Background Research on the combined effects of Naldemedine and targeted rehabilitation for managing opioid-induced constipation (OIC) is limited. This retrospective study aims to explore their use in chronic pain patients with OIC. Methods The study examined 53 patients with OIC, comparing outcomes between those receiving Naldemedine with targeted physical exercise (28 in Naldemedine + Rehabilitation group) and those receiving Naldemedine alone (25 in Naldemedine alone group). Assessments at baseline (T0), 14 ± 2 days (T1), and three months (T2) included Numerical Rating Scale (NRS), Patient Assessment of Constipation Quality of Life (PAC-QoL) and Bowel Function Index (BFI). Results Combining Naldemedine with rehabilitation led to higher patient satisfaction at three months compared to Naldemedine alone, while no significant between-group differences were observed in abdominal pain relief or bowel function. After 14 days of treatment, both groups demonstrated improvements in NRS, BFI, PAC-QoL total score, and PAC-QoL subscale for satisfaction ( p = 0.716, p = 0.886, p = 0.585, p = 0.431). After three-month, Naldemedine + Rehabilitation group showed significantly higher satisfaction levels compared to those on Naldemedine alone, as indicated by PAC-QoL total score and sub-score for satisfaction ( p = 0.031, p = 0.0163). Conclusions The implementation of a combined approach involving targeted physical exercise alongside Naldemedine treatment showed promising results in enhancing patients' satisfaction.

D-dimer has gained considerable attention since its inclusion as a minor criterion in the 2018 International Consensus Meeting. However, evidence regarding its diagnostic accuracy for periprosthetic joint infection (PJI) remains inconclusive. This systematic review and meta-analysis aimed to evaluate the diagnostic performance of D-dimer in diagnosing PJI and comprehensively explore the sources of heterogeneity. The PubMed, Scopus, Web of Science, Embase, and Cochrane library were systematically searched from their inception to 10 May 2025. Studies that evaluated D-dimer in serum or plasma for the diagnosis of PJI were included. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Subgroup analyses and meta-regression were performed to investigate sources of heterogeneity. Sensitivity analysis evaluated the robustness of the results, and publication bias was examined using Deeks' funnel plot. We assessed the certainty of the evidence for the pooled diagnostic accuracy estimates using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. This study encompassed 30 studies involving 6444 patients. The results of the quality assessment indicate that the majority of the literature was deemed acceptable. The aggregated sensitivity and specificity of D-dimer in diagnosing PJI were 0.74 [95% confidence interval [CI] 0.69-0.79] and 0.72 (95% CI 0.66-0.77), respectively. The summary receiver operating characteristic curve analysis yielded an area under the curve of 0.79 (95% CI 0.76-0.83). Meta-regression identified specimen type, infection type, surgical site, study design, sample size, and gold standard as major sources of heterogeneity; however, substantial residual heterogeneity persisted after multivariable analysis. This systematic review and meta-analysis demonstrate that, based on low-to-moderate certainty evidence, D-dimer is best used as an initial triage tool or adjunctive rule-out test for PJI, particularly in lower-prevalence settings. Subgroup analyses and meta-regression suggest better diagnostic performance in serum assays, chronic infections, and knee PJI. High-certainty evidence supports the use of D-dimer in combination with C-reactive protein in a serial testing strategy to confirm PJI. Future studies should include large, prospective, multicenter diagnostic cohorts with rigorous methods, minimal missing data, and standardized laboratory reporting to strengthen the evidence base for D-dimer as a diagnostic criterion.

The purpose of this study is to investigate the concept of accreditation in terms of Accreditation Bodies in Health (ABIH) through a bibliometric analysis. Co-citation, co-occurrence and co-authorship analyses were performed on 465 academic publications selected from the Web of Science database focusing on health accreditation bodies. The analyses were conducted using R-based Bibliometrix software, Python and Microsoft Excel. The co-citation analysis identified seven themes: "Prevention of Clinical Errors and Patient Safety: Guidelines for Accreditation Bodies," "Accreditation and Multidimensional Impacts on Healthcare Quality," "Multidimensional Assessment of Hospital Quality in the United States: Standardization, Regulation, and Accreditation," "Quality Assessment in Health Care: Theoretical Foundations and Personnel Management," "The Complex Dynamics of Accreditation in Health Care: Analyzing Quality, Cost, and Performance," "Quality and Performance Measurement in Health Care," and "Accreditation and Pain Management." Co-occurrence analyses revealed themes such as "Clinical Safety and Child Health," "Beliefs and Ethical Issues," "Patient Safety and System Errors," "Guidelines and Risk Management," "Quality and Performance Management," and "Clinical Practice and Health Services." The findings highlight the complexity of thematic categories and key issues in the literature on the contribution of accreditation bodies to the accreditation process in healthcare, which can inform policymakers and practitioners. This study provides a comprehensive bibliometric analysis of accreditation bodies in health, offering valuable insights into thematic clusters and contributing to the existing body of knowledge on healthcare accreditation.

