CMA) approach has been widely used to inform recommendations about the public subsidy of medicines in Australia. This research aimed to highlight the breadth of use of CMA in Australia and assess the influence of preconditions for the approach on subsidy recommendations Methods: Relevant information was extracted from Public Summary Documents of Pharmaceutical Benefits Advisory Committee (PBAC) meetings in Australia considering submissions for the subsidy of medicines that included a CMA and were assessed between July 2005 and December 2022. A generalised linear model was used to explore the relationship between whether medicines were recommended and variables that reflected the primary preconditions for using CMA set out in the published PBAC Methodology Guidelines. Other control variables were selected through the Bolasso Method. Subgroup analysis was undertaken which replicated this modelling process. Results: While the potential for inferior safety or efficacy reduced the likelihood of recommendation (p < 0.01), the effect sizes suggest that the requirements for CMA were not requisite for recommendation. Conclusion: The Australian practice of CMA does not strictly align with the PBAC Methodology Guidelines and the theoretically appropriate application of CMA. However, within the confines of a deliberative HTA decision-making process that balances values and judgement with available evidence, this may be considered acceptable, particularly if stakeholders consider the current approach delivers sufficient clarity of process and enables patients to access medicines at an affordable cost. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is to compare different information retrieval methods that can be used to identify utility inputs for health economic models. Methods: The usual practice of using systematic review methods was compared with two alternatives (iterative searching and rapid review), using a health technology assessment (HTA) case study in ulcerative colitis (UC). We analysed whether there were differences in the utility values identified when using the alternative search methods. Success was evaluated in terms of time, burden and relevance of identified information. The identified utility values were tested in an executable health economic model developed for UC, and the model results were compared. Results: The usual practice of using systematic review search approaches identified the most publications but was also the least precise method and took longest to complete. The inclusion of data from the different search methods in the model did not lead to different conclusions across search methods. Conclusions: In this case study, usual practice was less efficient and resulted in the same health economic model conclusions as the alternative search methods. Further case studies are required to examine whether this conclusion might be generalisable. [ABSTRACT FROM AUTHOR]

The advancement of health apps and wearables has garnered substantial academic attention, particularly in examining why individuals decide to use or not use them. In response to the extensive body of research on this topic, we conducted a scoping review of 61 articles published from 2007 to 2022, aiming to examine the dominant theoretical frameworks and antecedents of health apps and wearables use. The findings demonstrated that the dominant theoretical frameworks within this domain were rooted in the human-computer interaction theories, notably the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology. Next, our review identified four levels of antecedents: technological, individual, societal, and policy. At the technological level, emphasis was placed on functionality, reliability, and technological infrastructure. Individual antecedents encompassed socio-demographics, personality traits, cognitive responses to benefits and risks, emotional and affective responses, self-efficacy, and digital literacy. Societal antecedents highlighted the role of social networks and social norms, while policy antecedents elaborated on laws, regulations, and guidelines that encouraged health technology adoption. Our discussion illuminated that the evolving trend of theoretical frameworks in health apps and wearables use research, initially rooted in human-computer interaction, is progressively moving toward more comprehensive perspectives. We further underscored the importance of delving into societal and policy antecedents, which often are overshadowed by the more commonly discussed technological and individual factors. In conclusion, we advocated for a multi-stakeholder collaborative network approach, as this would enable communication researchers to understand the use of health apps and wearables more comprehensively. [ABSTRACT FROM AUTHOR]

Immortality constitutes a very human desire and its pursuit arguably shapes prominent features of human societies. In the twenty-first century, capitalism develops technologies that promise immortality as indefinite survival. Scholars who study immortality often showcase the links between technology, social structures and immortality projects, but a critical inquiry is needed to examine how (techno-)capitalism creates immortality projects that expand the frontiers of capital in contemporary societies. In this article, I highlight how techno-capitalism configures three prominent immortality imaginaries: transhumanist digital immortality, radical biological life-extension, and cryonics. I identify three tendencies of techno-capitalism − 1) expanding commodification to new realms of life, 2) creating new forms of alienation and 3) subordinating life to the private accumulation of capital – and explain how they shape the immortality imaginaries. I argue that pursuing techno-capitalist immortality would induce significant harms for human beings, promising freedom from death but actually sustaining techno-capitalism's exploitative relations. [ABSTRACT FROM AUTHOR]

Aims: The present analysis estimated the cost‐effectiveness of treatment with the Tandem t: slim X2 insulin pump with Control IQ technology (CIQ) in children with type 1 diabetes in Sweden. Methods: A four‐state Markov model and probabilistic sensitivity analyses (PSA) were used to assess the cost‐effectiveness of CIQ use compared with treatment with multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII) in conjunction with CGM. Data sources included clinical input data from a recent retrospective, observational study, cost data from local diabetes supply companies and government agencies, and published literature. Outcomes measures were quality adjusted life years (QALYs) at 10, 20 and 30‐year time horizons based on cost per QALY and incremental cost‐effectiveness ratio (ICER). Results: A total of 84 type 1 diabetes children were included (CIQ, n = 37; MDI, n = 19; CSII, n = 28). For all time horizons, the use of CIQ was a dominant strategy (e.g. more effective and less costly) compared with MDI or CSII use: 10‐year ICER, SEK ‐88,010.37 and SEK ‐91,723.92; 20‐year ICER, SEK −72,095.33 and SEK −87,707.79; and 30‐year ICER, SEK −65,573.01 and SEK ‐85,495.68, respectively. PSA confirmed that CIQ use was less costly compared with MDI and CSII. Conclusions: Initiation of CIQ use in children with type 1 diabetes is cost‐saving, besides previously shown improved glycaemic control, and increased quality of life. Further investigations are needed to more fully elucidate the cost‐effectiveness of these technologies in different countries with existing differences in payment models. [ABSTRACT FROM AUTHOR]

Aims: There are marked inequities in clinical outcomes and rates of diabetes technology use among youth with type 1 diabetes (T1D). The quantitative data from our mixed methods cohort study identified significant improvements in glycaemia and quality of life in participants. We aimed to use qualitative methods to provide further insight into our quantitative findings in the setting of underlying health disparities. Methods: Fifteen publicly insured, insulin pump‐naïve non‐Hispanic Black youth aged 6–21 years with T1D and baseline haemoglobin A1c (HbA1c) ≥86 mmol/mol (10%) and their parents participated in a mixed methods cohort study. Semi‐structured interviews were conducted separately with parents and youth after completion of 6 months of HCL use. Three topic areas were explored: (1) Experience using HCL, (2) barriers to HCL and (3) facilitators to accessing HCL. Semantic content analysis and consensus coding involving two team members were used to generate themes. Thematic saturation was achieved. Results: Youth (Medianage 14.9 years, 67% female) and parents (92% female) were interviewed. Youth and their parents reported that access to HCL provides a new outlook on living with T1D, although managing T1D is still hard. They felt that diabetes technology is most helpful for those struggling with management. Participants experienced barriers to access including misconceptions of HCL systems, clinician bias and systemic racism. They suggested these barriers can be overcome by offering diabetes technology education for all people with T1D, increasing awareness of HCL in the community and providing resources to overcome barriers created by social determinants of health. Conclusions: The voices of historically minoritised youth with suboptimal T1D control and their parents provide important, previously unreported experiences and perspectives on barriers and facilitators to using HCL that will shape interventions to improve equity in access to diabetes technology. [ABSTRACT FROM AUTHOR]

