ABSTRACT As the development focus of Chinese sports architecture has shifted from pursuing quantity to improving quality and prioritizing human-centered design in recent years, creating sports environments that deliver exceptional experiences through design has become a new challenge for architects and engineers. However, existing research on sports architecture largely concentrates on functional problem-solving, with limited attention given to perception and experience from a humanistic perspective. A key difficulty lies in the unique spatial characteristics of sports architecture and the abstractness and ambiguity of perceptual and experiential processes. To address this gap, this study incorporated spatial perception psychological process to develop a subject-object mapping, structured theoretical framework. On this basis, a perception and experience-oriented evaluation system is established and applied to three Shanghai sports venues. Fuzzy Comprehensive Evaluation and field research combined with Importance-Performance Analysis are used to verify its applicability. The results indicate that enhancing user experience is most effectively achieved through a balanced distribution of diverse, non-profit sports courts, greenery layouts aligned with human perception and circulation ranges, and prioritizing facade transparency. This study provides an evidence-based and user-centered framework for diagnosing and improving the spatial qualities of sports architecture, thereby supporting more informed decision-making in design practice.

Alcohol Use Disorder (AUD) is a leading contributor to global morbidity and mortality, disproportionately affecting people experiencing homelessness. Managed Alcohol Programs (MAPs) represent a harm reduction-based strategy for individuals with severe AUD and homelessness, providing controlled amounts of alcohol alongside comprehensive health and social supports. While evidence of MAP benefits continues to grow, important questions remain about how best to integrate social and medical care, and how to tailor services to align with participants' goals, values, and broader social and structural contexts. This commentary explores the operational strategies and clinical practices of the Ottawa Inner City Health (OICH) MAP, which has been running since 2001. We describe how the program is embedded within supportive housing and leverages an interdisciplinary team-including peer workers and an Indigenous healer-to deliver person-centered care. Key components include structured alcohol delivery tailored to individual needs, meal provision, social supports including life skills training, medication administration and comprehensive physical and mental health services. Clinical care is tailored to participants' day-to-day circumstances, challenges, and goals in managing their AUD, with particular attention to hygiene and nutrition, proactive screening for health decline, and timely management of common health complications. The program operates through strong partnerships with community organizations, pharmacies and subspecialists, to enable integrated, coordinated care. Collaborative and trauma-informed approaches reduce reliance on emergency care and foster a sense of dignity, stability, and community. MAPs have evolved from experimental interventions into internationally recognized harm reduction models. The OICH MAP demonstrates how the integration of housing, healthcare, and social supports can address the complex needs of individuals experiencing homelessness and severe AUD. However, challenges remain in scaling these models, refining screening protocols, and developing evidence-based policy frameworks. This commentary offers practical insights to inform the effective operation of MAPs and calls for continued research and dialogue to ensure they remain adaptable, sustainable, and aligned with the realities of the populations they serve.

Artificial intelligence (AI)-enabled clinical decision support systems (CDSS) demonstrate performance comparable or superior to human experts in certain tasks. However, their integration into surgical practice faces a significant implementation gap, alongside ethical, privacy, and legal concerns. Clear governance frameworks are needed to guide their responsible adoption in surgery, to prevent inconsistent application, care quality variation, and exacerbation of algorithmic bias. Herein, we establish a systematic, evidence-based, and consensus-driven framework to guide the ethical, effective, and sustainable adoption of AI-enabled CDSS in surgery. A systematic literature review was conducted of PubMed, Cochrane Library, Medline, and Embase databases until 2024 to identify key governance themes. The themes informed the generation of candidate items, which were then refined through a multi-round expert panel consensus process utilizing a modified Delphi approach to produce the final framework. Thematic analysis of 80 full-text articles meeting inclusion criteria identified four overarching themes for AI governance: (1) Technical Prerequisites and Model Design, (2) Clinical Implementation and Human Factors, (3) Ethics, Safety, and Trustworthiness, and (4) Bias, Fairness, and Equity. Panel consensus evaluation resulted in the development of a 19-item framework. The consensus-driven framework presented herein provides foundational guidance essential for navigating the complexities of implementing AI-enabled CDSS safely and ethically in surgery. Addressing the considerations outlined across these four core themes can facilitate the responsible adoption of AI, accelerating the transition towards an advanced, data-driven surgical practice while mitigating potential risks.