Elderly patients (≥ 75years) often require resuscitation room (RR) care in the emergency department (ED), yet decisions regarding intensive care unit (ICU) admission remain complex. Assessment of quality of life and frailty is necessary to determine the level of care required for elderly patients. The Clinical Frailty Scale (CFS) is a validated tool for assessing frailty and predicting mortality, but its role in ICU triage remains unclear. The aim of this study was to compare the CFS of patients admitted to the ICU with those admitted to the general inpatient unit (GIU) after receiving initial intensive care. This was a retrospective, single-center study including patients aged ≥ 75years admitted to the ED RR from November 1, 2023, to March 31, 2024. The primary outcome was the comparison of CFS between ICU and GIU admissions after RR management. Secondary outcomes included predictive performance of CFS for ICU admission and in-hospital mortality. Of the 392 patients enrolled, 170 (43%) were admitted to the ICU and 222 (57%) to the GIU. The median CFS was 3 (2-4) in ICU-admitted patients and 4 (3-5) in GIU-admitted patients (p < 0.001). In-hospital mortality rate was 30/170 (18%) in the ICU-admitted group and 35/222 (16%) in the GIU-admitted group (p = 0.72). CFS predictive value for ICU admission had an area under the curve of 0.68 (95% confidence interval (95%CI): 0.63-0.73) and for in-hospital mortality of 0.62 (95%CI: 0.55-0.69). In elderly patients admitted to the RR, CFS values differed between those admitted to ICU and those admitted to GIU. However, the discriminative performance of CFS for hospital orientation and in-hospital mortality was limited. These findings suggest that frailty assessment may contribute to the overall evaluation of elderly patients in the ED RR but should be interpreted in conjunction with acute severity scores and clinical judgment.

The rising demand for radiology services calls for innovative solutions to sustain diagnostic quality and efficiency. This study evaluated the diagnostic agreement between two commercially available artificial intelligence (AI) chest X-ray systems and human radiologists during routine clinical practice.We retrospectively analyzed 279 chest X-rays (204 standing, 63 supine, 12 sitting) from a Swiss university hospital. Seven thoracic pathologies - cardiomegaly, consolidation, mediastinal mass, nodule, pleural effusion, pneumothorax, and pulmonary oedema - were assessed. Radiologists' routine reports were compared against Rayvolve (AZmed) and ChestView (Gleamer, both from Paris, France). A Python code, provided as open access supplement, calculated performance metrics, agreement measures, and effect size quantification.Agreement between radiologists and AI ranged from moderate to almost perfect: Human-AZmed (Gwet's AC1: 0.47-0.72, moderate to substantial), and Human-Gleamer (Gwet's AC1: 0.56-0.96, moderate to almost perfect). Balanced accuracies ranged from 0.67-0.85 for Human-AZmed and 0.71-0.85 for Human-Gleamer, with peak performance for pleural effusion (0.85 both systems). Specificity consistently exceeded sensitivity across pathologies (0.70-0.98 vs 0.45-0.85). Common findings showed strong performance, pleural effusion (MCC 0.70-0.73), cardiomegaly (MCC 0.51), and consolidation (MCC 0.45-0.46). Rare pathologies demonstrated lower agreement, mediastinal mass, and nodules (MCC 0.23-0.31). Standing radiographs yielded superior agreement compared to supine studies. The two AI systems showed substantial inter-system agreement for consolidation and pleural effusion (balanced accuracy 0.81-0.84).Both commercial AI chest X-ray systems demonstrated comparable performance to human radiologists for common thoracic pathologies, with no meaningful differences between platforms. Performance was strongest for standing radiographs but declined for rare findings and supine studies. Position-dependent variability and reduced sensitivity for uncommon pathologies underscore the continued need for human oversight in clinical practice. · AI systems matched radiologists for common chest X-ray findings.. · Standing radiographs achieved the highest diagnostic agreement.. · Rare pathologies showed weaker AI-human agreement.. · Supine studies reduced diagnostic performance.. · Human oversight remains essential in clinical practice.. · Bosbach WA, Schoeni L, Senge JF et al. Novel Artificial Intelligence Chest X-ray Diagnostics: A Quality Assessment of Their Agreement with Human Doctors in Clinical Routine. Rofo 2025; DOI 10.1055/a-2778-3892.

