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Robots and artificial intelligence (AI) have seen increased adoption in healthcare. These health technologies have the capability of providing tailored messages and feedback to each individual. Thus, a robot can potentially serve as a personal health advisor, particularly for health issues that could be benefited through regular guidance and instructions. However, there is a limited understanding of how people might respond to the idea that their health advisor could be a robot. Thus, the present study employs the technology acceptance model (TAM) to examine intentions to adopt a robotic health advisor. Findings demonstrate that perceived ease of communication with and perceived usefulness of a robotic health advisor positively predict favorable attitudes toward a robotic health advisor, which subsequently leads to strong intentions to adopt it. The present investigation also finds that perceived usefulness of a robotic health advisor directly leads to an individual's intentions to adopt it. Overall, the present study provides important implications for perceptions of a robotic health advisor. [ABSTRACT FROM AUTHOR]

Background & Objective: Today, blockchain technology presents a new framework that can help address some challenges facing health and medical education. Accordingly, there is a growing interest in using this important technology, especially among medical educators. Looking towards the future of educational technology and considering the end of the COVID-19 pandemic, medical education experts are expected to accept blockchain technology widely. This study aims to investigate all aspects related to the application of blockchain in medical education. Material & Methods: The study was conducted through a PRISMA systematic review of 10 databases, namely Scopus, Web of Science, Eric, Wiley Online Library, ProQuest, Springer, Noormags, Magiran, and Irandoc, in December 2022, and was updated in February 2023. By utilizing the strategies of this systematic review, a total of 980 related articles were identified, of which 187 were selected. After screening and criteria were applied, 18 relevant articles were selected to complete the research. Results: The results show that the application of blockchain technology in medical education has the most significant impact in the two sectors of education and healthcare. In health and treatment, blockchain technology plays a crucial role in registering patients' treatment records, storing treatment information, and ensuring the security and durability of information. In medical education, blockchain technology is utilized to issue educational certificates, enhance credibility, offer cloud storage space, and enhance the quality of teaching and learning. The trend in research methods is shifting towards mixed methods. Conclusion: According to this study, blockchain technology in medical education creates suitable capacities for learners and teachers through a systemic approach and collective wisdom. Despite the positive aspects and efforts to address the challenges, the field of medical education is still experiencing an exponential trend in the use of technology. We expect more research and the integration of blockchain technology in medical education in the short term. [ABSTRACT FROM AUTHOR]

The appraisal of vaccines in the European Union (EU) currently involves many different decision-making bodies and processes. The objective of this study was to help inform the development of standardized methodology and vaccine-specific processes for use in the EU Regulation on health technology assessment (HTA). Literature reviews and expert consultation were conducted to identify current practices and gaps related to vaccine appraisals and to develop guiding principles for the joint clinical assessment of vaccines. We found that significant variation exists across the EU member states in the decision-making processes when clinically evaluating vaccines. Three guiding principles consisting of 13 recommendations were developed to help inform the development of decision-making frameworks for the joint clinical assessment of vaccines in the EU: (1) support the creation of appropriate terminology and measurements for clinical appraisals of vaccines; (2) develop inclusive, timely, and transparent vaccine appraisal processes to support stronger evidence generation for vaccine decision making and appraisal; and (3) improve the collection and interoperability of real-world data, including robust surveillance, to foster evidence generation and support the standardization of vaccine clinical appraisals. Given the significance of vaccines for public health, there is an urgency to develop standardized and vaccine-specific methodologies and processes for use in the EU joint HTA framework. The proposed guiding principles could support the effective implementation of the EU Regulation on HTA for vaccines and have the potential to ensure consistent, transparent, and timely access to new vaccines in the EU. • Vaccine assessment is a key component of immunization systems across European Union (EU) member states, determining not only when and which vaccines are included in National Immunization Programmes but also whether they are funded by the government. • In the context of the EU Regulation on health technology assessment (HTA), which will enter into force in January 2025, this article discusses how the joint EU HTA framework can contribute to unlocking the full value of vaccination as the main tool for primary disease prevention and address the significant variations that currently exist in vaccine evaluations and decision-making processes. • Three guiding principles consisting of 13 recommendations were developed to assist decision makers in considering vaccine specificities in the implementation of the EU Regulation on HTA to standardize assessment processes and methodologies for vaccines and ultimately reduce inequalities in population access to vaccines. [ABSTRACT FROM AUTHOR]

Uncertainty regarding the long-term relative effectiveness is an important factor in health technology assessment (HTA) of medicines. This study investigated how different HTA bodies address this uncertainty in their assessments. A total of 49 HTA reports from 6 national HTA bodies, assessing 9 medicines for spinal muscular atrophy, cystic fibrosis, and hypercholesterolemia, were included. In these reports, 81 relative effectiveness assessments and 45 cost-effectiveness assessments were performed on an indication level. We collected information on included trials, assessment outcomes, uncertainty regarding the long-term effectiveness, proposed managed entry agreements, and reassessments. Uncertainty regarding the long-term effectiveness was an important consideration in almost all cost-effectiveness assessments (91%) and three-quarters of relative effectiveness assessments (74%), despite differences in methodologies among HTA bodies. There were considerable differences in the amount and type of long-term effectiveness data included by HTA bodies due to timing and inclusion criteria. In total 23 managed entry agreements were proposed of which 14 were linked to uncertainty regarding the long-term effectiveness. In addition, 13 reassessments were performed of which 4 led to an increase in patient access because of more available long-term effectiveness data. Uncertainty regarding the long-term effectiveness is an important challenge for HTA bodies. There are large differences in the acceptance of evidence among HTA bodies, which leads to heterogeneity in the inclusion of available long-term effectiveness data for decision making. In cases with large uncertainty regarding the long-term effectiveness, outcome-based agreements and reassessments are used by HTA bodies, but differently between HTA bodies and indications. • To ensure patient access to effective medicines, health technology assessment (HTA) bodies are tasked with assessing the value of new therapies to make reimbursement recommendations. For medicines that seek reimbursement with limited long-term effectiveness data, this value assessment is challenging for HTA bodies. Given that these medicines can sometimes be very costly, the uncertainty regarding their long-term effectiveness introduces a financial risk to payers when reimbursing these medicines. • Differences in acceptance of evidence and timing of assessment led to differences in the amount and type of long-term effectiveness data used by HTA bodies. HTA bodies used outcome-based agreements and reassessments to address uncertainty regarding the long-term effectiveness to a limited extent and differences in implementation of these measures existed between HTA bodies and indications. • More alignment and transparency on the acceptance and inclusion of different types of evidence by HTA bodies might be needed to increase the quality of future studies, for instance through the EU joint clinical assessment and joint scientific consultations. Both outcome-based managed entry agreements and reassessments can be used to mitigate financial risk in cases with considerable uncertainty regarding the long-term effectiveness but more research is needed into their effective implementation. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic put unprecedented pressure on weight management services. These services were required to adapt to continue to provide care for people living with obesity. This study sought to develop consensus recommendations on the best practice solutions adopted by weight management services in the United Kingdom during the COVID‐19 pandemic. Methods: This study utilised a semi‐structured interview and a modified Delphi methodology to develop a consensus of best practice recommendations identified by specialist weight management services during the pandemic. Results: Twenty‐three healthcare professionals working in weight management service across the United Kingdom participated in the study. Analysis of interview transcripts identified four key thematic domains: outpatient, patient education and support, perioperative care and team working. Of the initial 43 unique recommendations, 30 reached consensus agreement. Outpatient recommendations focused on communication strategies, patient self‐monitoring and remote patient tracking. Patient education and support recommendations addressed the development of online educational resources and support groups. Perioperative care recommendations emphasised case prioritisation, waiting list support and postoperative care. Team working recommendations targeted the use of digital collaboration tools and strategies for effective teamwork. Conclusion: Developing consensus recommendations on best practice is a critical step for weight management and outpatient services to achieve higher standards of care. These recommendations provide a springboard for departmental discussions, paving the way for improved experiences for individuals living with obesity as they progress along their weight management journey. Key points: During times of crisis, healthcare providers in weight management services can rapidly adopt innovative digital solutions to support good patient care.Thirty expert consensus recommendations relating to outpatient management, patient education and support, perioperative care and team working were found.Collaborative research is key to further guideline development on obesity management in areas of outpatient care, patient education, perioperative care and team working. [ABSTRACT FROM AUTHOR]