The Internet offers help-seekers an abundance of resources that can potentially support their mental health. However, people often have trouble in finding personally relevant resources. Very few specialized mental health help-seeking technologies currently address this need. Instead, help-seeking typically begins with a known website or web-search. To understand how help-seeking technologies could be better designed, we conducted a study comparing existing technologies with two novel help-seeking prototypes. These prototypes were informed by empirically grounded design recommendations, which emphasize the need for connectedness, accessible and creditable information, personalization, and immediacy. Findings show that the resources recommended by current technologies are often experienced as 'overwhelming' or 'overly-medicalized'. The prototypes successfully improved connectedness, immediacy, and personalization, but were less successful in their ability to support symptom-based help-seeking. Based on our findings we contribute recommendations for integrated help-seeking technologies, which can guide people to mental health resources appropriate to both their personal preferences and current level of need. [ABSTRACT FROM AUTHOR]

• STAND is an evidence-based treatment for adolescent ADHD that focuses on engagement. • Provides a summary of the development of a community implementation model for STAND. • Features include use of artificial intelligence to monitor fidelity and digitizing clinician resources. • Pilot work in three community agencies suggests acceptability, feasibility, and fidelity to the model. Implementation of behavior therapy for ADHD faces challenges in community settings. We describe development of a community-based implementation model for adolescent ADHD behavior therapy (Supporting Teens' Autonomy Daily; STAND) blended with Motivational Interviewing (MI). A stakeholder-engaged development approach is used based on the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Resulting model features include: (a) task-shifting supervision from experts to agency supervisors, (b) holding bi-weekly technical assistance drop-ins to provide training and implementation supports, (c) MI integrity monitoring and feedback by artificial intelligence (AI), (d) AI-generated metrics for STAND content fidelity, (e) digitizing resources (manual, worksheets, tips, videos) on a clinician dashboard, (f) creating visual displays of feedback using badges and graphs, and (g) adding a rapport-building session prior to manualized content. We conducted stakeholder focus groups (N = 32) and two pilot studies to evaluate the new STAND AI measurement tool and revised service-delivery model (N = 6 therapists, 7 youth and parents, 3 agency supervisors). Results revealed advantages and disadvantages of the model, supported the promise of a STAND AI fidelity measurement tool, and indicated initial feasibility, acceptability, and agency engagement in STAND's community-based implementation model. We discuss future directions for continued iterative development and testing. Video examples are included as supplementary material. [ABSTRACT FROM AUTHOR]

In musculoskeletal and sports medicine, pain has traditionally been linked to tissue injury, often assuming a linear correlation between tissue damage and pain intensity. However, modern pain science has illuminated the complexity of the human pain experience, incorporating psychosocial elements, nervous system sensitization, immune responses, and structural changes in the brain as factors. This contemporary understanding of pain has proven highly beneficial for both clinicians treating individuals in pain and those experiencing pain. Pain neuroscience education (PNE) provides individuals in pain with an understanding of the underlying neurobiology and neurophysiology of their pain experience, which has been shown to result in decreased self-reported pain, reduced disability, the alleviation of fear and fear-avoidance behaviors, diminished pain catastrophizing, and improved movement. Currently, research on PNE predominantly focuses on interventions with individuals with persistent or chronic pain conditions. However, those who experience acute, sub-acute, and perioperative pain also have the potential for elevated levels of fear, fear-avoidance, and pain catastrophizing, indicating potential benefits from PNE. This invited commentary seeks to inform readers about the latest advancements in pain science and propose a conceptual model for delivering PNE in acute pain experiences. Level of Evidence 5 [ABSTRACT FROM AUTHOR]

Introduction: Identifying key differences between manufacturers' submitted analysis and economic reanalysis by the Canadian Agency for Drugs and Technologies in Health (CADTH) is an important step toward understanding reimbursement recommendations. We compared economic values reported in manufacturers' analysis with the CADTH reanalysis and also assessed methodological critiques. Methods: Two reviewers extracted data from the clinical and economic reports in publicly available CADTH reports from 2018 to 2022. We used the Wilcoxon rank-sum test to assess the difference between mean economic values, and the Chi-square test to assess the association between the CADTH critique final recommendations. Results: Of the total submissions, 99.4% included effectiveness critiques, 88.8% included model structure critiques, 69.1% included utility score critiques, and 78.7% included cost critiques. The median incremental cost-utility ratio (ICUR) in the manufacturers' analyses was $138,658/quality-adjusted life-year (QALY), 2.5-fold lower than the CADTH's reanalysis at $380,251/QALY (p < 0.001). The median CADTH reanalysis for 3-year budget impact analysis (BIA) was $4,575,102, which was 27% higher than the manufacturers' submitted 3-year BIA (p < 0.001). CADTH requested a price reduction for 95% of all submissions, and the median price reduction request was 63.5%. In 2021 and 2022, the willingness-to-pay threshold identified in CADTH reports remained constant at $50,000 per QALY gained for all medications. Conclusion: There was high frequency of CADTH critiques on manufacturers' submissions in all four aspects of economic submissions: effectiveness, cost, utility score and structure. We observed a higher median incremental cost and lower median incremental QALYs in the CADTH reanalysis compared with the manufacturers' submissions. The resulting higher ICUR in the CADTH reanalysis often leads to a recommendation that the manufacturer needs to reduce its price. The 3-year budget impact was higher in the CADTH reanalyses compared with manufacturers' submissions. [ABSTRACT FROM AUTHOR]