Risk of vertebral fractures is increased in primary hyperparathyroidism (PHPT). Bone qualities affected by PHPT are not necessarily reflected in bone mineral density (BMD), requiring imaging modalities with capability to capture bone microstructure and geometry. Digital tomosynthesis (DTS) imaging is a method with such capability. Therefore, the objectives of this study were to determine (i) vertebral bone quality differences between women who have established PHPT and normal controls using DTS, and (ii) the extent to which DTS discriminates patients with PHPT from those without. 50 postmenopausal women with established PHPT and 54 control women without PHPT (nPHPT) were DXA imaged to measure spine BMD and trabecular bone score (TBS). They were then DTS imaged to measure vertebral width and area as well as the textural properties of vertebral bone: Degree of anisotropy (DA), fractal dimension (FD), lacunarity (λ), scale-dependent lacunarity (Sλ) and line fraction deviation (LFD). FD was significantly higher while λ and LFD were significantly lower in the PHPT group than in the nPHPT group. λ was a significant predictor of PHPT status, independently from race, BMD and TBS, raising the overall AUC to 0.805. We observed a dichotomy between the races; larger vertebral area in White patients, but smaller vertebral area in Black patients, was associated with PHPT independently from BMD or TBS. DTS derived vertebral size and textural properties differ between PHPT and nPHPT, discriminate PHPT status independently from DXA, and therefore may be useful in the assessment of bone quality in PHPT.

The ongoing absence of a national Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) policy means that there remains a lack of explicit guidance on how clinicians should select, measure and assess relevant factors when deciding whether to implement a DNACPR order. Although previous studies have raised this as a concern, this qualitative study explores the extent to which individual clinicians not only adopt personal strategies to assess patients, but also value having a degree of professional autonomy when making DNACPR decisions. Sixteen semi-structured interviews were conducted with National Health Service (NHS) clinicians via video calls. Participants were recruited via snowball sampling. Thematic analysis was conducted using an inductive approach. Initial codes were generated from the interview transcripts, which were then organised into overarching themes based on patterns and relationships identified across the coded data. Four main groupings summarise the different considerations adopted by doctors when making DNACPR decisions: age, frailty, assessment of quality of life, and perceived outcome. However, whilst the same general areas for consideration were drawn on, the participating doctors nevertheless assessed them differently and often prioritised them in different ways. In the absence of explicit, standardised guidance for weighting these factors, decisions were often made on the basis of individual judgement and local convention. This study demonstrates that physician-level variation in DNACPR decision-making reflects the inherent tension clinicians experience when balancing individual patient needs with the absence of explicit, standardised guidance. The ability to make decisions on a case-by-case basis, with the freedom to weigh diverse factors in a nuanced way is an important aspect of clinical decision-making. However, this can lead to inadvertent bias if decisions are based on factors not necessarily supported by established evidence. Our findings highlight a clear need for a more robust and equitable framework for these critical conversations, whilst also enabling clinicians to be able to make case-by-case decisions. The development of a national DNAPR policy that integrates evidence-based data may help doctors select and weigh factors appropriately, and provide a framework for the initiation of DNACPR discussions. However, such a policy must nevertheless be sufficiently flexible to permit doctors the autonomy required to make nuanced decisions on the basis of a range of patient-specific contextual assessments. Our key recommendation, therefore, is that clinicians should be supported not only by improved procedures and processes, but also by confidence that their professional judgement is rooted in the most current clinical evidence.