India faces a growing need for Palliative Care due to its ageing population, rising cancer burden, and high prevalence of chronic illnesses. Unfortunately, less than 4% of the population has access to Palliative services, and the country ranks 59th in the 2021 Quality of Death Index. Contextually relevant and culturally sensitive nursing competencies are crucial to address this gap. However, there is no structured, evidence-based palliative nursing competency framework tailored to India's sociocultural and healthcare realities. This study explored stakeholder perspectives to identify core nursing competencies required for palliative care in the Indian context. A qualitative design was employed, comprising seven Focus Group Discussions with nurses involved in delivering care to patients with life-limiting illnesses, and thirty five In-Depth Interviews with patients and caregivers at various stages of the disease trajectory, from diagnosis to terminal illness and end-of-life. Data were analysed using Braun and Clarke's thematic analysis approach. Line-by-line coding was conducted using Open Code 4.02 version to systematically identify themes and subthemes. These were synthesized into competency domains and statements that reflect the essential skills, knowledge, and attitudes required for palliative nursing in India. To ensure the rigor and trustworthiness of the findings, measures such as member checking and peer debriefing were undertaken throughout the research process. Thematic analysis yielded seven distinct competency domains. These domains captured a wide range of nursing roles, including understanding foundations of Palliative Care, communication, ethical, legal, and professional responsibilities, symptom management and enhancing comfort, psychosocial, cultural, and spiritual aspects of care, and team collaboration. The findings emphasized the importance of culturally grounded, holistic, and compassionate care tailored to the needs of Indian patients and their families. Importantly, region-specific factors, such as Indian family dynamics, cultural attitudes towards death, and spiritual beliefs, emerged prominently during the thematic analysis. Interestingly, there was a notable convergence between the views expressed by nurses in focus group discussions and those of participants in in-depth interviews regarding essential palliative care competencies. This study presents an empirically derived set of thematic domains and insights for palliative care nursing competencies, grounded in stakeholder perspectives and tailored to the Indian context. The identified domains can inform curriculum development, training programs, and policy formulation to strengthen palliative care services across India. The study is registered in the Clinical Trials Registry of India CTRI/2023/07/055216) dated 14/07/2023.

Clinical reasoning is a core competency in medical practice; however, deficits in this domain among residents are often difficult to identify and remediate because of its cognitive complexity and the absence of standardized assessment approaches. This scoping review aimed to map and analyze existing evidence on strategies to remediate clinical reasoning skill deficits in underperforming medical residents. Using the Arksey and O’Malley framework as refined by Levac and his colleagues, and reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we systematically searched PubMed, Scopus, MEDLINE, Web of Science, SpringerLink, ProQuest, and EBSCOhost for studies published between 2000 and 2024. Definitions of clinical reasoning, underperformance, and remediation were adopted from prior literature. Twenty studies met the inclusion criteria, comprising original research and literature reviews in multiple medical specialties. Methods for identifying clinical reasoning deficits included written, oral, and performance-based assessments, as well as routine workplace-based evaluations. Remediation strategies ranged from structured institutional programs to individualized, case-specific interventions, with coaching, deliberate practice, guided reflection, and structured thinking frameworks frequently employed. Two studies reported positive outcomes following completion of remediation for clinical reasoning deficits. Key enablers included psychological safety, learner engagement, and accessible faculty support, whereas barriers included learner resistance, inadequate baseline knowledge, faculty skill limitations, and institutional resource constraints. Effective remediation requires early identification, comprehensive diagnostic assessment, and tailored, coaching-based interventions supported by institutional commitment. Nonetheless, substantial variability in definitions, remediation protocols, and evaluation methods highlights the need for greater standardization and further research across diverse contexts to inform evidence-based frameworks for clinical reasoning remediation.