The adoption of mobile health technology can assist in enhancing the quality of life of elderly people. Over the last few years, though mHealth research has expanded, the usage of mHealth applications among elderly is still minimal. This study aims to evaluate mobile user interfaces in mHealth applications and elicit the key ageing barriers that limit the use of such apps among the elderly. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) technique was used whereby 28 papers were identified and examined out of 742. In addition to the systematic review, an experiment of using 5 existing mHealth apps was conducted with 10 individuals within the age group of 60–79 to determine additional ageing barriers and usage challenges. The Questionnaire for User Interface Satisfaction approach was used to prepare a questionnaire to assess the overall system satisfaction and was provided to participants after one week of usage. In this work, issues with the user interface that impact the elderly have been highlighted. Three important ageing barriers hindering the use of mHealth among the elderly have been identified via PRISMA, namely physical, cognitive and perspective. Empirical findings from the experiment carried out further consolidate the findings obtained from the PRISMA approach. This study's investigation emphasised the performance of older persons with mHealth apps, their needs and the challenges they confront when adopting mHealth technologies. As a result, technology designers will benefit from this information when developing and designing mHealth apps and services that are suitable for older adults. [ABSTRACT FROM AUTHOR]

Health authorities using cost-effectiveness analysis (CEA) for informing reimbursement decisions on health technologies increasingly require economic evaluations encompassing both CEA and budget impact analysis (BIA). Good Research Practices advocate that the economic and clinical assumptions underlying these analyses are aligned and consistently applied. Nonetheless, CEAs and BIAs often are stand-alone analyses used in different stages of the decision-making process. This article used policy reports and Ministerial correspondence to discuss and elucidate the role of budget impact and its relationship with cost-effectiveness in reimbursement decisions in the Netherlands. The results indicate that CEAs and BIAs are both considered important for informing these decisions. While the requirements regarding CEAs—and application of the associated decision rule—are consistent across the different stages, the same does not hold for BIAs. Importantly, the definition of and evidence on budget impact differs between stages. Some important aspects (e.g. substitution and saving effects) typically are considered in the assessment and appraisal stages but are seemingly not considered in price negotiations and the final reimbursement decision. Further research is warranted to better understand why BIAs are not aligned with CEAs (e.g. in terms of underlying assumptions), vary in form and importance between stages, and do not have a clear relationship with the results of CEAs in the decision-making framework. Improving the understanding of the circumstances under which decision-makers attach a relatively larger or smaller weight to (different aspects of) budget impact may contribute to increasing the transparency, consistency, and optimality of reimbursement decisions in the Netherlands. [ABSTRACT FROM AUTHOR]

Our objective was to compare AOTMiT (Polish: Agencja Oceny Technologii Medycznych i Taryfikacji) recommendations to other HTA (Health Technology Assessment) agencies for newly registered drugs and new registration indications issued by the European Medicines Agency between 2014 and 2019. The study aims to assess the consistency and justifications of AOTMiT recommendations compared to that of other HTA agencies in 11 countries. A total of 2496 reimbursement recommendations published by 12 HTA agencies for 464 medicinal products and 525 indications were analyzed. Our analysis confirmed that the Polish AOTMiT agency seems to bear the closest resemblance to the corresponding HTA agencies from Canada (CADTH) and New Zealand (PHARMAC), when it comes to the outcome of HTA recommendations (positive or negative). Poland had a general scheme for justifying recommendations, similar to that of Ireland—four aspects (i.e., clinical efficacy, safety profile, cost-effectiveness, and impact on the payer's budget) are important for Poland when formulating the final decision. Compared to other countries, Poland shows a noticeably different pattern of justifying reimbursement recommendations, as revealed primarily in terms of budget impact and somewhat less so for cost-effectiveness rationales. [ABSTRACT FROM AUTHOR]

Aim: This paper reports the first estimation of an SF-6D value set based on the SF-12 for Spain. Methods: A representative sample (n = 1020) of the Spanish general population valued a selection of 56 hypothetical SF-6D health states by means of a probability lottery equivalent (PLE) method. The value set was derived using both random effects and mean models estimated by ordinary least squares (OLS). The best model was chosen on the basis of its predictive ability assessed in terms of mean absolute error (MAE). Results: The model yielding the lowest MAE (0.075) was that based on main effects using OLS. Pain was the most significant dimension in predicting health state severity. Comparison with the previous SF-6D (SF-36) model estimated for Spain revealed no significant differences, with a similar MAE (0.081). Nevertheless, the new SF-6D (SF-12) model predicted higher utilities than those generated by the SF-6D (SF-36) scoring algorithm (minimum value − 0.071 vs − 0.357). Conclusion: A value set for the SF-6D (SF-12) based on Spanish general population preferences elicited by means of a PLE technique is successfully estimated. The new estimated SF-6D (SF-12) preference-based measure provides a valuable tool for researchers and policymakers to assess the cost-effectiveness of new health technologies in Spain. [ABSTRACT FROM AUTHOR]

Predicting abnormalities of wearable medical devices plays a very important role in saving the lives and health of patients. This importance has opened new horizons for researchers with the development of newer algorithms. The long-term memory algorithm (LSTM) is one of the most important methods that are a special type of recurrent neural network (RNN) that has a high ability in this field and greatly increases the accuracy of correct and incorrect prediction of these abnormalities. In the current research, by using this algorithm and taking into account different parameters, the anomalies related to the sensors of the research field were determined. The results showed that there are influential parameters in the construction of this architecture, which include 3 very important factors: the number of neurons in the LSTM layer, the batch size, and the activation function. Also, the LSTM architecture together with the Dropout layer, with parameters Batch size = N = 128 and Tanh activation function shows a better performance and the lowest amount of error (MAPE) as well as the amount of the calculated mean square error (RMSE) in determining the anomaly. have sensors in the medical field. Investigations related to the results of 16 repetitions of optimization also showed that the process of reducing errors in the correct and incorrect identification of anomalies in the training phase has reached its lowest level with the increase in the number of tests, which shows the optimality and appropriateness of the work process. Therefore, this algorithm has a very good ability to identify errors in sensors and medical wearables, and it will be of great help in identifying the possible failure of sensors, and critical conditions of the patient, informing and finally helping patients in time. [ABSTRACT FROM AUTHOR]

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This study investigates the adoption of indoor air quality (IAQ) management technologies in Germany and Portugal, focusing on the common and differentiating factors influencing individuals' motivations and the perceived health impacts of these technologies. Utilizing a model based on the protection motivation theory, we surveyed 800 participants (400 from each country) to understand how their perceptions of the risks associated with poor IAQ and their evaluations of the effectiveness and costs of technologies like air purifiers and sensors drive the adoption intention of these technologies and well‐being of individuals. To estimate the complex relationships in our model, we employed partial least squares structural equation modeling (PLS‐SEM). Our model explains nearly 50% of the variance in well‐being for both countries. The results revealed significant differences in the factors driving technology adoption: Germans are primarily motivated by individual efficacy and personal responsibility with the people close to them. Regarding the similarities, participants from both countries value the technology's effectiveness in improving IAQ and do not see being vulnerable to health issues derived from poor IAQ as a motivator. These insights highlight the need for strategies that are tailored to specific cultural and national contexts to promote the adoption of IAQ management technologies, aiming to enhance IAQ and public health outcomes. [ABSTRACT FROM AUTHOR]