Tuberculosis (TB) remains a major global public health challenge, particularly in low-resource countries where access to trained radiologists is limited, making Chest X-ray (CXR) screening difficult to scale. The advancement of Artificial Intelligence (AI) and Computer-Aided Detection (CAD) technology offers a potential solution by providing automated TB detection and supporting diagnostic workflows. To assess their clinical readiness, this systematic review and meta-analysis was conducted using the PRISMA 2020 protocol and included studies from PubMed, Scopus, and Semantic Scholar that evaluated AI-CAD systems (Index Test) against microbiological or extended reference standards (Reference Standard). The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2 and QUADAS-C) tools were applied to measure risk of bias, and a random-effects model was used to estimate pooled Diagnostic Odds Ratio (DOR). Six studies with approximately 38,940 participants were eligible for analysis. Results showed a pooled DOR of 0.133 (95% CI: 0.047–0.377), indicating a significantly lower diagnostic error rate (P=0.000). Although sensitivity was consistently high (83.3%–100%), specificity varied widely (26.8%–98.9%), resulting in notable heterogeneity and a wide prediction interval (0.003–6.411). These findings conclude that AI-CAD tools demonstrate strong potential for TB screening but should undergo local validation, threshold calibration, and operational evaluation before broad clinical implementation, especially where specificity remains below the WHO Target Product Profile.

Abstract Satellite geometry and sky visibility critically influence Global Navigation Satellite System (GNSS) observation quality. Conventional quality measures such as multipath, cycle slip, SNR ratio, Position Dilution of Precision (PDOP) require sufficient valid data and time-consuming processing, whereas azimuth–elevation (Az–El) metrics can be derived directly from raw observations in RINEX files and satellite ephemeris. In this study, we propose a simple set of Az–El metrics to characterize site suitability and evaluate their ability to replicate the PDOP-based composite (baseline). We compared normalized composite scores from both approaches (Az–El composite (proposed)) using one year of GPS data from 66 continuously operating reference stations (CORS) in northern India (2024). All metrics were ECDF-scaled to [0–1], and ‘lower-is-better’ terms were flipped so higher values always indicate better quality. Agreement between Az–El and PDOP composites remained high (Spearman ρ ≈ 0.956, Kendall τ ≈ 0.831); 3-class accuracy ≈ 84.6 % with Cohen’s κ ≈ 0.769 (tertiles), with no Good↔Limited class flips. These results show that Az–El metrics provide a rapid, processing-light field-ready based QC, suitable for large-scale monitoring and national reference-frame operations. Unlike PDOP, the Az–El metrics explicitly localize direction-specific obstructions (largest blocked sector) and overall sky openness, enabling targeted field remediation and routine QC.

Ecological assessment of soil quality affected by the Shahed-136 drone strike: Case study in Kirovograd region, Ukraine

This research seeks to examine how three behavioral biases—dispositioneeffect, herding behavior, and blue chippstock bias—oniinvestment decision, considering risk perception as a mediating factor among retail investors PT. Phintraco Sekuritas Surabaya. The scope of this study includes testing the direct and indirect influences between variables through an explanatory quantitativeeapproach. Data was gathered from 100 participants throughaa Likerttscale questionnaireeand subsequently analyzed utilizing data quality assessments, classical assumption evaluations, multipleelinear regression, and Sobel tests to investigate the mediating effect. The results suggest that herd behavior and a preference forrblue-chip stocks have a significant influenceeon the perception of risk, while the dispositioneeffect has no influence. In testing investment decisions, only herding behavior and risk perception showed a significant effect, while the effects of disposition and blue chip stock bias had no direct effect. The Sobel test has shown thattrisk perceptionnmediates the relationshippbetween herding behavior and the blue-chip stocks biasiin investment decisions, but not the influence of disposition effect. Overall, the study concludes that herding behavior and perceptions of blueechip stocks shape riskpperception, which ultimately influences investmenttdecisions, thus proving that risk perception is an important mediator in the retail investor behavior model.

