Healthcare Challenges Research Articles

SEPT9_i1 and Septin Dynamics in Oncogenesis and Cancer Treatment.

Despite significant advancements in the field of oncology, cancers still pose one of the greatest challenges of modern healthcare. Given the cytoskeleton's pivotal role in regulating mechanisms critical to cancer development, further studies of the cytoskeletal elements could yield new practical applications. Septins represent a group of relatively well-conserved GTP-binding proteins that constitute the fourth component of the cytoskeleton. Septin 9 (SEPT9) has been linked to a diverse spectrum of malignancies and appears to be the most notable septin member in that category. SEPT9 constitutes a biomarker of colorectal cancer (CRC) and has been positively correlated with a high clinical stage in breast cancer, cervical cancer, and head and neck squamous cell carcinoma. SEPT9_i1 represents the most extensively studied isoform of SEPT9, which substantially contributes to carcinogenesis, metastasis, and treatment resistance. Nevertheless, the mechanistic basis of SEPT9_i1 oncogenicity remains to be fully elucidated. In this review, we highlight SEPT9's and SEPT9_i1's structures and interactions with Hypoxia Inducible Factor α (HIF-1 α) and C-Jun N-Terminal Kinase (JNK), as well as discuss SEPT9_i1's contribution to aneuploidy, cell invasiveness, and taxane resistance-key phenomena in the progression of malignancies. Finally, we emphasize forchlorfenuron and other septin inhibitors as potential chemotherapeutics and migrastatics.

Awareness of Interventional Radiology Among Medical Students.

Interventional radiology (IR) plays a crucial role in modern medicine, offering minimally invasive treatments for various conditions. Despite its growing significance, the awareness and understanding of IR among medical students are often limited. This research aims to evaluate the level of awareness of IR among medical students at the University of Gezira in Sudan Methodology: This study is a descriptive cross-sectional study that involved 174 medical students from batches 39 and 40. Data was collected through a structured questionnaire designed to assess participants' awareness and perception of IR. The questionnaire was carried out through Google Forms platform, and the data was analyzed using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States).The chi-square test was used to compare qualitative data, and a p-value of <0.05 wasconsidered significant. Females were 97 (55.7%) of the participants, while males were 77 (44.3%). The educational level found that 85 (48.9%) are finalists (fifth year) and 89 (51.1%) have graduated. A total of 75 (43.1%) of the medical students considered themselves havingpoor knowledge about IR. A total of 163 (93%) have confirmed that mandatory radiology courseis important to be added to the curriculum of the medical school. Furthermore, 149 (85.6%) are familiar with the concept of angioplasty, and 60 (34.5%) have seen patients treated by an interventional radiologist. Most of the students are not considering IR as a career mainly due to the lack of knowledgeor fear from radiological exposure. Medical students' awareness and perception of IR is inadequatewhich may adversely affect their consideration of pursuing it as a career path. Educational interventions aimed at enhancing medical students' knowledge and interest in IR may be needed to improve patient outcomes and tackle healthcare challenges.

Abstract B128: Underlying factors influencing kidney cancer surgical treatment disparities: Patients, non-patient community members and urologists’ perspectives