Nuclear Medicine is witnessing a revolution across a large spectrum of patient care applications, hardware, software and novel radiopharmaceuticals. We propose to offer a framework of the nuclear medicine practice of the future that incorporates multiple novelties and coined as the NEW (nu) Clear medicine. All these new developments offer a significant clarity and real clinical impact, and we need a concerted effort from all stakeholders in the field for bedside implementation and success. [ABSTRACT FROM AUTHOR]

Implantable medical devices have revolutionized healthcare by providing continuous monitoring and therapeutic interventions within the human body. The overall performance of these devices is heavily dependent on the effectiveness and efficiency of integrated electronic components, such as transistors. This survey explores the growing utilization of Tunnel Field-Effect Transistors (TFETs) in implantable devices, shedding light on their advantages and challenges in this specific application domain. TFETs, characterized by their unique tunnelling mechanism, offer several advantages that make them well suited for implantable devices. Their low-power consumption, reduced leakage current, and improved subthreshold swing make them ideal for energy-efficient, long-lasting operation within the constrained power budgets of implantable devices. Furthermore, TFETs exhibit excellent performance at low supply voltages, ensuring minimal tissue damage and heat generation. This survey also addresses the challenges associated with TFETs in implantable devices, including fabrication complexities, variability, and compatibility with existing technologies. It highlights recent advancements in TFET technology that address these concerns, such as improved material choices and manufacturing techniques. As technology continues to advance, TFETs are poised to play a pivotal role in improving the overall efficiency and reliability of life-saving technologies and medical devices. Overall, this survey provides valuable insights into the current state and future prospects of TFETs in implantable devices, guiding researchers and engineers in harnessing their potential for the benefit of healthcare and patient well-being. [ABSTRACT FROM AUTHOR]

Summary Radiation, a universal component of Earth's environment, is categorized into non‐ionizing and ionizing forms. While non‐ionizing radiation is relatively harmless, ionizing radiation possesses sufficient energy to ionize atoms and disrupt DNA, leading to cell damage, mutation, cancer, and cell death. The extensive use of radionuclides and ionizing radiation in nuclear technology and medical applications has sparked global concern for their capacity to cause acute and chronic illnesses. Ionizing radiation induces DNA damage either directly through strand breaks and base change or indirectly by generating reactive oxygen species (ROS) and reactive nitrogen species (RNS) via radiolysis of water. This damage triggers a complex cellular response involving recognition of DNA damage, cell cycle arrest, DNA repair mechanisms, release of pro‐inflammatory cytokines, and cell death. This review focuses on the mechanisms of radiation‐induced cellular damage, recognition of DNA damage and subsequent activation of repair processes, and the critical role of the innate immune response in resolution of the injury. Emphasis is placed on pattern recognition receptors (PRRs) and related receptors that detect damage‐associated molecular patterns (DAMPs) and initiate downstream signaling pathways. Radiation‐induced cell death pathways are discussed in detail. Understanding these processes is crucial for developing strategies to mitigate the harmful effects of radiation and improve therapeutic outcomes. [ABSTRACT FROM AUTHOR]

Protein-based wound dressings have garnered increasing interest in recent years owing to their distinct physical, chemical, and biological characteristics. The intricate molecular composition of proteins gives rise to unique characteristics, such as exceptional biocompatibility, biodegradability, and responsiveness, which contribute to the promotion of wound healing. Wound healing is an intricate and ongoing process influenced by multiple causes, and it consists of four distinct phases. Various treatments have been developed to repair different types of skin wounds, thanks to advancements in medical technology and the recognition of the diverse nature of wounds. This review has literature reviewed within the last 3–5 years—the recent progress and development of protein in wound dressings and the fundamental properties of an ideal wound dressing. Herein, the recent strides in protein-based state-of-the-art wound dressing emphasize the significant challenges and summarize future perspectives for wound healing applications. The graphical abstract illustrates different factors for protein-based dressing, wound healing phases, various responsive factors, and fundamental properties for an ideal wound dressing for wound healing applications. [ABSTRACT FROM AUTHOR]

Background: This correlative study aimed to examine how the different primary care models (physicians in solo practice, physicians in collaborative practice, physicians and nurse practitioners in collaborative practice, after-hours clinics, community centers, or emergency rooms) were associated with their capability to offer timely access to their patients. The data collected from the primary care provider's perspective was to complete the New Brunswick Health Council results on patients' perspective. Methods: A convenience sample of 120 primary care providers (33 physicians in solo practice, 33 physicians in collaborative practice, 27 providers in collaborative practice with nurse practitioners, 2 providers working in after-hours clinics, and 10 providers in Emergency departments) responded to an online survey about their primary care models and accessibility. We used the Statistical Package for Social Sciences software to run correlations, independent t-tests and Fisher's exact tests to compare timely access to care between variable groups. Results: A positive correlation was observed between patient load (or the number of patients under a primary care provider's practice), age and years of experience. However, the patient load did not translate to more timely access to care. However, a statistically significant difference (p = 0.032) was observed when primary care providers kept appointment slots available for daily urgent requests. When a primary care provider booked all available appointment slots, only 85% of them could offer timely appointments (in 5 days or less), compared to 97% who could deliver it when appointment slots were left open in their daily schedule. The primary care model (solo vs. collaboration), the use of health technologies and the type of provider did not significantly influence timely access to care. In contrast, the primary care providers who reported teleworking (or working remotely) were less likely to offer timely access to care. Conclusion: Timely access to care is not always available to patients, even those with a primary care provider. Certain organizational practices may improve access to care and should be integrated into primary care in New Brunswick and elsewhere in Canada. [ABSTRACT FROM AUTHOR]