Background: Knee osteoarthritis (KOA) is one of the most prevalent chronic musculoskeletal disorders among the elderly in Saudi Arabia, leading to persistent pain, joint stiffness, and reduced mobility. Physiotherapy remains a cornerstone of management; however, access barriers such as limited mobility, transportation issues, and unequal distribution of rehabilitation centers have prompted the emergence of tele-rehabilitation as an alternative. Tele-rehabilitation employs digital platforms to deliver physiotherapy interventions remotely, potentially increasing accessibility and adherence while reducing healthcare burden. Objective: This systematic review aimed to compare the effectiveness of tele-rehabilitation versus traditional, in-person physiotherapy in improving pain, physical function, and quality of life among elderly Saudi patients with chronic knee osteoarthritis. Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Saudi Digital Library databases for studies published between 2015 and 2025. Eligible studies included randomized controlled trials (RCTs), cohort studies, and quasi-experimental designs comparing tele-rehabilitation and conventional physiotherapy for knee osteoarthritis in adults aged ≥60 years. Primary outcomes were pain reduction (measured by the Visual Analogue Scale or WOMAC pain subscale), physical function (WOMAC or KOOS scores), and quality of life (SF-36 or EQ-5D). Data extraction and quality assessment followed PRISMA guidelines. Results: A total of 14 studies (n = 1,320 participants) met the inclusion criteria. Across studies, tele-rehabilitation interventions—delivered through video conferencing, mobile applications, or web-based platforms—demonstrated comparable improvements in pain reduction and physical function to traditional physiotherapy (mean difference in WOMAC pain score: −0.12, 95% CI −0.35 to 0.11, p &gt; 0.05). Several studies reported higher patient adherence and satisfaction with tele-rehabilitation, particularly due to convenience and reduced travel time. However, limitations included variations in digital literacy and inconsistent access to stable internet connections among older adults in rural Saudi regions. Conclusion: Tele-rehabilitation appears to be an effective and feasible alternative to traditional physiotherapy for elderly Saudi patients with chronic knee osteoarthritis. While both modalities yield similar outcomes in pain relief and functional improvement, tele-rehabilitation enhances accessibility and may improve adherence, particularly in underserved areas. Further large-scale, culturally adapted RCTs are recommended to optimize tele-rehabilitation protocols and assess long-term cost-effectiveness within the Saudi healthcare context.

Groundwater is a vital yet increasingly vulnerable resource, with nitrate contamination posing a significant risk to human beings and the ecosystem. The present study offers an integrated, sustainability-focused assessment of groundwater quality in India's eastern littoral state, based on groundwater quality data from 422 sampling locations. In 2024, nitrate concentrations peaked at 387ppm, with an average of over 37ppm; notably, more than 20% and 17% of samples exceeded the Bureau of Indian Standards and World Health Organization guidelines, respectively. Both non-carcinogenic and carcinogenic health risks were assessed, revealing that nitrate poses risks through oral and dermal exposure, while nitrite contributes to cancer risk through ingestion. Principal component analysis multiple linear regression highlighted strong correlations among nitrate and macro-elements such as sodium, chloride, calcium, magnesium, and potassium, indicating common anthropogenic sources such as fertilizer runoff and wastewater infiltration. Multivariate analysis showed that nitrate is the dominant contaminant influencing groundwater quality shifts from 2020 to 2024, largely driven by agricultural intensification and sewage disposal contributions. These findings underscore the critical importance of adopting strategic intervention policies and promoting resilient groundwater governance frameworks across national and international scales.

Integrated Assessment of Groundwater Quality and Recharge Potential for Sustainable Water Resource Management using Hydrogeochemical Analysis, GIS And AHP Techniques

The burgeoning interest in the flipped language learning approach (FLLA), characterized by its learner-centered pedagogy and utilization of instructional technology, necessitates a systematic review to synthesize its psychological and learning effects. This review meticulously analyzed 55 peer-reviewed articles published between 2010 and 2023, employing a comprehensive search strategy across major databases including Education Source, ERIC, Web of Science, Scopus, and Computers and Applied Sciences Complete. Through bidirectional citation searching and Boolean logic, this study ensured the inclusion of relevant studies, adhering to stringent eligibility criteria to maintain the review's integrity. The articles were subjected to an inductive paradigmatic analysis to identify empirical evidence of FLLA's affordances and challenges, focusing on psychological effects, learning effects, instructional tools, and educational activities. The review reveals that FLLA promotes a broad spectrum of positive psychological effects, such as enhanced motivation, reduced anxiety, and improved attitudes towards technology, alongside significant learning outcomes including increased learner autonomy, engagement, and skill development. However, challenges such as increased workload and inconsistency in instructional design were also identified. In addition, all 55 studies underwent a structured methodological quality assessment adapted from the Mixed Methods Appraisal Tool (MMAT) and four custom domains (sampling adequacy, instrumentation validity, statistical transparency, and ecological validity), revealing generally moderate-to-high methodological quality but with notable variability in sampling and reporting practices. The systematic review concludes that FLLA holds substantial promise for enriching language learning pedagogy, though further research is needed to address its challenges and fully leverage its benefits. The systematic review concludes that FLLA holds substantial promise for enriching language learning pedagogy, though further research is needed to address its challenges and fully leverage its benefits.