Getting patients out of intensive care units (ICUs) is a major goal for acute care clinicians, as prolonged stays increase the risk of complications and strain critical resources such as staff, equipment, and beds. The ICU Liberation bundle or the ABCDEF (A-F) care bundle is an evidence-based framework for improving outcomes in critically ill patients by addressing pain, sedation, delirium, mobility, and family engagement. However, variability in documentation and lack of standardized data elements hinder effective implementation and evaluation of adherence to bundle components. This study aims to characterize data elements of the A-F liberation bundle using a large, single-center critical care database and to develop standardized bundle cards that map bundle components to controlled vocabularies. We conducted a retrospective analysis of data elements related to A-F bundle using the MIMIC-IV database. Clinical concepts were mapped to standardized vocabularies and aligned with the OMOP common data model. Bundle cards were developed for each component to provide structured, accessible documentation of assessment tools, adherence criteria, and terminology mappings. Pain assessments were documented in over 11,000 patients, with a median of 23 assessments per day. Sedation levels for nearly 59,000 patients were evaluated, with 37.7% meeting Society of Critical Care Medicine (SCCM) adherence criteria. Delirium assessments followed standardized protocols incorporating RASS and CAM-ICU scores. Components E and F lacked formal compliance specifications; bundle cards for these components identified key activities and highlighted gaps in standardized vocabularies. Adherence analyses revealed variability likely due to non-standardized documentation practices. We developed and validated six ICU Liberation Bundle cards that map bundle components to standardized vocabularies and common data models, enabling retrospective adherence evaluation in real-world data. These information resources promote consistent documentation, support interoperability, and provide a foundation for prospective monitoring to enhance bundle implementation in critical care.

Endoscopic resection (ER) has transformed the management of early gastrointestinal (GI) malignancies by offering curative treatment with low morbidity and organ preservation. Traditionally restricted to mucosal disease with negligible risk of lymph node metastasis (LNM), recent advances in technique and risk stratification have prompted a re-evaluation of ER indications for esophageal, gastric, and colorectal cancers. This review summarizes the oncologic rationale, current evidence, and emerging technologies supporting the safe expansion of ER indications across GI malignancies. s: Refined histopathologic criteria, enhanced en-bloc resection through endoscopic submucosal dissection, and the introduction of endoscopic full-thickness resection have expanded curative resection to select early GI malignancies previously considered surgical. Clinical outcomes from large series demonstrate comparable long-term survival to surgery when rigorous selection and surveillance criteria are applied, while minimizing morbidity. Molecular biomarkers, artificial intelligence (AI)-based predictive models, and sentinel node mapping are promising tools to further improve risk assessment for occult LNM. Expansion of ER indications for early GI cancers is feasible and increasingly practiced in expert centers with outcomes approximating those of surgical resection. Ongoing integration of precision diagnostics, molecular profiling, and AI-driven risk models promises to further refine patient selection. However, widespread adoption should proceed within structured, evidence-based frameworks to prevent undertreatment of potentially curable disease and maintain oncologic integrity.

A multidimensional approach to sialorrhea management in elderly patients: Insights from the theory of unpleasant symptoms.