Background: Robotic-assisted technologies have been developed to increase surgical precision and reduce surgical variability in total knee arthroplasty (TKA). Several different robotic systems have been introduced in the last decade for TKA. The DePuy Synthes VELYS™ Robotic-Assisted Solution (VRAS) is an imageless system designed to eliminate the need for preoperative CT scans and is one of the latest entrants in the rapidly evolving field of robotic technology in TKA. This study compared the clinical and economic outcomes associated with VRAS and other robotic-assisted technologies for primary TKA. Methods: A retrospective cohort study using the Premier Healthcare Database included patients who underwent primary TKA with VRAS or other robotic-assisted technologies from January 1, 2022, to April 30, 2023. The primary outcome for the study was hospital follow-up visits (revisits) within 90 days post-TKA. Secondary outcomes included readmission and revision rates within 90 days post-TKA, operating room time, length of stay, discharge status and hospital costs. Cohorts were balanced using propensity score fine stratification, and generalized linear models were constructed to evaluate outcomes. Results: This study included 827 VRAS TKA patients and 16,428 TKA patients treated with other robotic-assisted technologies. The 90-day all-cause and knee-related revisit rates were significantly lower for VRAS than for other robotic-assisted technologies (all-cause 13.9% vs. 22.8% and knee-related 2.8% vs. 5.4%, respectively; p value < 0.01). The all-cause and knee-related 90-day readmission rates were also lower for VRAS, although the differences were not statistically significant. The 90-day revision rates were similar for VRAS and other robotic-assisted technologies (0.48% vs. 0.45%), as was the operating room time (138 vs. 137 min). The 90-day knee-related cost for the VRAS cohort was $15,048 compared to $16,867 for other robotic technologies. Conclusions: This database study demonstrated that early postoperative revisit rates and total cost of care are lower for VRAS than for all other robotic-assisted technologies for TKA, while operating room time and discharge status were similar. These are important findings in ever-evolving healthcare systems that are increasingly cost conscious and cognizant of principles associated with value-based care. [ABSTRACT FROM AUTHOR]

Immuno-positron emission tomography (immunoPET) enables imaging of specific targets that play a role in targeted therapy and immunotherapy, such as antigens on cell membranes, targets in the disease microenvironment, or immune cells. The most common immunoPET applications use a monoclonal antibody labeled with a relatively long-lived positron emitter such as 89Zr (T1/2 = 78.4 h), but smaller antibody-based constructs labeled with various other positron emitting radionuclides are also being investigated. This molecular imaging technique can thus guide the development of new drugs and may have a pivotal role in selecting patients for a particular therapy. In early phase immunoPET trials, multiple imaging time points are used to examine the time-dependent biodistribution and to determine the optimal imaging time point, which may be several days after tracer injection due to the slow kinetics of larger molecules. Once this has been established, usually only one static scan is performed and semi-quantitative values are reported. However, total PET uptake of a tracer is the sum of specific and nonspecific uptake. In addition, uptake may be affected by other factors such as perfusion, pre-/co-administration of the unlabeled molecule, and the treatment schedule. This article reviews imaging methodologies used in immunoPET studies and is divided into two parts. The first part summarizes the vast majority of clinical immunoPET studies applying semi-quantitative methodologies. The second part focuses on a handful of studies applying pharmacokinetic models and includes preclinical and simulation studies. Finally, the potential and challenges of immunoPET quantification methodologies are discussed within the context of the recent technological advancements provided by long axial field of view PET/CT scanners. [ABSTRACT FROM AUTHOR]

Wearables offer a promising solution for enhancing remote monitoring (RM) of heart failure (HF) patients by tracking key physiological parameters. Despite their potential, their clinical integration faces challenges due to the lack of rigorous evaluations. This review aims to summarize the current evidence and assess the readiness of wearables for clinical practice using the Medical Device Readiness Level (MDRL). A systematic search identified 99 studies from 3112 found articles, with only eight being randomized controlled trials. Accelerometery was the most used measurement technique. Consumer-grade wearables, repurposed for HF monitoring, dominated the studies with most of them in the feasibility testing stage (MDRL 6). Only two of the described wearables were specifically designed for HF RM, and received FDA approval. Consequently, the actual impact of wearables on HF management remains uncertain due to limited robust evidence, posing a significant barrier to their integration into HF care. [ABSTRACT FROM AUTHOR]

AbstractPurpose:Materials and methods:Results:Conclusions:\nIMPLICATIONS FOR REHABILITATIONBoth demand and need for assistive technology (AT) are growing worldwide. However, ensuring an optimal fit between the person and AT is complex. With health professionals often being the “gatekeeper” to AT, it is imperative to understand their experiences of AT. This study was positioned within a sociotechnical space known as “HabITec”, which aims to bring together potential AT users with health professionals and technology developers to enhance the technology-person fit. The current paper reports on health professionals’ experiences of the HabITec Lab (THL), the physical manifestation of HabITec that was piloted in a tertiary hospital for 12-months.The study used a qualitative descriptive approach to explore the experiences of nine health professionals who referred patients to the lab. Four major themes were identified together with suggestions for the future of THL and HabITec. The themes focused on 1) Balancing service and independence; 2) Capitalising on possibilities and connections; 3) Negotiating multiple mismatches; and 4) Fitting it all together in a coherent service.It was clear that health professionals who referred patients to THL identified a range of benefits associated with it, but barriers to its effectiveness were identified and concerns were raised over health professionals becoming too reliant on the lab. For THL to be sustainably implemented, it appears that a policy-level shift is needed to enable its appropriate resourcing.A sociotechnical space with the capacity to bring together assistive technology users with health professionals and technology developers has shown potential to enhance the technology-person fit.A policy-level shift is needed to ensure future successful and sustainable implementation of such a space; however, further comparison with standard assistive technology practice is needed to warrant investment.Such a space should be conscious of equipping health professionals with assistive technology knowledge and skills.Attention must be paid to adequate promotion of services to ensure appropriate uptake.A sociotechnical space with the capacity to bring together assistive technology users with health professionals and technology developers has shown potential to enhance the technology-person fit.A policy-level shift is needed to ensure future successful and sustainable implementation of such a space; however, further comparison with standard assistive technology practice is needed to warrant investment.Such a space should be conscious of equipping health professionals with assistive technology knowledge and skills.Attention must be paid to adequate promotion of services to ensure appropriate uptake. [ABSTRACT FROM AUTHOR]

Background: Application of data-driven strategies may support veterinarians' decision-making, benefitting pig disease prevention and control. However, little is known about veterinarians' need for data utilisation to support their decision-making process. The current study used qualitative methods, specifically focus group discussions, to explore veterinarians' views on data utilisation and their need for data tools in relation to pig health and welfare management in Spain, the Netherlands, and Ireland. Results: Generally, veterinarians pointed out the potential benefits of using technology for pig health and welfare management, but data is not yet structurally available to support their decision-making. Veterinarians pointed out the challenge of collecting, recording, and accessing data in a consistent and timely manner. Besides, the reliability, standardisation, and the context of data were identified as important factors affecting the efficiency and effectiveness of data utilisation by veterinarians. A user-friendly, adaptable, and integrated data tool was regarded as potentially helpful for veterinarians' daily work and supporting their decision-making. Specifically, veterinarians, particularly independent veterinary practitioners, noted a need for easy access to pig information. Veterinarians such as those working for integrated companies, corporate veterinarians, and independent veterinary practitioners expressed their need for data tools that provide useful information to monitor pig health and welfare in real-time, to visualise the prevalence of endemic disease based on a shared report between farmers, veterinarians, and other professional parties, to support decision-making, and to receive early warnings for disease prevention and control. Conclusions: It is concluded that the management of pig health and welfare may benefit from data utilisation if the quality of data can be assured, the data tools can meet veterinarians' needs for decision-making, and the collaboration of sharing data and using data between farmers, veterinarians, and other professional parties can be enhanced. Nevertheless, several notable technical and institutional barriers still exist, which need to be overcome. [ABSTRACT FROM AUTHOR]