The foundation of Bagong Dam in Trenggalek Regency faces geological challenges characterized by lithological heterogeneity with high permeability (0.03-106.70 Lugeon) and variable rock mass strength. This study aims to evaluate the influence of geological characteristics on grouting performance by integrating permeability classification and multi-parameter rock quality assessment. The research utilized grouting trial data from three main zones (Right Abutment, River Bed, and Left Abutment) employing methods that include Lugeon permeability testing, RQD, core sampling, and UCS. Grouting effectiveness was evaluated using the Quíñones-Rozo (2010) classification system and RQD regression analysis. Results demonstrated a reduction in permeability from Medium-High class to Very Low-Low following grouting, with effectiveness values of 94.8% (Right Abutment), 90.79% (Left Abutment), and 78.91% (River Bed). Analysis revealed three depth-dependent response zones: shallow zone (5-15 m) with high variability but good efficiency, transition zone (15-25 m) with consistent performance, and deep zone (25-40 m) with high effectiveness. Correlation analysis between RQD and grouting effectiveness yielded R² = 0.254 (Effectiveness = 0.408·RQD + 61.30), indicating that RQD alone is insufficient as a standalone predictor, corroborated by the PH18 anomaly (RQD 35%, effectiveness 95.65%) which demonstrates the necessity of multi-parameter integration. These findings prove that integrated permeability assessment and rock quality evaluation provide a more reliable basis for assessing grouting performance compared to conventional approaches using a single parameter.

Objective The evidence on postoperative pain and clinical outcomes in patients receiving primary non-surgical root canal therapy with bioceramic vs. resin-based sealers was compiled in this comprehensive review from systematic reviews and meta-analyses. Methods The review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42023461029). Systematic reviews included randomized or quasi-randomized trials of adult patients having treatment with either sealer type for postoperative pain, and used validated scales. Screening, data extraction, and quality assessment by A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR-2) were completed independently by two reviewers and review overlap was measured with the Corrected Covered Area (CCA). Where feasible, de novo random-effects meta-analyses were conducted to estimate standardized mean differences (SMD) in pain at 24 and 48 h. Heterogeneity was measured using the I 2 statistic and certainty of evidence with GRADE. Results Seven reviews (2020–2024) met eligibility, five with quantitative synthesis. Pooled analyses showed no significant differences in pain between sealer types within the first 6–48 h. Detected differences were small and clinically negligible. Both sealers showed similar analgesic use and flare-up rates. Methodological quality ranged from moderate to low; certainty of evidence for early pain was moderate and low for pain at &amp;gt;48 h due to study inconsistency and imprecision. Conclusions Bioceramic sealers offer only a minimal, clinically insignificant reduction in early postoperative pain compared to resin-based sealers. Both nevertheless remain suitable options for reducing patient discomfort. Future studies should standardize pain evaluation, include retreatment cases, and explain clinically significant findings. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42023461029 , PROSPERO CRD42023461029.