Abstract Background: Racial and ethnic minority patients often delay or forgo kidney cancer (KCa) surgical treatment and have an invasive surgical treatment. This study aimed to understand the underlying factors of KCa surgical treatment disparities through interviews with KCa patients and non-patients from racial and ethnic minority communities in Arizona and online surveys with urologists who practice in the U.S. Methods: We conducted phone interviews with KCa patients (n=13) and interviews at health events with community members without KCa (n=61). Online surveys were conducted with urologists (n=54). Results: Many interview participants had healthcare access issues with 22% reporting not having a primary care doctor and 12% reporting that there was a time when they could not see a doctor because of cost. Almost 50% reported that they had delayed care because they could not get an appointment soon enough. Among 10 patients who responded to a question about diagnosis delay, 4 answered that they waited over a year to see their doctor when they had health issues before their diagnosis. A quarter of community participants (25%) and about a third of patients (31%) reported that cultural values or religious beliefs influenced their choice of treatment. When community participants were asked what they knew about KCa symptoms and treatments, many did not provide relevant or correct information. Only 51% of non-patients reported that they trusted their doctor’s judgements about their medical care, but 92% of patients reported that they trusted their doctor’s judgement. About 30% of urologists reported that patients from racial and ethnic minority backgrounds often have healthcare access challenges, but only 9% responded that NHW patients often have challenges. They did not report that racial and ethnic differences in treatment exist. About 10% of urologists reported socioeconomic backgrounds of patients affect treatment decision and timeliness often or all the time. Only 46% reported that they refer patients to necessary services all the time, when patients express concerns of finance and healthcare access challenges. Many urologists strongly or slightly agreed that treatment decisions should be made by the treating clinicians (82%) and based on clinical information (87%). Many also strongly or slightly agreed that patients and their family members should contribute to decision-making (98%), while 46% strongly or slightly agreed that patients’ cultural and religious backgrounds often affect their treatment choices. In open-ended questions, urologists responded that work and family obligations, healthcare access, and health literacy rather than race and ethnicity are factors influencing treatment, while mistrust was identified as one of factors influencing treatment delay. Conclusions: Barriers to healthcare access, lack of knowledge, and mistrust before diagnosis may be underlying factors among patients, while urologists view healthcare access, social and economic factors, and mistrust influence KCa surgical treatment decision and delay. Citation Format: Ken Batai, Alex Cruz, Juan Adrover, Daphne Larose, D'Andre Gomez, Francine C. Gachupin, Jacquanette R. Slowtalker, Benjamin R. Lee, Juan Chipollini. Underlying factors influencing kidney cancer surgical treatment disparities: Patients, non-patient community members and urologists’ perspectives [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B128.

In Silico Decoding of Parkinson's: Speech & Writing Analysis.

Background: Parkinson's disease (PD) has transitioned from a rare condition in 1817 to the fastest-growing neurological disorder globally. The significant increase in cases from 2.5 million in 1990 to 6.1 million in 2016, coupled with predictions of a further doubling by 2040, underscores an impending healthcare challenge. This escalation aligns with global demographic shifts, including rising life expectancy and a growing global population. The economic impact, notably in the U.S., reached $51.9 billion in 2017, with projections suggesting a 46% increase by 2037, emphasizing the substantial socio-economic implications for both patients and caregivers. Coupled with a worldwide demand for health workers that is expected to rise to 80 million by 2030, we have fertile ground for a pandemic. Methods: Our transdisciplinary research focused on early PD detection through running speech and continuous handwriting analysis, incorporating medical, biomedical engineering, AI, and linguistic expertise. The cohort comprised 30 participants, including 20 PD patients at stages 1-4 on the Hoehn and Yahr scale and 10 healthy controls. We employed advanced AI techniques to analyze correlation plots generated from speech and handwriting features, aiming to identify prodromal PD biomarkers. Results: The study revealed distinct speech and handwriting patterns in PD patients compared to controls. Our ParkinsonNet model demonstrated high predictive accuracy, with F1 scores of 95.74% for speech and 96.72% for handwriting analyses. These findings highlight the potential of speech and handwriting as effective early biomarkers for PD. Conclusions: The integration of AI as a decision support system in analyzing speech and handwriting presents a promising approach for early PD detection. This methodology not only offers a novel diagnostic tool but also contributes to the broader understanding of PD's early manifestations. Further research is required to validate these findings in larger, diverse cohorts and to integrate these tools into clinical practice for timely PD pre-diagnosis and management.

Acetylcholine and Depression: Scrutinizing Future Therapeutic Targets for Novel Drug Development

Depression, a pervasive and disabling mental health disorder, presents a global healthcare challenge. Despite persistent research on its etiology and pathophysiology, many aspects remain unclear. Predominant neurobiological research and traditional pharmacotherapies have pointed out the monoamine hypothesis as a pivotal factor in the pathophysiology of depression. However, emerging perspectives on the monoamine hypothesis highlight the significance of the cholinergic system, a major regulator of diverse CNS functions encompassing attention, arousal, cognition, and memory. Cognitive impairments were frequently observed in depression along with other symptoms i.e. low mood and anhedonia. A comprehensive literature search was conducted across multiple databases (PubMed, Scopus, and Web of Science) from their inception until May 2023. We screened 1,200 articles, of which 400 full-text articles were assessed for eligibility, and 231 studies met the inclusion criteria. The review included both pre-clinical and clinical studies focusing on the role of acetylcholine (ACh) and its receptors in depression. Data extraction and quality assessment were performed independently by two reviewers. In literature, both pre-clinical and clinical studies suggest that elevated central ACh levels may contribute to depression, prompting investigations into intervention strategies targeting mAChRs/nAChRs and AChE. These receptors have become a critical target in drug-design strategies aimed at addressing depression-like symptoms. In addition, research has demonstrated a significant antidepressant-like effect of AChEIs in a dose-dependent manner in animal models. Hence, this evidence over the past decades underscores the pivotal role of the cholinergic system in mood regulation, offering promise for novel depression treatments. In this review, we tried to summarize the historical evolution of the cholinergic system from early discoveries to its role in the pathophysiology of depression. It presents evidence for the involvement of mAChRs and nAChRs, as well as AChE, in depression. By outlining the cholinergic theory of depression, this review suggests a novel therapeutic approach, emphasizing the role of ACh in the complex depression pathophysiology, and presenting avenues for further research and the development of targeted interventions.