Background: Africa, specifically the Sub-Saharan region, has had numerous medical technology clinical trials to address the various healthcare challenges around infectious diseases, non-communicable diseases, and nutritional disorders it is facing. Medical device clinical trials provide performance data in terms of safety, efficacy, and efficiency, which is a requirement before commercialization. Key players such as academicians, governments, international organizations, and funders collaborate to drive these trials, but their growth in Africa remains slower compared to other parts of the globe. This paper aims to evaluate the number of medical device clinical trials conducted in different African countries that are registered on the clinicaltrials.gov website. Methods: Data on medical device clinical trials was mined from clinicaltrials.gov website accessed on 22nd September, 2022. The data extracted was analyzed and cleaned in Microsoft Excel and R. Countries were grouped into regions and descriptive statistical analyses for each region were done. Additionally, frequency distributions were also generated and no inferential statistical tests were performed, as the primary focus of this analysis was to describe the distribution of medical conditions across regions. Results: Thirty-one African countries had registered medical device clinical trials on the website with the majority taking place in Egypt and South Africa. Medical device trials for heart related issues took longer to complete compared to other conditions. Malaria, HIV, and male circumcision related device trials were mainly conducted in Eastern and Southern Africa while trials related to dental, fertility, and obesity were concentrated in Northern Africa. Female reproductive health issues were studied equally across all regions. Some African countries did not have any trials registered on clinicaltrials.gov website. Conclusion: Findings from this study clearly show the disparity in the number, status, and duration of medical device clinical trials across various African countries. [ABSTRACT FROM AUTHOR]

Health Technology Assessment (HTA) is essential for evidence-based healthcare decision-making, yet its integration into Iran's healthcare system faces political and logistical challenges. Despite HTA's potential to improve resource allocation, limited awareness, data gaps, and competing priorities hinder its implementation. This commentary emphasizes the need for political support, advocating capacity-building, collaboration, and alignment with long-term health policies. Leveraging international partnerships and monitoring outcomes can enhance HTA's role in improving healthcare in Iran and contributing to global health advancements. [ABSTRACT FROM AUTHOR]

Reports of Large Language Models (LLMs) passing board examinations have spurred medical enthusiasm for their clinical integration. Through a narrative review, we reflect upon the skill shifts necessary for clinicians to succeed in an LLM-enabled world, achieving benefits while minimizing risks. We suggest how medical education must evolve to prepare clinicians capable of navigating human-AI systems. [ABSTRACT FROM AUTHOR]

Around the world, the adoption of digital technologies in health care has accelerated considerably in the wake of the COVID-19 pandemic. Prior to the emergence of the pandemic, China had already embarked on a private sector, technology enterprise-led creation of an innovative internet health care ecosystem, which has dramatically transformed China's health care landscape. In this article, we describe the evolution of China's internet health market, focusing on internet telemedicine. We trace its early origins with the establishment of information networks in the 1980s, to the emergence of a fast-growing internet health market in the 2010s that leveraged the capabilities of technology enterprises in e-commerce, logistics, and payment systems. Private health care platforms have played a central role throughout this transformative process. The supplyside of the market has a unique public-private mix structure, with the coexistence of public and private internet hospitals, and with the majority of telemedicine services provided by public hospital doctors working on private platforms in a dual practice capacity. We conclude with a discussion of the prospects of internet telemedicine, including how it should be optimized and harnessed to improve China's health system. Finally, we set out areas where more research is needed. [ABSTRACT FROM AUTHOR]

Robotic-assisted total knee arthroplasty (R-TKA) has emerged as a transformative technology in orthopedic surgery, potentially offering improved precision, better clinical outcomes and higher surgical efficiency compared to traditional methods. This work provides a detailed overview of the technological basis, clinical advantages and future developments of R-TKA. Current evidence suggests that R-TKA results in superior implant positioning, reduced postoperative pain and better functional outcomes. However, challenges such as high costs, associated learning curve and technological dependency need to be addressed to achieve wider adoption. [ABSTRACT FROM AUTHOR]

Introduction: Access to medicines is a critical aspect of healthcare, and health technology assessment (HTA) agencies play a pivotal role in evaluating innovative medicines. Objectives: The objective of this study was to critically review Health Technology Assessment (HTA) recommendations for innovative medicines across the United Kingdom (England, Scotland, Wales and Northern Ireland) following their licensure by the European Medicines Agency (EMA) in 2017. By analysing HTA recommendations, we aimed to understand differences between licensing and reimbursement recommendations and explore variations in access to innovative treatments within the UK. Methods: The study focused on HTA decisions made between 2017 and 2020 in the UK for innovative medicines that were licensed by the European Medicines Agency (EMA) in 2017. Published documents were used for the analysis. The decisions were categorized as 'recommend without restrictions', 'recommend with restrictions', 'not recommended' or 'not assessed'. Results: In 2017, the EMA approved licenses for 56 new innovative medicines. Between 2017 and January 2020, the National Institute for Health and Care Excellence (NICE) in England completed the appraisal of 28 of these medicines. Out of the 28, 11 were 'recommended without restrictions', 15 were 'recommended with restrictions' and 2 were 'not recommended'. The majority of NICE recommendations (21 out of 26, or 81%) were made through managed access agreements. The Scottish Medicines Consortium (SMC) assessed 31 out of the 56 medicines licensed in 2017. Among these 31, 8 were 'recommended without any restriction', 22 were 'recommended with restrictions' and 1 was 'not recommended'. In Wales, the All Wales Medicines Strategy Group (AWMSG) follows NICE guidance and does not review a medicine if NICE is planning to assess it within the next 12 months. In Northern Ireland, HTA guidance from either NICE or SMC is followed, and a decision is adopted shortly after one of them makes its decision. In Northern Ireland, 39 recommendations were adopted from either NICE or SMC, including 10 without restrictions, 21 with restrictions and 8 not recommended decisions. Conclusions: This study sheds light on the complex landscape of medicine licensing and reimbursement in the UK. While licensing approval ensures safety and efficacy, it does not guarantee access to medicines without reimbursement recommendations. Health technology assessment (HTA) bodies play a crucial role in evaluating clinical effectiveness and cost-effectiveness. Our findings reveal variations in HTA adoption across UK countries, emphasizing the importance of timely recommendations. Notably, 'recommendations with restrictions' prevail, often linked to managed access agreements. As we navigate this complex system, optimizing patient care remains paramount. [ABSTRACT FROM AUTHOR]