Human Immunodeficiency Virus (HIV) is a global health problem that causes many deaths, especially in low- and middle-income countries (LMICs). Most HIV cases occur in sub-Saharan Africa and Asia. In efforts to manage HIV, technologies such as telehealth have begun to be considered as an effective solution, both in high- and low-income countries. This study aims to identify telehealth models used in low-, middle-, and high-income countries and to evaluate their impact on treatment adherence, viral load, and HIV disease management. This study answers the question: "What telehealth models are used in countries with different income levels, and how do they impact HIV/AIDS patients?" This literature review was conducted between February and April 2025 by searching five databases: PubMed, Sage, ProQuest, Scopus, and ScienceDirect, covering the last 10years, from January 2015 to January 2025. Articles that met the inclusion criteria were original articles on the use of telehealth in HIV patients. Article selection was conducted using the PRISMA flowchart, and quality assessment was conducted using the Quality Assessment of Risk of Bias (RoB 2.0). Of the 4739 articles found, 11 articles met the criteria with four main themes: telehealth models, improving treatment adherence, reducing viral load, and the impact of telehealth on HIV management. The results of this study indicate that telehealth models vary, but their benefits have been proven significant in HIV management, especially in resource-limited countries, and they can improve treatment adherence and reduce viral load.

This systematic review evaluates the literature to determine the usefulness and rules of artificial intelligence (AI) in the diagnosis and prediction of maxillary canine impaction (MCI). The search was performed through four electronic databases (PubMed, Scopus, and Web of Science, with Google Scholar). The protocol was registered at the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY202550102). Original English-language research articles utilizing AI in MCI were included. The diagnostic accuracy studies were evaluated using the QUADAS-2 tool, while the predictive studies were evaluated using the PROBASST tool. The research strategy yielded seven articles deemed suitable for data extraction and quality assessment. Of these, five were diagnostic accuracy studies, and two were predictive studies. Overall, the studies demonstrated a low risk of bias. AI demonstrated high diagnostic performance, including improved detection accuracy (up to 98.3%), efficient segmentation (Dice similarity coefficient 0.99), and moderate-to-high predictive performance for three-dimensional (3D) reconstruction or root resorption classification. These findings highlight the potential of AI to enhance localization, diagnosis, and treatment planning of impacted maxillary canines. Across the seven included studies, AI demonstrated high accuracy in localizing impacted maxillary canines and showed predictive capability for eruption outcomes. These findings suggest that AI can meaningfully support clinicians in diagnosis, treatment planning, and management of MCI. Further research is necessary to elucidate the clinical applicability of AI by standardizing methodologies, including larger samples for better validity and generalizability.

The impacts of land use on stormwater runoff quality and Best Management Practices to mitigate these impacts have been investigated since the 1970s, yet challenges remain in providing a modeling approach that concomitantly considers contributions from different land use types. In densely developed urban areas, a buildup/washoff approach is often applied, while in rural areas, some type of erosion modeling is employed, as the processes of detachment, entrainment, and transport are fundamentally different. This study presents a coupled modeling approach within PCSWMM, integrating exponential buildup/washoff for impervious surfaces with the Modified Universal Soil Loss Equation (MUSLE) for pervious areas, including construction sites, to characterize water quality in the large mixed urban–rural Sparrovale catchment in Geelong, Australia. The watershed includes an innovative cascading system of 12 online NbS wetlands along one of the main tributaries, Armstrong Creek, to manage runoff quantity and quality, as well as 16 offline NbS wetlands that are tributary to the online system. A total of 78 samples for Total Suspended Solids (TSS), Total Phosphorus (TP), and Total Nitrogen (TN) were collected from six monitoring sites along Armstrong Creek during wet- and dry-weather events between May and July 2024 for model validation. The data were supplemented with six other catchment stormwater quality datasets collected during earlier studies, which provided an understanding of water quality status for the broader Geelong region. Results showed that average nutrient concentrations across all the sites ranged from 0.44 to 2.66 mg/L for TP and 0.69 to 5.7 mg/L for TN, spanning from within to above the ecological threshold ranges for eutrophication risk (TP: 0.042 to 1 mg/L, TN: 0.3 to 1.5 mg/L). In the study catchment, upstream wetlands reduced pollutant levels; however, downstream wetlands that received runoff from agriculture, residential areas, and, importantly, construction sites, showed a substantial increase in sediment and nutrient concentration. Water quality modeling revealed washoff parameters primarily influenced concentrations from established urban neighborhoods, whereas erosion parameters substantially impacted total pollutant loads for the larger system, demonstrating the importance of integrated modeling for capturing pollutant dynamics in heterogeneous, urbanizing catchments. The study results emphasize the need for spatially targeted management strategies to improve stormwater runoff quality and also show the potential for cascading wetlands to be an important element of the Nature-based Solution (NbS) runoff management system.