Vascularity plays a pivotal role in the progression of breast lesions and may be associated with their aggressiveness and likelihood of being malignant. Contrast-enhanced imaging techniques are necessary to evaluate vascularity due to the limited sensitivity of conventional color Doppler techniques, in which motion artifacts are eliminated using wall filters. However, in this process, low-flow signals from small vessels also get removed unintentionally. Advancements in technology have revolutionized the way ultrasound images are generated, resulting in tremendous improvements in Doppler imaging techniques. The new, ultrasound-based noncontrast microvascular imaging techniques overcome the limitations of conventional Doppler, and are highly sensitive for detecting microvessels and low flow. The resultant high Doppler sensitivity leads to detection of vascularity in more breast lesions. It is important for radiologists to understand the imaging principles and the clinical implications of the new techniques, to optimally utilize them and aid correct diagnosis. Angio-PLUS is one such recent advancement, which uses unfocused or plane waves and three-dimensional wall filtering to analyze tissue motion in time, space, and amplitude domains that effectively distinguish between blood flow and tissue. The information is beneficial for assessing the lesion vascularity without using contrast. This article aims to explain the Doppler imaging techniques, their clinical applications, scanning methods, and review the common Doppler-based diagnostic criteria used in the evaluation of breast lesions. [ABSTRACT FROM AUTHOR]

Background: Scar formation after neck surgery is a frequent concern, impacting patients both physically and psychologically. Cosmetic appearance plays a crucial role in assessing surgical success. At present, the evolving medical technologies introduces innovations like Geometric Electron Modulation (GEM) electrocautery. GEM technology offers potential benefits such as reduced thermal injury and consistent heat emission during surgery compared to conventional electrocautery. Objectives: To compare the difference between postoperative neck scars from the surgical blade as the gold standard and geometric electron modulation electrocautery. Material and methods: A randomized controlled study was performed on the patients who were diagnosed with surgical conditions requiring neck surgery at the Department of Otolaryngology Head and Neck Surgery, King Chulalongkorn Memorial Hospital, from 2023 to 2024. The Patient and Observer Scar Assessment Scale was utilized to assess scar appearance at 1 and 3 months following the surgery, and the amount of blood loss during incision was recorded. Results: 22 patients were enrolled to this study. At 1-month follow-up, we saw significant difference between GEM (20.32 ± 4.11) and the surgical blade (23.27 ± 4.59) (P = 0.008) from POSAS, patient scale but no significant difference in doctor scale, (GEM 21.55 ± 7.34, surgical blade 24.27 ± 7.88, P = 0.155). At 3-month follow-up, there were no significant difference between the groups both doctor (GEM 16.45 ± 4.62, surgical blade 17.65 ± 4.50, P = 0.411) and patient scale (GEM 13.15 ± 2.96, surgical blade 14.05 ± 3.33, P = 0.328). Conclusion: GEM electrocautery had a superior scar outcome to a surgical blade at 1 month from the patient perspective. There was also significantly less blood loss in GEM compared with the surgical blade. [ABSTRACT FROM AUTHOR]

New health technologies are constantly developing. However, their impacts on health and implications for health systems are not always clear. Faced with this situation, in the last 45 years, Health Technology Assessment (HTA) has taken an important role in the decision-making process related to the implementation of technologies in healthcare systems. According to the Core Model® EUnetHTA, a "full HTA" should cover nine domains: health problems and current use of technology, description and technical characteristics, safety, clinical effectiveness, costs and economic evaluation, ethical analysis, organizational aspects, patients and social aspects, legal aspects. In all domains of a HTA, the approach is evidence-based and uses epidemiological data, systematic reviews to gather the best level of proofs regarding clinical efficacy and safety of interventions and comparators and organizational and economic models. One exception is the ethical analysis, that uses value-based approach. Although in Neonatal Intensive Care Units (NICUs) there are highly advanced technological environments, HTA has not yet been widely used in this field for determining the "value" of the diagnostic and therapeutic procedures. An example of diagnostic tool used in NICUs is the near-infrared spectroscopy (NIRS), a noninvasive device that enables real-time monitoring of the condition of peripheral tissues in critically ill newborns. The availability of this diagnostic tool could improve the choice of the most appropriate treatment to the clinical situation of the newborn. The expected benefit of NIRS motivates the need of a full HTA. Conclusion: HTA is still little used in Neonatal Critical Care, but it may be the appropriate tool to determine the "value" of technologies used in this field. The implementation of clinical trials and HTA may help in an evidence-based evaluation of new technologies for the neonatal critical care. This could facilitate the rapid introduction of the best health technologies into clinical practice. What is Known: • Health Technology Assessment (HTA) has taken an important role in the decision-making process related to the implementation of technologies in healthcare systems • The centrality of ethics in HTA has been known. In fact, ethics is everywhere in HTA, and value judgments permeate all levels of HTA What is New: • HTA is still little used in Neonatal Critical Care, but it may be the appropriate tool to determine the "value" of technologies used in this field • The implementation of clinical trials and HTA may help in an evidence-based evaluation of new technologies for the neonatal critical care and in introduction of the best and ethically acceptable health technologies into clinical practice. [ABSTRACT FROM AUTHOR]

There is increasing interest in the use of cure modelling to inform health technology assessment (HTA) due to the development of new treatments that appear to offer the potential for cure in some patients. However, cure models are often not included in evidence dossiers submitted to HTA agencies, and they are relatively rarely relied upon to inform decision-making. This is likely due to a lack of understanding of how cure models work, what they assume, and how reliable they are. In this tutorial we explain why and when cure models may be useful for HTA, describe the key characteristics of mixture and non-mixture cure models, and demonstrate their use in a range of scenarios, providing Stata code. We highlight key issues that must be taken into account by analysts when fitting these models and by reviewers and decision-makers when interpreting their predictions. In particular, we note that flexible parametric non-mixture cure models have not been used in HTA, but they offer advantages that make them well suited to an HTA context when a cure assumption is valid but follow-up is limited. [ABSTRACT FROM AUTHOR]