This study aimed to explore behavior analysis and risk identification for stroke patients under medical technology intelligentization, to establish a design and implementation of risk control and post-event recovery. A total of 80 stroke patients from 2019 to 2021 were selected using service design thinking combined with patient behavior as the guiding principle. The study used smart device monitoring modules and balance monitoring applications to monitor the daily behavior and post-event behavior of stroke patients and used intelligent recognition and analysis of risk behavior to develop interventions for post-event recovery services. The conclusion is that by combining service design thinking with patient behavior as the guiding principle, medical technology advancements in the field of intelligentization have the potential to greatly impact stroke patient care by enabling behavior analysis and risk identification. By utilizing smart device monitoring modules and balance monitoring applications, healthcare professionals can gather valuable data to understand better the behaviors and risks associated with stroke patients. This approach can provide a forward-looking reminder for risky behaviors and intervene in stroke patients’ behaviors, reducing the risk of stroke recurrence. [ABSTRACT FROM AUTHOR]

The article evaluates three commercial lateral flow immunoassays for detecting carbapenemases in Gram-negative bacteria, emphasizing the importance of accurate identification for infection control and treatment. Results showed varying detection capabilities for different carbapenemase families, underscoring the need for timely identification. The document provides a detailed overview of various strains of bacteria, their species, and the carbapenemases they possess, essential for understanding resistance patterns and aiding in research and treatment strategies. The study found that while all three systems exhibited 100% specificity, some variants were missed, indicating challenges in diagnostic sensitivity and the need for further testing to enhance performance. [Extracted from the article]

Mobile health technologies enable continuous, quantitative assessment of mobility and gait in real-world environments, facilitating early diagnoses of gait disorders, disease progression monitoring, and prediction of adverse events like falls. Traditionally, mobile gait assessment predominantly relied on body-fixed sensors positioned at the feet or lower trunk. Here, we investigate the potential of an algorithm utilizing an ear-worn motion sensor for spatiotemporal segmentation of gait patterns. We collected 3D acceleration profiles from the ear-worn sensor during varied walking speeds in 53 healthy adults. Temporal convolutional networks were trained to detect stepping sequences and predict spatial relations between steps. The resulting algorithm, mEar, accurately detects initial and final ground contacts (F1 score of 99% and 91%, respectively). It enables the determination of temporal and spatial gait cycle characteristics (among others, stride time and stride length) with good to excellent validity at a precision sufficient to monitor clinically relevant changes in walking speed, stride-to-stride variability, and side asymmetry. This study highlights the ear as a viable site for monitoring gait and proposes its potential integration with in-ear vital-sign monitoring. Such integration offers a practical approach to comprehensive health monitoring and telemedical applications, by integrating multiple sensors in a single anatomical location. [ABSTRACT FROM AUTHOR]

Oximeters have significantly evolved since their invention and are essential for monitoring chronic diseases in home care. However, commercial models can present an economic barrier. Therefore, we conducted a review of the use of low-cost pulse oximeters in the home care of patients with respiratory diseases. Our review included studies addressing oxygen saturation and heart rate monitoring in adults, focusing on the use of portable devices. Our search identified advances in vital signs monitoring that could provide accessible solutions for non-clinical settings. Although there are challenges related to clinical validation and accuracy, these oximeters may improve medical care, particularly in resource-limited areas. As a result, the accessibility of these devices opens up new possibilities for patients with chronic respiratory diseases in home care, enabling regular self-monitoring and increasing control over their health. [ABSTRACT FROM AUTHOR]

In the last few decades, major progress has been made in the medical field; in particular, new treatments and advanced health technologies allow for considerable improvements in life expectancy and, more broadly, in quality of life. As a consequence, the number of elderly people is expected to increase in the following years. This trend, along with the need to improve the independence of frail people, has led to the development of unobtrusive solutions to monitor daily activities and provide feedback in case of risky situations and falls. Monitoring devices based on radar sensors represent a possible approach to tackle postural analysis while preserving the person's privacy and are especially useful in domestic environments. This work presents an innovative solution that combines millimeter-wave radar technology with artificial intelligence (AI) to detect different types of postures: a series of algorithms and neural network methodologies are evaluated using experimental acquisitions with healthy subjects. All methods produce very good results according to the main parameters evaluating performance; the long short-term memory (LSTM) and GRU show the most consistent results while, at the same time, maintaining reduced computational complexity, thus providing a very good candidate to be implemented in a dedicated embedded system designed to monitor postures. [ABSTRACT FROM AUTHOR]

Neural recording systems play a crucial role in comprehending the intricacies of the brain and advancing treatments for neurological disorders. Within these systems, the analog-to-digital converter (ADC) serves as a fundamental component, converting the electrical signals from the brain into digital data that can be further processed and analyzed by computing units. This research introduces a novel nonlinear ADC designed specifically for spike sorting in biomedical applications. Employing MOSFET varactors and voltage-controlled oscillators (VCOs), this ADC exploits the nonlinear capacitance properties of MOSFET varactors, achieving a parabolic quantization function that digitizes the noise with low resolution and the spikes with high resolution, effectively suppressing the background noise present in biomedical signals. This research aims to develop a reconfigurable, nonlinear voltage-controlled oscillator (VCO)-based ADC, specifically designed for implantable neural recording systems used in neuroprosthetics and brain–machine interfaces. The proposed design enhances the signal-to-noise ratio and reduces power consumption, making it more efficient for real-time neural data processing. By improving the performance and energy efficiency of these devices, the research contributes to the development of more reliable medical technologies for monitoring and treating neurological disorders. The quantization step of the ADC spans from 44.8 mV in the low-amplitude range to 1.4 mV in the high-amplitude range. The circuit was designed and simulated utilizing a 180 nm CMOS process; however, no physical prototype has been fabricated at this stage. Post-layout simulations confirm the expected performance. Occupying a silicon area is 0.09 mm2. Operating at a sampling frequency of 16 kS/s and a supply voltage of 1 volt, this ADC consumes 62.4 µW. [ABSTRACT FROM AUTHOR]