Research on the impacts of dysphagia and its interventions on quality of life, along with research on food-shaping, indicates that 3D food printing may help to improve mealtime experiences and mealtime-related quality of life for adults with dysphagia. To synthesise an integrated set of studies on the impact of dysphagia and its interventions on quality of life and the views of stakeholders on 3D food printing. This synthesis was done to inform the development of an evidence-based framework guiding future clinical practice and research into food design in dysphagia. A qualitative meta-synthesis of six integrated, related studies on dysphagia, quality of life and 3D food printing was conducted to identify content themes. A Framework of Mealtime Quality of Life for Adults with Dysphagia was established, illustrating the connections between the themes. Impacts of dysphagia and its interventions (texture-modified foods in particular) on quality of life for adults with dysphagia include reduced physical health, reduced choice and control, reduced social engagement, and poor mealtime experiences. There are a range of barriers and facilitators to improving quality of life for adults with dysphagia. Stakeholders viewed 3D food printing as a strategy that could, with further development, improve mealtime experiences; however, various feasibility issues and other identified problems would need to be addressed for such potential to be realised. Dysphagia and its interventions impact quality of life in many ways. The influence of food design on quality of life and mealtime experiences should be considered. The evidence-based framework established in this meta-synthesis for dysphagia, quality of life and food design could be used by health professionals to guide their considered assessment and interventions in mealtime management. What is already known on this subject Research shows that dysphagia negatively impacts on the quality of life of adults with dysphagia. Research also shows that 3D food printing may be one food design strategy to help improve the mealtime experience for people with dysphagia. However, findings from recent research needed to be synthesised to create a framework connecting the impacts of dysphagia on quality of life and the importance of food design in the mealtime experience. What this paper adds to existing knowledge This study synthesises six recent studies examining the impacts of dysphagia on quality of life and the feasibility of 3D food printing to improve the mealtime experience. From this a framework (Framework of Mealtime Quality of Life for People with Dysphagia) has been created. What are the potential or actual clinical implications of this study? The Framework of Mealtime Quality of Life for People with Dysphagia will encourage allied health professionals have greater consideration of their client.s quality of life as part of their assessment and interventions. Guidelines strategies to implement the framework have been provided (see Box 1).

Lived experiences of health professionals using digital health in Australian aged care: A scoping review.

Patellar management in primary total knee arthroplasty (TKA) remains one of the most debated and variable aspects of contemporary arthroplasty practice. Patellar resurfacing, non-resurfacing, and selective resurfacing each offer distinct advantages, but no universally superior strategy has emerged. Although global functional outcomes are generally comparable across techniques, differences persist in anterior knee pain, survivorship, patellofemoral degeneration, and the likelihood of secondary patellar procedures. This narrative review synthesizes current clinical, radiographic, biomechanical, and registry-based evidence to provide a comprehensive understanding of these differences. Patellar resurfacing tends to offer clearer benefits in patients with advanced patellofemoral osteoarthritis, significant preoperative symptoms, unfavorable patellar morphology, or implant designs that increase patellofemoral loading. Conversely, non-resurfacing remains a safe and effective option in patients with minimal patellofemoral disease and favorable anatomical characteristics. Selective resurfacing represents a patient-tailored compromise, though its effectiveness is currently limited by the absence of standardized selection criteria. The integration of evidence across multiple studies reinforces that patellar resurfacing should follow an individualized, indication-guided approach instead of routine application. It also proposes a structured framework that incorporates anatomical, radiographic, and implant-related factors to guide patellar management during primary TKA.

In an increasingly data-driven society, preparing new generations with robust competencies in science, technology, engineering, arts and mathematics (STEAM) is essential. Within this context, Data Science (DS) education requires the development of foundational mathematical concepts, terminology, and cognitive structures that support students’ progression from introductory to advanced levels. learnipedagogical approaches must enable learners not only to understand data but also to creatively and efficiently apply knowledge to tasks such as data collection, preprocessing, analysis, and visualization. This paper identifies persistent gaps in the design and evaluation of DS teaching initiatives in Basic Education and proposes an evidence-based pedagogical framework to address these challenges. Grounded in international literature and cognitive psychology, the framework integrates well-established learning principles, such as distributed practice, retrieval testing, and iterative project-based learning, with formative assessment tools that strengthen retention, transfer, metacognition, and engagement. The analysis demonstrates that the lack of coherent assessment models weakens the institutionalization of DS as a curricular component and limits its pedagogical effectiveness. The proposed framework offers a unified structure that aligns teaching strategies, learning progressions, and assessment instruments, while remaining adaptable to diverse lol contexts. By centering instructional design on scientific evidence, the model supports teachers in implementing practices that are both pedagogically sound and operationally feasible. The study concludes that fostering data literacy in Basic Education through evidence-based teaching is a crucial step toward promoting educational equity, digital citizenship, and students’ capacity to navigate and interpret the information-rich environments of the current digital era.