Culture, tradition and healthcare: exploring the Kisiizi Community Health Insurance scheme

In southwestern Uganda, a custom of health and social support has been managed through collective organizations known as engozi for centuries. Subscribers advanced help for those who were not able to provide for themselves and their households. Participants pooled financial and food resources, offered emotional assistance, and aided in transporting patients to hospitals. The institution of “free government health amenities” caused the decline of the engozi custom. However, with an insufficient annual health sector budget allocation, the state health services cannot satisfactorily meet the needs. The Kisiizi neighborhood, while depending on the engozi practice, arrived at a CHI system in 1996 as a self-help innovation to eliminate financial obstacles and enhance access to quality health amenities. Numerous studies on CHI have examined the structure, registration and memberships, health-related advantages, and monetary-related benefits, but little has been documented on how cultural beliefs and customs have affected its application. This study aimed to identify the role of culture and customs in tackling healthcare disparities via a CHI strategy. This study adopted a case study methodology and qualitative methods. The study utilizes Woolcock’s social capital theory and Cultural competence theory as the analytical framework. It identifies Brotherhood, Solidarity, Belonging, Cooperation, Volunteering, Reciprocity, and Respect for Authority and Leaders as key values upheld by the engozi tradition, strengthening social capital and laying a solid foundation for successful CHI. This study also identified that societal values and traditions have significantly impacted the implementation of the Kisiizi CHI scheme, as evidenced by the influence on CHI leadership and governance, collecting premium fees from subscribers, mobilization and registration of participants, and information dissemination. Lastly, the study identified that CHI has positively affected healthcare challenges within the community, evidenced by increased utilization of healthcare services, improved access to antenatal care, health promotion and disease prevention initiatives, and improved quality of services due to user feedback.

Semaglutide for the management of diabesity: The real-world experience.

Diabesity (diabetes as a consequence of obesity) has emerged as a huge healthcare challenge across the globe due to the obesity pandemic. Judicious use of antidiabetic medications including semaglutide is important for optimal management of diabesity as proven by multiple randomized controlled trials. However, more real-world data is needed to further improve the clinical practice. To study the real-world benefits and side effects of using semaglutide to manage patients with diabesity. We evaluated the efficacy and safety of semaglutide use in managing patients with diabesity in a large academic hospital in the United States. Several parameters were analyzed including demographic information, the data on improvement of glycated hemoglobin (HbA1c), body weight reduction and insulin dose adjustments at 6 and 12 months, as well as at the latest follow up period. The data was obtained from the electronic patient records between January 2019 to May 2023. 106 patients (56 males) with type 2 diabetes mellitus (T2DM), mean age 60.8 ± 11.2 years, mean durations of T2DM 12.4 ± 7.2 years and mean semaglutide treatment for 2.6 ± 1.1 years were included. Semaglutide treatment was associated with significant improvement in diabesity outcomes such as mean weight reductions from baseline 110.4 ± 24.6 kg to 99.9 ± 24.9 kg at 12 months and 96.8 ± 22.9 kg at latest follow up and HbA1c improvement from baseline of 82 ± 21 mmol/mol to 67 ± 20 at 12 months and 71 ± 23 mmol/mol at the latest follow up. An insulin dose reduction from mean baseline of 95 ± 74 units to 76.5 ± 56.2 units was also observed at the latest follow up. Side effects were mild and mainly gastrointestinal like bloating and nausea improving with prolonged use of semaglutide. Semaglutide treatment is associated with significant improvement in diabesity outcomes such as reduction in body weight, HbA1c and insulin doses without major adverse effects. Reviews of largescale real-world data are expected to inform better clinical practice decision making to improve the care of patients with diabesity.