Physical health habits including physical activity and nutrition are essential for numerous health benefits. However, beginning in childhood, individuals with intellectual disability engage in lower levels of physical activity and healthy nutrition habits compared to individuals without intellectual disability, a trend that carries on into adulthood. Researchers continue to examine the effectiveness of interventions to increase engagement in physical health habits and improve health outcomes for individuals with intellectual disability, with an increased focus on technology-based interventions. This scoping review aimed to describe how technology was being utilized within interventions to improve health-related outcomes for adults with intellectual disability. We described the technology being used, who used the technology, and the feasibility of the interventions. Forty-one studies met criteria, with a total of 698 adult participants with an intellectual disability. While no studies on nutrition were located, technology was used in various physical activity interventions, with the most common being preferred stimulus access, exergaming, and video-based instruction. Most studies took place at day or rehabilitation centers, were implemented by research teams, and either did not discuss cost or were vague in their description related to cost. Implications, limitations, and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Objective This proof-of-concept study assessed how confidently an artificial intelligence (AI) model can determine the sex of a fetus from an ultrasound image. Study Design Analysis was performed using 19,212 ultrasound image slices from a high-volume fetal sex determination practice. This dataset was split into a training set (11,769) and test set (7,443). A computer vision model was trained using a transfer learning approach with EfficientNetB4 architecture as base. The performance of the computer vision model was evaluated on the hold out test set. Accuracy, Cohen's Kappa and Multiclass Receiver Operating Characteristic area under the curve (AUC) were used to evaluate the performance of the model. Results The AI model achieved an Accuracy of 88.27% on the holdout test set and a Cohen's Kappa score 0.843. The ROC AUC score for Male was calculated to be 0.896, for Female a score of 0.897, for Unable to Assess a score of 0.916, and for Text Added a score of 0.981 was achieved. Conclusion This novel AI model proved to have a high rate of fetal sex capture that could be of significant use in areas where ultrasound expertise is not readily available. Key Points This is the first proof-of-concept AI model to determine fetal sex. This study adds to the growing research in ultrasound AI. Our findings demonstrate AI integration into obstetric care. [ABSTRACT FROM AUTHOR]

The articles in this issue of the Journal of Medicine and Philosophy explore emerging technologies, medical innovations, and shifting moral norms, expanding present discussions around topics in bioethics both old and new. Some question whether novel definitions of death and harm change the moral permissibility of killing, particularly at the hands of a physician. Others question how increased or decreased abilities affect responsibility and achievement. Another illustrates how rhetorical appeals to character have been used to justify otherwise morally illicit actions within the clinic. Together, these articles shed new light on topics in the field of bioethics. [ABSTRACT FROM AUTHOR]

Context: The European Union (EU) governs global health through its constituent laws, institutions, actors, and policies. However, it is unclear whether or how these political factors interact to position the EU as a political determinant of global health. Methods: The authors conduct a case study of the political factors influencing the adoption of the EU's Biotechnology Directive 98/44/EC and Orphan Medicines Regulation 141/2000. Findings: The European Commission (EC) generally framed both of its proposals around economical and biomedical paradigms aligned with the needs of the EU's industry and patients, whereas the European Parliament (EP) contested some of these frames and proposed amendments supporting global access to medical products. The political factors influencing the adoption (in the Biotechnology Directive) or rejection (in the Orphan Regulation) of the EP's amendments include the complementarity between the EP and EC proposals, the EP's power in the intra- and interinstitutional negotiating process, the existence and support of civil society, and the alignment with member state priorities in the Council. Conclusions: In the late 1990s, the EU was an internally fragmented and politicized player concerning global health matters. These political factors should be considered for a coherent post-2022 EU strategy on global health. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With people's concern for health and the development of medical technology, medical products for children are gradually appearing in pharmacies and online stores. However, the appearance of most children's household medical products tends to meet the needs of adults, which leads to low acceptance of medical products. This study aimed to explore 10- to 16-year-old children's visual and tactile perception of different materials by researching the relationship between the psychological quantities of visual and tactile perception and the physical quantities of the material surface. Based on the theory of kansei engineering, we measured the physical quantities of nine materials used in insulin syringe products and administered a perceptual questionnaire test for children. By correlating subjective perceptions with the physical attributes of the materials' surfaces, we determined a strong correlation between the visual and tactile psychological properties and the properties of the materials' surfaces. Children clearly perceive materials, and materials with lower roughness can elicit calmness, while materials with higher gloss elicit negative emotions. This paper establishes an evaluation model and provides a scientific selection method for surface materials in different children's household medical products. [ABSTRACT FROM AUTHOR]

Technical and accessibility issues in hospitals often prevent patients from receiving optimal mental and physical health care, which is essential for independent living, especially as societies age and chronic diseases like diabetes and cardiovascular disease become more common. Recent advances in the Internet of Things (IoT)-enabled wearable devices offer potential solutions for remote health monitoring and everyday activity recognition, gaining significant attention in personalized healthcare. This paper comprehensively reviews wearable healthcare technology integrated with the IoT for continuous vital sign monitoring. Relevant papers were extracted and analyzed using a systematic numerical review method, covering various aspects such as sports monitoring, disease detection, patient monitoring, and medical diagnosis. The review highlights the transformative impact of IoT-enabled wearable devices in healthcare, facilitating real-time monitoring of vital signs, including blood pressure, temperature, oxygen levels, and heart rate. Results from the reviewed papers demonstrate high accuracy and efficiency in predicting health conditions, improving sports performance, enhancing patient care, and diagnosing diseases. The integration of IoT in wearable healthcare devices enables remote patient monitoring, personalized care, and efficient data transmission, ultimately transcending traditional boundaries of healthcare and leading to better patient outcomes. [ABSTRACT FROM AUTHOR]

Community pharmacies are rapidly becoming destinations for health services beyond medication dispensing. Delivery models for community‐based services have become increasingly complex, creating expanded opportunities and necessitating collaboration between pharmacists in the community setting and other health care professionals. As a result, it is essential to articulate best practices and recommendations to assist stakeholders in responding to the changing landscape and optimize care for patients. This white paper provides a summary of published examples of interprofessional practice that include community pharmacies in the United States and internationally, and then adapts established guiding principles for interprofessional practice to the community pharmacy setting to outline a framework and specific recommendations for consideration. This framework highlights a need to place patients at the center of collaborative community‐based care models, have organizational leaders show a commitment to and establish an infrastructure for interprofessional collaboration that includes community‐based pharmacists, foster respect for community pharmacy practice, address communication and technology barriers in the health care system, and finally, embrace interprofessional learning in the community pharmacy setting. Addressing challenges and embracing opportunities is vital to accelerate practice transformation and further position community‐based pharmacists as essential members of interprofessional care teams. [ABSTRACT FROM AUTHOR]

The multifaceted potential of ChatGPT in the medical domain remains underexplored, particularly regarding its application in software development by individuals with a medical background but limited information technology expertise. This study investigates ChatGPT's utility in creating a laboratory medicine application. Despite minimal programming skills, the authors successfully developed an automated intra-assay, inter-device precision test for immunophenotyping with a shiny user interface, facilitated by ChatGPT. While the coding process was expedited, meticulous oversight and error correction by the authors were imperative. These findings highlight the value of large language models such as ChatGPT in code-based application development for automating work processes in a medical context. Particularly noteworthy is the facilitation of these tasks for non-technically trained medical professionals and its potential for digital medical education. [ABSTRACT FROM AUTHOR]

Wearable and implantable medical technologies are increasingly being used for the diagnosis, treatment, and prevention of illnesses and other health concerns. One's respiration can be monitored using any number of different biosensors and tracking devices. Self-powered sensors, for example, have a reduced total cost, are easy to prepare, have a high degree of design-ability, and are available in a number of different forms when compared to other types of sensors. The mechanical energy stored in the respiratory system could be converted into electrical energy by using airflow to operate selfpowered sensors. Self-recharging sensors and systems are now in development to make home health monitoring and diagnosis more practical. There has not been a lot of study devoted to the models of respiratory sickness or the output signals that connect with them. Thus, investigating the character of their bond is not only difficult but also crucial. This article examined the theory behind self-powered breathing sensors and systems, as well as their output characteristics, detection indices, and other cutting-edge developments. To help communicate knowledge to other academics working in this field and interested in this topic, we also explored the challenges and potential benefits of autonomous sensors. [ABSTRACT FROM AUTHOR]