The professional growth of teachers serves as a key mechanism to drive curriculum transformation and pedagogical methods which develop student abilities in soft skills such as communication, teamwork, adaptability, and critical thinking. The research presented here is an evidence-based framework to enhance novice secondary school teachers' delivery of such soft skills education. As a small island developing state (SIDS), the Maldives, experiences significant teacher attrition rates in secondary education due to teacher dissatisfaction and burn out, which could be alleviated through gaining the relevant soft skills. The proposed framework combines international teaching methods from Finland, Singapore, and Australia with local solutions to manage the challenges of insufficient mentorship and restricted professional development opportunities. The novelty of the proposed framework lies in combining interactive strategies, reflective practices, and structured mentorship into an integrated model tailored to under-resourced contexts. The framework will be implemented through four sequential phases: (1) qualitative needs assessment, (2) framework co-design and development, (3) pilot testing and empirical validation, and (4) iterative refinement, using Design Based Research (DBR) principles, and a pragmatic paradigm. It is expected to increase novice teachers' confidence in integrating collaboration, communication, and emotional intelligence in their teaching methods, while also enhancing student participation through project-based and interactive learning methods.

Background The optimal surgical strategy for petroclival meningiomas (PCMs) remains debated, balancing the extent of resection against the risk of neurological morbidity. While the goal of gross total resection is widely acknowledged, its functional benefit is not uniform and may be significantly influenced by specific anatomical and pathological factors, such as cavernous sinus (CS) invasion patterns and World Health Organization (WHO) grade. This study aimed to develop and validate a quantitative, individualized surgical decision-making framework incorporating these understudied parameters. Methods We conducted a retrospective cohort analysis of 100 consecutive patients who underwent microsurgical resection for PCMs between 2013 and 2023. High-resolution MRI was used to preoperatively grade CS invasion (0–3 scale) and neurovascular encirclement (≥270° contact). Functional outcomes were assessed serially using the Karnofsky Performance Scale (KPS) preoperatively and up to 24 months postoperatively. Multivariable logistic regression and propensity score matching were employed to identify independent predictors of functional outcome (KPS improvement). Subgroup analyses informed the development of a novel Resection Utility Score (RUS). Results Complete resection predicted KPS improvement (OR = 2.34, p = 0.001), while CS invasion (OR = 0.52, p = 0.013), WHO Grade 2 (OR = 0.61, p = 0.022), and neurovascular encirclement (OR = 0.45, p = 0.002) reduced functional gains. The derived RUS guided a decision algorithm. For subgroups with RUS > 1 (CS 0–1, WHO Grade 1), complete resection was recommended. For RUS < 1 (CS 2–3, WHO Grade 2), subtotal resection was advised. Conclusion The functional benefit of resection in PCMs is modulated by CS invasion and WHO grade. The proposed RUS and decision algorithm provide a quantitative, evidence-based framework for individualized surgical planning, shifting the paradigm from a universal goal of maximal resection toward a risk-adapted strategy aimed at optimizing functional preservation without compromising oncologic control. Prospective multicenter validation is warranted.