Exploiting Speech Tremors: Machine Learning for Early Diagnosis of Amyotrophic Lateral Sclerosis

Abstract Neurodegenerative diseases pose significant challenges in healthcare, with Amyotrophic Lateral Sclerosis (ALS) being one such rare yet debilitating condition affecting motor neurons. Machine learning (ML) and artificial intelligence (AI) have emerged as powerful tools in healthcare, offering insights and solutions for various medical conditions. This study focuses on utilizing ML and AI to establish an early diagnosis of ALS through tremor detection in sustained speech. The study aims to establish an early diagnosis of ALS by analyzing tremors detected in sustained speech. The dataset comprises 54 patients from the Republican Research and Clinical Centre of Neurology and Neurosurgery in Belarus, Minsk. The study adopts a two-faceted approach: (1) Exploratory voice analysis to identify tremors associated with ALS in speech samples. (2) Development of ML algorithms to construct predictive models for early ALS diagnosis based on the identified tremors. The ML models exhibit promising results in distinguishing ALS patients from healthy controls based on speech analysis. Tremor detection in sustained speech proves to be an effective marker for early ALS diagnosis. While initial findings are encouraging, larger-scale studies are required to validate the clinical applicability of this approach. The successful application of ML and AI in early ALS diagnosis by leveraging innovative approaches, such as tremor detection in sustained speech, we can enhance early diagnosis and improve patient outcomes in neurodegenerative diseases like ALS on a broader scale.&amp;#xD;

Predominance of blaNDM- and blaIMP-Harboring Escherichia coli Belonging to Clonal Complexes 131 and 23 in a Major University Hospital.

Background and Objectives: Carbapenem resistance is a growing global challenge for healthcare, and, therefore, monitoring its prevalence and patterns is crucial for implementing targeted interventions to mitigate its impact on patient outcomes and public health. This study aimed to determine the prevalence of carbapenem resistance among Escherichia coli (E. coli) strains in the largest tertiary care hospital of the capital territory of Pakistan and to characterize the isolates for the presence of antimicrobial resistance genes. Additionally, the most prevalent sequence types were analyzed. Materials and Methods: A total of 15,467 clinical samples were collected from November 2020 to May 2022, underwent antimicrobial susceptibility testing, and were analyzed for antimicrobial resistance genes through conventional PCR and sequence typing using MLST. Results: In carbapenem-resistant E. coli (CR-EC), 74.19% of isolates harbored the blaNDM gene, with blaNDM-1 (66.96%), blaNDM-5 (12.17%), and blaNDM-7 (20.87%) variants detected. Additionally, blaIMP was found in 25.81% and blaOXA-48 in 35.48% of isolates. The presence of blaCTX-M15 and blaTEM was identified in 83.87% and 73.55% of CR-EC isolates, respectively, while armA and rmtB were detected in 40% and 65.16% of isolates, respectively. Colistin and tigecycline were the most effective drugs against CR-EC isolates, with both showing an MIC50 of 0.5 µg/mL. The MIC90 for colistin was 1 µg/mL, while for tigecycline, it was 2 µg/mL. MLST analysis revealed that the CR-EC isolates belonged to ST131 (24.52%), ST2279 (23.87%), ST3499 (16.13%), ST8051 (15.48%), ST8900 (9.68%), ST3329 (7.10%), ST88 (1.94%), and ST6293 (1.29%). The ST131 complex (70.97%) was the most prevalent, harboring 95.65% of the blaNDM gene, while the ST23 complex (18.06%) harbored 62.50% of the blaIMP gene. Conclusions: Implementing large-scale surveillance studies to monitor the spread of specific pathogens, along with active infection control policies, is crucial for the effective containment and prevention of future epidemics.

Mortality and Associated Risk Factors in Patients With Candida auris: Insights From a Tertiary Care Hospital in Bahrain.