Children with type 1 diabetes and their caregivers face numerous challenges navigating the unpredictability of this complex disease. Although the burden of managing diabetes remains significant, new technology has eased some of the load and allowed children with type 1 diabetes to achieve tighter glycaemic management without fear of excess hypoglycaemia. Continuous glucose monitor use alone improves outcomes and is considered standard of care for paediatric type 1 diabetes management. Similarly, automated insulin delivery (AID) systems have proven to be safe and effective for children as young as 2 years of age. AID use improves not only blood glucose levels but also quality of life for children with type 1 diabetes and their caregivers and should be strongly considered for all youth with type 1 diabetes if available and affordable. Here, we review key data on the use of diabetes technology in the paediatric population and discuss management issues unique to children and adolescents. [ABSTRACT FROM AUTHOR]

Violence and abuse in rural America are exacerbated by limited access to support services for victims of intimate partner violence (IPV) due to family connections with people in positions of authority, geographic isolation, transportation barriers, stigma of abuse, lack of available shelters and affordable housing, poverty as a barrier to care, and other challenges. Victims of abuse who live in small communities may be well-acquainted with local health care providers and often voter-elected law enforcement officers. Individuals may fear being seen walking into a mental health clinic, with subsequent (and reality-based) fear that deter them from seeking help. Thus, advances in technology are becoming a much-needed option. Although telehealth has been used for some time in rural health settings, only in more recent years has there been an increase toward quality trauma-informed care. With increasing focus on the impact of social determinants of health, agencies continue to shift to telehealth to provide virtual support. Specifically, telehealth visits can potentially extend the reach of the limited number of primary care and mental health providers to those who are significantly in need of services. [Journal of Psychosocial Nursing and Mental Health Services, 62(10), 25–30.] [ABSTRACT FROM AUTHOR]

Copyright of China Medical Education Technology is the property of China Medical Education Technology Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of China Medical Education Technology is the property of China Medical Education Technology Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of China Medical Education Technology is the property of China Medical Education Technology Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This commentary narrates on the building of an effective and innovative medicines optimisation model. It discusses the essential features, emphasizes the need, and considers the strong health and pharmacy system as a prerequisite before such a model could be built. The paper argues that it is important to strengthen the health system before the elements of pharmaceutical care and medicine optimisation can take shape. It discusses the discourse and interplay between medicine use and medicine access research. The other important elements to include are the "selection of medicines by health technology assessment", "economic evaluation of pharmacy services", "pharmacists' remuneration by the government", "Health system strengthening status", "quality use of generic medicines programmes", "rationale prescribing", "access to medicines and medicines pricing", "medicines advertising" and the "state of pharmacy practice and the development of the pharmacist's role". A set of different high-, middle- and low-income countries are used to provide examples of the status of the health system and the subsequent development of pharmacy practice and medicines optimisation. The countries include the UK, Australia, New Zealand, Pakistan, Türkiye, Malaysia, India, and Pakistan. [ABSTRACT FROM AUTHOR]

Background: When clinically effective, cost-effective health interventions are not fully implemented in clinical practice, population health suffers. Economic factors are among the most commonly cited reasons for suboptimal implementation. Despite this, implementation and economic evaluation are not routinely performed in conjunction with one another. This review sought to identify and describe what methods are available for researchers to incorporate implementation within economic evaluation, how these methods differ, when they should be used, and where gaps remain. Methods: We conducted a scoping review using systematic methods. A pearl-growing approach was used to identify studies. References and citations were identified using Web of Science and Scopus. We included for review any study that contained terms relating to economic evaluation and a series of implementation-related terms in the title or abstract. The search was conducted and validated using two independent researchers. Results: Our review identified 42 unique studies that included a methodology for combining implementation and economic evaluation. The methods identified could be categorized into four broad themes: (i) policy cost–effectiveness approach (11 studies), (ii) value of information and value of implementation approach (16 studies), (iii) mixed methods approach (6 studies), and (iv) costing approach (9 studies). We identified a trend over time from methods that adopted the policy cost–effectiveness approach to methods that considered the trade-off between the value of information and value of implementation. More recently, mixed methods approaches to incorporate economic evaluation and implementation have been developed, alongside methods to define, measure and cost individual components of the implementation process for use in economic evaluation. Conclusion: Our review identified a range of methods currently available for researchers considering implementation alongside economic evaluation. There is no single method or tool that can incorporate all the relevant issues to fully incorporate implementation within an economic evaluation. Instead, there are a suite of tools available, each of which can be used to answer a specific question relating to implementation. Researchers, reimbursement agencies and national and local decision-makers need to consider how best to utilize these tools to improve implementation. [ABSTRACT FROM AUTHOR]

Background: Electronic prescribing (e-prescribing) is an essential technology in the modern health system. This technology has made many changes in the prescription process, which have advantages and disadvantages and have created opportunities for transforming the health system. This study aimed to investigate the strengths, weaknesses, opportunities, and threats of the e-prescribing system implemented in Iran from the physician's viewpoint. Methods: This phenomenological qualitative study was conducted in 2022. The participants were 15 Iranian specialist physicians working at Urmia University of Medical Sciences, selected purposively and deliberately. Data was collected through in-depth semi-structured interviews using an interview guide comprising 16 questions. Interviews were conducted until data saturation was reached. The audio data was transcribed into text and analyzed using the thematic analysis. To ensure the validity and reliability of the findings, the criteria introduced by Lincoln and Guba were employed. Results: The results of this study showed that the e-prescribing system executed in Iran has diverse and multidimensional strengths, weaknesses, opportunities, and threats. In the strengths section, the analysis of the interviews led to the extraction of semantic units in the categories of prescription process, prescriber, patient, technical, economic, communication, and insurance. Also, the weaknesses in the three categories of the prescriber, patient, and technical were debatable. The opportunities extracted from the narratives of the interviewees were placed in four categories including technical, national macro policies, Ministry of Health macro-policies, and socio-cultural issues. Finally, the discussed threats are classified into two technical and macro policies of the Ministry of Health categories. On the other hand, technical issues played an effective role in all aspects of the SWOT model. Conclusion: The e-prescribing system in Iran has strengths, weaknesses, opportunities, and threats. An overarching factor across all aspects of the SWOT model was technical infrastructure. A robust technical infrastructure is considered a strength and an opportunity for the growth of the electronic prescribing system in Iran. Conversely, any shortcomings in these systems are viewed as weaknesses and pose a threat to the system's sustainability. [ABSTRACT FROM AUTHOR]