ObjectiveTo develop and validate an evidence-based framework guiding therapists in arm-hand rehabilitation in individuals with cervical spinal cord injury, to enhance performance and activities of daily living.DesignThe framework was developed using a mixed-method approach: (1) item generation based on the UK Medical Research Council's guidelines for complex interventions; (2) four-round e-Delphi study with Likert scales and qualitative input; and (3) expert panel discussion.ParticipantsThe e-Delphi panel comprised 24 international rehabilitation professionals (16 occupational therapists and eight physiotherapists) with mostly ≥5 years of clinical and/or scientific experience in spinal cord injury rehabilitation. A separate expert panel included seven individuals with cervical spinal cord injury.Main measurese-Delphi consensus for each item was predefined as ≥70% agreement or inclusion across four rounds, with content analysis for qualitative input. Items were further discussed and validated during the expert panel and analyzed by content analysis.Results65 initially generated items were included in the e-Delphi; 36 were added from qualitative input; consensus was reached on 100 of the 101 items. The expert panel confirmed these items, added five, and reprioritized personal load capacity and motivation. The validated framework comprises three interrelated phases: (a) knowledge gathering-assessing personal needs, load capacity, and environment; (b) goal setting-collaboratively formulating person-centered, realistic goals; and (c) acting-a task- and goal-oriented training targeting meaningful activities and daily life integration. Motivation plays a key role across all phases.ConclusionsThis evidence-based framework provides guidance for therapists to deliver person-centered arm-hand rehabilitation tailored to patients' needs.

Over the past three decades, fields such as education, medicine, social work, and criminology/criminal justice have increasingly acknowledged the value of integrating lived experience into knowledge production and professional practice. In corrections, this trend is exemplified by Convict Criminology, which emphasizes the voices and experiences of incarcerated and formerly incarcerated people in scholarly research, mentorship, and activism. Yet, integrating these perspectives faces persistent challenges, including the conflation of practitioner experience with lived experience and the demand for robust empirical evidence to justify such approaches. This paper critically examines these challenges and outlines strategies for incorporating formerly incarcerated individuals into correctional program design and policy development. It presents evidence-based frameworks for utilizing their expertise in the corrections field, offers practical guidelines for mentorship programs that bridge academic research and practitioner knowledge, and suggests methods for overcoming professionals’ resistance within correctional institutions to such integration. By doing so, this paper contributes to the growing movement toward more humane, effective, and socially just correctional policy and practice.

Conservative management of rotator cuff disorders remains challenging, with no comprehensive, evidence-based framework integrating diagnosis, prognosis, rehabilitation, and biological therapies. Existing recommendations usually address isolated components of care, leading to inconsistent treatment strategies. This article proposes a global, pragmatic protocol for the non-surgical management of rotator cuff lesions, from initial assessment to long-term follow-up. Drawing on clinical expertise supported by recent literature, we outline a stepwise approach that begins with a comprehensive diagnostic process that combines history, clinical examination, and targeted imaging. Based on lesion type, associated shoulder or neurogenic conditions, and patient profile, rotator cuff disorders are stratified into three prognostic categories under conservative care: good, borderline, and poor prognosis, highlighting factors that require treatment adaptation or early surgical consideration. Rehabilitation objectives are structured around four domains: (1) inflammation and pain control, (2) mobility and scapular kinematics, (3) strengthening and motor control with tendon-sparing strategies, and (4) preservation or restoration of anatomy. For each prognostic category, we define a monitoring plan integrating clinical reassessment, ultrasound follow-up, and functional milestones, including return-to-play criteria for athletes. This comprehensive narrative review demonstrates that precise diagnosis and individualized rehabilitation can optimize medical follow-up, active strengthening, and complementary or regenerative therapies. Aligning therapeutic decisions with prognostic and functional goals allows clinicians to optimize patient satisfaction and recovery, providing a clear, evidence-informed roadmap for conservative management of rotator cuff disorders.