Introduction Candida auris poses a significant healthcare challenge due to its high mortality rates, difficulties in identification, and resistance to antifungal treatment. This study aims to identify risk factors associated with 30-day mortality in patients with either invasive Candida auris infection or colonization. Methods We conducted a prospective study at Salmaniya Medical Complex, a tertiary care hospital in Bahrain, from September 2023 to February 2024. The study included 59 patients infected or colonized by Candida auris. Data were systematically collected from patient records, including demographics, clinical characteristics, and outcomes. Risk factors for 30-day mortality were analyzed using both univariate and multivariate statistical methods. Results Among the 59 patients studied, the mean age was 63.9 years, and the cohort was predominantly male (74.6%). Key findings include a high prevalence of multiple indwelling catheters (44.2%) and recent intubation (42.4%). Candida auris was most frequently isolated from the groin (33.9%) and urine (25.4%), with a notable presence in the axillary regions (23.7%). The mortality rate was 44.1%. Univariate and multivariate analyses revealed that age (≥65 years), multiple indwelling catheters, ICU admission for over 24 hours, and recent intubation were significant risk factors for mortality while chronic kidney disease did not retain its significance in the multivariate model. Conclusion The study underscores the critical need for focused infection control and strong antimicrobial stewardship to address the high mortality associated with Candida auris infections. Emphasizing the importance of early detection and a multidisciplinary approach, these strategies are essential for managing and mitigating the impact of Candida auris in healthcare settings.

Challenges and strategies for navigating Australian healthcare access: experience from Chinese international students

BackgroundAustralia hosts over 680,000 international students, contributing $47.8 billion to the Australian economy in 2023, and Chinese students rank first among all nationalities. However, despite their considerable numbers, research focusing on their access to healthcare services is scant. This study aimed to explore barriers and supports regarding the utilisation of healthcare services among Chinese international students studying in Australia.MethodsSemi-structured interviews were conducted in Chinese between October and December 2023 with 25 Chinese international students (age range, 19–30; female/male, n = 18/7; undergraduate/postgraduate/doctoral, n = 1/18/6) enrolled in three Australian universities to understand the healthcare challenges they encountered and the coping strategies they recommended. These interviews were recorded, and thematic analysis was applied to the interview data. An adapted social-ecological model was used to identify barriers and pragmatic strategies to deal with the challenges at different levels.ResultsChinese international students in Australia faced healthcare barriers at different levels. Individual barriers included language and cultural disparities, lack of knowledge about the healthcare system, and reluctance to seek help. Institutional barriers involved high costs, difficulties regarding appointments, and procedures related to the referral system. Policy barriers included insurance coverage and reimbursement issues. The students interviewed for this study proposed individual-level strategies, such as trying various methods to reduce language barriers, seeking information online, and using online resources and consultations. A central appointment platform and multilingual medical service were recommended from students to medical institutions, while medical service guidance and psychological support were suggested to education institutions. Higher-level strategies were also reported, which were mainly pertaining to insurance terms and coverage for overseas students and improving the accessibility of medical information.ConclusionsOur study identifies barriers to healthcare access for Chinese international students in Australia, including culture-specific challenges. To mitigate these issues, we recommend self-directed health promotion, targeted support by education institutions, enhanced cross-cultural communication and expanded telemedicine by hospitals, and attention to insurance coverage. Future research should explore optimising these approaches to improve support systems and policy frameworks.

Predicting ICU Readmission from Electronic Health Records via BERTopic with Long Short Term Memory Network Approach.

Background: The increasing rate of intensive care unit (ICU) readmissions poses significant challenges in healthcare, impacting both costs and patient outcomes. Predicting patient readmission after discharge is crucial for improving medical quality and reducing expenses. Traditional analyses of electronic health record (EHR) data have primarily focused on numerical data, often neglecting valuable text data. Methods: This study employs a hybrid model combining BERTopic and Long Short-Term Memory (LSTM) networks to predict ICU readmissions. Leveraging the MIMIC-III database, we utilize both quantitative and text data to enhance predictive capabilities. Our approach integrates the strengths of unsupervised topic modeling with supervised deep learning, extracting potential topics from patient records and transforming discharge summaries into topic vectors for more interpretable and personalized predictions. Results: Utilizing a comprehensive dataset of 36,232 ICU patient records, our model achieved an AUROC score of 0.80, thereby surpassing the performance of traditional machine learning models. The implementation of BERTopic facilitated effective utilization of unstructured data, generating themes that effectively guide the selection of relevant predictive factors for patient readmission prognosis. This significantly enhanced the model's interpretative accuracy and predictive capability. Additionally, the integration of importance ranking methods into our machine learning framework allowed for an in-depth analysis of the significance of various variables. This approach provided crucial insights into how different input variables interact and impact predictions of patient readmission across various clinical contexts. Conclusions: The practical application of BERTopic technology in our hybrid model contributes to more efficient patient management and serves as a valuable tool for developing tailored treatment strategies and resource optimization. This study highlights the significance of integrating unstructured text data with traditional quantitative data to develop more accurate and interpretable predictive models in healthcare, emphasizing the importance of individualized care and cost-effective healthcare paradigms.