Background: Abortion and its complications have always been associated with challenges such as the lack of awareness, high cost of receiving in-person services, lack of access to the skilled healthcare workers, distance from healthcare centers in remote areas, and cultural sensitivities. Therefore, the use of mobile health technology in post-abortion care has been suggested. This study aimed to investigate factors influencing the acceptance and use of mhealth technology in post-abortion care. Method: A mixed-methods study was completed in 2023. Initially, a literature review was conducted. Then, a five-point Likert-scale questionnaire was designed based on the results of the literature review. The research participants were gynecologists (n = 24), midwives (n = 38), and women who had experience of abortion (n = 183). Data were analyzed using descriptive and inferential statistics. Results: The findings revealed that the participants had different opinions about the importance of motivating and inhibiting factors which included individual, technical, economic, organizational, and ethico-legal aspects. It seems that the individual, organizational, economic, and ethico-legal motivating factors as well as the ethico-legal inhibiting factors were more important than other factors and had higher mean values. In addition, there was a statistically significant difference between the mean values of gynecologists and patients regarding the individual motivating (P = 0.014) and technical inhibiting factors (P = 0.016). The gynecologists' opinions regarding the technical motivating factors were also significantly different from midwives (P = 0.044) and patients (P = 0.010). Conclusion: Multiple factors may influence the acceptance and use of mhealth technology in post-abortion care. Therefore, mhealth service developers must consider these factors to improve the quality of services and increase technology adoption. This will lead to saving costs, improving health, reducing abortion complications, and ultimately improving quality of life for women. However, further research in patient engagement and health interventions tailored to diverse cultural contexts are recommended. [ABSTRACT FROM AUTHOR]

Background: Telehealth uses Information and Communication Technologies (ICT) in distance health-related activities between professionals, managers, and patients of health services. This cross-sectional study compared the ICT infrastructure available in Brazilian Basic Health Units (BHU) for telehealth actions, along with evaluation cycles of the National Program for Improving Access and Quality of Primary Care (PMAQ-AB). Methods: Data from the second and third cycles of the PMAQ-AB were used. A total of 22,021 BHUs were evaluated concerning the availability of computers, cameras, stereo boxes, microphones, printers, television, and internet available. The presence of each ICT equipment assigned a score to each BHU. The sum of these scores assigned a final score to the BHU and was used for comparison among different Brazilian regions. The data were analyzed descriptively and by Wilcoxon test (p ≤ 0.05) using SPSS v. 25. Results: The increase in the median number of ICT equipment was statistically significant in the BHU in Brazil and the Brazilian regions (p < 0.001). The South, Southeast, and Midwest regions had the highest median scores in both cycles. Conclusions: The availability of ICT equipment for telehealth actions in BHU improved over the PMAQ-AB cycles, with differences in the ICT structure between Brazilian regions. [ABSTRACT FROM AUTHOR]

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Entrepreneurial ecosystems in various geographical areas of the world are often compared in the context of entrepreneurship research. There are far fewer comparative studies on different types of ecosystems. In this study, a traditional entrepreneurial ecosystem based in Canada is compared with a digital entrepreneurial ecosystem specializing in life sciences, in Switzerland, bridging the gap between both and yielding previously unknown insights. The aim is twofold: to decipher both the differences and the similarities between the two models and to describe the predominant type of entrepreneurship in each case. The method consisted of a quantitative study of socio-economic data in combination with the administration of a qualitative analysis of interviews with—industry, government, and university—experts with links to one or the other ecosystem. The main findings showed that the traditional ecosystem had varied entrepreneurial support, public financial support, and collaborative networks between SMEs and start-ups, whereas in the specialized digital ecosystem, business support tended to be sector-specific with private financial support and networks emerging between multinationals and start-ups. Our study contributes to entrepreneurship research by showing that high-tech industries such as biotechnology and medical technology manage to go beyond a purely digital approach in digital ecosystems. The generic nature of the high-tech industries within the traditional ecosystem was the main driver of traditional entrepreneurship, while the sector-specific approaches of the industries within the specialized digital ecosystems were shown to drive innovative entrepreneurship. [ABSTRACT FROM AUTHOR]

In health technology assessment, matching‐adjusted indirect comparison (MAIC) is the most common method for pairwise comparisons that control for imbalances in baseline characteristics across trials. One of the primary challenges in MAIC is the need to properly account for the additional uncertainty introduced by the matching process. Limited evidence and guidance are available on variance estimation in MAICs. Therefore, we conducted a comprehensive Monte Carlo simulation study to evaluate the performance of different statistical methods across 108 scenarios. Four general approaches for variance estimation were compared in both anchored and unanchored MAICs of binary and time‐to‐event outcomes: (1) conventional estimators (CE) using raw weights; (2) CE using weights rescaled to the effective sample size (ESS); (3) robust sandwich estimators; and (4) bootstrapping. Several variants of sandwich estimators and bootstrap methods were tested. Performance was quantified on the basis of empirical coverage probabilities for 95% confidence intervals and variability ratios. Variability was underestimated by CE + raw weights when population overlap was poor or moderate. Despite several theoretical limitations, CE + ESS weights accurately estimated uncertainty across most scenarios. Original implementations of sandwich estimators had a downward bias in MAICs with a small ESS, and finite sample adjustments led to marked improvements. Bootstrapping was unstable if population overlap was poor and the sample size was limited. All methods produced valid coverage probabilities and standard errors in cases of strong population overlap. Our findings indicate that the sample size, population overlap, and outcome type are important considerations for variance estimation in MAICs. [ABSTRACT FROM AUTHOR]

Although preventive health technologies are commonly considered as enhancing consumer wellbeing, little is known about their unintended consequences. This paper explores the relationship between consumer engagement (CE) with preventive health technologies and wellbeing, to best understand when engagement is beneficial‐versus detrimental‐to consumer wellbeing. A thematic analysis of 30 in‐depth interviews with users of such technologies reveal that (1) consumers engage with preventive health technologies based on a variety of health goals, (2) specific engagement trajectories result from those contrasting consumer health goals, and (3) the beneficial versus detrimental role of CE with preventive health technologies in consumer wellbeing is conditioned by the type of trajectories consumers engage in. This paper proposes a nuanced perspective by demonstrating that CE with preventive health technologies can be considered a double‐edged sword for consumer wellbeing. While these technologies can support healthy routines, they can also lead to maladaptive behavior through over‐engagement. [ABSTRACT FROM AUTHOR]

When faced with the prospect of death, some people would prefer a form of long-term preservation that may allow them to be restored to healthy life in the future, if technology ever develops to the point that this is feasible and humane. Some believe that we may have the capacity to perform this type of experimental preservation today--although it has never been proven--using contemporary methods to preserve the structure of the brain. The idea is that the morphomolecular organization of the brain encodes the information required for psychological properties such as personality and long-term memories. If these structures in the brain can be maintained intact over time, this could theoretically provide a bridge to access restorative technologies in the future. To consider this hypothesis, we first describe possible metrics that can be used to assess structural brain preservation quality. We next explore several possible methods to preserve structural information in the brain, including the traditional cryonics method of cryopreservation, as well as aldehyde-stabilized cryopreservation and fluid preservation. We focus in-depth on fluid preservation, which relies on aldehyde fixation to induce chemical gel formation in a wide set of biomolecules and appears to be a cost-effective method. We describe two theoretical recovery technologies, alongside several of the ethical and legal complexities of brain preservation, all of which will require a prudent approach. We believe contemporary structural brain preservation methods have a non-negligible chance of allowing successful restoration in the future and that this deserves serious research efforts by the scientific community. [ABSTRACT FROM AUTHOR]

Following the emergence of AI technology such as ChatGPT, young adults in the USA with limited access to school-based sexuality education are likely to utilise AI to acquire sexual knowledge. Through the application of Technology Mediation Theory, which highlights the interactions between technology and humans, we identified various potential outcomes of AI-Facilitated sexuality education. These outcomes were examined in terms of the degree to which they aligned with and/or diverged from the US National Standards of Sex Education (NSES). Beneficial outcomes included accessibility, emotionally neutral responses and impartial information, and accuracy. Conversely, detrimental outcomes include limited ability to monitor developmental appropriateness, lack of human empathy, lack of interactive learning techniques, and concerns about the accuracy of current information. To optimise the benefits, and to mitigate the potential drawbacks of ChatGPT as a form of AI-Facilitated Sexuality Education, we offer recommendations of use to AI designers, sexuality educators, parents, and users. [ABSTRACT FROM AUTHOR]