Prescribing is a complex, essential skill that doctors must acquire to practice medicine safely and effectively. The British Pharmacological Society has historically provided a core curriculum to guide clinical pharmacology and prescribing education in UK medical schools. This study aimed to update the 2012 curriculum to reflect contemporary practice, regulatory requirements and the evolving needs of medical education. A modified Delphi was undertaken. A steering committee of six clinical and educational experts reviewed the previous curriculum and oversaw the process. Forty experts, comprising clinical and academic pharmacologists, medical educators and pharmacists from across the UK, participated in three Delphi rounds. Round 1 involved item-level review of existing learning outcomes; Round 2 incorporated feedback and new proposals; Round 3 convened expert panels to resolve outstanding disagreements. Consensus was defined as ≥75% agreement. The updated curriculum comprises four sections: (I) Principles of Clinical Pharmacology, (II) Drugs, (III) Therapeutics and (IV) Prescribing and related skills. Key changes include consistent application of clearly defined command verbs, updates to reflect current practice and a reduction in learning outcomes (226 to 205), particularly in Section I. The core drug list remained stable, with minor revisions and reorganization. This updated British Pharmacological Society curriculum provides a robust, evidence-based framework for clinical pharmacology and prescribing education. Its structured approach supports curriculum design, mapping and quality assurance, while alignment with national assessments and regulatory expectations ensures relevance for undergraduate education and early clinical practice. It aims to enhance safe, effective and responsible prescribing by future doctors.

Perioperative and periinterventional antibiotic prophylaxis remains fundamental to infection prevention in surgical and interventional urology, yet its overuse and unjustified prolongation continue to drive antimicrobial resistance and expose patients to avoidable harm. The newly finalized German interdisciplinary AWMF S3 Clinical Practice Guideline establishes an evidence-based, risk-adapted, and stewardship-oriented framework that redefines antibiotic prophylaxis as a rigorously justified and time-limited intervention. This manuscript distills the urology-specific recommendations and contrasts them with the 2025 EAU Guidelines on Urological Infections, emphasizing alignment, procedural nuance, and practical relevance. The AWMF S3 framework mandates strict indication, intravenous administration 30 to 60 minutes before incision, single-dose prophylaxis for most clean and clean-contaminated procedures, and redosing only when pharmacokinetically warranted, with discontinuation at wound closure as a universal standard. Within urology, resistance-adapted prophylaxis with rectal antisepsis is recommended for transrectal prostate biopsy, whereas transperineal biopsy may be safely performed without antibiotics in low-risk patients with sterile urine and proper antisepsis. Prophylaxis confers no consistent benefit for ureterorenoscopy or cystoscopy in sterile urine, but remains indicated for percutaneous nephrolithotomy, transurethral resection of the prostate, and major open or laparoscopic procedures such as radical prostatectomy and cystectomy, where broad-spectrum single-dose coverage with intraoperative redosing may be required in prolonged surgery. Across all procedures, the AWMF S3 and EAU 2025 recommendations show high concordance, differing primarily in granularity and evidence grading. A risk-adapted, single-dose strategy unites patient safety with antimicrobial stewardship and positions urology as a model discipline for rational, quality-assured infection prevention in modern surgery.

Teachers in special education schools face complex emotional and occupational challenges that can compromise their well-being and the quality of teaching. Growing evidence suggests that exposure to green environments, particularly school gardens, may support psychological restoration and promote healthier educational settings. This systematic literature review aimed to synthesize existing studies on three main aspects: (1) the sources and types of psychological stress experienced by special education teachers, (2) the documented functions and restorative value of school gardens, and (3) the current research progress on landscapes in special education schools. Following the PRISMA 2020 framework, studies published between 2005 and 2025 in English and Chinese were identified from databases such as Scopus, Web of Science, ERIC, ProQuest, and Google Scholar. A total of thirty-three studies met the inclusion criteria and were analyzed through thematic synthesis. The results indicated that emotional labor, behavioral management, parental communication, and role ambiguity were the primary sources of stress among special education teachers. School gardens were found to serve educational, restorative, and therapeutic functions that foster experiential learning, reduce stress, and strengthen teacher–student relationships. Recent research trends revealed an increasing integration of psychological and spatial perspectives; however, there remains a lack of validated frameworks for restorative design in special education campuses. This review concludes that well-designed school gardens can play a critical role in supporting teacher well-being and inclusive education. Future research should focus on combining psychological, spatial, and ecological indicators to develop evidence-based restorative landscape frameworks tailored specifically for special education schools.