Catheter-Directed Therapies for Deep Vein Thrombosis and Pulmonary Embolism: Nationwide Trends in Medicare Part B Patients from 2015 to 2021

Abstract Background Nationwide trends in the utilization of catheter-directed therapies for deep vein thrombosis and pulmonary embolism in the Medicare population are essential as they represent a major health care challenge. The annual incidence and mortality with venous thromboembolism are around 900,000 and 60,000 to 100,000 patients, respectively, in the United States. Methods Data were acquired from the Data.CMS.gov website on Physician/Supplier Procedure Summary with a list of Medicare Part B fee-for-service claims from 2015 to 2021. Current Procedural Terminology codes 37187 (percutaneous venous mechanical thrombectomy) and 37212 (thrombolytic venous therapy) were queried for deep vein thrombosis. Similarly, Current Procedural Terminology codes 37184 (percutaneous arterial mechanical thrombectomy) and 37211 (thrombolytic arterial therapy) were queried for pulmonary embolism. Annual procedure counts, site of service, and self-reported specialty of the operator were recorded. Results Overall, there was a trend toward increasing utilization of thrombectomy and decreasing utilization of thrombolysis procedures for both deep vein thrombosis and pulmonary embolism. Radiologists performed the majority of the catheter-directed therapy interventions for deep vein thrombosis, while radiologists and surgeons performed a similar number of catheter-directed therapy procedures for pulmonary embolism. Cardiologists were third in the catheter-directed therapy procedure count for both deep vein thrombosis and pulmonary embolism. Conclusion An analysis of nationwide trends from 2015 to 2021 suggests increasing utilization of thrombectomy starting in 2020 when compared to thrombolysis for catheter-directed therapies for both deep vein thrombosis and pulmonary embolism procedures. Newer thrombectomy technologies may be one of the drivers of this shift from thrombolysis to thrombectomy.

Current nanocomposite advances for biomedical and environmental application diversity.

Nanocomposite materials are emerging as key players in addressing critical challenges in healthcare, energy storage, and environmental remediation. These innovative systems hold great promise in engineering effective solutions for complex problems. Nanocomposites have demonstrated various advantages such as simplicity, versatility, lightweight, and potential cost-effectiveness. By reinforcing synthetic and natural polymers with nanomaterials, a range of nanocomposites have exhibited unique physicochemical properties, biocompatibility, and biodegradability. Current research on nanocomposites has demonstrated promising clinical and translational applications. Over the past decade, the production of nanocomposites has emerged as a critical nano-structuring methodology due to their adaptability and controllable surface structure. This comprehensive review article systematically addresses two principal domains. A comprehensive survey of metallic and nonmetallic nanomaterials (nanofillers), elucidating their efficacy as reinforcing agents in polymeric matrices. Emphasis is placed on the methodical design and engineering principles governing the development of functional nanocomposites. Additionally, the review provides an exhaustive examination of recent noteworthy advancements in industrial, environmental, biomedical, and clinical applications within the realms of nanocomposite materials. Finally, the review concludes by highlighting the ongoing challenges facing nanocomposites in a wide range of applications.

Balancing family and career for female physicians in Germany: insights from asurvey of female urologists