Modern medical technology innovation is a critical safeguard for human health, while a significant number of developing nations are confronted with the challenge of biopharmaceutical technological advancement. To investigate the possible routes of technological advancement, we investigated the impact of the endogenous knowledge spillover effect on firm innovation endeavors. Our research involves a theoretical two-stage R&D game model that is built around the characteristics of pharmaceutical organizations. Theoretical studies elucidated the impact as well as the probable mechanism of the spillover effect. To verify the theoretical study, we conducted econometric analysis using data from the pharmaceutical sector of Chinese enterprise listed on the A-share market. The study's findings indicate that endogenous knowledge spillovers impede organizations' innovation endeavors. This phenomenon may be attributed to the existence of the patent race paradigm and high concentration of enterprises' R&D endeavors in specific areas. Additional examination of heterogeneity demonstrates that private firms, small and medium-sized enterprises (SMEs), and non-high-tech enterprises experience a larger adverse impact from the spillover effect. Hence, we suggest implementing "loser's subsidies", reallocating R&D resources, and making modifications to competition policies as measures to enhance the innovation performance of biopharmaceutical markets. These policies will facilitate the technical advancement of medicines in developing nations. [ABSTRACT FROM AUTHOR]

OBJECTIVES: During the COVID-19 pandemic, medical education programs were challenged to optimize learning while balancing social interaction with exposure risk. In response, our internal medicine (IM) residency program transitioned to "simulcast" educational sessions. In simulcast sessions, multiple small groups of learners met in person in separate rooms and connected to the large-group session via videoconferencing. This qualitative study describes IM residents' perceptions regarding the advantages and disadvantages of learning in simulcast compared to virtual and in-person settings during the pandemic. METHODS: Categorical IM residents at Penn State during the academic year 2020-2021 were invited to participate. Eligible residents participated in one 30-min virtual, semistructured focus group. We used inductive thematic coding to analyze resident responses. RESULTS: Forty-eight percent (n = 29/60) of invited residents participated in focus groups. In the simulcast setting, participants felt more accountability to participate in their small groups compared to a larger group or virtual setting. Educational experiences varied based upon facilitator skill level. Overall, in-person settings were preferred to virtual, when possible, due to increased social connection. Respondents identified educator enthusiasm and presentation quality as key to engagement regardless of setting. CONCLUSION: Residents had variable responses to the simulcast setting based upon their comfort with participation by group size, desire for social connection, and perception of teaching strategies. The key identified pitfalls to simulcast teaching were resident discomfort in small groups, heterogeneous learning experience, lack of engagement, and technology challenges. These pitfalls can be mitigated through strategic distribution of learners in groups, trained facilitators, and interactive teaching modalities. Given that simulcast and mixed (simulcast, virtual, and in-person) teaching settings are here to stay postpandemic, anticipating pitfalls and creating adaptable educational content that translates in multiple settings is crucial. [ABSTRACT FROM AUTHOR]

Background: In China, Internet-Based Sharing Nursing Service (IBSNS) is a new mode of nursing service delivery that has been in practice for over five years, which enables nurses to provide care at clients' home. However, the acceptance and associated factors of IBSNS among caregivers of elderly with chronic diseases who are the major clients of the service were unclear. Aim: To explore the acceptance of IBSNS and its associated factors among Chinese caregivers of elderly patient with chronic diseases based on the modified Technology Acceptance Model (mTAM). Methods: A cross-sectional study was conducted from February 2023 to March 2023. Caregivers of hospitalized elderly with chronic diseases were recruited using convenience sampling method from three hospitals in Beijing, China. Data were obtained from self-reports of participants. Structural equation modeling was used to analyze data. Results: A total of 65.1% of the caregivers had neutral to weakly positive behavioral intention of IBSNS use. The mTAM model was supported with good model fit. Perceived ease of use was positively associated with perceived usefulness. Both perceived usefulness and perceived security were positively associated with attitude, consequently, attitude was associated with behavioral intention. Conclusions: Improving the ease of use, security, and usefulness may be helpful to increase the positive attitude towards IBSNS and behavioral intention of using IBSNS, which provides valuable insights that can help healthcare providers improve the integration of technology in patient care, ultimately leading to better health outcomes and more efficient healthcare systems. [ABSTRACT FROM AUTHOR]

Managing genetic disease using medically assisted reproductive technology is increasingly promoted as a feasible option, given revolutionary advances in genomics. Far less attention has been directed to the issue of whether there is equitable access to this option. Context and circumstance determine equitable access; however, reporting has drawn overwhelmingly from affluent Anglo-western populations in developed countries. The experiences of poorer, less educated subpopulations within affluent countries and populations in less developed countries are underreported. The ability of consumers to understand the opportunities and risks of medically assisted reproductive technology is likewise not well described in the literature despite significant technological complexity and evidence that genetic disease may be overrepresented within some disadvantaged population groups. Equity is achieved by identifying barriers and allocating appropriate resources to enable understanding and access. In the case of utilising medically assisted technology, social and power relationships, regulations, and the presumptions of authority figures and policymakers reduce equitable access. Physical or cultural marginalisation from mainstream health services may result in reduced access to genetic and prenatal testing, in-vitro fertilisation and genetic screening of embryos necessary for medically assisted reproduction. Cost and regulatory frameworks can likewise limit opportunities to engage with services. Moreover, the quality of the information provided to prospective users of the technology and how it is received governs understanding of prevention and inhibits adequately informed choice. Best practice care and adequately informed choice can only be achieved by conscientiously attending to these accessibility issues. Deep engagement with at-risk people and critical reflection on mainstream accepted standpoints is required. This paper outlines issues associated with engaging with medically assisted reproduction encountered by Aboriginal families living with Machado-Joseph Disease in some of the most remote areas of Australia. It is the right of these families to access such technologies regardless of where they live. Current barriers to access raise important questions for service providers with implications for practice as new technologies increasingly become part of standard medical care. [ABSTRACT FROM AUTHOR]

The Internet of Things (IoT) base has grown to over 20 billion devices currently operational worldwide. As they greatly extend the applicability and use of biosensors, IoT developments are transformative. Recent studies show that IoT, coupled with advanced communication frameworks, such as machine-to-machine (M2M) interactions, can lead to (1) improved efficiency in data exchange, (2) accurate and timely health monitoring, and (3) enhanced user engagement and compliance through advancements in human–computer interaction. This systematic review of the 19 most relevant studies examines the potential of IoT in health and lifestyle management by conducting detailed analyses and quality assessments of each study. Findings indicate that IoT-based systems effectively monitor various health parameters using biosensors, facilitate real-time feedback, and support personalized health recommendations. Key limitations include small sample sizes, insufficient security measures, practical issues with wearable sensors, and reliance on internet connectivity in areas with poor network infrastructure. The reviewed studies demonstrated innovative applications of IoT, focusing on M2M interactions, edge devices, multimodality health monitoring, intelligent decision-making, and automated health management systems. These insights offer valuable recommendations for optimizing IoT technologies in health and wellness management. [ABSTRACT FROM AUTHOR]