Simple Summary: Brachytherapy is a form of internal radiation therapy where radioactive sources are placed directly in or near tumors. This paper shows how brachytherapy can be personalized using new technologies like 3D-printed applicators, advanced imaging techniques, and artificial intelligence to make treatment more precise and effective. The authors also explore the role of genetic tests and biomarkers for choosing the best treatments for each patient, as well as future approaches such as combining brachytherapy with immunotherapy and developing new ways to shape radiation doses using shielding. By tailoring treatments to individual patients, personalized brachytherapy aims to effectively treat cancer while reducing treatment-related side effects. Brachytherapy offers a highly conformal and adaptive approach to radiation therapy for various oncologic conditions. This review explores the rationale, applications, technological advances, and future directions of personalized brachytherapy. Integration of advanced imaging techniques, 3D-printed applicators, and artificial intelligence are rapidly enhancing brachytherapy delivery and efficiency, while genomic tests and molecular biomarkers are refining patient and dose selection. Emerging research on combining brachytherapy with immunotherapy offers unique synergistic potential, and technologies such as intensity-modulated and shielded brachytherapy applicators present novel opportunities to further optimize dose distributions. Despite these promising advances, the field faces challenges including a need to train more practitioners and develop new approaches to treating a broader range of malignancies. As personalized medicine evolves, brachytherapy's ability to deliver highly targeted, individualized treatments positions it as a critical component in future cancer care. [ABSTRACT FROM AUTHOR]

Simple Summary: Salivary gland tumors (SGTs) are rare and complex, making them difficult to diagnose and treat. This work focuses on the role of exosomes, extracellular vesicles secreted by almost all cell types, in the development and progression of SGT. Exosomes are crucial in cell-to-cell communication and play significant roles in tumor biology, including modulating the tumor environment, aiding metastasis, and affecting immune responses. A better understanding of exosome biology can lead to their use as biomarkers for diagnosis and prognosis, as well as targets for treatment, potentially transforming SGT management and improving patient outcomes. Exosome-based liquid biopsies could offer non-invasive, real-time diagnostics and enhance patient care through precision medicine. This review explores the advancements in salivary exosome analysis, highlighting its potential for non-invasive cancer detection and the development of innovative diagnostic techniques. Backgroud: Salivary gland tumors (SGTs) are rare and diverse neoplasms, presenting significant challenges in diagnosis and management due to their rarity and complexity. Exosomes, lipid bilayer vesicles secreted by almost all cell types and present in all body fluids, have emerged as crucial intercellular communication agents. They play multifaceted roles in tumor biology, including modulating the tumor microenvironment, promoting metastasis, and influencing immune responses. Results: This review focuses on the role of exosomes in SGT, hypothesizing that novel diagnostic and therapeutic approaches can be developed by exploring the mechanisms through which exosomes influence tumor occurrence and progression. By understanding these mechanisms, we can leverage exosomes as diagnostic and prognostic biomarkers, and target them for therapeutic interventions. The exploration of exosome-mediated pathways contributing to tumor progression and metastasis could lead to more effective treatments, transforming the management of SGT and improving patient outcomes. Ongoing research aims to elucidate the specific cargo and signaling pathways involved in exosome-mediated tumorigenesis and to develop standardized techniques for exosome-based liquid biopsies in clinical settings. Conclusions: Exosome-based liquid biopsies have shown promise as non-invasive, real-time systemic profiling tools for tumor diagnostics and prognosis, offering significant potential for enhancing patient care through precision and personalized medicine. Methods like fluorescence, electrochemical, colorimetric, and surface plasmon resonance (SPR) biosensors, combined with artificial intelligence, improve exosome analysis, providing rapid, precise, and clinically valid cancer diagnostics for difficult-to-diagnose cancers. [ABSTRACT FROM AUTHOR]

Introduction: Pulsed‐field ablation (PFA) is a novel nonthermal energy that shows unique features that can be of use beyond pulmonary vein ablation, like tissue selectivity or proximity rather than contact dependency. Methods and Results: We report three cases of right focal atrial tachycardias arising from the superior cavoatrial junction and the crista terminalis, in close relationship with the phrenic nerve, effectively ablated using a commercially available PFA catheter designed for pulmonary vein isolation without collateral damage. Conclusion: PFA can be useful for treating right atrial tachycardias involving sites near the phrenic nerve, avoiding the need for complex nerve‐sparing strategies. [ABSTRACT FROM AUTHOR]

Assisted reproductive technologies (ARTs) have become a widely utilized medical technology for treating infertility worldwide. However, societies and countries have applied these technologies in accordance with their cultural practices and belief systems. This paper presents an overview of ART providers in Bangladesh and analyzes their online content in addressing potential infertile couples. Examining the topic within the context of socio-economic and public health challenges in Bangladesh, particularly overpopulation, poverty, and lack of education, the research conducted a web content analysis of ART providers in Bangladesh from July 1 to September 1, 2023. Twenty active ART providers were identified using Google searches and an exploratory key. The analysis considered locations, landing page information, ethical standards, quality certification, foreign affiliations, and success rates. The findings revealed a concentration of centers in urban areas, raising concerns about equitable access. The absence of regulation and guidelines, coupled with the lack of ART clinic registration, highlighted potential risks to patient well-being. Landing page statements utilized highly emotive language and ambiguous terms, raising ethical concerns. The absence of explicit mention of quality standards, including ISO 9001:2000 certification, indicated potential gaps in transparency. Foreign affiliations were employed for credibility, raising concerns of misleading advertising. Limited and ambiguous reporting of success rates posed challenges for informed decision-making. Evident exploitative and commercialized practices raised concerns about potentially commodifying reproductive services. The study emphasizes the need for regulatory frameworks, transparency in reporting, adherence to ethical advertising, and increased cultural sensitivity to enhance the ethical standards of ART providers in Bangladesh. [ABSTRACT FROM AUTHOR]

It is the year 2050, and the world of medicine has undergone significant changes. With the advent of advanced technology and medical breakthroughs, medical schools have become even more competitive. Medical students are now required to have an exceptional academic record, outstanding research experience, and a perfect social media presence. However, with the rise of social media, a new phenomenon has emerged, one that has been plaguing medical students for years - imposter syndrome. [ABSTRACT FROM AUTHOR]

Introduction: The use of portable ultrasound equipment in emergency medicine has shown the capacity to greatly improve patient care in the swiftly changing field. This research evaluates the influence of the Butterfly POCUS device on patient contentment in the Emergency Department at Jordan University Hospital. Materials and Methods: We conducted a cross-sectional survey of 98 patients to examine their satisfaction levels after undergoing an ultrasound examination. We then evaluated these levels in relation to demographic and clinical characteristics. Results: Seventy eight percent of the patients expressed a high level of satisfaction with their evaluation. This satisfaction level was consistent across all patient demographics, with no notable differences. Significantly, there was a clear correlation between greater satisfaction levels and higher first pain ratings, indicating that the technology effectively addresses patient concerns and enhances the diagnostic experience. Conclusion: The findings of our study support the wider use of portable ultrasound technology in emergency care settings, emphasizing its ability to greatly enhance patient satisfaction and outcomes. Further investigation should include multicenter trials to authenticate these results and investigate the long-term effects on clinical practice. [ABSTRACT FROM AUTHOR]