The shortage of skilled labor in medicine is one of the most pressing challenges in healthcare. The increasing number of women in medicine, particularly in the field of urology, raises questions about the compatibility of family and career, especially concerning the work environment and working time models. The aim of this study is to capture the impact of motherhood on the professional lives of female physicians and scientists in the field of urology in Germany. Specific challenges in this surgical specialty and the compatibility of family and career will be highlighted. The working group "Female Physicians and Scientists in Urology" of the German Society of Urology (DGU) surveyed its 1343female members regarding demographic data, professional status, and aspects of work-life balance. Among 487female urologists in Germany, 53.4% had children. Mothers tended to be older, less frequently in training, less often in inpatient settings, and less frequently engaged in surgical activities. Notably, the proportion of full-time working mothers (36.2%) was significantly lower compared to female urologists without children (92.4%). Among female urologists with children, 32.3% reported having changed their workplace because of their children, while 10.7% indicated that their responsibilities had changed at least once after pregnancy. Additionally, 76.9% of mothers had reduced their weekly working hours due to family commitments. Multivariate analysis showed an influence of motherhood on professional status and parttime work. The fact that starting afamily for women in urology in Germany is associated with areduction in working hours and the end of clinical careers suggests aneed for optimizing the compatibility of family and career in Germany. The increasing feminization of the medical profession exacerbates the existing shortage of skilled workers due to the exit of mothers from professional life. To meet the needs of working parents, particularly mothers, urgent adjustments in the work environment are necessary. Promoting flexible working time models and creating supportive conditions are crucial to preventing the loss of skilled professionals and maintaining job satisfaction in this field.

Medication-related harm (MRH) in Egyptian older adults post-hospital discharge: a health-care challenge

Medication-related harm (MRH) in Egyptian older adults post-hospital discharge: a health-care challenge

Survey on data fusion approaches for fall-detection

Human fall detection is a critical research area focused on developing methods and systems that can automatically detect and recognize falls, particularly among the elderly and individuals with disabilities. Falls are a major cause of injuries and deaths among these populations, and timely intervention can reduce the severity of consequences. This article presents a comprehensive review of fall detection systems, emphasizing the use of cutting-edge technologies such as deep learning, sensor fusion, and machine learning. The research explores a variety of methodologies and strategies employed in fall detection systems, including the integration of wearable sensors, smartphones, and cameras. By examining various fall detection techniques and their experimental results, the article highlights the effectiveness of these systems in identifying and classifying falls. The study also addresses the challenges and limitations associated with fall detection systems, emphasizing the need for ongoing research and advancements. In summary, this research contributes to the development of advanced fall detection systems, demonstrating their potential to improve the quality of life for the elderly, alleviate healthcare burdens, and provide reliable solutions for fall detection and classification.

EHealth in pediatric respiratory allergy.

This review explores the relevance of eHealth technologies to address unmet needs in pediatric respiratory allergies, particularly allergic rhinitis (AR) and asthma. Given the increasing burden of these conditions, there is a pressing need for effective solutions to enhance disease surveillance, diagnosis, and management. Recent literature highlights the potential of eHealth tools to transform pediatric respiratory allergy care. The use of digital data for infodemiology, application of machine learning models to improve diagnostic sensitivity, smartphone apps with digital patient reported outcome measure (PROMs) and embedded sensors to monitor disease, healthcare professional dashboards with real-time data monitoring and clinical decision support systems (CDSS) are advances emerging to optimize pediatric respiratory allergy care. Integrating eHealth technologies into the pediatric respiratory allergy care pathway is a potential solution for current healthcare challenges to better meet the needs of children with AR and asthma. However, while the potential of eHealth is evident, its widespread implementation in real-world practice requires continued research, collaboration, and efforts to overcome existing barriers.

Lights, camera, surgery: VIP syndrome and the challenge of treating celebrities

VIP Syndrome, a term coined to describe the phenomenon where high-profile patients receive preferential treatment that deviates from standard medical protocols, poses significant challenges in healthcare. In ophthalmology, where precision is critical, VIP Syndrome can result in compromised outcomes. This editorial explores how VIP Syndrome impacts medical field, with real-world examples involving prominent figures such as Shahrukh Khan, and Michael Jackson. Additionally, it examines the broader implications for non-VIP patients and discusses clinical and institutional strategies to mitigate VIP Syndrome. Ethical considerations and guidelines for preventing this phenomenon, including the Cleveland Journal of Medicine’s nine principles, are also reviewed.

Including a wider range of values in healthcare policy: how can public value evaluation help?

To meet future healthcare challenges a broader range of values need to be included in analysis, debate and policy. Different modes of governance foreground and facilitate different values. Collaboration, the governing principle of the newly formed integrated care systems, values the contribution of diverse stakeholders in discussions and decisions, to foster creativity and produce durable solutions to complex problems. Approaches to evaluation reinforce particular values, as captured in the adage 'what's measured is what matters'. New approaches are needed to support the collaborative aims of integrated care systems. Public value evaluation proceeds through values inquiry, establishing what is important to different stakeholders (including policy makers, healthcare staff, patients and communities) as a backdrop to understanding the effects of policies and programmes.