Background: Graded diagnosis and treatment, referral, and expert consultations between medical institutions all require cross domain access to patient medical information to support doctors' treatment decisions, leading to an increase in cross domain access among various medical institutions within the medical consortium. However, patient medical information is sensitive and private, and it is essential to control doctors' cross domain access to reduce the risk of leakage. Access control is a continuous and long-term process, and it first requires verification of the legitimacy of user identities, while utilizing control policies for selection and management. After verifying user identity and access permissions, it is also necessary to monitor unauthorized operations. Therefore, the content of access control includes authentication, implementation of control policies, and security auditing. Unlike the existing focus on authentication and control strategy implementation in access control, this article focuses on the control based on access log security auditing for doctors who have obtained authorization to access medical resources. This paper designs a blockchain based doctor intelligent cross domain access log recording system, which is used to record, query and analyze the cross domain access behavior of doctors after authorization. Through DBSCAN clustering analysis of doctors' cross domain access logs, we find the abnormal phenomenon of cross domain access, and build a penalty function to dynamically control doctors' cross domain access process, so as to reduce the risk of Data breach. Finally, through comparative analysis and experiments, it is shown that the proposed cross domain access control model for medical consortia based on DBSCAN and penalty function has good control effect on the cross domain access behavior of doctors in various medical institutions of the medical consortia, and has certain feasibility for the cross domain access control of doctors. [ABSTRACT FROM AUTHOR]

Background: The development of novel medical imaging technologies and treatment procedures hinges on the availability of accurate and versatile phantoms. This paper presents a cost-effective approach for creating anthropomorphic abdominal phantoms. Methods: This study proposes a cost-effective method using 3D printing and readily available materials (beeswax, plaster, and epoxy resin) to create high-fidelity anthropomorphic abdominal phantoms. The three-dimensionally printed phantoms exhibited X-ray attenuation properties closely matching those of human tissues, with measured Hounsfield unit (HU) values of −115.41 ± 20.29 HU for fat, 65.61 ± 18.06 HU for muscle, and 510 ± 131.2 HU for bone. These values were compared against patient images and a commercially available phantom, and no statistically significant difference was observed in fat tissue simulation (p = 0.428). Differences were observed for muscle and bone tissues, in which the 3D-printed phantom demonstrated higher HU values compared with patient images (p < 0.001). The 3D-printed phantom's bone simulation was statistically like that of the commercially available phantom (p = 0.063). Conclusion: This method offers a cost-effective, accessible, and customizable alternative for abdominal phantoms. This innovation has the potential to accelerate advancements in abdominal imaging research, leading to improved diagnostic tools and treatment options for patients. These phantoms could be used to develop and test new imaging techniques with high accuracy. [ABSTRACT FROM AUTHOR]

Several technologies have been introduced into neurorehabilitation programs to enhance traditional treatment of individuals with Spinal Cord Injury (SCI). Their effectiveness has been widely investigated, but their adoption has not been properly quantified. The aim of this study is to assess the distribution of conventional (Treatment As Usual—TAU) and technology-aided (Treatment With Technologies—TWT) treatments conveniently grouped based on different therapeutic goals in a selected SCI unit. Data from 104 individuals collected in 29 months were collected in a custom database and categorized according to both the conventional American Impairment Scale classification and a newly developed Multifactor (MF) clustering approach that considers additional sources of information (the lesion level, the level of independence in the activities of daily living, and the hospitalization duration). Results indicated an average technology adoption of about 30%. Moreover, the MF clusters were less overlapped, and the differences in TWT adoption were more pronounced than in AIS-based clustering. MF clustering was capable of grouping individuals based both on neurological features and functional abilities. In particular, individuals with motor complete injuries were grouped together, whereas individuals with sensorimotor incomplete SCI were collected separately based on the lesion level. As regards TWT adoption, we found that in the case of motor complete SCI, TWT for muscle tone control and modulation was mainly selected (about 90% of TWT), while the other types of TWT were seldom adopted. Even for individuals with incomplete SCI, the most frequent rehabilitation goal was muscle tone modulation (about 75% of TWT), regardless of the AIS level, and technologies to improve walking ability (about 12% of TWT) and balance control (about 10% of TWT) were mainly used for individuals with thoracic or lumbar lesions. Analyzing TAU distribution, we found that the highest adoption of muscle tone modulation strategies was reported in the case of individuals with motor complete SCI (about 42% of TAU), that is, in cases when almost no gait training was pursued (about 1% of TAU). In the case of cervical motor incomplete SCI, compared to thoracic and lumbar incomplete SCI, there was a greater focus on muscle tone control and force recruitment in addition to walking training (38% and 14% of TAU, respectively) than on balance training. Overall, the MF clustering provided more insights than the traditional AIS-based classification, highlighting differences in TWT adoption. These findings suggest that a wider overview that considers both neurological and functional characteristics of individuals after SCI based on a multifactor analysis could enhance the personalization of neurorehabilitation strategies. [ABSTRACT FROM AUTHOR]

Background: Anatomical reduction and stable fixation of complex tibial plateau fractures remain challenging in clinical practice. This study examines the efficacy of using 3D printing technology combined with customized plates for treating these fractures. Methods: We retrospectively analyzed 22 patients treated with 3D printing and customized plates at the Orthopedic Department of the Central Hospital affiliated with Shenyang Medical College from September 2020 to January 2023. These patients were matched with 22 patients treated with traditional plates with similar baseline characteristics. Patients were divided into an experimental group (3D-printed models and customized plates) and a control group (traditional plates). The control group underwent traditional surgical methods, while the experimental group had a preoperative 3D model and customized plates for surgical planning. We compared baseline characteristics and recorded various indicators, including preoperative preparation time, surgical time, intraoperative blood loss, number of intraoperative fluoroscopies, hospital stay duration, fracture healing time, complications, knee joint range of motion (ROM), Rasmussen anatomical and functional scores, and HSS scores. Results: All surgeries were successful with effective follow-up. The experimental group had shorter surgical time, less intraoperative blood loss, and fewer intraoperative fluoroscopies (P < 0.05). At 6 months and 1 year postoperatively, the experimental group had better knee joint HSS scores than the control group. Preoperative preparation time and total hospital stay were shorter in the control group (P < 0.05). There were no significant differences in fracture healing time and follow-up duration between groups. The experimental group showed better knee joint flexion angles (P < 0.05). Rasmussen scores showed no statistical difference between groups (P > 0.05). The incidence of complications was slightly lower in the experimental group but not significantly different. Conclusion: 3D printing technology combined with customized plates for complex tibial plateau fractures enables precise articular surface reduction, significantly shortens surgical time, and reduces intraoperative blood loss. This method improves knee joint function, offering a more effective treatment option. [ABSTRACT FROM AUTHOR]

Background: Digital health technologies are increasingly used by healthcare professionals working in pediatric hospital and rehabilitation settings. Multiple factors may affect the implementation and use of digital health technologies in these settings. However, such factors have not been identified in a multidisciplinary, pediatric context. The objective of this study was to describe actual use and to identify the factors that promote or hinder the intention to use digital health technologies (mobile learning applications, virtual/augmented reality, serious games, robotic devices, telehealth applications, computerized assessment tools, and wearables) among pediatric healthcare professionals. Methods: An online survey evaluating opinions, current use, and future intentions to use digital health technologies was completed by 108 professionals at one of Canada's largest pediatric institutes. Mann-Whitney U tests were used to compare the attitudes of healthcare professionals who intend to increase their use of digital health technologies and those who do not. Linear regression analyses were used to determine predictors of usage success. Results: Healthcare professionals reported mostly using mobile and tablet learning applications (n = 43, 38.1%), telehealth applications (n = 49, 43.4%), and computerized assessment tools (n = 33, 29.2%). Attitudes promoting the intention to increase the use of digital health technologies varied according to technology type. Healthcare professionals who wished to increase their use of digital health technologies reported a more positive attitude regarding benefits in clinical practice and patient care, but were also more critical of potential negative impacts on patient-professional relationships. Ease of use (β = 0.374; p = 0.020) was a significant predictor of more favorable usage success. The range of obstacles encountered was also a significant predictor (β = 0.342; p = 0.032) of less favorable evaluation of usage success. Specific factors that hinder successful usage are lack of training (β = 0.303; p = 0.033) and inadequate infrastructure (β = 0.342; p = 0.032). Conclusions: When working with children, incorporating digital health technologies can be effective for motivation and adherence. However, it is crucial to ensure these tools are implemented properly. The findings of this study underscore the importance of addressing training and infrastructure needs when elaborating technology-specific strategies for multidisciplinary adoption of digital health technologies in pediatric settings. [ABSTRACT FROM AUTHOR]

Background: Health professionals need to be prepared for interdisciplinary research collaborations aimed at the development and implementation of medical technology. Expertise is highly domain-specific, and learned by being immersed in professional practice. Therefore, the approaches and results from one domain are not easily understood by experts from another domain. Interdisciplinary collaboration in medical research faces not only institutional, but also cognitive and epistemological barriers. This is one of the reasons why interdisciplinary and interprofessional research collaborations are so difficult. To explain the cognitive and epistemological barriers, we introduce the concept of disciplinary perspectives. Making explicit the disciplinary perspectives of experts participating in interdisciplinary collaborations helps to clarify the specific approach of each expert, thereby improving mutual understanding. Method: We developed a framework for making disciplinary perspectives of experts participating in an interdisciplinary research collaboration explicit. The applicability of the framework has been tested in an interdisciplinary medical research project aimed at the development and implementation of diffusion MRI for the diagnosis of kidney cancer, where the framework was applied to analyse and articulate the disciplinary perspectives of the experts involved. Results: We propose a general framework, in the form of a series of questions, based on new insights from the philosophy of science into the epistemology of interdisciplinary research. We explain these philosophical underpinnings in order to clarify the cognitive and epistemological barriers of interdisciplinary research collaborations. In addition, we present a detailed example of the use of the framework in a concrete interdisciplinary research project aimed at developing a diagnostic technology. This case study demonstrates the applicability of the framework in interdisciplinary research projects. Conclusion: Interdisciplinary research collaborations can be facilitated by a better understanding of how an expert's disciplinary perspectives enables and guides their specific approach to a problem. Implicit disciplinary perspectives can and should be made explicit in a systematic manner, for which we propose a framework that can be used by disciplinary experts participating in interdisciplinary research project. Furthermore, we suggest that educators can explore how the framework and philosophical underpinning can be implemented in HPE to support the development of students' interdisciplinary expertise. [ABSTRACT FROM AUTHOR]

Background: Obesity, characterized by excessive fat accumulation, poses a significant public health challenge globally. Recent advancements in medical technology have heralded the emergence of endoscopic bariatric treatments (EBTs) as innovative alternatives to conventional obesity interventions. Despite previous systematic reviews and network meta-analyses, they also highlighted discrepancies in outcomes and efficacy among different EBTs. Here, we will update a systematic review and network meta-analysis of randomized controlled trials (RCTs) focusing on EBTs and presents a protocol for the reproducibility and transparency. Methods: The core protocol of this study was registered at PROSPERO database (CRD42024514249) on Jan 2024. Core databases including MEDLINE through PubMed, Embase, and Cochrane library will be searched relevant studies, and a systematic review with network meta-analysis will be performed. Two evaluators (EJ Gong and CS Bang) will independently screen the titles and abstracts following the eligibility criteria; (1) RCTs investigated the compared the efficacy of EBTs and controls; (2) studies published in English; and (3) studies in full-text format. We will exclude studies meeting the following criteria; (1) studies that did not report the treatment outcomes, such as percent excess weight loss or percent total body weight loss; (2) case reports and review articles; (3) ineligible research objects, for example, animals or children; and (4) insufficient data regarding treatment outcome. The primary outcomes will be the common efficacy metric found after systematic review of relevant studies, such as percent excess weight loss or percent total body weight loss with a follow-up of at least 6 months. Narrative (descriptive) synthesis is planned and quantitative synthesis will be used if the included studies are sufficiently homogenous. The quality of the identified studies will be assessed using the Cochrane Risk of Bias assessment tool version 2.0 (ROB 2.0). All the systematic review and network meta-analysis process will be undertaken keeping the principles of the Preferred Reporting Items for a Systematic Review and Meta-analysis for systematic review protocols (PRISMA-P) and PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions (PRISMA-NMA). Discussion: This updated systematic review and network meta-analysis will provide information about comparative efficacy of various EBTs and this will help physicians in the decision-making process for the selection of treatment modalities in the clinical practice. [ABSTRACT FROM AUTHOR]

Flexible devices, such as soft bioelectronics and stretchable supercapacitors, have their practical performance limited by electrodes which are desired to have high conductivity and capacitance, outstanding mechanical flexibility and strength, great electrochemical stability, and good biocompatibility. Here, we report a simple and efficient method to synthesize a nanostructured conductive hydrogel to meet such criteria. Specifically, templated by a hyperconnective nanofibrous network from aramid hydrogels, the conducting polymer, polypyrrole, assembles conformally onto nanofibers through in-situ polymerization, generating continuous nanostructured conductive pathways. The resulting conductive hydrogel shows superior conductivity (72 S cm−1) and fracture strength (27.2 MPa). Supercapacitor electrodes utilizing this hydrogel exhibit high specific capacitance (240 F g−1) and cyclic stability. Furthermore, bioelectrodes of patterned hydrogels provide favorable bioelectronic interfaces, allowing high-quality electrophysiological recording and stimulation in physiological environments. These high-performance electrodes are readily scalable to applications of energy and power systems, healthcare and medical technologies, smart textiles, and so forth. [ABSTRACT FROM AUTHOR]

Purpose: The purposes of this review article were to provide an introduction to and "bird's-eye" overview of the current evidence base for treatment of childhood apraxia of speech (CAS), identify some gaps and trends in this rapidly growing literature, and formulate some future research directions, in order to advance the evidence base and clinical practice for children with CAS. Method: Following a brief introduction outlining important concepts, a narrative review of the CAS treatment literature is provided, and trends and future directions are identified based on this review. The review is organized around four fundamental treatment research questions: (a) "Does Treatment X work?", (b) "Does Treatment X work better than Treatment Y?", (c) "For whom does Treatment X work?", and (d) "What does 'work' mean, anyway?" Results: A wide range of CAS treatments with varying degrees of evidence for efficacy exists. Research is beginning to emerge that compares different treatments and seeks to determine optimal treatment parameters. Few studies to date have explored child-level predictors of treatment response, and the evidence base currently is limited in scope with respect to populations and outcomes studied. Conclusions: A growing evidence base supports the efficacy of a number of treatments for CAS. However, many important gaps in the literature were identified that warrant redoubled and sustained research attention. Research is beginning to emerge that addresses treatment optimization, comparison, candidacy, and outcomes. Suggestions for future research are offered, and the concept of a hypothesized pathway was applied to CAS to illustrate how components of an intervention can effect change in a clinical goal and can help guide development and refinement of treatments for children with CAS. [ABSTRACT FROM AUTHOR]